AMPS data management concepts. [Atmospheric, Magnetospheric and Plasma in Space experiment

NASA Technical Reports Server (NTRS)

Metzelaar, P. N.

1975-01-01

Five typical AMPS experiments were formulated to allow simulation studies to verify data management concepts. Design studies were conducted to analyze these experiments in terms of the applicable procedures, data processing and displaying functions. Design concepts for AMPS data management system are presented which permit both automatic repetitive measurement sequences and experimenter-controlled step-by-step procedures. Extensive use is made of a cathode ray tube display, the experimenters' alphanumeric keyboard, and the computer. The types of computer software required by the system and the possible choices of control and display procedures available to the experimenter are described for several examples. An electromagnetic wave transmission experiment illustrates the methods used to analyze data processing requirements.

77 FR 39300 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... Change Relating to New Market Access Risk Management Service, EdgeRisk Controls SM June 26, 2012... access risk management service, called EdgeRisk Controls SM (the ``Service''). II. Self-Regulatory..., document and maintain a system of risk management controls and supervisory procedures that are reasonably...

14 CFR 11.201 - Office of Management and Budget (OMB) control numbers assigned under the Paperwork Reduction Act.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Office of Management and Budget (OMB) control numbers assigned under the Paperwork Reduction Act. 11.201 Section 11.201 Aeronautics and Space... PROCEDURES Paperwork Reduction Act Control Numbers § 11.201 Office of Management and Budget (OMB) control...

[Recommendations for the control of documents and the establishment of a documentary system].

PubMed

Vinner, E

2013-06-01

The quality management system that must be implemented in a MBL to meet the requirements of the standard NF EN ISO 15189 is based, among other things, on the creation and use by staff of a documentary system approved and updated. This documentary system is constituted by external documents (standards, suppliers' documents...) and internal documents (quality manual, procedures, instructions, technical and quality recordings...). A procedure of the documentary system control must be formalized. The documentary system should be modeled in order to identify the various procedures to be drafted and the incurred risks in the case a document would be missing in this system. Each document must be indexed in a unique way and document management must be carried out rigorously. The use of document management software is a great help to manage the life cycle of documents.

A robust and high-performance queue management controller for large round trip time networks

NASA Astrophysics Data System (ADS)

Khoshnevisan, Ladan; Salmasi, Farzad R.

2016-05-01

Congestion management for transmission control protocol is of utmost importance to prevent packet loss within a network. This necessitates strategies for active queue management. The most applied active queue management strategies have their inherent disadvantages which lead to suboptimal performance and even instability in the case of large round trip time and/or external disturbance. This paper presents an internal model control robust queue management scheme with two degrees of freedom in order to restrict the undesired effects of large and small round trip time and parameter variations in the queue management. Conventional approaches such as proportional integral and random early detection procedures lead to unstable behaviour due to large delay. Moreover, internal model control-Smith scheme suffers from large oscillations due to the large round trip time. On the other hand, other schemes such as internal model control-proportional integral and derivative show excessive sluggish performance for small round trip time values. To overcome these shortcomings, we introduce a system entailing two individual controllers for queue management and disturbance rejection, simultaneously. Simulation results based on Matlab/Simulink and also Network Simulator 2 (NS2) demonstrate the effectiveness of the procedure and verify the analytical approach.

An Advanced Microcosting System for Forecasting and Managing Radiology Expenses

PubMed Central

Arenson, Ronald; Viale, Richard; van der Voorde, Frans

1985-01-01

The new prospective payment system encourages hospital cost containment and necessitates understanding actual costs for radiology procedures. The automated microcosting system described here, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning.

40 CFR 31.20 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Standards for financial management... LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 31.20 Standards for financial... procedures for expending and accounting for its own funds. Fiscal control and accounting procedures of the...

Public participation in wilderness and backcountry litter control: a review of research and management experience.

Treesearch

Robert M. Muth; Roger N. Clark

1978-01-01

This paper describes the application of the Incentive System for Litter Control to wilderness and backcountry environments. Based on research, observation, and management experience, a set of procedures was developed and is presented here. Additional management considerations are discussed.

Skin penetration operators' knowledge and attitudes towards infection control.

PubMed

Oberdorfer, Aurmporn; Wiggers, John H; Considine, Robyn J; Bowman, Jenny; Cockburn, Jill

2003-01-01

To assess the knowledge and attitudes of owners/managers of commercial skin-penetration premises regarding infection control. A telephone survey was conducted with a randomly selected sample of 874 owners/managers. Participants appeared to lack knowledge of essential infection-control practices. Less than 39% correctly identified recommended disinfection procedures, and between 12% to 67% were not aware of inappropriate sterlization procedures. Almost all participants accepted the need for guidelines. Half acknowledged a need to improve their infection-control compliance, and most accepted having their premises regularly checked by the councils. There is a considerable opportunity to increase infection-control compliance among skin-penetration operators.

Cost Effective, Ultra Sensitive Groundwater Monitoring for Site Remediation and Management: Standard Operating Procedures with QA/QC

DTIC Science & Technology

2015-05-01

in consultation with the site management . 4.0 DATA TYPES AND QUALITY CONTROL A sampling plan must account for the collection, handling, and...GUIDANCE DOCUMENT Cost-Effective, Ultra-Sensitive Groundwater Monitoring for Site Remediation and Management : Standard Operating Procedures...Groundwater Monitoring for Site Remediation and Management 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Halden, R.U., Roll, I.B. 5d

41 CFR 105-71.120 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Standards for financial... GOVERNMENTS 71.12-Post-Award Requirements/Financial Administration § 105-71.120 Standards for financial... procedures for expending and accounting for its own funds. Fiscal control and accounting procedures of the...

78 FR 31430 - Proposed Establishment of Class E Airspace; Wagner, SD

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... accommodate new Standard Instrument Approach Procedures (SIAP) at Wagner Municipal Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rules (IFR) operations for SIAPs... approach procedures at the airport. Controlled airspace is needed for the safety and management of IFR...

78 FR 67297 - Establishment of Class E Airspace; Curtis, NE

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... approach procedures. Controlled airspace is needed for the safety and management of IFR operations at the... Instrument Approach Procedures at Curtis Municipal Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the airport. DATES: Effective date...

5 CFR 1305.3 - Procedures in the event of a demand for disclosure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Procedures in the event of a demand for disclosure. 1305.3 Section 1305.3 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE.... (Approved by the Office of Management and Budget under control number 0348-0056) ...

5 CFR 1305.4 - Procedure in the event of an adverse ruling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Procedure in the event of an adverse ruling. 1305.4 Section 1305.4 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE...)). (Approved by the Office of Management and Budget under control number 0348-0056) ...

Development of traffic control and queue management procedures for oversaturated arterials

DOT National Transportation Integrated Search

1997-01-01

The formulation and solution of a new algorithm for queue management and coordination of traffic signals along oversaturated arterials are presented. Existing traffic-control and signal-coordination algorithms deal only with undersaturated steady-sta...

Pain Management for Gynecologic Procedures in the Office.

PubMed

Ireland, Luu Doan; Allen, Rebecca H

2016-02-01

Satisfactory pain control for women undergoing office gynecologic procedures is critical for both patient comfort and procedure success. Therefore, it is important for clinicians to be aware of the safety and efficacy of different pain control regimens. This article aimed to review the literature regarding pain control regimens for procedures such as endometrial biopsy, intrauterine device insertion, colposcopy and loop electrosurgical excisional procedure, uterine aspiration, and hysteroscopy. A search of published literature using PubMed was conducted using the following keywords: "pain" or "anesthesia." These terms were paired with the following keywords: "intrauterine device" or "IUD," "endometrial biopsy," "uterine aspiration" or "abortion," "colposcopy" or "loop electrosurgical excisional procedure" or "LEEP," "hysteroscopy" or "hysteroscopic sterilization." The search was conducted through July 2015. Articles were hand reviewed and selected by the authors for study quality. Meta-analyses and randomized controlled trials were prioritized. Although local anesthesia is commonly used for gynecologic procedures, a multimodal approach may be more effective including oral medication, a dedicated emotional support person, and visual or auditory distraction. Women who are nulliparous, are postmenopausal, have a history of dysmenorrhea, or suffer from anxiety are more likely to experience greater pain with gynecologic procedures. Evidence for some interventions exists; however, the interpretation of intervention comparisons is limited by the use of different regimens, pain measurement scales, patient populations, and procedure techniques. There are many options for pain management for office gynecologic procedures, and depending on the procedure, different modalities may work best. The importance of patient counseling and selection cannot be overstated.

17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

Code of Federal Regulations, 2014 CFR

2014-04-01

... apply; (D) As part of the internal risk management control system for the affiliate group, establish... risk management control system for the affiliate group that the ultimate holding company has... reports or to modify its group-wide internal risk management control procedures. If the Commission finds...

Chronic relapsing pancreatitis in a child. Use of the Puestow procedure to achieve ductal drainage.

PubMed

Duncan, N D; McDonald, A; James, M; Brown, B; Mitchell, D I

2000-09-01

A case of chronic relapsing pancreatitis presenting in an 8-year-old African Jamaican girl is outlined. Aggressive supportive management failed to control pain and vomiting. The Puestow Procedure effectively procedure aborted these symptoms. The use of the Puestow procedure should not be inordinately delayed in chronic relapsing pancreatitis if symptoms persist, since it may not only control pain but also halt declining pancreatic function.

Development of the L-1011 four-dimensional flight management system

NASA Technical Reports Server (NTRS)

Lee, H. P.; Leffler, M. F.

1984-01-01

The development of 4-D guidance and control algorithms for the L-1011 Flight Management System is described. Four-D Flight Management is a concept by which an aircraft's flight is optimized along the 3-D path within the constraints of today's ATC environment, while its arrival time is controlled to fit into the air traffic flow without incurring or causing delays. The methods developed herein were designed to be compatible with the time-based en route metering techniques that were recently developed by the Dallas/Fort Worth and Denver Air Route Traffic Control Centers. The ensuing development of the 4-D guidance algorithms, the necessary control laws and the operational procedures are discussed. Results of computer simulation evaluation of the guidance algorithms and control laws are presented, along with a description of the software development procedures utilized.

77 FR 36019 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... 2006. The Statement describes the types of internal controls and risk management procedures that the... PRA that does not display a valid Office of Management and Budget (OMB) control number. Background..., Washington, DC 20549-0213. Extension: Interagency Statement on Sound Practices; OMB Control No. 3235- 0622...

Comparison of Different Analgesia Drug Regimens for Pain Control During Extracorporeal Shock Wave Lithotripsy for Renal Stones: A Randomized Control Study

PubMed Central

Butt, Amna; Ayaz Khan, Mohammad; Khan, Ijaz; Saqib, Imad-ud-din; Hussain, Tariq; Akhter, Saeed

2017-01-01

Introduction With the increased use of extracorporeal shock wave lithotripsy (ESWL), the management of urolithiasis has become much convenient for the patients and the health care professionals alike. However, associated with the procedure is the common complaint of pain. No agreed upon pain management strategy has yet been developed for the procedure. We compared the effect of different analgesia drug regiments for pain control. Methodology A randomised controlled trial was carried out in Shifa International Hospital from between July 2015 to January 2016. A total of 135 patients were divided into three groups; group A received 30 g lidocaine 2% gel applied locally on corresponding lumber area 30 minutes before the procedure, group B received oral naproxen sodium 550 mg 45 minutes before the procedure, and group C received both oral naproxen and lidocaine gel. Patients were supplemented with intravenous nalbuphine during the procedure. The pain was assessed with 0-10 visual analogue scale. Both pre-procedure and post-procedure pain score was measured. Results Among 135 patients, 105 (77.8%) were male and 29 (21.5%) were female with mean age of 38.7 ± 1.31 years. There was no difference of mean pain score or need for supplemental intravenous nalbuphine between groups B and C but there was significantly decreased mean pain score and need for supplemental intravenous nalbuphine in groups B and C in comparison with group A. Conclusion The use of oral naproxen sodium with or without the addition of lidocaine gel during ESWL is a promising option for pain management during the procedure with significant improvement in comparison with lidocaine gel alone. PMID:28560121

Simulation of time-control procedures for terminal area flow management

NASA Technical Reports Server (NTRS)

Alcabin, M.; Erzberger, H.; Tobias, L.; Obrien, P. J.

1985-01-01

Simulations of a terminal area traffic-management system incorporating automated scheduling and time-control (four-dimensional) techniques conducted at NASA Ames Research Center jointly with the Federal Aviation Administration, have shown that efficient procedures can be developed for handling a mix of 4D-equipped and conventionally equipped aircraft. A crucial role in this system is played by an ATC host computer algorithm, referred to as a speed advisory, that allows controllers to maintain accurate time schedules of the conventionally equipped aircraft in the traffic mix. Results are of the most recent simulations in which two important special cases were investigated. First, the effects of a speed advisory on touchdown time scheduling are examined, when unequipped aircraft are constrained to follow fuel-optimized profiles in the near-terminal area, and rescheduling procedures are developed to handle missed approaches of 4D-equipped aircraft. Various performance measures, including controller opinion, are used to evaluate the effectiveness of the procedures.

Air Traffic Management Technology Demostration: 1 Research and Procedural Testing of Routes

NASA Technical Reports Server (NTRS)

Wilson, Sara R.; Kibler, Jennifer L.; Hubbs, Clay E.; Smail, James W.

2015-01-01

NASA's Air Traffic Management Technology Demonstration-1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The ATD-1 integrated system consists of the Traffic Management Advisor with Terminal Metering which generates precise time-based schedules to the runway and merge points; Controller Managed Spacing decision support tools which provide controllers with speed advisories and other information needed to meet the schedule; and Flight deck-based Interval Management avionics and procedures which allow flight crews to adjust their speed to achieve precise relative spacing. Initial studies identified air-ground challenges related to the integration of these three scheduling and spacing technologies, and NASA's airborne spacing algorithm was modified to address some of these challenges. The Research and Procedural Testing of Routes human-in-the-loop experiment was then conducted to assess the performance of the new spacing algorithm. The results of this experiment indicate that the algorithm performed as designed, and the pilot participants found the airborne spacing concept, air-ground procedures, and crew interface to be acceptable. However, the researchers concluded that the data revealed issues with the frequency of speed changes and speed reversals.

I-15 integrated corridor management system : project management plan.

DOT National Transportation Integrated Search

2011-06-01

The Project Management Plan (PMP) assists the San Diego ICM Team by defining a procedural framework for management and control of the I-15 Integrated Corridor Management Demonstration Project, and development and deployment of the ICM System. The PMP...

23 CFR 630.1106 - Policy and procedures for work zone safety management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... established in accordance with 23 CFR 630.1006, shall include the consideration and management of road user...; Exposure Control Measures to avoid or minimize worker exposure to motorized traffic and road user exposure... road users. (b) Agency processes, procedures, and/or guidance should be based on consideration of...

77 FR 22005 - Proposed Extension of Existing Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-12

... describes the types of internal controls and risk management procedures that the Agencies believe are... display a valid Office of Management and Budget (OMB) control number. Please direct your written comments... Control No. 3235- 0622, SEC File No. 270-560. Notice is hereby given that pursuant to the Paperwork...

Test Area C-62 Final Range Environmental Assessment at Eglin Air Force Base, Florida

DTIC Science & Technology

2015-06-05

requirements to submit with EPCRA reports. Federal agencies must comply. Air Armament Center Plan 32-3; January 2004; Asbestos Management Plan; This...plan establishes procedures for the Eglin Air Force Base (AFB) facility asbestos management program. It contains the policies and procedures used in...controlling the health hazards created by asbestos containing materials (ACM), and the procedures used in ACM removal required to protect the health

75 FR 33385 - Agency Information Collection Activities: Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... the types of internal controls and risk management procedures that the agencies (OCC, Board of... information collection unless it displays a currently valid Office of Management and Budget (OMB) control..., please send a copy of your comments to OCC Desk Officer, 1557-0229, by mail to U.S. Office of Management...

34 CFR 303.323 - Nondiscriminatory procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Services Identification and Evaluation § 303.323 Nondiscriminatory procedures. Each lead agency shall adopt... qualified personnel. (Approved by the Office of Management and Budget under control number 1820-0550...

The role of surgery in the management of gestational trophoblastic neoplasia.

PubMed

Doll, Kemi M; Soper, John T

2013-07-01

Although sensitive human chorionic gonadotropin assays and advances in chemotherapy have assumed primary importance in the management of gestational trophoblastic neoplasia, surgery remains important in the overall care of these patients. Management of molar pregnancies consists of surgical evacuation and subsequent monitoring. Hysterectomy decreases the risk of post-molar trophoblastic disease in appropriate patients and, when incorporated to primary management of gestational trophoblastic neoplasia, can decrease the chemotherapy requirements of patients with low-risk disease. In patients with high-risk disease, surgical intervention is frequently required to control complications of disease or as therapy to stabilize patients during chemotherapy. Hysterectomy, thoracotomy, or other extirpative procedures may be integrated into the management of patients with chemorefractory disease. Interventional procedures are useful adjuncts to control bleeding from metastases.

48 CFR 1503.500-71 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Business Practices 1503.500-71 Procedures. (a) A contractor's system of management controls should provide... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Procedures. 1503.500-71 Section 1503.500-71 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY GENERAL...

Guidelines for developing transportation management plans in Virginia.

DOT National Transportation Integrated Search

2005-01-01

A transportation management plan (TMP) is a comprehensive program of traffic control, communication, operation, and demand management strategies designed to maintain acceptable levels of traffic flow in work zones. A systematic procedure and/or check...

Dog population management for the control of human echinococcosis.

PubMed

Kachani, Malika; Heath, David

2014-11-01

Cystic and alveolar hydatid disease of humans caused by infection with Echinococcus granulosus or Echinococcus multilocularis are significant zoonoses in developing countries. For human infections, the main definitive host is the dog, and reduction in the population of unwanted dogs, together with anthelmintic treatment of wanted dogs, are recommended control procedures for these zoonoses. Both owned and unowned dogs have been shown to be a major source of Echinococcus spp. infection in developing countries. Unowned dogs are the most challenging category in dog population management for the control of major zoonotic diseases. Unowned dogs are those dogs that do not have an owner, and those dogs whose owner cannot readily be identified. Control of numbers of unowned dogs can be done in various ways if funds are available. Fertility control and humane euthanasia are likely to be the most effective procedures in developing countries. Fertility control requires significant funding, and where resources are scarce humane euthanasia may be the most effective option. Both procedures are ongoing events, with no predictable end point. This paper examines the sociology and technology for the population management of owned and unowned dogs, specifically for the reduction of human hydatid disease. Examples are given for developing and developed countries. Although a "One Health" approach is desirable, the technology for hydatid control is different from that for rabies, and FAO Animal Welfare recommendations for dog population management should be adjusted accordingly. Copyright © 2014 Elsevier B.V. All rights reserved.

75 FR 51531 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... controls and risk management procedures that the agencies (OCC, Board of Governors of the Federal Reserve... collection unless it displays a currently valid Office of Management and Budget (OMB) control number. The OCC... of your comments to OCC Desk Officer, 1557-0229, by mail to U.S. Office of Management and Budget, 725...

Management control and status reports documentation standard and Data Item Descriptions (DID). Volume of the information system life-cycle and documentation standards, volume 5

NASA Technical Reports Server (NTRS)

Callender, E. David; Steinbacher, Jody

1989-01-01

This is the fifth of five volumes on Information System Life-Cycle and Documentation Standards. This volume provides a well organized, easily used standard for management control and status reports used in monitoring and controlling the management, development, and assurance of informations systems and software, hardware, and operational procedures components, and related processes.

Air Traffic Management Technology Demostration Phase 1 (ATD) Interval Management for Near-Term Operations Validation of Acceptability (IM-NOVA) Experiment

NASA Technical Reports Server (NTRS)

Kibler, Jennifer L.; Wilson, Sara R.; Hubbs, Clay E.; Smail, James W.

2015-01-01

The Interval Management for Near-term Operations Validation of Acceptability (IM-NOVA) experiment was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) in support of the NASA Airspace Systems Program's Air Traffic Management Technology Demonstration-1 (ATD-1). ATD-1 is intended to showcase an integrated set of technologies that provide an efficient arrival solution for managing aircraft using Next Generation Air Transportation System (NextGen) surveillance, navigation, procedures, and automation for both airborne and ground-based systems. The goal of the IMNOVA experiment was to assess if procedures outlined by the ATD-1 Concept of Operations were acceptable to and feasible for use by flight crews in a voice communications environment when used with a minimum set of Flight Deck-based Interval Management (FIM) equipment and a prototype crew interface. To investigate an integrated arrival solution using ground-based air traffic control tools and aircraft Automatic Dependent Surveillance-Broadcast (ADS-B) tools, the LaRC FIM system and the Traffic Management Advisor with Terminal Metering and Controller Managed Spacing tools developed at the NASA Ames Research Center (ARC) were integrated into LaRC's Air Traffic Operations Laboratory (ATOL). Data were collected from 10 crews of current 757/767 pilots asked to fly a high-fidelity, fixed-based simulator during scenarios conducted within an airspace environment modeled on the Dallas-Fort Worth (DFW) Terminal Radar Approach Control area. The aircraft simulator was equipped with the Airborne Spacing for Terminal Area Routes (ASTAR) algorithm and a FIM crew interface consisting of electronic flight bags and ADS-B guidance displays. Researchers used "pseudo-pilot" stations to control 24 simulated aircraft that provided multiple air traffic flows into the DFW International Airport, and recently retired DFW air traffic controllers served as confederate Center, Feeder, Final, and Tower controllers. Analyses of qualitative data revealed that the procedures used by flight crews to receive and execute interval management (IM) clearances in a voice communications environment were logical, easy to follow, did not contain any missing or extraneous steps, and required the use of an acceptable workload level. The majority of the pilot participants found the IM concept, in addition to the proposed FIM crew procedures, to be acceptable and indicated that the ATD-1 procedures could be successfully executed in a nearterm NextGen environment. Analyses of quantitative data revealed that the proposed procedures were feasible for use by flight crews in a voice communications environment. The delivery accuracy at the achieve-by point was within +/-5 sec, and the delivery precision was less than 5 sec. Furthermore, FIM speed commands occurred at a rate of less than one per minute, and pilots found the frequency of the speed commands to be acceptable at all times throughout the experiment scenarios.

Initial Investigations of Controller Tools and Procedures for Schedule-Based Arrival Operations with Mixed Flight-Deck Interval Management Equipage

NASA Technical Reports Server (NTRS)

Callantine, Todd J.; Cabrall, Christopher; Kupfer, Michael; Omar, Faisal G.; Prevot, Thomas

2012-01-01

NASA?s Air Traffic Management Demonstration-1 (ATD-1) is a multi-year effort to demonstrate high-throughput, fuel-efficient arrivals at a major U.S. airport using NASA-developed scheduling automation, controller decision-support tools, and ADS-B-enabled Flight-Deck Interval Management (FIM) avionics. First-year accomplishments include the development of a concept of operations for managing scheduled arrivals flying Optimized Profile Descents with equipped aircraft conducting FIM operations, and the integration of laboratory prototypes of the core ATD-1 technologies. Following each integration phase, a human-in-the-loop simulation was conducted to evaluate and refine controller tools, procedures, and clearance phraseology. From a ground-side perspective, the results indicate the concept is viable and the operations are safe and acceptable. Additional training is required for smooth operations that yield notable benefits, particularly in the areas of FIM operations and clearance phraseology.

Management Methods Applied to Lunch Program. What Food Management Companies Can Do for You - 2

ERIC Educational Resources Information Center

Davidson, Kenneth R.

1974-01-01

In Joliet, Illinois, a food management system based on increased student participation in the school lunch program, was so successful that the controls developed to manage it were adopted as standard operating procedure in overall school system management. (Author/MLF)

78 FR 32085 - Amendment of Class E Airspace; Eureka, NV

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... instrument approach procedures at the airport. This improves the safety and management of Instrument Flight... aircraft using the RNAV (GPS) standard instrument approach procedures at Eureka Airport. Class E airspace...) standard instrument approach procedures at the airport. Additional controlled airspace extending upward...

34 CFR 361.89 - Enforcement procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Standards and Performance Indicators § 361.89 Enforcement procedures. (a) If a DSU fails to meet the... satisfactory level on the compliance indicators. (Approved by the Office of Management and Budget under control...

Guidelines for procedural pain in the newborn

PubMed Central

Lago, Paola; Garetti, Elisabetta; Merazzi, Daniele; Pieragostini, Luisa; Ancora, Gina; Pirelli, Anna; Bellieni, Carlo Valerio

2009-01-01

Despite accumulating evidence that procedural pain experienced by newborn infants may have acute and even long-term detrimental effects on their subsequent behaviour and neurological outcome, pain control and prevention remain controversial issues. Our aim was to develop guidelines based on evidence and clinical practice for preventing and controlling neonatal procedural pain in the light of the evidence-based recommendations contained in the SIGN classification. A panel of expert neonatologists used systematic review, data synthesis and open discussion to reach a consensus on the level of evidence supported by the literature or customs in clinical practice and to describe a global analgesic management, considering pharmacological, non-pharmacological, behavioural and environmental measures for each invasive procedure. There is strong evidence to support some analgesic measures, e.g. sucrose or breast milk for minor invasive procedures, and combinations of drugs for tracheal intubation. Many other pain control measures used during chest tube placement and removal, screening and treatment for ROP, or for postoperative pain, are still based not on evidence, but on good practice or expert opinions. Conclusion: These guidelines should help improving the health care professional's awareness of the need to adequately manage procedural pain in neonates, based on the strongest evidence currently available. PMID:19484828

41 CFR 109-27.5008 - Control of drug substances and potable alcohol.

Code of Federal Regulations, 2011 CFR

2011-01-01

... substances and potable alcohol. 109-27.5008 Section 109-27.5008 Public Contracts and Property Management..., and Guidelines § 109-27.5008 Control of drug substances and potable alcohol. Effective procedures and... alcohol from receipt to the point of use. Such procedures shall, as a minimum, provide for safeguarding...

Equipment management user's handbook for property custodians

NASA Technical Reports Server (NTRS)

1993-01-01

The NASA Equipment Management User's Handbook for Property Custodians is issued as an instructional guide for personnel designated as property custodians and technical personnel involved in the acquisition, management, and use of NASA-owned equipment. This handbook provides general information and basic operational procedures for processing equipment transactions through the agency-wide NASA Equipment Management System (NEMS). Each NASA installation must prepare supplementary instructions for local requirements beyond the scope of NASA-wide policies and procedures contained herein, or as specified for local implementation in NHB 4200.1, 'NASA Equipment Management Manual.' NHB 4200.1 sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for the acquisition, management, and use of NASA-owned equipment. This handbook is a controlled document, issued in loose-leaf form and revised by page changes. Additional copies for internal use may be obtained through normal distribution.

Selecting Statistical Procedures for Quality Control Planning Based on Risk Management.

PubMed

Yago, Martín; Alcover, Silvia

2016-07-01

According to the traditional approach to statistical QC planning, the performance of QC procedures is assessed in terms of its probability of rejecting an analytical run that contains critical size errors (PEDC). Recently, the maximum expected increase in the number of unacceptable patient results reported during the presence of an undetected out-of-control error condition [Max E(NUF)], has been proposed as an alternative QC performance measure because it is more related to the current introduction of risk management concepts for QC planning in the clinical laboratory. We used a statistical model to investigate the relationship between PEDC and Max E(NUF) for simple QC procedures widely used in clinical laboratories and to construct charts relating Max E(NUF) with the capability of the analytical process that allow for QC planning based on the risk of harm to a patient due to the report of erroneous results. A QC procedure shows nearly the same Max E(NUF) value when used for controlling analytical processes with the same capability, and there is a close relationship between PEDC and Max E(NUF) for simple QC procedures; therefore, the value of PEDC can be estimated from the value of Max E(NUF) and vice versa. QC procedures selected by their high PEDC value are also characterized by a low value for Max E(NUF). The PEDC value can be used for estimating the probability of patient harm, allowing for the selection of appropriate QC procedures in QC planning based on risk management. © 2016 American Association for Clinical Chemistry.

76 FR 19750 - Gulf of Mexico Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... control rule, establish a generic framework procedure for implementing management changes, establish the... Mexico Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS.... SUMMARY: The Gulf of Mexico Fishery Management Council will convene a meeting of the Reef Fish Advisory...

Space Transportation System Cargo projects: inertial stage/spacecraft integration plan. Volume 1: Management plan

NASA Technical Reports Server (NTRS)

1981-01-01

The Kennedy Space Center (KSC) Management System for the Inertial Upper Stage (IUS) - spacecraft processing from KSC arrival through launch is described. The roles and responsibilities of the agencies and test team organizations involved in IUS-S/C processing at KSC for non-Department of Defense missions are described. Working relationships are defined with respect to documentation preparation, coordination and approval, schedule development and maintenance, test conduct and control, configuration management, quality control and safety. The policy regarding the use of spacecraft contractor test procedures, IUS contractor detailed operating procedures and KSC operations and maintenance instructions is defined. Review and approval requirements for each documentation system are described.

Critical systems for public health management of floods, North Dakota.

PubMed

Wiedrich, Tim W; Sickler, Juli L; Vossler, Brenda L; Pickard, Stephen P

2013-01-01

Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build public health response capabilities. Five of the 15 public health preparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding.

48 CFR 970.4401-2 - Review and approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Management and Operating Contractor Purchasing... contract; (2) The size, experience, ability, reliability, and organization of the management and operating contractor's purchasing function; (3) The internal controls, procedures, and organizational stature of the...

Air Traffic Management Technology Demonstration-1 Concept of Operations (ATD-1 ConOps), Version 2.0

NASA Technical Reports Server (NTRS)

Baxley, Brian T.; Johnson, William C.; Swenson, Harry N.; Robinson, John E.; Prevot, Tom; Callantine, Todd J.; Scardina, John; Greene, Michael

2013-01-01

This document is an update to the operations and procedures envisioned for NASA s Air Traffic Management (ATM) Technology Demonstration #1 (ATD-1). The ATD-1 Concept of Operations (ConOps) integrates three NASA technologies to achieve high throughput, fuel-efficient arrival operations into busy terminal airspace. They are Traffic Management Advisor with Terminal Metering (TMA-TM) for precise time-based schedules to the runway and points within the terminal area, Controller-Managed Spacing (CMS) decision support tools for terminal controllers to better manage aircraft delay using speed control, and Flight deck Interval Management (FIM) avionics and flight crew procedures to conduct airborne spacing operations. The ATD-1 concept provides de-conflicted and efficient operations of multiple arrival streams of aircraft, passing through multiple merge points, from top-of-descent (TOD) to the Final Approach Fix. These arrival streams are Optimized Profile Descents (OPDs) from en route altitude to the runway, using primarily speed control to maintain separation and schedule. The ATD-1 project is currently addressing the challenges of integrating the three technologies, and their implantation into an operational environment. The ATD-1 goals include increasing the throughput of high-density airports, reducing controller workload, increasing efficiency of arrival operations and the frequency of trajectory-based operations, and promoting aircraft ADS-B equipage.

48 CFR 242.7502 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 242.7502 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Accounting Systems and Related Controls 242.7502 Procedures. (a) Upon receipt of an audit report identifying...

Evaluation of Flight Deck-Based Interval Management Crew Procedure Feasibility

NASA Technical Reports Server (NTRS)

Wilson, Sara R.; Murdoch, Jennifer L.; Hubbs, Clay E.; Swieringa, Kurt A.

2013-01-01

Air traffic demand is predicted to increase over the next 20 years, creating a need for new technologies and procedures to support this growth in a safe and efficient manner. The National Aeronautics and Space Administration's (NASA) Air Traffic Management Technology Demonstration - 1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The integration of these technologies will increase throughput, reduce delay, conserve fuel, and minimize environmental impacts. The ground-based tools include Traffic Management Advisor with Terminal Metering for precise time-based scheduling and Controller Managed Spacing decision support tools for better managing aircraft delay with speed control. The core airborne technology in ATD-1 is Flight deck-based Interval Management (FIM). FIM tools provide pilots with speed commands calculated using information from Automatic Dependent Surveillance - Broadcast. The precise merging and spacing enabled by FIM avionics and flight crew procedures will reduce excess spacing buffers and result in higher terminal throughput. This paper describes a human-in-the-loop experiment designed to assess the acceptability and feasibility of the ATD-1 procedures used in a voice communications environment. This experiment utilized the ATD-1 integrated system of ground-based and airborne technologies. Pilot participants flew a high-fidelity fixed base simulator equipped with an airborne spacing algorithm and a FIM crew interface. Experiment scenarios involved multiple air traffic flows into the Dallas-Fort Worth Terminal Radar Control airspace. Results indicate that the proposed procedures were feasible for use by flight crews in a voice communications environment. The delivery accuracy at the achieve-by point was within +/- five seconds and the delivery precision was less than five seconds. Furthermore, FIM speed commands occurred at a rate of less than one per minute, and pilots found the frequency of the speed commands to be acceptable at all times throughout the experiment scenarios.

75 FR 69791 - Risk Management Controls for Brokers or Dealers With Market Access

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... relationship with the ultimate customer, can more effectively implement them. In addition, a broker or dealer... specific risk management controls and supervisory procedures to a customer that is a registered broker... such customer, based on its position in the transaction and relationship with the ultimate customer...

33 CFR 385.21 - Quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... will be produced by a Project Delivery Team. The quality control plan shall be included in the Project Management Plan and shall describe the procedures to be used to ensure compliance with technical and policy requirements during implementation. (b) During development of the Project Management Plan for each project, the...

Behavior-Based Safety and Occupational Risk Management

ERIC Educational Resources Information Center

Geller, E. Scott

2005-01-01

The behavior-based approach to managing occupational risk and preventing workplace injuries is reviewed. Unlike the typical top-down control approach to industrial safety, behavior-based safety (BBS) provides tools and procedures workers can use to take personal control of occupational risks. Strategies the author and his colleagues have been…

17 CFR 39.13 - Risk management.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Risk management. 39.13 Section... ORGANIZATIONS Compliance with Core Principles § 39.13 Risk management. (a) General. A derivatives clearing..., procedures, and controls, approved by its board of directors, which establish an appropriate risk management...

17 CFR 39.13 - Risk management.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Risk management. 39.13 Section... ORGANIZATIONS Compliance with Core Principles § 39.13 Risk management. (a) General. A derivatives clearing..., procedures, and controls, approved by its board of directors, which establish an appropriate risk management...

17 CFR 39.13 - Risk management.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Risk management. 39.13 Section... ORGANIZATIONS Compliance with Core Principles § 39.13 Risk management. (a) General. A derivatives clearing..., procedures, and controls, approved by its board of directors, which establish an appropriate risk management...

77 FR 61472 - Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

...--Aimed at discrete capital projects that will result in service benefits or other tangible improvements...) managing, rather than eliminating, risk through program management structure, controls and procedures that...

17 CFR 270.30a-3 - Controls and procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... management must evaluate, with the participation of the company's principal executive and principal financial... accumulated and communicated to the investment company's management, including its principal executive and...) Every registered management investment company, other than a small business investment company...

Test Area C-74 Complex Final Range Environmental Assessment at Eglin Air Force Base, Florida

DTIC Science & Technology

2015-08-21

LAWS, REGULATIONS, AND POLICIES ACRONYMS AND ABBREVIATIONS ACHP Advisory Council on Historic Preservation ACM asbestos -containing materials...agencies must comply. Air Armament Center Plan 32-3; January 2004; Asbestos Management Plan; This plan establishes procedures for the Eglin AFB...facility asbestos management program. It contains the policies and procedures used in controlling the health hazards created by asbestos containing

Information Management: Records Management: Official Mail and Distribution Management

DTIC Science & Technology

1992-11-30

Official Mail Cost Control Program and the Department of the Army Official Mail and Distribution Management Program. It addresses the use of postage meters...mailing permits, special mail services, postage stamps, correspondence distribution management , mailing procedures for certain U.S. Army activities and U.S. citizens overseas, and street addressing of correspondence.

Formalizing procedures for operations automation, operator training and spacecraft autonomy

NASA Technical Reports Server (NTRS)

Lecouat, Francois; Desaintvincent, Arnaud

1994-01-01

The generation and validation of operations procedures is a key task of mission preparation that is quite complex and costly. This has motivated the development of software applications providing support for procedures preparation. Several applications have been developed at MATRA MARCONI SPACE (MMS) over the last five years. They are presented in the first section of this paper. The main idea is that if procedures are represented in a formal language, they can be managed more easily with a computer tool and some automatic verifications can be performed. One difficulty is to define a formal language that is easy to use for operators and operations engineers. From the experience of the various procedures management tools developed in the last five years (including the POM, EOA, and CSS projects), MMS has derived OPSMAKER, a generic tool for procedure elaboration and validation. It has been applied to quite different types of missions, ranging from crew procedures (PREVISE system), ground control centers management procedures (PROCSU system), and - most relevant to the present paper - satellite operation procedures (PROCSAT developed for CNES, to support the preparation and verification of SPOT 4 operation procedures, and OPSAT for MMS telecom satellites operation procedures).

Quality Management Plan for EPA Region 1

EPA Pesticide Factsheets

The QMP describes policies, procedures & management systems within EPA NE that govern quality assurance & quality control activities supporting the transparency & scientific defensibility of environmental data collected, used & disseminated by the Region.

Naval Training Equipment Center Index of Technical Reports,

DTIC Science & Technology

1982-09-01

741 RECOMMENDED PROCEDURES AND TRAINING NAVAL TRAINING AIDS. tAMPHIBIOUS OPERATIONS PROCEDURES AND RESEARCH PLANNING AD- 642 590 TRAINING DEVICES FOR...PROCEDURES AND RESEARCH PLANNING OBSERVATION AND FIRE CONTROL WITH FOR ANTI-AIR WARFARE TRAINING SPECIFIC REFERENCE TO THE TRAINING *AMPUTEES PROGRAM...619 AD- 707 757 NAVAL PERSONNEL *COMMUNICATION SATELLITES PROCEDURES AND RESEARCH PLANNING *COMBUSTION PRODUCTS Computer Managed Instruction by FOR

33 CFR 96.250 - What documents and reports must a safety management system have?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Safety management system document and data maintenance (1) Procedures which establish and maintain control of all documents and data relevant to the safety management system. (2) Documents are available at... safety management system have? 96.250 Section 96.250 Navigation and Navigable Waters COAST GUARD...

76 FR 40378 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

..., 11.50, and 11.300) require the following standard operating procedures to assure appropriate use of... this regulation is a one-time burden associated with the creation of standard operating procedures... procedures and controls for persons who use closed systems to create, modify, maintain, or transmit...

78 FR 52194 - Agency Information Collection Activities: Proposed Collection Renewal; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... describes the types of internal controls and risk management procedures that the Agencies believe are... relevant OMB control number. A copy of the comments may also be submitted to the OMB desk officer for the FDIC: Office of Information and Regulatory Affairs, Office of Management and Budget, New Executive...

NASA's ATM Technology Demonstration-1: Integrated Concept of Arrival Operations

NASA Technical Reports Server (NTRS)

Baxley, Brian T.; Swenson, Harry N.; Prevot, Thomas; Callantine, Todd J.

2012-01-01

This paper describes operations and procedures envisioned for NASA s Air Traffic Management (ATM) Technology Demonstration #1 (ATD-1). The ATD-1 Concept of Operations (ConOps) demonstration will integrate three NASA technologies to achieve high throughput, fuel-efficient arrival operations into busy terminal airspace. They are Traffic Management Advisor with Terminal Metering (TMA-TM) for precise time-based schedules to the runway and points within the terminal area, Controller-Managed Spacing (CMS) decision support tools for terminal controllers to better manage aircraft delay using speed control, and Flight deck Interval Management (FIM) avionics and flight crew procedures to conduct airborne spacing operations. The ATD-1 concept provides de-conflicted and efficient operations of multiple arrival streams of aircraft, passing through multiple merge points, from top-of-descent (TOD) to touchdown. It also enables aircraft to conduct Optimized Profile Descents (OPDs) from en route altitude to the runway, using primarily speed control to maintain separation and schedule. The ATD-1 project is currently addressing the challenges of integrating the three technologies, and implantation into an operational environment. Goals of the ATD-1 demonstration include increasing the throughput of high-density airports, reducing controller workload, increasing efficiency of arrival operations and the frequency of trajectory-based operations, and promoting aircraft ADS-B equipage.

42 CFR 56.603 - Project elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of acute pain and suffering for medical emergencies, when provision of such services is necessary to...) Develop management and control systems which are in accordance with sound financial management procedures... (e) of this section. (g) Develop an overall financial management plan and an operating budget for the...

42 CFR 56.603 - Project elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of acute pain and suffering for medical emergencies, when provision of such services is necessary to...) Develop management and control systems which are in accordance with sound financial management procedures... (e) of this section. (g) Develop an overall financial management plan and an operating budget for the...

42 CFR 56.603 - Project elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of acute pain and suffering for medical emergencies, when provision of such services is necessary to...) Develop management and control systems which are in accordance with sound financial management procedures... (e) of this section. (g) Develop an overall financial management plan and an operating budget for the...

17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... unenforceable; (6) Procedures are in place to identify and address any deficiencies in the operating systems and... control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An...

17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... unenforceable; (6) Procedures are in place to identify and address any deficiencies in the operating systems and... control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An...

17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... unenforceable; (6) Procedures are in place to identify and address any deficiencies in the operating systems and... control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An...

Procedures in complex systems: the airline cockpit.

PubMed

Degani, A; Wiener, E L

1997-05-01

In complex human-machine systems, successful operations depend on an elaborate set of procedures which are specified by the operational management of the organization. These procedures indicate to the human operator (in this case the pilot) the manner in which operational management intends to have various tasks done. The intent is to provide guidance to the pilots and to ensure a safe, logical, efficient, and predictable (standardized) means of carrying out the objectives of the job. However, procedures can become a hodge-podge. Inconsistent or illogical procedures may lead to noncompliance by operators. Based on a field study with three major airlines, the authors propose a model for procedure development called the "Four P's": philosophy, policies, procedures, and practices. Using this model as a framework, the authors discuss the intricate issue of designing flight-deck procedures, and propose a conceptual approach for designing any set of procedures. The various factors, both external and internal to the cockpit, that must be considered for procedure design are presented. In particular, the paper addresses the development of procedures for automated cockpits--a decade-long, and highly controversial issue in commercial aviation. Although this paper is based on airline operations, we assume that the principles discussed here are also applicable to other high-risk supervisory control systems, such as space flight, manufacturing process control, nuclear power production, and military operations.

42 CFR 418.302 - Payment procedures for hospice care.

Code of Federal Regulations, 2014 CFR

2014-10-01

... individual who has elected hospice care receives general inpatient care in an inpatient facility for pain control or acute or chronic symptom management which cannot be managed in other settings. (c) The payment...

42 CFR 418.302 - Payment procedures for hospice care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... individual who has elected hospice care receives general inpatient care in an inpatient facility for pain control or acute or chronic symptom management which cannot be managed in other settings. (c) The payment...

42 CFR 418.302 - Payment procedures for hospice care.

Code of Federal Regulations, 2013 CFR

2013-10-01

... individual who has elected hospice care receives general inpatient care in an inpatient facility for pain control or acute or chronic symptom management which cannot be managed in other settings. (c) The payment...

42 CFR 418.302 - Payment procedures for hospice care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... individual who has elected hospice care receives general inpatient care in an inpatient facility for pain control or acute or chronic symptom management which cannot be managed in other settings. (c) The payment...

Control of black walnut root rot diseases in nurseries.

Treesearch

Kenneth J. Jr. Kessler

1982-01-01

Current nursery methods used to control black walnut root rot diseases are considered in terms of integrated pest management. Suggestions for future root rot control research studies and procedures to minimize root rot problems are provided.

7 CFR 1721.109 - OMB control number.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE POST-LOAN POLICIES AND PROCEDURES FOR INSURED ELECTRIC LOANS Extensions of Payments of Principal... approved by the Office of Management and Budget and assigned OMB control number 0572-0123. ...

Quality assurance: Importance of systems and standard operating procedures

PubMed Central

Manghani, Kishu

2011-01-01

It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company. PMID:21584180

Quality assurance: Importance of systems and standard operating procedures.

PubMed

Manghani, Kishu

2011-01-01

It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company.

14 CFR 1216.200 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Management; and, (h) Establish internal management controls to monitor NASA actions to assure compliance with... Wetlands Management § 1216.200 Scope. This subpart 1216.2 prescribes procedures to: (a) Avoid long- and... practicable alternative; (c) Reduce the risk of flood loss; (d) Minimize the impact of floods on human health...

Management Tools for Bus Maintenance: Current Practices and New Methods. Final Report.

ERIC Educational Resources Information Center

Foerster, James; And Others

Management of bus fleet maintenance requires systematic recordkeeping, management reporting, and work scheduling procedures. Tools for controlling and monitoring routine maintenance activities are in common use. These include defect and fluid consumption reports, work order systems, historical maintenance records, and performance and cost…

49 CFR 256.11 - Applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... accordance with appendix M of Office of Management and Budget Circular A-102, applicants shall use the pre... appendix M of Office of Management and Budget Circular A-102. Applicants shall include under Part IV... of Management and Budget Circular A-102, adequate procedures for financial control, accounting, and...

Evaluation in the Transnational "Management by Projects" Policies

ERIC Educational Resources Information Center

Heikkinen, Anja

2004-01-01

There is a supranational tendency in educational governance towards a "management by projects" policy, which substitutes democratic procedures and norm-based control in the materialisation of educational justice. The organisational level becomes crucial for the management of education and the pressure to conceive education as a…

Emergency management and infection control in a radiology department during an outbreak of severe acute respiratory syndrome.

PubMed

Lin, Y C; Dong, S L; Yeh, Y H; Wu, Y S; Lan, G Y; Liu, C M; Chu, T C

2005-07-01

The World Health Organization classified Taiwan as a serious epidemic-stricken area when the extent of severe acute respiratory syndrome (SARS) in Taiwan became clear. As of 11 July 2003, 671 probable SARS cases had been identified in Taiwan and 7 healthcare workers had died from the disease. Radiographers were easily infected by SARS because they had close contact with suspected or probable cases while conducting chest X-ray examinations. Three radiographers had been infected by the end of May 2003. Because of the impact of SARS on the Radiology Department, the department established a SARS emergency infection control team and re-designed the department's infection-control and emergency-management procedures based on the concept of risk-grade protection. This effort included installing a radiographic room at the fever-screening station, re-allocating human resources in the Radiology Department, training the department staff in infection control, and drafting new operational procedures for radiographers conducting X-ray examinations on SARS patients. The goal of this program was to reduce the infection rate and distribute materials efficiently in the department. This article introduces the emergency-management procedure of the Radiology Department during the SARS outbreak and the infection-protection experience of the department staff.

76 FR 51457 - Order Temporarily Exempting the Floor Broker Operations of Broker-Dealers With Market Access That...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... applicable in connection with market access.\\9\\ The required financial risk management controls and... Act of 1934 August 15, 2011. I. Introduction Pursuant to Rule 15c3-5(f) under the Securities Exchange... maintain a system of risk management controls and supervisory procedures that, among other things, is...

The implementation of a Hazard Analysis and Critical Control Point management system in a peanut butter ice cream plant.

PubMed

Hung, Yu-Ting; Liu, Chi-Te; Peng, I-Chen; Hsu, Chin; Yu, Roch-Chui; Cheng, Kuan-Chen

2015-09-01

To ensure the safety of the peanut butter ice cream manufacture, a Hazard Analysis and Critical Control Point (HACCP) plan has been designed and applied to the production process. Potential biological, chemical, and physical hazards in each manufacturing procedure were identified. Critical control points for the peanut butter ice cream were then determined as the pasteurization and freezing process. The establishment of a monitoring system, corrective actions, verification procedures, and documentation and record keeping were followed to complete the HACCP program. The results of this study indicate that implementing the HACCP system in food industries can effectively enhance food safety and quality while improving the production management. Copyright © 2015. Published by Elsevier B.V.

14 CFR 1216.201 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION ENVIRONMENTAL QUALITY Floodplain and Wetlands Management § 1216.201 Applicability. These procedures are applicable to Federal lands and facilities under the management control of NASA Headquarters and field installations regardless of location. ...

42 CFR 418.302 - Payment procedures for hospice care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... brief periods of crisis as described in § 418.204(a) and only as necessary to maintain the terminally... control or acute or chronic symptom management which cannot be managed in other settings. (c) The payment...

A Preliminary Assessment of Corps of Engineers’ Reservoirs Their Purposes, and Susceptibility to Drought

DTIC Science & Technology

1991-09-01

SEVERITY INDEX (PDSI) ................. 116 iv FOREWORD Recent droughts in the United States have caused water management agencies to examine the operation ...detail, and a discussion of reservoir operating procedures, may be found in the Corps’ Engineering Manual on Management of Water Control Systems (U. S...fishery management . The seasonal fluctuation that occurs at many flood control reservoirs, and the daily fluctuations that occur with hydropower operation

40 CFR 60.2095 - What site-specific documentation is required?

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (5) Procedures for operating the incinerator and associated air pollution control systems within the... incinerator operating limits. (7) Reporting and recordkeeping procedures. (8) The waste management plan... required? 60.2095 Section 60.2095 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...

Behavioral Treatment of Children's Fears and Phobias: A Review.

ERIC Educational Resources Information Center

Morris, Richard J.; Kratochwill, Thomas R.

1985-01-01

An overview of the behaviorally-oriented fear reduction methods for children is presented. Systematic desensitization and related procedures, flooding-related therapies, contingency management approaches, modeling procedures, and self-control methods are discussed after reviewing normative and prevalence data regarding children's fears. Research…

77 FR 39691 - Commission Information Collection Activities (FERC-725); Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

... information collection FERC-725, Certification of Electric Reliability Organization; Procedures for Electric Reliability Standards, to the Office of Management and Budget (OMB) for review of the information collection..., Certification of Electric Reliability Organization; Procedures for Electric Reliability Standards. OMB Control...

Improvement of burn pain management through routine pain monitoring and pain management protocol.

PubMed

Yang, Hyeong Tae; Hur, Giyeun; Kwak, In-Suk; Yim, Haejun; Cho, Yong Suk; Kim, Dohern; Hur, Jun; Kim, Jong Hyun; Lee, Boung Chul; Seo, Cheong Hoon; Chun, Wook

2013-06-01

Pain management is an important aspect of burn management. We developed a routine pain monitoring system and pain management protocol for burn patients. The purpose of this study is to evaluate the effectiveness of our new pain management system. From May 2011 to November 2011, the prospective study was performed with 107 burn patients. We performed control group (n=58) data analysis and then developed the pain management protocol and monitoring system. Next, we applied our protocol to patients and performed protocol group (n=49) data analysis, and compared this to control group data. Data analysis was performed using the Numeric Rating Scale (NRS) of background pain and procedural pain, Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory Scale (STAIS), and Holmes and Rahe Stress Scale (HRSS). The NRS of background pain for the protocol group was significantly decreased compared to the control group (2.8±2.0 versus 3.9±1.9), and the NRS of procedural pain of the protocol group was significantly decreased compared to the control group (4.8±2.8 versus 3.7±2.5). CAPS and HDRS were decreased in the protocol group, but did not have statistical significance. STAIS and HRSS were decreased in the protocol group, but only the STAIS had statistical significance. Our new pain management system was effective in burn pain management. However, adequate pain management can only be accomplished by a continuous and thorough effort. Therefore, pain control protocol and pain monitoring systems need to be under constant revision and improvement using creative ideas and approaches. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

45 CFR 2541.200 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Standards for financial management systems. 2541... STATE AND LOCAL GOVERNMENTS Post-Award Requirements § 2541.200 Standards for financial management... for expending and accounting for its own funds. Fiscal control and accounting procedures of the State...

42 CFR 7.5 - Payment procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... obtain information on terms of payment and a fee schedule by writing the “Centers for Disease Control,” Financial Management Office, Buckhead Facility, Room 200, Centers for Disease Control, 1600 Clifton Road...

42 CFR 7.5 - Payment procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... obtain information on terms of payment and a fee schedule by writing the “Centers for Disease Control,” Financial Management Office, Buckhead Facility, Room 200, Centers for Disease Control, 1600 Clifton Road...

Aeropropulsion facilities configuration control: Procedures manual

NASA Technical Reports Server (NTRS)

Lavelle, James J.

1990-01-01

Lewis Research Center senior management directed that the aeropropulsion facilities be put under configuration control. A Configuration Management (CM) program was established by the Facilities Management Branch of the Aeropropulsion Facilities and Experiments Division. Under the CM program, a support service contractor was engaged to staff and implement the program. The Aeronautics Directorate has over 30 facilities at Lewis of various sizes and complexities. Under the program, a Facility Baseline List (FBL) was established for each facility, listing which systems and their documents were to be placed under configuration control. A Change Control System (CCS) was established requiring that any proposed changes to FBL systems or their documents were to be processed as per the CCS. Limited access control of the FBL master drawings was implemented and an audit system established to ensure all facility changes are properly processed. This procedures manual sets forth the policy and responsibilities to ensure all key documents constituting a facilities configuration are kept current, modified as needed, and verified to reflect any proposed change. This is the essence of the CM program.

Multiple curved descending approaches and the air traffic control problem

NASA Technical Reports Server (NTRS)

Hart, S. G.; Mcpherson, D.; Kreifeldt, J.; Wemple, T. E.

1977-01-01

A terminal area air traffic control simulation was designed to study ways of accommodating increased air traffic density. The concepts that were investigated assumed the availability of the microwave landing system and data link and included: (1) multiple curved descending final approaches; (2) parallel runways certified for independent and simultaneous operation under IFR conditions; (3) closer spacing between successive aircraft; and (4) a distributed management system between the air and ground. Three groups each consisting of three pilots and two air traffic controllers flew a combined total of 350 approaches. Piloted simulators were supplied with computer generated traffic situation displays and flight instruments. The controllers were supplied with a terminal area map and digital status information. Pilots and controllers also reported that the distributed management procedure was somewhat more safe and orderly than the centralized management procedure. Flying precision increased as the amount of turn required to intersect the outer mark decreased. Pilots reported that they preferred the alternative of multiple curved descending approaches with wider spacing between aircraft to closer spacing on single, straight in finals while controllers preferred the latter option. Both pilots and controllers felt that parallel runways are an acceptable way to accommodate increased traffic density safely and expeditiously.

Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial.

PubMed

Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

2016-01-01

Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies.

Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial

PubMed Central

Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

2016-01-01

Background Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Methods Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Results Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Conclusion Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. Clinical implication A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies. PMID:27536093

25 CFR 900.58 - Do the same accountability and control procedures described above apply to Federal property?

Code of Federal Regulations, 2012 CFR

2012-04-01

... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Property Management System Standards § 900.58 Do the same accountability and...

25 CFR 900.58 - Do the same accountability and control procedures described above apply to Federal property?

Code of Federal Regulations, 2010 CFR

2010-04-01

... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Property Management System Standards § 900.58 Do the same accountability and...

25 CFR 900.58 - Do the same accountability and control procedures described above apply to Federal property?

Code of Federal Regulations, 2013 CFR

2013-04-01

... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Property Management System Standards § 900.58 Do the same accountability and...

25 CFR 900.58 - Do the same accountability and control procedures described above apply to Federal property?

Code of Federal Regulations, 2011 CFR

2011-04-01

... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Property Management System Standards § 900.58 Do the same accountability and...

25 CFR 900.58 - Do the same accountability and control procedures described above apply to Federal property?

Code of Federal Regulations, 2014 CFR

2014-04-01

... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Property Management System Standards § 900.58 Do the same accountability and...

76 FR 43615 - Proposed Amendment of Class E Airspace; Evansville, IN

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

... to accommodate new Standard Instrument Approach Procedures at Evansville Regional Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rules (IFR) operations for... new standard instrument approach procedures at Evansville Regional Airport, Evansville, IN. Controlled...

Treatment of plaque-induced gingivitis, chronic periodontitis, and other clinical conditions.

PubMed

2001-12-01

The inflammatory components of plaque induced gingivitis and chronic periodontitis can be managed effectively for the majority of patients with a plaque control program and non-surgical and/or surgical root debridement coupled with continued periodontal maintenance procedures. Some patients may need additional therapeutic procedures. All of the therapeutic modalities reviewed in this position paper may be utilized by the clinician at various times over the long-term management of the patient's periodontal condition.

Treatment of plaque-induced gingivitis, chronic periodontitis, and other clinical conditions.

PubMed

The inflammatory components of plaque induced gingivitis and chronic periodontitis can be managed effectively for the majority of patients with a plaque control program and nonsurgical and/or surgical root debridement coupled with continued periodontal maintenance procedures. Some patients may need additional therapeutic procedures. All of the therapeutic modalities reviewed in this position paper may be utilized by the clinician at various times over the long-term management of the patient's periodontal condition.

17 CFR 240.15c3-1g - Conditions for ultimate holding companies of certain brokers or dealers (Appendix G to 17 CFR 240...

Code of Federal Regulations, 2012 CFR

2012-04-01

... Commission determines, based on a review of the group-wide internal risk management control system and... regulator, all written policies and procedures concerning the group-wide internal risk management control... (as defined in 12 CFR 225, appendix A); (ii) Cumulative and non-cumulative preferred stock, except...

17 CFR 240.15c3-1g - Conditions for ultimate holding companies of certain brokers or dealers (Appendix G to 17 CFR 240...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commission determines, based on a review of the group-wide internal risk management control system and... regulator, all written policies and procedures concerning the group-wide internal risk management control... (as defined in 12 CFR 225, appendix A); (ii) Cumulative and non-cumulative preferred stock, except...

Landscape control points: a procedure for predicting and monitoring visual impacts

Treesearch

R. Burton Litton

1973-01-01

The visual impacts of alterations to the landscape can be studied by setting up Landscape Control Points–a network of permanently established observation sites. Such observations enable the forest manager to anticipate visual impacts of management decision, select from a choice of alternative solutions, cover an area for comprehensive viewing, and establish a method to...

Advanced Cyber Industrial Control System Tactics, Techniques, and Procedures (ACI TTP) for Department of Defense (DOD) Industrial Control Systems (ICS)

DTIC Science & Technology

2016-08-10

enable JCS managers to detect advanced cyber attacks, mitigate the effects of those attacks, and recover their networks following an attack. It also... managers of ICS networks to Detect, Mitigate, and Recover from nation-state-level cyber attacks (strategic, deliberate, well-trained, and funded...Successful Detection of cyber anomalies is best achieved when IT and ICS managers remain in close coordination. The Integrity Checks Table

Development of a Space Station Operations Management System

NASA Technical Reports Server (NTRS)

Brandli, A. E.; Mccandless, W. T.

1988-01-01

To enhance the productivity of operations aboard the Space Station, a means must be provided to augment, and frequently to supplant, human effort in support of mission operations and management, both on the ground and onboard. The Operations Management System (OMS), under development at the Johnson Space Center, is one such means. OMS comprises the tools and procedures to facilitate automation of station monitoring, control, and mission planning tasks. OMS mechanizes, and hence rationalizes, execution of tasks traditionally performed by mission planners, the mission control center team, onboard System Management software, and the flight crew.

Development of a Space Station Operations Management System

NASA Astrophysics Data System (ADS)

Brandli, A. E.; McCandless, W. T.

To enhance the productivity of operations aboard the Space Station, a means must be provided to augment, and frequently to supplant, human effort in support of mission operations and management, both on the ground and onboard. The Operations Management System (OMS), under development at the Johnson Space Center, is one such means. OMS comprises the tools and procedures to facilitate automation of station monitoring, control, and mission planning tasks. OMS mechanizes, and hence rationalizes, execution of tasks traditionally performed by mission planners, the mission control center team, onboard System Management software, and the flight crew.

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe. (1) The PERM claims universe includes payments that were originally paid (paid claims) and for which... must establish controls to ensure FFS and managed care universes are accurate and complete, including...

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe. (1) The PERM claims universe includes payments that were originally paid (paid claims) and for which... must establish controls to ensure FFS and managed care universes are accurate and complete, including...

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe. (1) The PERM claims universe includes payments that were originally paid (paid claims) and for which... must establish controls to ensure FFS and managed care universes are accurate and complete, including...

38 CFR 43.20 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Standards for financial... LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 43.20 Standards for financial... procedures for expending and accounting for its own funds. Fiscal control and accounting procedures of the...

78 FR 41837 - Establishment of Class E Airspace; Parkston, SD

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... Instrument Approach Procedures at Parkston Municipal Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the airport. DATES: Effective date... airspace exists to contain new standard instrument approach procedures at the airport. Controlled airspace...

78 FR 41838 - Establishment of Class E Airspace; Colt, AR

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... Instrument Approach Procedures at Delta Regional Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the airport. DATES: Effective date: 0901... exists to contain new standard instrument approach procedures at the airport. Controlled airspace...

78 FR 14478 - Proposed Establishment of Class E Airspace; Linton, ND

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... accommodate new Standard Instrument Approach Procedures (SIAP) at Linton Municipal Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rules (IFR) operations for SIAPs... accommodate new standard instrument approach procedures at Linton Municipal Airport, Linton, ND. Controlled...

78 FR 76053 - Establishment of Class E Airspace; Loup City, NE

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... (RNAV) Standard Instrument Approach Procedures at Loup City Municipal Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the airport... contain aircraft executing new standard instrument approach procedures at the airport. Controlled airspace...

14 CFR 91.1101 - Pilots: Initial, transition, and upgrade ground training.

Code of Federal Regulations, 2014 CFR

2014-01-01

... consumption and cruise control; (9) Flight planning; (10) Each normal and emergency procedure; and (11) The..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT... manager's flight locating procedures; (2) Principles and methods for determining weight and balance, and...

14 CFR 91.1101 - Pilots: Initial, transition, and upgrade ground training.

Code of Federal Regulations, 2013 CFR

2013-01-01

... consumption and cruise control; (9) Flight planning; (10) Each normal and emergency procedure; and (11) The..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT... manager's flight locating procedures; (2) Principles and methods for determining weight and balance, and...

14 CFR 91.1101 - Pilots: Initial, transition, and upgrade ground training.

Code of Federal Regulations, 2012 CFR

2012-01-01

... consumption and cruise control; (9) Flight planning; (10) Each normal and emergency procedure; and (11) The..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT... manager's flight locating procedures; (2) Principles and methods for determining weight and balance, and...

Theory Z: Panacea or Placebo?

ERIC Educational Resources Information Center

Waagen, Christopher L.

William Ouchi's Theory Z, a theory that focuses on the identification of both management and labor with the company's goals, emphasizes communication structures and styles. Ringi is a Japanese procedure for decision making in which all levels of management participate. In Ringi, a manager's task is to communicate. In quality control (Q-C) circles,…

40 CFR 51.302 - Implementation control strategies for reasonably attributable visibility impairment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... hearings to each affected Federal Land Manager, and other affected States, and must state where the public can inspect a summary prepared by the Federal Land Managers of their conclusions and recommendations... conducted in accordance with the procedures in § 51.103. (b) State and Federal Land Manager Coordination. (1...

Critical Drivers for Safety Culture: Examining Department of Energy and U.S. Army Operational Experiences - 12382

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

Lowes, Elizabeth A.

2012-07-01

Evaluating operational incidents can provide a window into the drivers most critical to establishing and maintaining a strong safety culture, thereby minimizing the potential project risk associated with safety incidents. By examining U.S. Department of Energy (DOE) versus U.S. Army drivers in terms of regulatory and contract requirements, programs implemented to address the requirements, and example case studies of operational events, a view of the elements most critical to making a positive influence on safety culture is presented. Four case studies are used in this evaluation; two from DOE and two from U.S. Army experiences. Although the standards guiding operationsmore » at these facilities are different, there are many similarities in the level of hazards, as well as the causes and the potential consequences of the events presented. Two of the incidents examined, one from a DOE operation and the other from a U.S. Army facility, resulted in workers receiving chemical burns. The remaining two incidents are similar in that significant conduct of operations failures occurred resulting in high-level radioactive waste (in the case of the DOE facility) or chemical agent (in the case of the Army facility) being transferred outside of engineering controls. A review of the investigation reports for all four events indicates the primary causes to be failures in work planning leading to ineffective hazard evaluation and control, lack of procedure adherence, and most importantly, lack of management oversight to effectively reinforce expectations for safe work planning and execution. DOE and Army safety programs are similar, and although there are some differences in contractual requirements, the expectations for safe performance are essentially the same. This analysis concludes that instilling a positive safety culture comes down to management leadership and engagement to (1) cultivate an environment that values a questioning attitude and (2) continually reinforce expectations for the appropriate level of rigor in work planning and procedure adherence. A review of the root causes and key contributing causes to the events indicate: - Three of the four root cause analyses cite lack of management engagement (oversight, involvement, ability to recognize issues, etc.) as a root cause to the events. - Two of the four root cause analyses cite work planning failures as a root cause to the events and all cause analyses reflect work planning failures as contributing factors to the events. - All events with the exception of the Tuba City plant shutdown indicate procedure noncompliance as a key contributor; in the case of Tuba City the procedure issues were primarily related to a lack of procedures, or a lack of sufficiently detailed procedures. - All events included discussion or suggestion of a lack of a questioning attitude, either on the part of management/supervision, work planners, or workers. This analysis suggests that the most critical drivers to safety culture are: - Management engagement, - Effective work planning and procedures, and - Procedure adherence with a questioning attitude to ensure procedural problems are identified and fixed. In high-hazard operational environments the importance of robust work planning processes and procedure adherence cannot be overstated. However, having the processes by themselves is not enough. Management must actively engage in expectation setting and ensure work planning that meets expectations for hazard analysis and control, develop a culture that encourages incident reporting and a questioning attitude, and routinely observe work performance to reinforce expectations for adherence to procedures/work control documents. In conclusion, the most critical driver to achieving a workforce culture that supports safe and effective project performance can be summarized as follows: 'Management engagement to continually reinforce expectations for work planning processes and procedure adherence in an environment that cultivates a questioning attitude'. (authors)« less

Local flow management/profile descent algorithm. Fuel-efficient, time-controlled profiles for the NASA TSRV airplane

NASA Technical Reports Server (NTRS)

Groce, J. L.; Izumi, K. H.; Markham, C. H.; Schwab, R. W.; Thompson, J. L.

1986-01-01

The Local Flow Management/Profile Descent (LFM/PD) algorithm designed for the NASA Transport System Research Vehicle program is described. The algorithm provides fuel-efficient altitude and airspeed profiles consistent with ATC restrictions in a time-based metering environment over a fixed ground track. The model design constraints include accommodation of both published profile descent procedures and unpublished profile descents, incorporation of fuel efficiency as a flight profile criterion, operation within the performance capabilities of the Boeing 737-100 airplane with JT8D-7 engines, and conformity to standard air traffic navigation and control procedures. Holding and path stretching capabilities are included for long delay situations.

Aerospace technology and commercial nuclear power; Proceedings of the Workshop Conference, Williamsburg, VA, November 18-20, 1981

NASA Technical Reports Server (NTRS)

Grey, J. (Editor)

1982-01-01

An attempt has been made to compare the technologies, institutions and procedures of the aerospace and commercial nuclear power industries, in order to characterize similarities and contrasts as well as to identify the most fruitful means by which to transfer information, technology, and procedures between the two industries. The seven working groups involved in this study took as their topics powerplant design formulation and effectiveness, plant safety and operations, powerplant control technology and integration, economic and financial analyses, public relations, and the management of nuclear waste and spent fuel. Consequential differences are noted between the two industries in matters of certification and licencing procedures, assignment of responsibility for both safety and financial performance, and public viewpoint. Areas for beneficial interaction include systems management and control and safety system technology. No individual items are abstracted in this volume

Human Factors Analysis of Pipeline Monitoring and Control Operations: Final Technical Report

DOT National Transportation Integrated Search

2008-11-26

The purpose of the Human Factors Analysis of Pipeline Monitoring and Control Operations project was to develop procedures that could be used by liquid pipeline operators to assess and manage the human factors risks in their control rooms that may adv...

USA’S PRACTICES FOR CONTROLLING PATHOGENS IN BIOSOLIDS

EPA Science Inventory

The U.S.A. initially established regulations for the management of sewage sludge in 1979 and updated them in 1993. They are briefly discussed with emphasis on the rationale for the procedures chosen to disinfect sludge and control its vector attractiveness. By controlling pathoge...

75 FR 76082 - Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA Guaranteed Loans) Activity Under OMB Review AGENCY... information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA...

Avoiding Scandal and Headlines with Ethics and Accountability

ERIC Educational Resources Information Center

Haubold, Glen; Throneberry, Angela

2010-01-01

Procedures, financial controls and reports, and leadership are the three major components that "set the tone" for an effective, accountable, and ethical organization. Procedures must be formally documented instead of passed down verbally on the premise that "we've always done it this way." Meaningful management reports should be developed and…

49 CFR 192.605 - Procedural manual for operations, maintenance, and emergencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... maintenance activities and for emergency response. For transmission lines, the manual must also include... and effective manner. (5) Starting up and shutting down any part of the pipeline in a manner designed... control room management procedures required by § 192.631. (c) Abnormal operation. For transmission lines...

Use These Seven Checklists to Maintain Firm Control over Business Procedures.

ERIC Educational Resources Information Center

Scebra, J. Boyd

1983-01-01

Checklist for evaluating school management covers (1) budgeting, revenues, expenditures; (2) accounting and payroll; (3) purchasing and warehousing; (4) debts and captial outlay; (5) insurance; (6) property control; and (7) school activity funds. (JBM)

78 FR 41032 - Proposed Information Collection; Comment Request; Foreign Availability Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... control ineffective. II. Method of Collection Submitted electronically or on paper. III. Data OMB Control..., Management Analyst, Office of the Chief Information Officer. [FR Doc. 2013-16301 Filed 7-8-13; 8:45 am...

Two-stage vs single-stage management for concomitant gallstones and common bile duct stones

PubMed Central

Lu, Jiong; Cheng, Yao; Xiong, Xian-Ze; Lin, Yi-Xin; Wu, Si-Jia; Cheng, Nan-Sheng

2012-01-01

AIM: To evaluate the safety and effectiveness of two-stage vs single-stage management for concomitant gallstones and common bile duct stones. METHODS: Four databases, including PubMed, Embase, the Cochrane Central Register of Controlled Trials and the Science Citation Index up to September 2011, were searched to identify all randomized controlled trials (RCTs). Data were extracted from the studies by two independent reviewers. The primary outcomes were stone clearance from the common bile duct, postoperative morbidity and mortality. The secondary outcomes were conversion to other procedures, number of procedures per patient, length of hospital stay, total operative time, hospitalization charges, patient acceptance and quality of life scores. RESULTS: Seven eligible RCTs [five trials (n = 621) comparing preoperative endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) + laparoscopic cholecystectomy (LC) with LC + laparoscopic common bile duct exploration (LCBDE); two trials (n = 166) comparing postoperative ERCP/EST + LC with LC + LCBDE], composed of 787 patients in total, were included in the final analysis. The meta-analysis detected no statistically significant difference between the two groups in stone clearance from the common bile duct [risk ratios (RR) = -0.10, 95% confidence intervals (CI): -0.24 to 0.04, P = 0.17], postoperative morbidity (RR = 0.79, 95% CI: 0.58 to 1.10, P = 0.16), mortality (RR = 2.19, 95% CI: 0.33 to 14.67, P = 0.42), conversion to other procedures (RR = 1.21, 95% CI: 0.54 to 2.70, P = 0.39), length of hospital stay (MD = 0.99, 95% CI: -1.59 to 3.57, P = 0.45), total operative time (MD = 12.14, 95% CI: -1.83 to 26.10, P = 0.09). Two-stage (LC + ERCP/EST) management clearly required more procedures per patient than single-stage (LC + LCBDE) management. CONCLUSION: Single-stage management is equivalent to two-stage management but requires fewer procedures. However, patient’s condition, operator’s expertise and local resources should be taken into account in making treatment decisions. PMID:22791952

Procedural errors in air traffic control: effects of traffic density, expertise, and automation.

PubMed

Di Nocera, Francesco; Fabrizi, Roberto; Terenzi, Michela; Ferlazzo, Fabio

2006-06-01

Air traffic management requires operators to frequently shift between multiple tasks and/or goals with different levels of accomplishment. Procedural errors can occur when a controller accomplishes one of the tasks before the entire operation has been completed. The present study had two goals: first, to verify the occurrence of post-completion errors in air traffic control (ATC) tasks; and second, to assess effects on performance of medium term conflict detection (MTCD) tools. There were 18 military controllers who performed a simulated ATC task with and without automation support (MTCD vs. manual) in high and low air traffic density conditions. During the task, which consisted of managing several simulated flights in an enroute ATC scenario, a trace suddenly disappeared "after" the operator took the aircraft in charge, "during" the management of the trace, or "before" the pilot's first contact. In the manual condition, only the fault type "during" was found to be significantly different from the other two. On the contrary, when in the MTCD condition, the fault type "after" generated significantly less errors than the fault type "before." Additionally, automation was found to affect performance of junior controllers, whereas seniors' performance was not affected. Procedural errors can happen in ATC, but automation can mitigate this effect. Lack of benefits for the "before" fault type may be due to the fact that operators extend their reliance to a part of the task that is unsupported by the automated system.

Liquid Pipeline Operator's Control Room Human Factors Risk Assessment and Management Guide

DOT National Transportation Integrated Search

2008-11-26

The purpose of this guide is to document methodologies, tools, procedures, guidance, and instructions that have been developed to provide liquid pipeline operators with an efficient and effective means of managing the human factors risks in their con...

Policy, Procedures and Guidance for System Life Cycle Management (SLCM)

EPA Pesticide Factsheets

The purpose of this policy is to establish a consistent framework across the Agency to ensure that EPA IT systems and applications are properly planned and managed, controllable, cost-effective and that they support the Agency’s mission and business goals.

Standardization of the Self Control and Self-Management Skills Scale (SCMS) on the Student of University of Najran

ERIC Educational Resources Information Center

Al-Smadi, Marwan Saleh; Bani-Abduh, Yahya Mohammed

2017-01-01

This study aimed to standardize self-control and self-management skills (SCMS), Mezo 2009 , on students in the university of Najran And to identify the psychometric properties of the scale in the Arab Environment the society of Najran University student by taking a number of Procedures (Validity and reliability of the Scale ) and to get the Arabic…

Increasing Competition for Spares within AFLC (Air Force Logistics Center). Revision.

DTIC Science & Technology

1982-11-30

Managers 45 On Competing the Production of Weapon Systems 46 Sole Source and Competitive Price Trends in Spare Parts Acquisition 47 Controlled...future directions in research and policy . 3- TOPIC: Acquisition TYPE: AFIT Thesis TITLE: Spares Acquisition Integrated with Production and Its...evaluate Air Force management policies , procedures, practices, and controls over the acquisition and pricing of spare parts. Specific objectives

A regional protocol for evaluating the effectiveness of forestry best management practices at controlling erosion and sedimentation

Treesearch

Roger Ryder; Pamela Edwards; Pamela Edwards

2006-01-01

Forestry operations do not have permitting requirements under the Clean Water Act because there is a ccsilvicultural exemption" given in that law, as long as best management practices (BMPs) are used to help control non-point source pollution. However, states' monitoring of BMP effectiveness often has been sporadic and anecdotal, and the procedures used have...

Corrosion Prevention and Control Planning Guidebook Spiral 3

DTIC Science & Technology

2007-09-01

programs. 5. Develop and recommend corrective and preventive procedures based on reliability and maintainability analyses of field data on similar in...One of the many challenges facing the Program/Acquisition Managers is the ability to develop a meaningful Corrosion Prevention and Control Plan...designated program manager of all activities associated with the acquisition, development , production, fielding , sustainment, and disposal of a DoD weapon

Negotiating Narratives, Accessing Asylum: Evaluating Language Policy as Multi-Level Practice, Beliefs and Management

ERIC Educational Resources Information Center

Smith-Khan, Laura

2017-01-01

Theories of language policy increasingly emphasise focusing on the specific contexts in which language management occurs. In government settings, policy seeks to shape how individuals interact with officials. Australian asylum procedure is an area where policy aims at tight control. I examine how communication is managed in this setting, in which…

9 CFR 381.309 - Finished product inspection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FSIS-approved total quality control system; or (3) Alternative documented procedures that will ensure... contamination, where there is no approved total quality control system, or where the establishment has no... Office of Management and Budget under control number 0583-0015) [51 FR 45634, Dec. 19, 1986, as amended...

Man-rated flight software for the F-8 DFBW program

NASA Technical Reports Server (NTRS)

Bairnsfather, R. R.

1976-01-01

The design, implementation, and verification of the flight control software used in the F-8 DFBW program are discussed. Since the DFBW utilizes an Apollo computer and hardware, the procedures, controls, and basic management techniques employed are based on those developed for the Apollo software system. Program assembly control, simulator configuration control, erasable-memory load generation, change procedures and anomaly reporting are discussed. The primary verification tools are described, as well as the program test plans and their implementation on the various simulators. Failure effects analysis and the creation of special failure generating software for testing purposes are described.

VERIFICATION TESTING OF AIR POLLUTION CONTROL TECHNOLOGY QUALITY MANAGEMENT PLAN

EPA Science Inventory

This document is the basis for quality assurance for the Air Pollution Control Technology Verification Center (APCT Center) operated under the U.S. Environmental Protection Agency (EPA). It describes the policies, organizational structure, responsibilities, procedures, and qualit...

Role of diode lasers in oro-facial pain management.

PubMed

Javed, F; Kellesarian, S V; Romanos, G E

2017-01-01

With the increasing use of low level laser therapy (LLLT) in clinical dentistry, the aim of the present study was to assess the effectiveness of diode lasers in the management of orofacial pain. Indexed databases were searched without language and time restrictions up to and including July 2016 using different combinations of the following key words: oral, low level laser therapy, dental, pain, diode lasers, discomfort and analgesia. From the literature reviewed it is evident that LLLT is effective compared to traditional procedures in the management of oro-facial pain associated to soft tissue and hard tissue conditions such as premalignant lesions, gingival conditions and dental extractions. However, it remains to be determined which particular wavelength will produce the more favorable and predictable outcome in terms of pain reduction. It is highly recommended that further randomized control trials with well-defined control groups should be performed to determine the precise wavelengths of the diode lasers for the management of oro-facial pain. Within the limits of the present review, it is concluded that diode lasers therapy is more effective in the management of oro-facial pain compared to traditional procedures.

Interventional procedures and future drug therapy for hypertension

PubMed Central

Lobo, Melvin D.; Sobotka, Paul A.; Pathak, Atul

2017-01-01

Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious. For those patients who either do not tolerate or wish to take medication for hypertension or in whom BP control is not attained despite multiple antihypertensives, a novel class of interventional procedures to manage hypertension has emerged. While most of these target various aspects of the sympathetic nervous system regulation of BP, an additional procedure is now available, which addresses mechanical aspects of the circulation. Most of these new devices are supported by early and encouraging evidence for both safety and efficacy, although it is clear that more rigorous randomized controlled trial data will be essential before any of the technologies can be adopted as a standard of care. PMID:27406184

Doulas for surgical management of miscarriage and abortion: a randomized controlled trial.

PubMed

Wilson, Susan F; Gurney, Elizabeth P; Sammel, Mary D; Schreiber, Courtney A

2017-01-01

Women undergoing office-based surgical management of a failed or undesired pregnancy often report fear of pain and anxiety pertaining to the procedure. Doulas are trained to specifically address women's physical and emotional needs in obstetric care, and recently have extended their practice to support women through all pregnancy outcomes. We sought to evaluate the impact of doulas on patients' physical and emotional responses to surgical management of a first-trimester failed or undesired pregnancy under local anesthesia. In this nonblinded, randomized trial, women received doula support or routine care during office uterine aspiration for failed or unwanted pregnancies in the first trimester. The primary outcome was pain measured on a 100-mm visual analog scale. Secondary outcomes included satisfaction, emotional state, sense of personal empowerment, and ability to cope immediately and 1 month after the procedure, as well as medical assistants' assessment of the doula's utility. A sample size of 35 per group (N = 70) was planned to detect a 20% difference in pain score. From April 2014 through January 2015, 129 women were screened and 70 were randomized. The 2 study groups were similar on all baseline characteristics. The primary outcome was not different between the doula and control groups (pain score 70.7 ± 24.5 mm vs 59.7 ± 32.5 mm, P = .11, respectively), even after controlling for procedure indication (P = .20). While 97% of women who received doula support reported this helped with their experience, there was no statistically significant difference in satisfaction, emotional response, sense of empowerment, or perceived ability to cope between the 2 groups of women immediately following or 1 month after the procedure. Of all study participants, 72% reported that it was important to have someone with them during the procedure, but that the support person did not have to be a doula. Doula support during office uterine aspiration for failed or undesired pregnancies is well received and desired by women undergoing this procedure despite no significant effect on physical comfort or emotional responses related to the procedure. This may suggest an unmet psychosocial need for procedure-related support among such women. Copyright © 2016 Elsevier Inc. All rights reserved.

Management systems research study

NASA Technical Reports Server (NTRS)

Bruno, A. V.

1975-01-01

The development of a Monte Carlo simulation of procurement activities at the NASA Ames Research Center is described. Data cover: simulation of the procurement cycle, construction of a performance evaluation model, examination of employee development, procedures and review of evaluation criteria for divisional and individual performance evaluation. Determination of the influences and apparent impact of contract type and structure and development of a management control system for planning and controlling manpower requirements.

12 CFR 225.24 - Procedures for other nonbanking proposals.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., internal controls and risk management systems that will be utilized in the conduct of the proposed... FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y) Regulations... listed activities. A bank holding company seeking to acquire or control voting securities or assets of a...

An Investigation of Naturally Occurring Episodes of Self-Controlled Behaviors

ERIC Educational Resources Information Center

Perri, Michael G.; Richards, C. Steven

1977-01-01

College students, 48 males and 48 females, were interviewed about attempts to self-control overeating, smoking, studying, or dating. Results indicated successful self-controllers used more techniques for longer periods of time, use of self-reinforcement procedures was an important discriminant of successful self-management, and methods varied…

Guidelines for the use of GYPCHEK to control the gypsy moth

Treesearch

Franklin B. Lewis; Michael L. McManus; Noel F. Schneeberger

1979-01-01

This paper presents positive and negative attributes of GYPCHEK for evaluation by land managers contemplating gypsy moth control. Special precautions and procedures are outlined. Environmental and ecological considerations are discussed and results to be expected from the use of GYPCHEK in gypsy moth control are presented.

Three studies of biographical factors associated with success in air traffic control specialist screening/training at the FAA Academy.

DOT National Transportation Integrated Search

1983-04-01

The current Air Traffic Control Specialist (ATCS) selection procedure requires that all applicants pass the Office of Personnel Management (OPM) air traffic control aptitude test. In addition to the test scores, applicants may also receive points for...

76 FR 26293 - Public Information Collection Being Submitted for Review and Approval to the Office of Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... proceedings that are similar in many respects to the Federal Rules of Civil Procedure. See 47 CFR [email protected] . SUPPLEMENTARY INFORMATION: OMB Control Number: 3060-0411. Title: Procedures for Formal..., regulation, or practice''). Formal complaint proceedings before the Commission are similar to civil...

Individuals with Mental Illness Can Control Their Aggressive Behavior through Mindfulness Training

ERIC Educational Resources Information Center

Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Adkins, Angela D.; Wahler, Robert G.; Sabaawi, Mohamed; Singh, Judy

2007-01-01

Verbal and physical aggression are risk factors for community placement of individuals with serious and persistent mental illness. Depending on the motivations involved, treatment typically consists of psychotropic medications and psychosocial interventions, including contingency management procedures and anger management training. Effects of a…

76 FR 14799 - Amendment of Class E Airspace; Newport, VT

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... cancellation of the NDB approach. Controlled airspace is necessary for the safety and management of IFR... Instrument Approach Procedures (SIAPs) have been developed for Newport State Airport. This action enhances the safety and airspace management of Instrument Flight Rules (IFR) operations at the airport. DATES...

75 FR 2488 - Mid-Atlantic Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Mid-Atlantic Fishery Management Council's (MAFMC) Scientific and Statistical Committee (SSC) will hold... include new member orientation (overview of Council process and role of the SSC), review and adoption of SSC Standard Operating Practices and Procedures, ABC Control Rule Framework and Council Risk Policy...

23 CFR 650.313 - Inspection procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Quality control and quality assurance. Assure systematic quality control (QC) and quality assurance (QA... periodic field review of inspection teams, periodic bridge inspection refresher training for program managers and team leaders, and independent review of inspection reports and computations. (h) Follow-up on...

Statewide Intelligent Transportation Systems As-Is Agency Reports For Minnesota, Volume 6, City Of St. Paul

DOT National Transportation Integrated Search

1996-08-01

KEYWORDS: : TRAFFIC SIGNAL CONTROL/REAL-TIME ADAPTIVE CONTROL, ADVANCED TRAFFIC MANAGEMENT SYSTEMS OR ATMS : THIS DOCUMENT PRESENTS THE METHODS, ASSUMPTIONS AND PROCEDURES USED TO COLLECT THE BASELINE INFORMATION. THE DOCUMENTATION OF SYSTEMS ...

Application of systems and control theory-based hazard analysis to radiation oncology.

PubMed

Pawlicki, Todd; Samost, Aubrey; Brown, Derek W; Manger, Ryan P; Kim, Gwe-Ya; Leveson, Nancy G

2016-03-01

Both humans and software are notoriously challenging to account for in traditional hazard analysis models. The purpose of this work is to investigate and demonstrate the application of a new, extended accident causality model, called systems theoretic accident model and processes (STAMP), to radiation oncology. Specifically, a hazard analysis technique based on STAMP, system-theoretic process analysis (STPA), is used to perform a hazard analysis. The STPA procedure starts with the definition of high-level accidents for radiation oncology at the medical center and the hazards leading to those accidents. From there, the hierarchical safety control structure of the radiation oncology clinic is modeled, i.e., the controls that are used to prevent accidents and provide effective treatment. Using STPA, unsafe control actions (behaviors) are identified that can lead to the hazards as well as causal scenarios that can lead to the identified unsafe control. This information can be used to eliminate or mitigate potential hazards. The STPA procedure is demonstrated on a new online adaptive cranial radiosurgery procedure that omits the CT simulation step and uses CBCT for localization, planning, and surface imaging system during treatment. The STPA procedure generated a comprehensive set of causal scenarios that are traced back to system hazards and accidents. Ten control loops were created for the new SRS procedure, which covered the areas of hospital and department management, treatment design and delivery, and vendor service. Eighty three unsafe control actions were identified as well as 472 causal scenarios that could lead to those unsafe control actions. STPA provides a method for understanding the role of management decisions and hospital operations on system safety and generating process design requirements to prevent hazards and accidents. The interaction of people, hardware, and software is highlighted. The method of STPA produces results that can be used to improve safety and prevent accidents and warrants further investigation.

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain

PubMed Central

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.

2017-01-01

Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations:The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion:The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY. PMID:29200944

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

PubMed

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations: The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion: The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY.

Combined effects of uncertainty and organizational justice on employee health: testing the uncertainty management model of fairness judgments among Finnish public sector employees.

PubMed

Elovainio, Marko; van den Bos, Kees; Linna, Anne; Kivimäki, Mika; Ala-Mursula, Leena; Pentti, Jaana; Vahtera, Jussi

2005-12-01

We examined whether the combination of uncertainty (lack of work-time control, and negative changes at work) and organizational justice (i.e., justice of decision-making procedures and interpersonal treatment at work) contributes to sickness absence. A total of 7083 male and 24,317 female Finnish public sector employees completed questionnaires designed to assess organizational justice, workload and other factors. Hierarchical regression showed that after adjustment for age, income, and health behaviors low procedural and interactional justice were related to long sickness absence spells. In accordance with the uncertainty management model, these associations were dependent on experienced work-time control and perceived changes at work.

Investigation of energy management strategies for photovoltaic systems - A predictive control algorithm

NASA Technical Reports Server (NTRS)

Cull, R. C.; Eltimsahy, A. H.

1983-01-01

The present investigation is concerned with the formulation of energy management strategies for stand-alone photovoltaic (PV) systems, taking into account a basic control algorithm for a possible predictive, (and adaptive) controller. The control system controls the flow of energy in the system according to the amount of energy available, and predicts the appropriate control set-points based on the energy (insolation) available by using an appropriate system model. Aspects of adaptation to the conditions of the system are also considered. Attention is given to a statistical analysis technique, the analysis inputs, the analysis procedure, and details regarding the basic control algorithm.

9 CFR 381.311 - Recall procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... review. (Approved by the Office of Management and Budget under control number 0583-0015) ...

9 CFR 381.311 - Recall procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... review. (Approved by the Office of Management and Budget under control number 0583-0015) ...

9 CFR 381.311 - Recall procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... review. (Approved by the Office of Management and Budget under control number 0583-0015) ...

9 CFR 381.311 - Recall procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... review. (Approved by the Office of Management and Budget under control number 0583-0015) ...

75 FR 60690 - Defense Federal Acquisition Regulation Supplement (DFARS); Electronic Ordering Procedures (DFARS...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

... event of conflict between a delivery order or task order and this contract, the contract shall control.... This change will ultimately help improve the management and promotion of electronic Government services... impose any information collection requirements that require the approval of the Office of Management and...

76 FR 46212 - Proposed Modification of Class E Airspace; Blythe, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... procedures at Blythe Airport. The FAA is proposing this action to enhance the safety and management of... be submitted in triplicate to the Docket Management System (see ADDRESSES section for address and... controlled airspace is necessary to accommodate aircraft using the RNAV (GPS) standard instrument approach...

78 FR 33019 - Proposed Amendment of Class E Airspace; Commerce, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-03

... accommodate new Standard Instrument Approach Procedures (SIAPs) at Commerce Municipal Airport (AAF). The FAA is taking this action to enhance the safety and management of Instrument Flight Rules (IFR... airport to provide adequate controlled airspace for the safety and management of IFR operations at the...

76 FR 41145 - Proposed Amendment of Class E Airspace; Glendive, MT

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... procedures at the airport. The FAA is proposing this action to enhance the safety and management of aircraft... submitted in triplicate to the Docket Management System (see ADDRESSES section for address and phone number.... Controlled airspace is necessary to accommodate aircraft using the RNAV (GPS) standard instrument approach...

Guidelines for Automatic Data Processing Physical Security and Risk Management. Federal Information Processing Standards Publication 31.

ERIC Educational Resources Information Center

National Bureau of Standards (DOC), Washington, DC.

These guidelines provide a handbook for use by federal organizations in structuring physical security and risk management programs for their automatic data processing facilities. This publication discusses security analysis, natural disasters, supporting utilities, system reliability, procedural measures and controls, off-site facilities,…

Evaluation of Approval Request 47; Call for Release Procedures for Charlotte Douglas International Airport

NASA Technical Reports Server (NTRS)

Stevens, Lindsay; Martin, Lynne; Jobe, Kimberly; Parke, Bonny; Chevalley, Eric; Lee, Hanbong; Verma, Savita; Dulchinos, Victoria

2017-01-01

NASA is collaborating with the Federal Aviation Administration (FAA) and aviation industry partners to develop and demonstrate new concepts and technologies for Integrated Arrival, Departure, and Surface (IADS) traffic management capabilities under the Airspace Technology Demonstration 2 (ATD-2) project. One of the goals of the IADS capabilities in the ATD-2 project is to increase predictability and throughput of airspace operations by improving Traffic Management Initiative (TMI) compliance. This paper focuses on the Approval Request (APREQ) procedures developed for the ATD-2 project between the Air Traffic Control (ATC) Tower at Charlotte Douglas International Airport and Washington Center. In March 2017, NASA conducted a Human-in-the-Loop (HITL) simulation to evaluate the operational procedures and information requirements for the APREQ procedures in the ATD-2 IADS system between ATC Tower and Center. The findings from the HITL are used to compare ATD-2 APREQ procedures with information about current day APREQ procedures.

Evaluation of Approval Request/Call for Release Coordination Procedures for Charlotte Douglas International Airport

NASA Technical Reports Server (NTRS)

Stevens, Lindsay; Martin, Lynne; Jobe, Kimberly; Parke, Bonny; Chevalley, Eric; Lee, Hanbong; Verma, Savita; Dulchinos, Victoria

2017-01-01

NASA is collaborating with the Federal Aviation Administration (FAA) and aviation industry partners to develop and demonstrate new concepts and technologies for Integrated Arrival, Departure, and Surface (IADS) traffic management capabilities under the Airspace Technology Demonstration 2 (ATD-2) project. One of the goals of the IADS capabilities in the ATD-2 project is to increase predictability and throughput of airspace operations by improving Traffic Management Initiative (TMI) compliance. This paper focuses on the Approval Request (APREQ) procedures developed for the ATD-2 project between the Air Traffic Control (ATC) Tower at Charlotte Douglas International Airport and Washington Center. In March 2017, NASA conducted a Human-in-the-Loop (HITL) simulation to evaluate the operational procedures and information requirements for the APREQ procedures in the ATD-2 IADS system between ATC Tower and Center. The findings from the HITL are used to compare ATD-2 APREQ procedures with information about current day APREQ procedures.

Best management practices used by KYTC for on-site erosion control.

DOT National Transportation Integrated Search

2006-11-01

New erosion control procedures (ECP) have recently been implemented by the Kentucky Transportation Cabinet (KYTC). Previously, consultants and designers developed the ECP as a part of the design plans. In many cases these did not work in the field. T...

[Compatibility of different quality control systems].

PubMed

Invernizzi, Enrico

2002-01-01

Management of the good laboratory practice (GLP) quality system presupposes its linking to a basic recognized and approved quality system, from which it can draw on management procedures common to all quality systems, such as the ISO 9000 set of norms. A quality system organized in this way can also be integrated with other dedicated quality systems, or parts of them, to obtain principles or management procedures for specific topics. The aim of this organization is to set up a reliable, recognized quality system compatible with the principles of GLP and other quality management systems, which provides users with a simplified set of easily accessible management tools and answers. The organization of this quality system is set out in the quality assurance programme, which is actually the document in which the test facility incorporates the GLP principles into its own quality organization.

[Quality control in anesthesiology].

PubMed

Muñoz-Ramón, J M

1995-03-01

The process of quality control and auditing of anesthesiology allows us to evaluate care given by a service and solve problems that are detected. Quality control is a basic element of care giving and is only secondarily an area of academic research; it is therefore a meaningless effort if the information does not serve to improve departmental procedures. Quality assurance procedures assume certain infrastructural requirements and an initial period of implementation and adjustment. The main objectives of quality control are the reduction of morbidity and mortality due to anesthesia, assurance of the availability and proper management of resources and, finally, the well-being and safety of the patient.

A Multiple Agent Model of Human Performance in Automated Air Traffic Control and Flight Management Operations

NASA Technical Reports Server (NTRS)

Corker, Kevin; Pisanich, Gregory; Condon, Gregory W. (Technical Monitor)

1995-01-01

A predictive model of human operator performance (flight crew and air traffic control (ATC)) has been developed and applied in order to evaluate the impact of automation developments in flight management and air traffic control. The model is used to predict the performance of a two person flight crew and the ATC operators generating and responding to clearances aided by the Center TRACON Automation System (CTAS). The purpose of the modeling is to support evaluation and design of automated aids for flight management and airspace management and to predict required changes in procedure both air and ground in response to advancing automation in both domains. Additional information is contained in the original extended abstract.

Crew Procedures for Continuous Descent Arrivals Using Conventional Guidance

NASA Technical Reports Server (NTRS)

Oseguera-Lohr, Rosa M.; Williams, David H.; Lewis, Elliot T,

2007-01-01

This paper presents results from a simulation study which investigated the use of Continuous Descent Arrival (CDA) procedures for conducting a descent through a busy terminal area, using conventional transport-category automation. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, that addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for low noise operations. The procedures and chart were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC. The test runs were intended to represent situations typical of what exists in many of today's terminal areas, including interruptions to the descent in the form of clearances issued by ATC.

Policies and procedures in the workplace: how health care organizations compare.

PubMed

Loo, R

1993-01-01

Many organizations are implementing programs and services to manage the human and economic costs of stress. A mail survey was conducted of 500 randomly selected Canadian organizations having at least 500 employees. The survey tapped four major areas: organizational policies and procedures for managing stress; programs and services offered; perceived benefits and constraints for the organization; and projected future directions in this area. Analyses of returns from 210 organizations-43 health and 167 non-health-revealed various findings. For example, over half of health care organizations have policies and procedures as opposed to less than half of non-health care organizations. Also, health care organizations place greater emphasis on smoking cessation, weight control programs and on stress management training. Although some Canadian organizations are addressing stress, much more could and should be done, especially by organizations that do not yet recognize the impact of stress on employees and their work performance.

Quantifying opportunities for hospital cost control: medical device purchasing and patient discharge planning.

PubMed

Robinson, James C; Brown, Timothy T

2014-09-01

To quantify the potential reduction in hospital costs from adoption of best local practices in supply chain management and discharge planning. We performed multivariate statistical analyses of the association between total variable cost per procedure and medical device price and length of stay, controlling for patient and hospital characteristics. Ten hospitals in 1 major metropolitan area supplied patient-level administrative data on 9778 patients undergoing joint replacement, spine fusion, or cardiac rhythm management (CRM) procedures in 2008 and 2010. The impact on each hospital of matching lowest local market device prices and lowest patient length of stay (LOS) was calculated using multivariate regression analysis controlling for patient demographics, diagnoses, comorbidities, and implications. Average variable costs ranged from $11,315 for joint replacement to $16,087 for CRM and $18,413 for spine fusion. Implantable medical devices accounted for a large share of each procedure's variable costs: 44% for joint replacement, 39% for spine fusion, and 59% for CRM. Device prices and patient length-of-stay exhibited wide variation across hospitals. Total potential hospital cost savings from achieving best local practices in device prices and patient length of stay are 14.5% for joint replacement, 18.8% for spine fusion;,and 29.1% for CRM. Hospitals have opportunities for cost reduction from adoption of best local practices in supply chain management and discharge planning.

Joint NASA Ames/Langley Experimental Evaluation of Integrated Air/Ground Operations for En Route Free Maneuvering

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Kopardekar, Parimal; Battiste, Vernol; Doble, Nathan; Johnson, Walter; Lee, Paul; Prevot, Thomas; Smith, Nancy

2005-01-01

In order to meet the anticipated future demand for air travel, the National Aeronautics and Space Administration (NASA) is investigating a new concept of operations known as Distributed Air-Ground Traffic Management (DAG-TM). Under the En Route Free Maneuvering component of DAG-TM, appropriately equipped autonomous aircraft self separate from other autonomous aircraft and from managed aircraft that continue to fly under today s Instrument Flight Rules (IFR). Controllers provide separation services between IFR aircraft and assign traffic flow management constraints to all aircraft. To address concept feasibility issues pertaining to integrated air/ground operations at various traffic levels, NASA Ames and Langley Research Centers conducted a joint human-in-the-loop experiment. Professional airline pilots and air traffic controllers flew a total of 16 scenarios under four conditions: mixed autonomous/managed operations at three traffic levels and a baseline all-managed condition at the lowest traffic level. These scenarios included en route flights and descents to a terminal area meter fix in airspace modeled after the Dallas Ft. Worth area. Pilots of autonomous aircraft met controller assigned meter fix constraints with high success. Separation violations by subject pilots did not appear to vary with traffic level and were mainly attributable to software errors and procedural lapses. Controller workload was lower for mixed flight conditions, even at higher traffic levels. Pilot workload was deemed acceptable under all conditions. Controllers raised several safety concerns, most of which pertained to the occurrence of near-term conflicts between autonomous and managed aircraft. These issues are being addressed through better compatibility between air and ground systems and refinements to air and ground procedures.

9 CFR 318.311 - Recall procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... available to Program employees for review. (Approved by the Office of Management and Budget under control...

9 CFR 318.311 - Recall procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... available to Program employees for review. (Approved by the Office of Management and Budget under control...

9 CFR 318.311 - Recall procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... available to Program employees for review. (Approved by the Office of Management and Budget under control...

9 CFR 318.311 - Recall procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... available to Program employees for review. (Approved by the Office of Management and Budget under control...

9 CFR 318.311 - Recall procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND... available to Program employees for review. (Approved by the Office of Management and Budget under control...

Simulations of Continuous Descent Operations with Arrival-management Automation and Mixed Flight-deck Interval Management Equipage

NASA Technical Reports Server (NTRS)

Callantine, Todd J.; Kupfer, Michael; Martin, Lynne Hazel; Prevot, Thomas

2013-01-01

Air traffic management simulations conducted in the Airspace Operations Laboratory at NASA Ames Research Center have addressed the integration of trajectory-based arrival-management automation, controller tools, and Flight-Deck Interval Management avionics to enable Continuous Descent Operations (CDOs) during periods of sustained high traffic demand. The simulations are devoted to maturing the integrated system for field demonstration, and refining the controller tools, clearance phraseology, and procedures specified in the associated concept of operations. The results indicate a variety of factors impact the concept's safety and viability from a controller's perspective, including en-route preconditioning of arrival flows, useable clearance phraseology, and the characteristics of airspace, routes, and traffic-management methods in use at a particular site. Clear understanding of automation behavior and required shifts in roles and responsibilities is important for controller acceptance and realizing potential benefits. This paper discusses the simulations, drawing parallels with results from related European efforts. The most recent study found en-route controllers can effectively precondition arrival flows, which significantly improved route conformance during CDOs. Controllers found the tools acceptable, in line with previous studies.

21 CFR 107.50 - Terms and conditions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Center for Food Safety and Applied Nutrition concludes that additional or modified quality control... also typically represented and labeled for use to provide dietary management for diseases or conditions... regulations promulgated under section 412(a)(2) of the act, the quality control procedure requirements of part...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... to exceed 15 months; and (5) Establish and implement procedures for when a different controller..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

Human-Centered Technologies and Procedures for Future Air Traffic Management

NASA Technical Reports Server (NTRS)

Smith, Philip; Woods, David; McCoy, Elaine; Billings, Charles; Sarter, Nadine; Denning, Rebecca; Dekker, Sidney

1997-01-01

The use of various methodologies to predict the impact of future Air Traffic Management (ATM) concepts and technologies is explored. The emphasis has been on the importance of modeling coordination and cooperation among multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, identifying critical problem areas and looking for examples suggestive of general approaches for solving such problems. Using the results of these field studies, we have developed a set of concrete scenarios centered around future designs, and have studied performance in these scenarios with a set of 40 controllers, dispatchers, pilots and traffic managers.

Conceptual Processes for Linking Eutrophication and Network Models

DTIC Science & Technology

2006-08-01

recommends a general procedure for future endeavors in this area. BACKGROUND: In recent years new ideas for nutrient management to control...network model. Coupling these two models will provide managers a new perspective on how to improve management strategies and help answer questions such...Dorothy H. Tillman, Dr. Carl F. Cerco, and Mr. Mark R. Noel of the Water Quality and Contaminant Modeling Branch, Enviromental Laboratory (EL

Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

PubMed

Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

1988-01-01

This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

NASA Radio Frequency Spectrum Management Manual

NASA Technical Reports Server (NTRS)

1989-01-01

The Radio Frequency (RF) Spectrum Management Manual sets forth procedures and guidelines for the management requirements for controlling the use of radio frequencies by the National Aeronautics and Space Administration. It is applicable to NASA Headquarters and field installations. NASA Management Instruction 1102.3 assigns the authority for management of radio frequencies for the National Aeronautics and Space Administration to the Associate Administrator for Space Operations, NASA Headquarters. This manual is issued in loose-leaf form and will be revised by page changes.

Developing a ubiquitous health management system with healthy diet control for metabolic syndrome healthcare in Taiwan.

PubMed

Kan, Yao-Chiang; Chen, Kai-Hong; Lin, Hsueh-Chun

2017-06-01

Self-management in healthcare can allow patients managing their health data anytime and everywhere for prevention of chronic diseases. This study established a prototype of ubiquitous health management system (UHMS) with healthy diet control (HDC) for people who need services of metabolic syndrome healthcare in Taiwan. System infrastructure comprises of three portals and a database tier with mutually supportive components to achieve functionality of diet diaries, nutrition guides, and health risk assessments for self-health management. With the diet, nutrition, and personal health database, the design enables the analytical diagrams on the interactive interface to support a mobile application for diet diary, a Web-based platform for health management, and the modules of research and development for medical care. For database integrity, dietary data can be stored at offline mode prior to transformation between mobile device and server site at online mode. The UHMS-HDC was developed by open source technology for ubiquitous health management with personalized dietary criteria. The system integrates mobile, internet, and electronic healthcare services with the diet diary functions to manage healthy diet behaviors of users. The virtual patients were involved to simulate the self-health management procedure. The assessment functions were approved by capturing the screen snapshots in the procedure. The proposed system development was capable for practical intervention. This approach details the expandable framework with collaborative components regarding the self-developed UHMS-HDC. The multi-disciplinary applications for self-health management can support the healthcare professionals to reduce medical resources and improve healthcare effects for the patient who requires monitoring personal health condition with diet control. The proposed system can be practiced for intervention in the hospital. Copyright © 2017 Elsevier B.V. All rights reserved.

33 CFR 104.215 - Vessel Security Officer (VSO).

Code of Federal Regulations, 2011 CFR

2011-07-01

... procedures, including scenario-based response training; (4) Crowd management and control techniques; (5) Operations of security equipment and systems; and (6) Testing and calibration of security equipment and...

Management Information Systems: Applications to Educational Administration.

ERIC Educational Resources Information Center

Witkin, Belle Ruth

An orientation to management information systems (MIS) is offered which presents information about MIS in the context of public education and suggests some considerations that should be taken into account in designing and operating such systems. MIS is defined as a set of operating procedures that act as a control system to automatically provide…

24 CFR 200.935 - Administrator qualifications and procedures for HUD building products certification programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... guidelines in any quality assurance review: (1) ASQC Q9000-1-1994 Quality Management and Quality Assurance... Systems—Model for Quality Assurance in Final Inspection and Test; (5) ASQC Q9004-1-1994 Quality Management... in interpreting testing standards, test methods, evaluating test reports and quality control programs...

Software control and system configuration management - A process that works

NASA Technical Reports Server (NTRS)

Petersen, K. L.; Flores, C., Jr.

1983-01-01

A comprehensive software control and system configuration management process for flight-crucial digital control systems of advanced aircraft has been developed and refined to insure efficient flight system development and safe flight operations. Because of the highly complex interactions among the hardware, software, and system elements of state-of-the-art digital flight control system designs, a systems-wide approach to configuration control and management has been used. Specific procedures are implemented to govern discrepancy reporting and reconciliation, software and hardware change control, systems verification and validation testing, and formal documentation requirements. An active and knowledgeable configuration control board reviews and approves all flight system configuration modifications and revalidation tests. This flexible process has proved effective during the development and flight testing of several research aircraft and remotely piloted research vehicles with digital flight control systems that ranged from relatively simple to highly complex, integrated mechanizations.

Software control and system configuration management: A systems-wide approach

NASA Technical Reports Server (NTRS)

Petersen, K. L.; Flores, C., Jr.

1984-01-01

A comprehensive software control and system configuration management process for flight-crucial digital control systems of advanced aircraft has been developed and refined to insure efficient flight system development and safe flight operations. Because of the highly complex interactions among the hardware, software, and system elements of state-of-the-art digital flight control system designs, a systems-wide approach to configuration control and management has been used. Specific procedures are implemented to govern discrepancy reporting and reconciliation, software and hardware change control, systems verification and validation testing, and formal documentation requirements. An active and knowledgeable configuration control board reviews and approves all flight system configuration modifications and revalidation tests. This flexible process has proved effective during the development and flight testing of several research aircraft and remotely piloted research vehicles with digital flight control systems that ranged from relatively simple to highly complex, integrated mechanizations.

[Nursing service certification. Norm UNE-EN-ISO 9001-2008].

PubMed

Salazar de la Guerra, R; Ferrer Arnedo, C; Labrador Domínguez, M J; Sangregorio Matesanz, A

2014-01-01

To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process. The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements. The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%. The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays.

PubMed

Rossum, Huub H van; Kemperman, Hans

2017-07-26

General application of a moving average (MA) as continuous analytical quality control (QC) for routine chemistry assays has failed due to lack of a simple method that allows optimization of MAs. A new method was applied to optimize the MA for routine chemistry and was evaluated in daily practice as continuous analytical QC instrument. MA procedures were optimized using an MA bias detection simulation procedure. Optimization was graphically supported by bias detection curves. Next, all optimal MA procedures that contributed to the quality assurance were run for 100 consecutive days and MA alarms generated during working hours were investigated. Optimized MA procedures were applied for 24 chemistry assays. During this evaluation, 303,871 MA values and 76 MA alarms were generated. Of all alarms, 54 (71%) were generated during office hours. Of these, 41 were further investigated and were caused by ion selective electrode (ISE) failure (1), calibration failure not detected by QC due to improper QC settings (1), possible bias (significant difference with the other analyzer) (10), non-human materials analyzed (2), extreme result(s) of a single patient (2), pre-analytical error (1), no cause identified (20), and no conclusion possible (4). MA was implemented in daily practice as a continuous QC instrument for 24 routine chemistry assays. In our setup when an MA alarm required follow-up, a manageable number of MA alarms was generated that resulted in valuable MA alarms. For the management of MA alarms, several applications/requirements in the MA management software will simplify the use of MA procedures.

Interventional procedures and future drug therapy for hypertension.

PubMed

Lobo, Melvin D; Sobotka, Paul A; Pathak, Atul

2017-04-14

Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious. For those patients who either do not tolerate or wish to take medication for hypertension or in whom BP control is not attained despite multiple antihypertensives, a novel class of interventional procedures to manage hypertension has emerged. While most of these target various aspects of the sympathetic nervous system regulation of BP, an additional procedure is now available, which addresses mechanical aspects of the circulation. Most of these new devices are supported by early and encouraging evidence for both safety and efficacy, although it is clear that more rigorous randomized controlled trial data will be essential before any of the technologies can be adopted as a standard of care. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

[Recommendations for inspections of the French nuclear safety authority].

PubMed

Rousse, C; Chauvet, B

2015-10-01

The French nuclear safety authority is responsible for the control of radiation protection in radiotherapy since 2002. Controls are based on the public health and the labour codes and on the procedures defined by the controlled health care facility for its quality and safety management system according to ASN decision No. 2008-DC-0103. Inspectors verify the adequacy of the quality and safety management procedures and their implementation, and select process steps on the basis of feedback from events notified to ASN. Topics of the inspection are communicated to the facility at the launch of a campaign, which enables them to anticipate the inspectors' expectations. In cases where they are not physicians, inspectors are not allowed to access information covered by medical confidentiality. The consulted documents must therefore be expunged of any patient-identifying information. Exchanges before the inspection are intended to facilitate the provision of documents that may be consulted. Finally, exchange slots between inspectors and the local professionals must be organized. Based on improvements achieved by the health care centres and on recommendations from a joint working group of radiotherapy professionals and the nuclear safety authority, changes will be made in the control procedure that will be implemented when developing the inspection program for 2016-2019. Copyright © 2015. Published by Elsevier SAS.

28 CFR 541.67 - Review of controlled housing status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Review of controlled housing status. 541.67 Section 541.67 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.67 - Review of controlled housing status.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Review of controlled housing status. 541.67 Section 541.67 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.67 - Review of controlled housing status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Review of controlled housing status. 541.67 Section 541.67 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.67 - Review of controlled housing status.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Review of controlled housing status. 541.67 Section 541.67 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.68 - Release from controlled housing status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Release from controlled housing status. 541.68 Section 541.68 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.68 - Release from controlled housing status.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Release from controlled housing status. 541.68 Section 541.68 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.68 - Release from controlled housing status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Release from controlled housing status. 541.68 Section 541.68 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.68 - Release from controlled housing status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Release from controlled housing status. 541.68 Section 541.68 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.67 - Review of controlled housing status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Review of controlled housing status. 541.67 Section 541.67 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

28 CFR 541.68 - Release from controlled housing status.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Release from controlled housing status. 541.68 Section 541.68 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who...

Biofeedback Training in Crisis Managers: A Randomized Controlled Trial.

PubMed

Janka, A; Adler, C; Brunner, B; Oppenrieder, S; Duschek, S

2017-06-01

Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers. The training comprised exercises promoting acquisition of control over sympathetic arousal under resting conditions and during exposure to visual, acoustic and cognitive stressors resembling situations related to crisis management. In a randomized controlled design, 36 crisis managers were assigned to either a biofeedback training group or waiting list control group. Subjective stress was assessed using the Perceived Stress Scale. In the training group, stress level markedly decreased; the decrease remained stable at follow-up 2 months after the training. The results indicate that biofeedback training in crisis management is an effective method for stress management that may help to reduce vulnerability to stress-related performance decline and stress-related disease.

Energy Navigation: Simulation Evaluation and Benefit Analysis

NASA Technical Reports Server (NTRS)

Williams, David H.; Oseguera-Lohr, Rosa M.; Lewis, Elliot T.

2011-01-01

This paper presents results from two simulation studies investigating the use of advanced flight-deck-based energy navigation (ENAV) and conventional transport-category vertical navigation (VNAV) for conducting a descent through a busy terminal area, using Continuous Descent Arrival (CDA) procedures. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, and the subsequent Airspace Super Density Operations (ASDO) research focus area of the Airspace Project. A piloted simulation study addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for high density terminal operations. The procedures and charts were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC.

A web based relational database management system for filariasis control

PubMed Central

Murty, Upadhyayula Suryanarayana; Kumar, Duvvuri Venkata Rama Satya; Sriram, Kumaraswamy; Rao, Kadiri Madhusudhan; Bhattacharyulu, Chakravarthula Hayageeva Narasimha Venakata; Praveen, Bhoopathi; Krishna, Amirapu Radha

2005-01-01

The present study describes a RDBMS (relational database management system) for the effective management of Filariasis, a vector borne disease. Filariasis infects 120 million people from 83 countries. The possible re-emergence of the disease and the complexity of existing control programs warrant the development of new strategies. A database containing comprehensive data associated with filariasis finds utility in disease control. We have developed a database containing information on the socio-economic status of patients, mosquito collection procedures, mosquito dissection data, filariasis survey report and mass blood data. The database can be searched using a user friendly web interface. Availability http://www.webfil.org (login and password can be obtained from the authors) PMID:17597846

Presentation of a quality management program in off-pump coronary bypass surgery.

PubMed

Bougioukakis, Petros; Kluegl, Stefan J; Babin-Ebell, Joerg; Tagarakis, Giorgios I; Mandewirth, Martin; Zacher, Michael; Diegeler, Anno

2014-01-01

To increase the number of off-pump coronary procedures at our institution, a new surgical team was formed. The first 3 years of "learning period" were accompanied by a quality management program aimed to control and adjust the surgical process and to ensure the safety and quality of the procedure. All patients were operated on by the same surgeon between January 2004 and December 2006; all procedures were performed under the following quality management protocol. First, a flow chart regulated surgical and anesthetic details. Second, an online file, named "disturbance file," was used to report work flow interruption, disturbance, and intraoperative events, that is, myocardial ischemia, hypotension, conversion to cardiopulmonary bypass, and any violation of the protocol. Each event was coded with 1 point and added to a score (the higher the score is, the greater the disturbance). Outcome parameters known as major events-major cardiac and cerebral events: mortality within 30 days/myocardial infarction confirmed by electrocardiogram or significantly high levels of total creatine kinase-myocardial muscle creatine kinase/reintervention within 30 days/stroke--and new-onset dialysis were also measured. Success was defined as freedom from any of those events and depicted in a cumulative sum control (CUSUM) chart. Outcome data and CUSUM were correlated with the intraoperative Disturbance Index. In total, 490 off-pump coronary bypass operations were performed by the named surgeon during the study period. The 30-day mortality was reduced from 4.0% to 1.9%. Disturbance Index score of greater than 1 declined from 41.6% to 23.3%. All major cardiac and cerebral events declined. The CUSUM chart showed two critical periods during the learning period, which made an adjustment of the protocol necessary. Quality management control is efficient in improving the postoperative results of a surgical procedure. A learning period is of cardinal importance for any new team wishing to engage in a novel surgical technique.

Use of Data Comm by Flight Crew to Conduct Interval Management Operations to Parallel Dependent Runways

NASA Technical Reports Server (NTRS)

Baxley, Brian T.; Hubbs, Clay; Shay, Rick; Karanian, James

2011-01-01

The Interval Management (IM) concept is being developed as a method to maintain or increase high traffic density airport arrival throughput while allowing aircraft to conduct near idle thrust descents. The Interval Management with Spacing to Parallel Dependent Runways (IMSPiDR1) experiment at NASA Langley Research Center used 24 commercial pilots to examine IM procedures to conduct parallel dependent runway arrival operations while maintaining safe but efficient intervals behind the preceding aircraft. The use of IM procedures during these operations requires a lengthy and complex clearance from Air Traffic Control (ATC) to the participating aircraft, thereby making the use of Controller Pilot Data Link Communications (CPDLC) highly desirable as the communication method. The use of CPDLC reduces the need for voice transmissions between controllers and flight crew, and enables automated transfer of IM clearance elements into flight management systems or other aircraft avionics. The result is reduced crew workload and an increase in the efficiency of crew procedures. This paper focuses on the subset of data collected related to the use of CPDLC for IM operations into a busy airport. Overall, the experiment and results were very successful, with the mean time under 43 seconds for the flight crew to load the clearance into the IM spacing tool, review the calculated speed, and respond to ATC. An overall mean rating of Moderately Agree was given when the crews were asked if the use of CPDLC was operationally acceptable as simulated in this experiment. Approximately half of the flight crew reported the use of CPDLC below 10,000 for IM operations was unacceptable, with 83% reporting below 5000 was unacceptable. Also described are proposed modifications to the IM operations that may reduce CPDLC Respond time to less than 30 seconds and should significantly reduce the complexity of crew procedures, as well as follow-on research issues for operational use of CPDLC during IM operations.

NASA information resources management handbook

NASA Technical Reports Server (NTRS)

1992-01-01

This National Aeronautics and Space Administration (NASA) Handbook (NHB) implements recent changes to Federal laws and regulations involving the acquisition, management, and use of Federal Information Processing (FIP) resources. This document defines NASA's Information Resources Management (IRM) practices and procedures and is applicable to all NASA personnel. The dynamic nature of the IRM environment requires that the controlling management practices and procedures for an Agency at the leading edge of technology, such as NASA, must be periodically updated to reflect the changes in this environment. This revision has been undertaken to accommodate changes in the technology and the impact of new laws and regulations dealing with IRM. The contents of this document will be subject to a complete review annually to determine its continued applicability to the acquisition, management, and use of FIP resources by NASA. Updates to this document will be accomplished by page changes. This revision cancels NHB 2410.1D, dated April 1985.

Principles of Burn Pain Management.

PubMed

James, Dominika Lipowska; Jowza, Maryam

2017-10-01

This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options. A brief synopsis of the principles of outpatient pain management is provided. Copyright © 2017 Elsevier Inc. All rights reserved.

Severe gastric variceal bleeding successfully treated by emergency splenic artery embolization.

PubMed

Sankararaman, Senthilkumar; Velayuthan, Sujithra; Vea, Romulo; Herbst, John

2013-06-01

Bleeding from gastric varices due to splenic vein obstruction is extremely rare in children, but it can be catastrophic. Reported herein is the case of a teenager with splenic vein thrombosis and chronic decompensated liver disease from autoimmune hepatitis who presented with massive gastric variceal bleeding. Standard medical management did not control the bleeding. Due to decompensated liver disease and continuous active bleeding, emergency partial splenic artery embolization was preferred over splenectomy or a shunt procedure. Bleeding was successfully controlled by partial splenic artery embolization by decreasing the inflow of blood into the portal system. It is concluded that emergency partial splenic artery embolization is a safer alternative life-saving procedure to manage severe gastric variceal bleeding due to splenic vein obstruction in a patient with high surgical risk. To our knowledge, only one other patient with similar management has been reported in the pediatric age group. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Cryogenic fluid management in space

NASA Technical Reports Server (NTRS)

Antar, Basil N.

1988-01-01

Many future space based vehicles and satellites will require on orbit refuelling procedures. Cryogenic fluid management technology is being developed to assess the requirements of such procedures as well as to aid in the design and development of these vehicles. Cryogenic fluid management technology for this application could be divided into two areas of study, one is concerned with fluid transfer process and the other with cryogenic liquid storage. This division is based upon the needed technology for the development of each area. In the first, the interaction of fluid dynamics with thermodynamics is essential, while in the second only thermodynamic analyses are sufficient to define the problem. The following specific process related to the liquid transfer area are discussed: tank chilldown and fill; tank pressurization; liquid positioning; and slosh dynamics and control. These specific issues are discussed in relation with the required technology for their development in the low gravity application area. In each process the relevant physics controlling the technology is identified and methods for resolving some of the basic questions are discussed.

An unwanted visitor. Aggressive infection control strategies are needed to shorten the hospital visit of the easily spread norovirus.

PubMed

Albers, Marilyn K

2004-11-01

Norovirus is the name for a group of Norwalk-like viruses that cause acute gastroenteritis of rapid onset. A recent outbreak at a tertiary care facility in Alberta provided an opportunityfor staff and management to review their outbreak protocol and improve their infection prevention and control procedures. The outbreak caused illness in 32 of 73 exposed patients as well as 42 staff members. None of the infected patients or staff developed complications. The source of norovirus contamination was probably associated with a symptomatic food services staff member serving food cafeteria style in a satellite patient dining room. Food service procedures and serving techniques were reviewed; although no breaks in technique were identified, correct food handling procedures were reviewed with staff. Subsequent patient and staff cases were probably related to the cross contamination of environmental surfaces and patient care equipment. The director of nursing and the infection control practitioner led the investigation and management of the outbreak. An Outbreak Management Committee was also formed to reinforce routine infection prevention practices and implement infection control strategies. Communication strategies for staff, patients and visitors were quickly devised and implemented. Gaps in the outbreak protocol were identified and resolved promptly Four permanent changes were made: the use of alcohol hand rinse in designated locations; the development of a comprehensive e-mail to facilitate site-wide communication; the development of teamwork checklists and accountabilities; and the establishment of criteria for use in outbreak situations to proactively determine essential and non-essential therapies and treatments.

Validation of laser-guided variable-rate sprayer for managing insects in ornamental nurseries

USDA-ARS?s Scientific Manuscript database

Conducting on-farm evaluations of pest control and economic feasibility is a necessary procedure to assure successful adoption of new spray technologies by commercial horticulture enterprises. A newly developed laser-guided air-assisted variable-rate sprayer was tested for control of spirea aphids (...

77 FR 29918 - Proposed Amendment of Class E Airspace; Battle Creek, MI

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

... airspace is necessary to accommodate new Standard Instrument Approach Procedures (SIAP) at W. K. Kellogg.... Kellogg Airport, Battle Creek, MI. Controlled airspace is needed for the safety and management of IFR... controlled airspace at W.K. Kellogg Airport, Battle Creek, MI. Environmental Review This proposal will be...

40 CFR 272.201 - Arkansas State-administered program: Final authorization.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Arkansas Pollution Control and Ecology (APC&E) Commission Regulation No. 23, Hazardous Waste Management, as... Three, Sections 19 and 21, 22; Chapter Five, Section 28. (x) Arkansas Pollution Control and Ecology (APC... Ecology (APC&E) Commission, Regulation No. 8, Administrative Procedures, June 12, 2000. (3) The following...

40 CFR 272.201 - Arkansas State-administered program: Final authorization.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Arkansas Pollution Control and Ecology (APC&E) Commission Regulation No. 23, Hazardous Waste Management, as... Three, Sections 19 and 21, 22; Chapter Five, Section 28. (x) Arkansas Pollution Control and Ecology (APC... Ecology (APC&E) Commission, Regulation No. 8, Administrative Procedures, June 12, 2000. (3) The following...

40 CFR 272.201 - Arkansas State-administered program: Final authorization.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Arkansas Pollution Control and Ecology (APC&E) Commission Regulation No. 23, Hazardous Waste Management, as... Three, Sections 19 and 21, 22; Chapter Five, Section 28. (x) Arkansas Pollution Control and Ecology (APC... Ecology (APC&E) Commission, Regulation No. 8, Administrative Procedures, June 12, 2000. (3) The following...

40 CFR 272.201 - Arkansas State-administered program: Final authorization.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Arkansas Pollution Control and Ecology (APC&E) Commission Regulation No. 23, Hazardous Waste Management, as... Three, Sections 19 and 21, 22; Chapter Five, Section 28. (x) Arkansas Pollution Control and Ecology (APC... Ecology (APC&E) Commission, Regulation No. 8, Administrative Procedures, June 12, 2000. (3) The following...

28 CFR 541.61 - Standard for placement in controlled housing status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Standard for placement in controlled housing status. 541.61 Section 541.61 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive...

28 CFR 541.61 - Standard for placement in controlled housing status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Standard for placement in controlled housing status. 541.61 Section 541.61 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive...

28 CFR 541.61 - Standard for placement in controlled housing status.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Standard for placement in controlled housing status. 541.61 Section 541.61 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive...

28 CFR 541.61 - Standard for placement in controlled housing status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Standard for placement in controlled housing status. 541.61 Section 541.61 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive...

28 CFR 541.61 - Standard for placement in controlled housing status.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Standard for placement in controlled housing status. 541.61 Section 541.61 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive...

Skill sets required for the management of military head, face and neck trauma: a multidisciplinary consensus statement.

PubMed

Breeze, John; Blanch, R; Baden, J; Monaghan, A M; Evriviades, D; Harrisson, S E; Roberts, S; Gibson, A; MacKenzie, N; Baxter, D; Gibbons, A J; Heppell, S; Combes, J G; Rickard, R F

2018-05-01

The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma. A multidisciplinary consensus group was convened following this with military HFN trauma expertise to define those procedures commonly required to conduct deployed, in-theatre HFN surgical combat trauma management. Head, face, neck and eye damage control surgical procedures were identified as comprising surgical cricothyroidotomy, cervico-facial haemorrhage control and decompression of orbital haemorrhage through lateral canthotomy. Acute in-theatre surgical skills required within 24 hours consist of wound debridement, surgical tracheostomy, decompressive craniectomy, intracranial pressure monitor placement, temporary facial fracture stabilisation for airway management or haemorrhage control and primary globe repair. Delayed in-theatre procedures required within 5 days prior to predicted evacuation encompass facial fracture fixation, delayed lateral canthotomy, evisceration, enucleation and eyelid repair. The identification of those skill sets required for deployment is in keeping with the General Medical Council's current drive towards credentialing consultants, by which a consultant surgeon's capabilities in particular practice areas would be defined. Limited opportunities currently exist for trainees and consultants to gain experience in the management of traumatic head, face, neck and eye injuries seen in a kinetic combat environment. Predeployment training requires that the surgical techniques described in this paper are covered and should form the curriculum of future military-specific surgical fellowships. Relevant continued professional development will be necessary to maintain required clinical competency. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines

PubMed Central

Kim, Yeesuk; Cho, Hong-Man; Park, Kyung-Soon; Yoon, Pil Whan; Nho, Jae-Hwi; Kim, Sang-Min; Lee, Kyung-Jae; Moon, Kyong-Ho

2016-01-01

Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty. PMID:27536639

Using NetMaster to manage IBM networks

NASA Technical Reports Server (NTRS)

Ginsburg, Guss

1991-01-01

After defining a network and conveying its importance to support the activities at the JSC, the need for network management based on the size and complexity of the IBM SNA network at JSC is demonstrated. Network Management consists of being aware of component status and the ability to control resources to meet the availability and service needs of users. The concerns of the user are addressed as well as those of the staff responsible for managing the network. It is explained how NetMaster (a network management system for managing SNA networks) is used to enhance reliability and maximize service to SNA network users through automated procedures. The following areas are discussed: customization, problem and configuration management, and system measurement applications of NetMaster. Also, several examples are given that demonstrate NetMaster's ability to manage and control the network, integrate various product functions, as well as provide useful management information.

Functional Gap Analysis of the Maritime Operations Centers

DTIC Science & Technology

2009-12-01

Messaging Services TBMCS , DJC2 MI.1.3.5 Manage Suspense Control Capability Gap MI.1.3.6 Provide Component IM Cell Services Capability Gap MI.1.4 Provide...Admin Support MSRT MI.1.3.3 Manage Electronic File Plan Capability Gap MI.1.3.4 Manage Messaging Services TBMCS , DJC2 MI.1.3.5 Manage Suspense...1.5.9 Execute C4 Policies & Procedures for the Joint Operations Area GCCS-J, DCGS-N, TBMCS , CENTRIX-M EHQ.1.11 Sub Component Interagency

Endoscopic and laparoscopic treatment of gastroesophageal reflux.

PubMed

Watson, David I; Immanuel, Arul

2010-04-01

Gastroesophageal reflux is extremely common in Western countries. For selected patients, there is an established role for the surgical treatment of reflux, and possibly an emerging role for endoscopic antireflux procedures. Randomized trials have compared medical versus surgical management, laparoscopic versus open surgery and partial versus total fundoplications. However, the evidence base for endoscopic procedures is limited to some small sham-controlled studies, and cohort studies with short-term follow-up. Laparoscopic fundoplication has been shown to be an effective antireflux operation. It facilitates quicker convalescence and is associated with fewer complications, but has a similar longer term outcome compared with open antireflux surgery. In most randomized trials, antireflux surgery achieves at least as good control of reflux as medical therapy, and these studies support a wider application of surgery for the treatment of moderate-to-severe reflux. Laparoscopic partial fundoplication is an effective surgical procedure with fewer side effects, and it may achieve high rates of patient satisfaction at late follow-up. Many of the early endoscopic antireflux procedures have failed to achieve effective reflux control, and they have been withdrawn from the market. Newer procedures have the potential to fashion a surgical fundoplication. However, at present there is insufficient evidence to establish the safety and efficacy of endoscopic procedures for the treatment of gastroesophageal reflux, and no endoscopic procedure has achieved equivalent reflux control to that achieved by surgical fundoplication.

[Quality management in emergency departments: Lack of uniform standards for fact-based controlling].

PubMed

Ries, M; Christ, M

2015-11-01

The general high occupancy of emergency departments during the winter months of 2014/2015 outlined deficits in health politics. Whether on the regional, province, or federal level, verifiable and accepted figures to enable in depth analysis and fact-based controlling of emergency care systems are lacking. As the first step, reasons for the current situation are outlined in order to developed concrete recommendations for individual hospitals. This work is based on a selective literature search with focus on quality management, ratio driven management, and process management within emergency departments as well as personal experience with implementation of a key ratio system in a German maximum care hospital. The insufficient integration of emergencies into the DRG systematic, the role as gatekeeper between inpatient and outpatient care sector, the decentralized organization of emergency departments in many hospitals, and the inconsistent representation within the medical societies can be mentioned as reasons for the lack of key ratio systems. In addition to the important role within treatment procedures, emergency departments also have an immense economic importance. Consequently, the management of individual hospitals should promote implementation of key ratio systems to enable controlling of emergency care processes. Thereby the perspectives finance, employees, processes as well as partners and patients should be equally considered. Within the process perspective, milestones could be used to enable detailed controlling of treatment procedures. An implementation of key ratio systems without IT support is not feasible; thus, existing digital data should be used and future data analysis should already be considered during implementation of new IT systems.

A cost analysis of stenting in uncomplicated semirigid ureteroscopic stone removal.

PubMed

Seklehner, Stephan; Sievert, Karl-Dietrich; Lee, Richard; Engelhardt, Paul F; Riedl, Claus; Kunit, Thomas

2017-05-01

To evaluate the outcome and the costs of stenting in uncomplicated semirigid ureteroscopic stone removal. A decision tree model was created to evaluate the economic impact of routine stenting versus non-stenting strategies in uncomplicated ureteroscopy (URS). Probabilities of complications were extracted from twelve randomized controlled trials. Stone removal costs, costs for complication management, and total costs were calculated using Treeage Pro (TreeAge Pro Healthcare version 2015, Software, Inc, Williamstown Massachusetts, USA). Stone removal costs were higher in stented URS (€1512.25 vs. €1681.21, respectively). Complication management costs were higher in non-stented procedures. Both for complications treated conservatively (€189.43 vs. €109.67) and surgically (€49.26 vs. €24.83). When stone removal costs, costs for stent removal, and costs for complication management were considered, uncomplicated URS with stent placement yielded an overall cost per patient of €1889.15 compared to €1750.94 without stent placement. The incremental costs of stented URS were €138.25 per procedure. Semirigid URS with stent placement leads to higher direct procedural costs. Costs for managing URS-related complications are higher in non-stented procedures. Overall, a standard strategy of deferring routine stenting uncomplicated ureteroscopic stone removal is more cost efficient.

A Hybrid Procedural/Deductive Executive for Autonomous Spacecraft

NASA Technical Reports Server (NTRS)

Pell, Barney; Gamble, Edward B.; Gat, Erann; Kessing, Ron; Kurien, James; Millar, William; Nayak, P. Pandurang; Plaunt, Christian; Williams, Brian C.; Lau, Sonie (Technical Monitor)

1998-01-01

The New Millennium Remote Agent (NMRA) will be the first AI system to control an actual spacecraft. The spacecraft domain places a strong premium on autonomy and requires dynamic recoveries and robust concurrent execution, all in the presence of tight real-time deadlines, changing goals, scarce resource constraints, and a wide variety of possible failures. To achieve this level of execution robustness, we have integrated a procedural executive based on generic procedures with a deductive model-based executive. A procedural executive provides sophisticated control constructs such as loops, parallel activity, locks, and synchronization which are used for robust schedule execution, hierarchical task decomposition, and routine configuration management. A deductive executive provides algorithms for sophisticated state inference and optimal failure recover), planning. The integrated executive enables designers to code knowledge via a combination of procedures and declarative models, yielding a rich modeling capability suitable to the challenges of real spacecraft control. The interface between the two executives ensures both that recovery sequences are smoothly merged into high-level schedule execution and that a high degree of reactivity is retained to effectively handle additional failures during recovery.

The efficacy and safety of using cooled radiofrequency in treating chronic sacroiliac joint pain

PubMed Central

Sun, Hui-Hui; Zhuang, Su-Yang; Hong, Xin; Xie, Xin-Hui; Zhu, Lei; Wu, Xiao-Tao

2018-01-01

Abstract Background: Cooled radiofrequency procedure is a novel minimally invasive surgical technique and has been occasionally utilized in managing chronic sacroiliac joint (SIJ) pain. A meta-analysis was conducted to systematically assess the efficacy and safety of using cooled radiofrequency in treating patients with chronic SIJ pain in terms of pain and disability relief, patients’ satisfaction degree as well as complications. Methods: Studies of using cooled radiofrequency procedure in managing SIJ pain were retrieved from Medline and Web of Science according to inclusion and exclusion criteria. Quality evaluation was conducted using Cochrane collaboration tool for randomized controlled trials and MINORS quality assessment for noncomparative trials. Statistics were managed using Review Manager 5.3. Results: Totally 7 studies with 240 eligible patients were enrolled. The overall pooled results demonstrated that pain intensity decreased significantly after cooled radiofrequency procedure compared with that measured before treatment. The mean difference (MD) was 3.81 [95% confidence intervals (95% CIs): 3.29–4.33, P < .001] and 3.78 (95% CIs: 3.31–4.25, P < .001) as measured by the Numerical Rating Scale (NRS) and Visual Analog Scale (VAS), respectively. Disability also relieved significantly after treatment compared with that measured before treatment. The MD was 18.2 (95% CIs: 12.22–24.17, P < .001) as measured by the Oswestry Disability Index (ODI). Seventy-two percent of the patients presented positive results as measured by the Global Perceived Effect (GPE). The OR was 0.01 (95% CIs: 0.00–0.05, P < .001). Only mild complications were observed in the 7 studies, including transient hip pain, soreness, and numbness. Conclusion: Cooled radiofrequency procedure can significantly relieve pain and disability with no severe complications, and majority of patients are satisfied with this technique. Thus, it is safe and effective to use this procedure in managing patients with chronic SIJ pain. More high-quality and large-scale randomized controlled trials (RCTs) are required to validate our findings. Limitations: The sample size of the included studies was small and various heterogeneity existed. PMID:29419679

Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study.

PubMed

Khadra, Christelle; Ballard, Ariane; Déry, Johanne; Paquin, David; Fortin, Jean-Simon; Perreault, Isabelle; Labbe, David R; Hoffman, Hunter G; Bouchard, Stéphane; LeMay, Sylvie

2018-01-01

Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics. We recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals. The projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy.

Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study

PubMed Central

Khadra, Christelle; Ballard, Ariane; Déry, Johanne; Paquin, David; Fortin, Jean-Simon; Perreault, Isabelle; Labbe, David R; Hoffman, Hunter G; Bouchard, Stéphane

2018-01-01

Background Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. Aim We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. Methods From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics. Results We recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals. Conclusion The projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy. PMID:29491717

Vocal local versus pharmacological treatments for pain management in tubal ligation procedures in rural Kenya: a non-inferiority trial.

PubMed

Keogh, Sarah C; Fry, Kenzo; Mbugua, Edwin; Ayallo, Mark; Quinn, Heidi; Otieno, George; Ngo, Thoai D

2014-02-04

Vocal local (VL) is a non-pharmacological pain management technique for gynecological procedures. In Africa, it is usually used in combination with pharmacological analgesics. However, analgesics are associated with side-effects, and can be costly and subject to frequent stock-outs, particularly in remote rural settings. We compared the effectiveness of VL + local anesthesia + analgesics (the standard approach), versus VL + local anesthesia without analgesics, on pain and satisfaction levels for women undergoing tubal ligations in rural Kenya. We conducted a site-randomised non-inferiority trial of 884 women receiving TLs from 40 Marie Stopes mobile outreach sites in Kisii and Machakos Districts. Twenty sites provided VL + local anesthesia + analgesics (control), while 20 offered VL + local anesthesia without additional analgesics (intervention). Pain was measured using a validated 11-point Numeric Rating Scale; satisfaction was measured using 11-point scales. A total of 461 women underwent tubal ligations with VL + local anesthesia, while 423 received tubal ligations with VL + local anesthesia + analgesics. The majority were aged ≥30 years (78%), and had >3 children (99%). In a multivariate analysis, pain during the procedure was not significantly different between the two groups. The pain score after the procedure was significantly lower in the intervention group versus the control group (by 0.40 points; p = 0.041). Satisfaction scores were equally high in both groups; 96% would recommend the procedure to a friend. VL + local anesthesia is as effective as VL + local anesthesia + analgesics for pain management during tubal ligation in rural Kenya. Avoiding analgesics is associated with numerous benefits including cost savings and fewer issues related to the maintenance, procurement and monitoring of restricted opioid drugs, particularly in remote low-resource settings where these systems are weak. Pan-African Clinical Trials Registry PACTR201304000495942.

Lower-extremity peripheral nerve blocks in the perioperative pain management of orthopaedic patients: AAOS exhibit selection.

PubMed

Stein, Benjamin E; Srikumaran, Umasuthan; Tan, Eric W; Freehill, Michael T; Wilckens, John H

2012-11-21

The utilization of peripheral nerve blocks in orthopaedic surgery has paralleled the rise in the number of ambulatory surgical procedures performed. Optimization of pain control in the perioperative orthopaedic patient contributes to improved patient satisfaction, early mobilization, decreased length of hospitalization, and decreased associated hospital and patient costs. Our purpose was to provide a concise, pertinent review of the use of peripheral nerve blocks in various orthopaedic procedures of the lower extremity, with specific focus on procedural anatomy, indications, patient outcome measures, and complications. We reviewed the literature and reference textbooks on commonly performed lower-extremity peripheral nerve block procedures in orthopaedic surgery, focusing on those most commonly used. The use of lower-extremity peripheral nerve blocks is a safe and effective approach to perioperative pain management. Different techniques and timing can have an important impact on patient satisfaction, and each technique has specific indications and complications. For major hip surgery, one of the most commonly used is the lumbar plexus block, which can result in early mobilization, reduced postoperative pain, and decreased opioid-associated adverse events. Associated complications include epidural spread of anesthesia, retroperitoneal hematoma formation, and postoperative falls. For arthroscopic and open knee procedures, the femoral nerve block is frequently used adjunctively. It provides improved early postoperative pain control, early mobilization with therapy, and increased patient satisfaction compared with intra-articular or intravenous opioids alone; it also provides cost savings. However, some studies have shown no significant difference in outcome measures compared with intra-articular opioids alone for arthroscopic anterior cruciate ligament reconstruction. Associated complications include nerve injury, intravascular injection, and postoperative falls. The use of peripheral nerve blocks in lower-extremity surgery is becoming a mainstay of perioperative pain management strategy.

[Prompt control of an imported carbapenem-resistant Acinetobacter baumanii outbreak in a French intensive care unit].

PubMed

Guth, C; Cavalli, Z; Pernod, C; Lhopital, C; Wey, Pf; Gerome, P; Turc, J

2016-01-01

to describe the management and control of a limited outbreak of carbapenem-resistant Acinetobacter baumanii (CRAB) outbreak in a French intensive care unit. Careful review of the contact's and carrier's files and outbreak management procedures. An undiagnosed CRAB carrier was admitted to our intensive care unit after medical evacuation from Turkey. Despite preventive isolation and contact precautions, a secondary case was diagnosed 5 days after admission of the index case and resulted in the creation of a crisis unit. Prompt management included an epidemiologic investigation with contact screening and follow-up, environmental screening, and additional restrictive measures: isolation room, closure of adjacent rooms, patient cohorting with designated nurses, and reinforcement of contact precautions. restrictive management of CRAB outbreaks may allow prompt outbreak control and avoid prolonged room closures.

Step 1: Human System Integration (HSI) FY05 Pilot-Technology Interface Requirements for Contingency Management

NASA Technical Reports Server (NTRS)

2005-01-01

This document involves definition of technology interface requirements for Contingency Management. This was performed through a review of Contingency Management-related, HSI requirements documents, standards, and recommended practices. Technology concepts in use by the Contingency Management Work Package were considered. Beginning with HSI high-level functional requirements for Contingency Management, and Contingency Management technology elements, HSI requirements for the interface to the pilot were identified. Results of the analysis describe (1) the information required by the pilot to have knowledge of system failures and associated contingency procedures, and (2) the control capability needed by the pilot to obtain system status and procedure information. Fundamentally, these requirements provide the candidate Contingency Management technology concepts with the necessary human-related elements to make them compatible with human capabilities and limitations. The results of the analysis describe how Contingency Management operations and functions should interface with the pilot to provide the necessary Contingency Management functionality to the UA-pilot system. Requirements and guidelines for Contingency Management are partitioned into four categories: (1) Health and Status and (2) Contingency Management. Each requirement is stated and is supported with a rationale and associated reference(s).

Specific and Nonspecific Factors in the Effectiveness of a Behavioral Approach to the Treatment of Marital Discord.

ERIC Educational Resources Information Center

Jacobson, Neil S.

1978-01-01

Compared two behavioral treatments for marital discord with a nonspecific control and waiting-list control. Behavioral treatments combined problem-solving skills with contingency management procedures, differing only in contracting form, good faith contracts, and quid pro quo contracts. Both behavioral groups improved significantly more than…

Controlled burning in the western white pine type

Treesearch

Kenneth P. Davis; Karl A. Klehm

1939-01-01

Controlled burning admittedly is a highly controversial procedure, but the authors show that under certain conditions when adequate precautionary measures are taken it has a definite place in western white pine forest management. More important still, the authors describe the conditions under which it is useful, the precautionary measures that must he taken, the...

Internal Controls for Accounting Areas. Alliance Action Information Sheets

ERIC Educational Resources Information Center

Technical Assistance ALLIANCE for Parent Centers, 2006

2006-01-01

Internal controls are important to ensure your Parent Center's resources are well protected. Steps should be taken to ensure that finance transactions are authorized by management, executed properly and on time, and recorded appropriately. Some centers may not have staff with all of the titles used in the procedures presented in this paper.…

14 CFR Special Federal Aviation... - Air Traffic Control System Emergency Operation

Code of Federal Regulations, 2010 CFR

2010-01-01

..., prohibition, procedure or other action taken by the Director of the Office of Air Traffic Systems Management... is necessary for the safety and efficiency of the National Airspace System. Upon activation of the... Control system will be announced in Notices to Airmen issued pursuant to § 91.139 of the Federal Aviation...

[The "Würzburg T". A concept for optimization of early multiple trauma care in the emergency department].

PubMed

Kuhnigk, H; Steinhübel, B; Keil, T; Roewer, N

2004-07-01

Anaesthesia management, radiological diagnostic and the concept of damage control surgery should be combined in the resuscitation room. Defined clinical targets and their realisation are a CT-scan and complete damage control surgery in the shock room. Furthermore minimised patient transfer and positioning with continuous access to the head, upper parts of the body and anaesthesia machine should be realised during diagnostic procedures. Based on a carbon-slide fixed on a turntable and innovative alignment of diagnostic devices, a three phase treatment algorithm has been established. Phase A includes primary survey, anaesthetic management and ultrasound examination. Following a turn of the table conventional x-ray diagnostic is assessed in phase B. Tracks for the slide enable immediate transfer to a spiral CT-scan without additional patient positioning (phase C). Following complete CT-scan rearrangement of the table to phase A facilitates immediate damage control surgery. To accelerate device operation and treatment the integrated anaesthesia workstation is ceiling-mounted and manoeuvres close to the patient. This concept realizes complete diagnostic procedures and damage control surgery without time consuming patient transfer or rearrangement.

34 CFR 691.16 - Rigorous secondary school program of study.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MATHEMATICS ACCESS TO RETAIN TALENT GRANT (NATIONAL SMART GRANT) PROGRAMS Application Procedures § 691.16..., 2009. (Approved by the Office of Management and Budget under control number 1845-0078] (Authority: 20 U...

75 FR 30368 - Proposed Information Collection; Comment Request; Foreign Availability Procedures and Criteria

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... the control ineffective. II. Method of Collection Submitted electronically or in paper form. III. Data... record. Dated: May 25, 2010. Gwellnar Banks, Management Analyst, Office of the Chief Information Officer...

24 CFR 203.368 - Claims without conveyance procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... market value in accordance with paragraph (e), the Commissioner may require the mortgagee to advertise... of Management and Budget under control number 2502-0347) [52 FR 1327, Jan. 13, 1987, as amended at 61...

A review of human-automation interaction and lessons learned

DOT National Transportation Integrated Search

2006-10-01

This report reviews 37 accidents in aviation, other vehicles, process control and other complex systems where human-automation interaction is involved. Implications about causality with respect to design, procedures, management and training are drawn...

PC based temporary shielding administrative procedure (TSAP)

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

Olsen, D.E.; Pederson, G.E.; Hamby, P.N.

1995-03-01

A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison`s six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative proceduremore » and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met.« less

The Design of Management Practices To Improve the Physical Plant Maintenance of Southwest Texas Junior College.

ERIC Educational Resources Information Center

Box, Wilford Winston

A study was conducted of the physical plant maintenance department (PPMD) of Southwest Texas Junior College (SWTJC), in order to determine if the department was structured as a functional organization, if maintenance control procedures were in place, and if efficient management practices were being used. Consultations with the director of the PPMD…

Writing standard operating procedures (SOPs) for cryostorage protocols: using shoot meristem cryopreservation as an example.

PubMed

Harding, Keith; Benson, Erica E

2015-01-01

Standard operating procedures are a systematic way of making sure that biopreservation processes, tasks, protocols, and operations are correctly and consistently performed. They are the basic documents of biorepository quality management systems and are used in quality assurance, control, and improvement. Methodologies for constructing workflows and writing standard operating procedures and work instructions are described using a plant cryopreservation protocol as an example. This chapter is pertinent to other biopreservation sectors because how methods are written, interpreted, and implemented can affect the quality of storage outcomes.

Defense Commissary Resale Stock Fund Financial Statements For FY 1992

DTIC Science & Technology

1993-06-30

present DeCA’s accounting procedures during FY 1992. We understand DeCA is aggressively working to improve its financial management system. However...the year ended September 30, 1992, we considered the related internal control structure. The purpose of the planning work was to determine the...auditing procedures we would apply for the purposes of expressing our opinion on the Financial Statements. Planning work included obtaining an

Antecedent control in the treatment of brain-injured clients.

PubMed

Zencius, A H; Wesolowski, M D; Burke, W H; McQuade, P

1989-01-01

Three brain-injured clients failed to respond significantly to consequence management programmes designed to increase attendance, use of a cane, and to reduce unauthorized breaks. When antecedent stimulus control procedures were applied, attendance and use of a cane increased and unauthorized breaks decreased. The study shows that antecedent control may be the treatment of choice when treating brain-injured clients with memory loss.

Current biomedical waste management practices and cross-infection control procedures of dentists in India.

PubMed

Singh, Balendra Pratap; Khan, Suleman A; Agrawal, Neeraj; Siddharth, Ramashanker; Kumar, Lakshya

2012-06-01

To investigate the knowledge, attitudes and behaviour of dentists working in dental clinics and dental hospitals regarding biomedical waste management and cross-infection control. A national survey was conducted. Self-administered questionnaires were sent to 800 dentists across India. A total of 494 dentists responded, giving a response rate of 61.8%. Of these, 228 of 323 (70.6%) general dentists reported using boiling water as a sterilising medium and 339 (68.6%) dentists reported disposing of hazardous waste such as syringes, blades and ampoules in dustbins and emptying these into municipal corporation bins. Dentists should undergo continuing education programmes on biomedical waste management and infection control guidelines. Greater cooperation between dental clinics and hospitals and pollution control boards is needed to ensure the proper handling and disposal of biomedical waste. © 2012 FDI World Dental Federation.

Management of neurosurgical instruments and patients exposed to Creutzfeldt-Jakob disease.

PubMed

Belay, Ermias D; Blase, Jennifer; Sehulster, Lynne M; Maddox, Ryan A; Schonberger, Lawrence B

2013-12-01

To summarize the approaches used to manage exposure of patients to inadequately sterilized neurosurgical instruments contaminated as a result of Creutzfeldt-Jakob disease (CJD). Information on past CJD exposure incidents reported to the Centers for Disease Control and Prevention (CDC) was aggregated and summarized. In addition, inactivation studies were reviewed, and data from selected publications were provided for reference. Nineteen incidents of patient exposure to potentially CJD-contaminated instruments were reported to the CDC, including 17 that involved intracranial procedures and 2 that involved ophthalmologic procedures. In more than 50% of incidents, the neurosurgical procedures were performed for diagnostic work up of the index patients. At least 12 of the hospitals had multiple neurosurgical sets, and the CJD-contaminated instruments could not be identified in 11 of 19 hospitals. In 12 of 15 hospitals with neurosurgical incidents, a decision was made to notify patients of their potential exposure. Neurosurgical instruments used for treatment of patients with suspected or diagnosed CJD or patients whose diagnosis is unclear should be promptly identified and sterilized using recommended CJD decontamination protocols. Inability to trace instruments complicates appropriate management of exposure incidents. The feasibility of instituting instrument tracking procedures should be considered.

Management of Neurosurgical Instruments and Patients Exposed to Creutzfeldt-Jakob Disease

PubMed Central

Belay, Ermias D.; Blase, Jennifer; Sehulster, Lynne M.; Maddox, Ryan A.; Schonberger, Lawrence B.

2015-01-01

OBJECTIVE To summarize the approaches used to manage exposure of patients to inadequately sterilized neurosurgical instruments contaminated as a result of Creutzfeldt-Jakob disease (CJD). METHODS Information on past CJD exposure incidents reported to the Centers for Disease Control and Prevention (CDC) was aggregated and summarized. In addition, inactivation studies were reviewed, and data from selected publications were provided for reference. RESULTS Nineteen incidents of patient exposure to potentially CJD-contaminated instruments were reported to the CDC, including 17 that involved intracranial procedures and 2 that involved ophthalmologic procedures. In more than 50% of incidents, the neurosurgical procedures were performed for diagnostic work up of the index patients. At least 12 of the hospitals had multiple neurosurgical sets, and the CJD-contaminated instruments could not be identified in 11 of 19 hospitals. In 12 of 15 hospitals with neurosurgical incidents, a decision was made to notify patients of their potential exposure. CONCLUSIONS Neurosurgical instruments used for treatment of patients with suspected or diagnosed CJD or patients whose diagnosis is unclear should be promptiy identified and sterilized using recommended CJD decontamination protocols. Inability to trace instruments complicates appropriate management of exposure incidents. The feasibility of instituting instrument tracking procedures should be considered. PMID:24225612

Fishery management problems and possibilities on large southeastern reservoirs

USGS Publications Warehouse

Parsons, John W.

1958-01-01

In recognition of these problems, the development and application of sound management procedures may be accomplished by controlling species composition and availability of fish through water level control, timber clearing, application of selective toxicants, commercial fishing, introduction of new fish species, and the management of tailwaters and tributaries. Extended research and interagency cooperation are necessary to properly develop and apply sound management. Promotion of angling and regulation of the fishery may best be realized by providing adequate fishing facilities, elimination of certain restricted areas, and in some cases revision of laws and regulations. Biologists must not only meet the present demands for improved sport fishing but must also balance fish yield by increasing the use of food fish by sport and commercial operations.

Software engineering project management - A state-of-the-art report

NASA Technical Reports Server (NTRS)

Thayer, R. H.; Lehman, J. H.

1977-01-01

The management of software engineering projects in the aerospace industry was investigated. The survey assessed such features as contract type, specification preparation techniques, software documentation required by customers, planning and cost-estimating, quality control, the use of advanced program practices, software tools and test procedures, the education levels of project managers, programmers and analysts, work assignment, automatic software monitoring capabilities, design and coding reviews, production times, success rates, and organizational structure of the projects.

Virtual reality distraction for pain control during periodontal scaling and root planing procedures.

PubMed

Furman, Elena; Jasinevicius, T Roma; Bissada, Nabil F; Victoroff, Kristin Z; Skillicorn, Robert; Buchner, Marc

2009-12-01

Although pain management during periodontal treatment usually is achieved with anesthesia, alternative methods are available. The authors conducted a study to evaluate the analgesic effect of immersive virtual reality (VR) during periodontal scaling and root planing (SRP) procedures. The authors recruited 38 patients. They used a within-patient/split-mouth design. Patients received SRP under three treatment conditions in three quadrants. The three conditions were control, watching a movie and VR. After each SRP procedure, patients responded to questions about their discomfort and/or pain by using a visual analog scale (VAS) (range, 0 to 10 in which lower numbers indicate less pain or discomfort). The authors also recorded patients' blood pressure (BP) and pulse rate (PR). Patients were asked which of the three treatment modalities they preferred. The mean (+/- standard deviation) VAS scores for five questions pertaining to control, movie and VR were 3.95 +/- 2.1, 2.57 +/- 1.8 and 1.76 +/- 1.4, respectively. Paired t tests revealed that VAS scores were significantly lower during VR compared with the movie (P <.001) and control (P <.001) conditions. Similarly, BP and PR were lowest during VR, followed by the movie and control conditions. Patients reported that they preferred the VR condition. The results of this study suggest that use of immersive VR distraction may be an effective method of pain control during SRP procedures. Practitioners can use immersive VR distraction for pain control during SRP procedures.

Risk Management Structured for Today's Environment

NASA Technical Reports Server (NTRS)

Greenfield, Michael A.

1998-01-01

In NPG (NASA Procedures and Guidelines) 7120.5A, we define risk management as "an organized, systematic decision-making process that efficiently identifies, analyzes, plans, tracks, controls, and communicates and documents risk in order to increase the likelihood of achieving program/project goals." Effective risk management depends upon a thorough understanding of the concept of risk, the principles of risk management and the formation of a disciplined risk management process. In human spaceflight programs, NASA has always maintained a rigorous and highly structured risk management effort. When lives are at stake, NASA's missions must be 100% safe; the risk management approach used in human spaceflight has always been comprehensive.

Report: EPA Needs to Strengthen Internal Controls for Determining Workforce Levels

EPA Pesticide Factsheets

Report #11-P-0031, December 20, 2010. EPA’s policies and procedures do not include a process for determining employment levels based on workload as prescribed by the Office of Management and Budget.

NAFTA Revised Procedures for Joint Review of Microbials and Semiochemicals

EPA Pesticide Factsheets

The Canadian Pest Management Regulatory Agency and EPA have established a process for the joint review of pest control products in which the new active ingredient is a microbial or an arthropod semiochemical (including pheromones).

Monitoring rationale, strategy, issues, and methods: UMRR-EMP LTRMP fish component

USGS Publications Warehouse

Ickes, Brian S.; Sauer, Jennifer S.; Rogala, James T.

2014-01-01

The Long Term Resource Monitoring Program (LTRMP), an element of the multiagency partnership Upper Mississippi River Restoration-Environmental Management Program, has been monitoring fishes in the Upper Mississippi River System (UMRS) for over two decades, using scientific and highly standardized methods. Today, the LTRMP’s data assets represent one of the world’s largest and most extensive datasets on a great river. Methods and procedures used over the past two decades have been documented and have proven a key tool towards gaining data that are (a) scientifically valid, (b) comparable over time, and (c) comparable over space. These procedures manuals coordinate and standardize methods, procedures, and field behaviors in the execution of long-term monitoring, permitting the informed management and control of important sources of error actually under program control. As LTRMP databases have matured in scope and accumulated more years' worth of data, their utility in research and management in the UMRS basin has increased notably. To maximize their utility, data users need not only be aware of “how the data were collected,” as portrayed in the procedures manuals, but also “why the data were collected in the way they were, at the scales they were, and in the manner that they were.” Whereas the procedures manuals contribute information as to the “how” the data were gained, this document seeks to contribute information as to the “why.” As such, this document is intended to be a companion document to the procedures manuals. Herein, we present information on the rationale for monitoring nearly one-fifth of the entire North American freshwater fish fauna (representing the greatest freshwater fish diversity on the planet at temperate latitudes); strategies employed and their reasoning; and discussions on issues associated with the sampling design itself, data arising therefrom, and uses of those data in different contexts.

Role of Endoscopic Gastroplasty Techniques in the Management of Obesity.

PubMed

Jung, Yunho

2017-01-01

Health and wellness represent a major global concern. Trends such as a lack of exercise and excessive consumption of calories are major causes of the rapid increase in obesity worldwide. Obesity should be controlled because it can result in other illnesses, such as diabetes, high blood pressure, high cholesterol, coronary artery disease, stroke, breathing disorders, or cancer. However, many people have difficulty in managing obesity through exercise, dietary control, behavioral modifications, and drug therapy. Bariatric surgery is not commonly used due to a variety of complications, even though it has been demonstrated to produce reliable results with respect to adequate weight loss when performed using an open or a laparoscopic approach. Endoscopic bariatric procedures are emerging techniques that are less invasive and safer compared with current surgical approaches. However, the evaluation of endoluminal procedures is limited by the small number of studies and their short-term follow-up.

Nasa Records Disposition Handbook: Procedures Governing the Retention, Retirement, and Destruction of Agency Records

NASA Technical Reports Server (NTRS)

1970-01-01

This handbook sets forth the disposition of official records of the National Aeronautics and Space Administration. Its provisions are applicable to NASA Headquarters and all field installations. This revised edition has been enlarged in scope and re-titled to provide guidance in all aspects of records retirements, transfers, destruction, and retrievals from Federal Records Centers. New records control schedules have been added and others revised. Also included are procedures for making recommendations for improved coverage of records categories by additions or revisions. The NASA Records Control Schedules are issued under authority of the NASA Records Management Officer in accordance with Section 101-11.406, Federal Property Management Regulations. They were approved for NASA use by the National Archives and Records Service, the General Accounting Office, and by the Joint Committee on the Disposition of Executive Papers, U.S. Congress.

Intervention strategies for the management of human error

NASA Technical Reports Server (NTRS)

Wiener, Earl L.

1993-01-01

This report examines the management of human error in the cockpit. The principles probably apply as well to other applications in the aviation realm (e.g. air traffic control, dispatch, weather, etc.) as well as other high-risk systems outside of aviation (e.g. shipping, high-technology medical procedures, military operations, nuclear power production). Management of human error is distinguished from error prevention. It is a more encompassing term, which includes not only the prevention of error, but also a means of disallowing an error, once made, from adversely affecting system output. Such techniques include: traditional human factors engineering, improvement of feedback and feedforward of information from system to crew, 'error-evident' displays which make erroneous input more obvious to the crew, trapping of errors within a system, goal-sharing between humans and machines (also called 'intent-driven' systems), paperwork management, and behaviorally based approaches, including procedures, standardization, checklist design, training, cockpit resource management, etc. Fifteen guidelines for the design and implementation of intervention strategies are included.

International interface design for Space Station Freedom - Challenges and solutions

NASA Technical Reports Server (NTRS)

Mayo, Richard E.; Bolton, Gordon R.; Laurini, Daniele

1988-01-01

The definition of interfaces for the International Space Station is discussed, with a focus on negotiations between NASA and ESA. The program organization and division of responsibilities for the Space Station are outlined; the basic features of physical and functional interfaces are described; and particular attention is given to the interface management and documentation procedures, architectural control elements, interface implementation and verification, and examples of Columbus interface solutions (including mechanical, ECLSS, thermal-control, electrical, data-management, standardized user, and software interfaces). Diagrams, drawings, graphs, and tables listing interface types are provided.

The M68HC11 gripper controller software. Thesis

NASA Technical Reports Server (NTRS)

Tsai, Jodi Wei-Duk

1991-01-01

This thesis discusses the development of firmware for the 68HC11 gripper controller. A general description of the software and hardware interfaces is given. The C library interface for the gripper is then described and followed by a detailed discussion of the software architecture of the firmware. A procedure to assemble and download 68HC11 programs is presented in the form of a tutorial. The tools used to implement this environment are then described. Finally, the implementation of the configuration management scheme used to manage all CIRSSE software is presented.

Management Control Systems in Not-for-Profit Organizations: A Case Study.

DTIC Science & Technology

1982-12-01

UNCLASSIFIED F/G 5/1 NL mhmmhhhhhmhmmum IEIIEEIIIIIEEE EIIIIIIIIIIIIl Diiit 1.1_I220 H- M141116 MICROCOPY RESOLUION4 TEST CHART 14ATIONAL BUREAU Of... test case. C. RESEARCH RET HODS The first phase of the study was a review of current literature on management control procedures and systems in...RESOLUTION TEST CHART NATIONAL BUREAU 0f SIANDARD 96% A I II a U a .1 ii IiU- I! IA i -~ - U I -..................... I I ~ 3 ,’u!nAA~~ -~~j ~; Eu ~ II 8I~ ~B

Information Security Management (ISM)

NASA Astrophysics Data System (ADS)

Šalgovičová, Jarmila; Prajová, Vanessa

2012-12-01

Currently, all organizations have to tackle the issue of information security. The paper deals with various aspects of Information Security Management (ISM), including procedures, processes, organizational structures, policies and control processes. Introduction of Information Security Management should be a strategic decision. The concept and implementation of Information Security Management in an organization are determined by the corporate needs and objectives, security requirements, the processes deployed as well as the size and structure of the organization. The implementation of ISM should be carried out to the extent consistent with the needs of the organization.

Planning and Resource Management in an Intelligent Automated Power Management System

NASA Technical Reports Server (NTRS)

Morris, Robert A.

1991-01-01

Power system management is a process of guiding a power system towards the objective of continuous supply of electrical power to a set of loads. Spacecraft power system management requires planning and scheduling, since electrical power is a scarce resource in space. The automation of power system management for future spacecraft has been recognized as an important R&D goal. Several automation technologies have emerged including the use of expert systems for automating human problem solving capabilities such as rule based expert system for fault diagnosis and load scheduling. It is questionable whether current generation expert system technology is applicable for power system management in space. The objective of the ADEPTS (ADvanced Electrical Power management Techniques for Space systems) is to study new techniques for power management automation. These techniques involve integrating current expert system technology with that of parallel and distributed computing, as well as a distributed, object-oriented approach to software design. The focus of the current study is the integration of new procedures for automatically planning and scheduling loads with procedures for performing fault diagnosis and control. The objective is the concurrent execution of both sets of tasks on separate transputer processors, thus adding parallelism to the overall management process.

The Effectiveness of a Web-Based Resource in Improving Post-Concussion Management in High Schools

PubMed Central

Glang, Ann E.; Koester, Michael C.; Chesnutt, James C.; Gioia, Gerard A.; McAvoy, Karen; Marshall, Sondra; Gau, Jeff M.

2014-01-01

BACKGROUND Because many sports concussions happen during school-sponsored sports events, most state concussion laws specifically hold schools accountable for coach training and effective concussion management practices. Brain 101: The Concussion Playbook is a web-based intervention that includes training in sports concussion for each member of the school community, presents guidelines on creating a concussion management team, and includes strategies for supporting students in the classroom. METHODS The group randomized controlled trial examined the efficacy of Brain 101 in managing sports concussion. Participating high schools (N=25) were randomly assigned to the Brain 101 intervention or control. Fall athletes and their parents completed online training, and Brain 101 school administrators were directed to create concussion management policy and procedures. RESULTS Student athletes and parents at Brain 101 schools significantly outperformed those at control schools on sports concussion knowledge, knowledge application, and behavioral intention to implement effective concussion management practices. Students who had concussions in Brain 101 schools received more varied academic accommodations than students in control schools. CONCLUSIONS Brain 101 can help schools create a comprehensive school-wide concussion management program. It requires minimal expenditures and offers engaging and effective education for teachers, coaches, parents, and students. PMID:25438964

Pacifier and swaddling effective in impeding premature infant's pain score and heart rate.

PubMed

Efendi, Defi; Rustina, Yeni; Gayatri, Dewi

2018-02-01

To assess the effectiveness of pacifier and swaddling on premature infant's pain score, hearthrate, and oxygen saturation during an invasive procedure. This randomized control trial involv 30 premature infants who were randomly assigned into control (n=15) and intervention (n=15) groups using parallel design. Infants in the intervention group received pacifier and swaddling when they were undergoing invasive procedures. The outcome indicators of the two-day intervention were pain score, hearth rate, and oxygen saturation. The Premature Infant Pain Profile (PIPP) was used in this study to measure infants' pain. The paired t-test results showed that the pain score and heart rate were significantly increased following the procedure in the control group (p=0.003; p=0.013 < 0.05); meanwhile, there was no significant increase in the intervention group (p=0.256; p=0.783 > 0.005). There was no significant different in oxygen saturation in the control group (p=0.270) and in the intervention (p=0.370) group before and after the procedure. Providing pacifier and swaddling can impede the increase of premature infants' pain score and hearth rate during an invasive procedures, therefore it can be implemented as an alternative to pain management in premature infants. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

On the design of flight-deck procedures

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, Earl L.

1994-01-01

In complex human-machine systems, operations, training, and standardization depend on a elaborate set of procedures which are specified and mandated by the operational management of the organization. The intent is to provide guidance to the pilots, to ensure a logical, efficient, safe, and predictable means of carrying out the mission objectives. In this report the authors examine the issue of procedure use and design from a broad viewpoint. The authors recommend a process which we call 'The Four P's:' philosophy, policies, procedures, and practices. We believe that if an organization commits to this process, it can create a set of procedures that are more internally consistent, less confusing, better respected by the flight crews, and that will lead to greater conformity. The 'Four-P' model, and the guidelines for procedural development in appendix 1, resulted from cockpit observations, extensive interviews with airline management and pilots, interviews and discussion at one major airframe manufacturer, and an examination of accident and incident reports. Although this report is based on airline operations, we believe that the principles may be applicable to other complex, high-risk systems, such as nuclear power production, manufacturing process control, space flight, and military operations.

How to implement security controls for an information security program at CBRN facilities

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

Lenaeus, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.

This document was prepared by PNNL within the framework of Project 19 of the European Union Chemical Biological Radiological and Nuclear Risk Mitigation Centres of Excellence Initiative entitled, ''Development of procedures and guidelines to create and improve secure information management systems and data exchange mechanisms for CBRN materials under regulatory control.'' It provides management and workers at CBRN facilities, parent organization managers responsible for those facilities, and regulatory agencies (governmental and nongovernmental) with guidance on the best practices for protecting information security. The security mitigation approaches presented in this document were chosen because they present generally accepted guidance in anmore » easy-to-understand manner, making it easier for facility personnel to grasp key concepts and envision how security controls could be implemented by the facility. This guidance is presented from a risk management perspective.« less

[Design of an HACCP program for a cocoa processing facility].

PubMed

López D'Sola, Patrizia; Sandia, María Gabriela; Bou Rached, Lizet; Hernández Serrano, Pilar

2012-12-01

The HACCP plan is a food safety management tool used to control physical, chemical and biological hazards associated to food processing through all the processing chain. The aim of this work is to design a HACCP Plan for a Venezuelan cocoa processing facility.The production of safe food products requires that the HACCP system be built upon a solid foundation of prerequisite programs such as Good Manufacturing Practices (GMP) and Sanitation Standard Operating Procedures (SSOP). The existence and effectiveness of these prerequisite programs were previously assessed.Good Agriculture Practices (GAP) audit to cocoa nibs suppliers were performed. To develop the HACCP plan, the five preliminary tasks and the seven HACCP principles were accomplished according to Codex Alimentarius procedures. Three Critical Control Points (CCP) were identified using a decision tree: winnowing (control of ochratoxin A), roasting (Salmonella control) and metallic particles detection. For each CCP, Critical limits were established, the Monitoring procedures, Corrective actions, Procedures for Verification and Documentation concerning all procedures and records appropriate to these principles and their application was established. To implement and maintain a HACCP plan for this processing plant is suggested. Recently OchratoxinA (OTA) has been related to cocoa beans. Although the shell separation from the nib has been reported as an effective measure to control this chemical hazard, ochratoxin prevalence study in cocoa beans produced in the country is recommended, and validate the winnowing step as well

Statistical Methods in Assembly Quality Management of Multi-Element Products on Automatic Rotor Lines

NASA Astrophysics Data System (ADS)

Pries, V. V.; Proskuriakov, N. E.

2018-04-01

To control the assembly quality of multi-element mass-produced products on automatic rotor lines, control methods with operational feedback are required. However, due to possible failures in the operation of the devices and systems of automatic rotor line, there is always a real probability of getting defective (incomplete) products into the output process stream. Therefore, a continuous sampling control of the products completeness, based on the use of statistical methods, remains an important element in managing the quality of assembly of multi-element mass products on automatic rotor lines. The feature of continuous sampling control of the multi-element products completeness in the assembly process is its breaking sort, which excludes the possibility of returning component parts after sampling control to the process stream and leads to a decrease in the actual productivity of the assembly equipment. Therefore, the use of statistical procedures for continuous sampling control of the multi-element products completeness when assembled on automatic rotor lines requires the use of such sampling plans that ensure a minimum size of control samples. Comparison of the values of the limit of the average output defect level for the continuous sampling plan (CSP) and for the automated continuous sampling plan (ACSP) shows the possibility of providing lower limit values for the average output defects level using the ACSP-1. Also, the average sample size when using the ACSP-1 plan is less than when using the CSP-1 plan. Thus, the application of statistical methods in the assembly quality management of multi-element products on automatic rotor lines, involving the use of proposed plans and methods for continuous selective control, will allow to automating sampling control procedures and the required level of quality of assembled products while minimizing sample size.

Comparative Analysis of Doppler Guided Hemorrhoidal Artery Ligation (DG-HAL) & Infrared Coagulation (IRC) in Management of Hemorrhoids.

PubMed

Ahmad, Arshad; Kant, Rama; Gupta, Avneet

2013-08-01

Both Doppler-guided hemorrhoidal artery ligation (DG-HAL) and infrared coagulation (IRC) are well-established techniques in the management of hemorrhoids. The aim of the study is to compare the clinical outcomes of DG-HAL and IRC in the patients with grade 1 and 2 hemorrhoids. A total of 296 patients were registered for the study, but 51 patients were lost in follow-up; hence, finally 245 patients were included in the analysis. Patients were randomized into two groups (mean age, 42 years; range, 19-60 years). Group A (n = 116) was treated with DG-HAL and group B (n = 129) was treated with IRC. Patients were examined at 1 week, 1 month, and 6 months after the procedure. Mean time taken for HAL was 21 min and for IRC, 12 min. The cost of the DG-HAL procedure was 1,440 rupees ($31.53) and that of IRC was 376 rupees ($8). The mean duration of hospital stay after HAL was 6 h and after IRC, 2 h. Control of symptoms with HAL was 96 %, whereas with IRC, 81 %. Postoperative complication rate for HAL was 2 %, whereas for IRC, 13 %. Requirement of repeat procedure with HAL was 9 % and with IRC, 28 %. Both the procedures are minimally invasive, associated with minimal discomfort, and suitable for day care surgery. IRC requires lesser procedure time, lesser postoperative hospital stay, and has lower procedure cost, whereas DG-HAL is more effective in controlling symptoms of hemorrhoids, has lower post operative complication rate, and has lesser requirement of repeat procedure.

Standard operating procedures improve acute neurologic care in a sub-Saharan African setting

PubMed Central

Jaiteh, Lamin E.S.; Helwig, Stefan A.; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman

2017-01-01

Objective: Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Methods: Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. Results: At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p < 0.05) and assessments of respiratory rate (98.0% vs 81.9%, p < 0.001), temperature (60.0% vs 36.2%; p < 0.001), and glucose levels (73.0% vs 58.1%; p < 0.05), in addition to written directives by physicians (96.0% vs 88.6%, p < 0.05), whereas assessments of other vital signs remained unchanged. In stroke patients, rates of stroke-related procedures increased: early CT scanning (24.3% vs 9.9%; p < 0.05), blood count (73.0% vs 49.3%; p < 0.01), renal and liver function tests (50.0% vs 5.6%, p < 0.001), aspirin prophylaxis (47.3% vs 9.9%; p < 0.001), and physiotherapy (41.9% vs 4.2%; p < 0.001). Most effects persisted until the second-year evaluation. SOP implementation was similarly feasible and beneficial at the Brikama hospital. However, outcomes did not significantly differ in the hospitals. Conclusions: Implementing SOPs is a realistic, low-cost option for improving process quality of neurologic emergency management in under-resourced settings. Classification of evidence: This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. PMID:28600460

Vaccine cold chain: Part 2. Training personnel and program management.

PubMed

Rogers, Bonnie; Dennison, Kim; Adepoju, Nikki; Dowd, Shelia; Uedoi, Kenneth

2010-09-01

The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program. Copyright 2010, SLACK Incorporated.

Managing complaints in health and social care.

PubMed

Holmes-Bonney, Kathy

2010-04-01

An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.

Control by quality: proposition of a typology.

PubMed

Pujo, P; Pillet, M

The application of Quality tools and methods in industrial management has always had a fundamental impact on the control of production. It influences the behavior of the actors concerned, while introducing the necessary notions and formalizations, especially for production systems with little or no automation, which constitute a large part of the industrial activity. Several quality approaches are applied in the workshop and are implemented at the level of the control. In this paper, the authors present a typology of the various approaches that have successively influenced control, such as statistical process control, quality assurance, and continuous improvement. First the authors present a parallel between production control and quality organizational structure. They note the duality between control, which is aimed at increasing productivity, and quality, which aims to satisfy the needs of the customer. They also note the hierarchical organizational structure of these two systems of management with, at each level, the notion of a feedback loop. This notion is fundamental to any kind of decision making. The paper is organized around the operational, tactical, and strategic levels, by describing for each level the main methods and tools for control by quality. The overview of these tools and methods starts at the operational level, with the Statistical Process Control, the Taguchi technique, and the "six sigma" approach. On the tactical level, we find a quality system approach, with a documented description of the procedures introduced in the firm. The management system can refer here to Quality Assurance, Total Productive Maintenance, or Management by Total Quality. The formalization through procedures of the rules of decision governing the process control enhances the validity of these rules. This leads to the enhancement of their reliability and to their consolidation. All this counterbalances the human, intrinsically fluctuating, behavior of the control operators. Strategic control by quality is then detailed, and the two main approaches, the continuous improvement approach and the proactive improvement approach, are introduced. Finally, the authors observe that at each of the three levels, the continuous process improvement, which is a component of Total Quality, becomes an essential preoccupation for the control. Ultimately, the recursive utilization of the Deming cycle remains the best practice for the control by quality.

The Government of Islamic Republic of Afghanistan’s Controls Over the Contract Management Process for U.S. Direct Assistance Need Improvement

DTIC Science & Technology

2015-02-25

develop, award, execute, or monitor individual contracts funded with U.S. direct assistance. This occurred because the Ministry of Finance ( MoF ...trained staff to collaborate with the Ministry of Finance ( MoF ), MoD, and MoI for budgeting, acquisition planning, procurement, financial management...and contract management and oversight. Finally, CSTC-A must ensure MoF , MoD, and MoI establish standard operating procedures and maintain adequate

Equipment Management Manual

NASA Technical Reports Server (NTRS)

1992-01-01

The NASA Equipment Management Manual (NHB 4200.1) is issued pursuant to Section 203(c)(1) of the National Aeronautics and Space Act of 1958, as amended (42 USC 2473), and sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for the acquisition, management, and use of NASA-owned equipment. This revision is effective upon receipt. This is a controlled manual, issued in loose-leaf form, and revised through page changes. Additional copies for internal use may be obtained through normal distribution.

Monitoring and control of spacecraft systems using procedural reasoning

NASA Technical Reports Server (NTRS)

Georgeff, Michael P.; Ingrand, Francois Felix

1990-01-01

Research concerned with automating the monitoring and control of spacecraft systems is discussed. In particular, the application of SRI's Procedural Reasoning System (PRS) to the handling of malfunctions in the Reaction Control System (RCS) of NASA's Space Shuttle is examined. Unlike traditional monitoring and control systems, PRS is able to reason about and perform complex tasks in a very flexible and robust manner, somewhat in the manner of a human assistant. Using various RCS malfunctions as examples (including sensor faults, leaking components, multiple alarms, and regulator and jet failures), it is shown how PRS manages to combine both goal-directed reasoning and the ability to react rapidly to unanticipated changes in its environment. In conclusion, some important issues in the design of PRS are reviewed and future enhancements are indicated.

Laboratory cost control and financial management software.

PubMed

Mayer, M

1998-02-09

Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

Assessment of average of normals (AON) procedure for outlier-free datasets including qualitative values below limit of detection (LoD): an application within tumor markers such as CA 15-3, CA 125, and CA 19-9.

PubMed

Usta, Murat; Aral, Hale; Mete Çilingirtürk, Ahmet; Kural, Alev; Topaç, Ibrahim; Semerci, Tuna; Hicri Köseoğlu, Mehmet

2016-11-01

Average of normals (AON) is a quality control procedure that is sensitive only to systematic errors that can occur in an analytical process in which patient test results are used. The aim of this study was to develop an alternative model in order to apply the AON quality control procedure to datasets that include qualitative values below limit of detection (LoD). The reported patient test results for tumor markers, such as CA 15-3, CA 125, and CA 19-9, analyzed by two instruments, were retrieved from the information system over a period of 5 months, using the calibrator and control materials with the same lot numbers. The median as a measure of central tendency and the median absolute deviation (MAD) as a measure of dispersion were used for the complementary model of AON quality control procedure. The u bias values, which were determined for the bias component of the measurement uncertainty, were partially linked to the percentages of the daily median values of the test results that fall within the control limits. The results for these tumor markers, in which lower limits of reference intervals are not medically important for clinical diagnosis and management, showed that the AON quality control procedure, using the MAD around the median, can be applied for datasets including qualitative values below LoD.

Six Sigma Quality Management System and Design of Risk-based Statistical Quality Control.

PubMed

Westgard, James O; Westgard, Sten A

2017-03-01

Six sigma concepts provide a quality management system (QMS) with many useful tools for managing quality in medical laboratories. This Six Sigma QMS is driven by the quality required for the intended use of a test. The most useful form for this quality requirement is the allowable total error. Calculation of a sigma-metric provides the best predictor of risk for an analytical examination process, as well as a design parameter for selecting the statistical quality control (SQC) procedure necessary to detect medically important errors. Simple point estimates of sigma at medical decision concentrations are sufficient for laboratory applications. Copyright © 2016 Elsevier Inc. All rights reserved.

A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania

PubMed Central

Fillinger, Ulrike; Kannady, Khadija; William, George; Vanek, Michael J; Dongus, Stefan; Nyika, Dickson; Geissbühler, Yvonne; Chaki, Prosper P; Govella, Nico J; Mathenge, Evan M; Singer, Burton H; Mshinda, Hassan; Lindsay, Steven W; Tanner, Marcel; Mtasiwa, Deo; de Castro, Marcia C; Killeen, Gerry F

2008-01-01

Background As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. Methods A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. Results The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6–37.6%; p = 0.04). Conclusion This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience. PMID:18218148

NASA UAS Traffic Management National Campaign Operations across Six UAS Test Sites

NASA Technical Reports Server (NTRS)

Rios, Joseph; Mulfinger, Daniel; Homola, Jeff; Venkatesan, Priya

2016-01-01

NASA's Unmanned Aircraft Systems Traffic Management research aims to develop policies, procedures, requirements, and other artifacts to inform the implementation of a future system that enables small drones to access the low altitude airspace. In this endeavor, NASA conducted a geographically diverse flight test in conjunction with the FAA's six unmanned aircraft systems Test Sites. A control center at NASA Ames Research Center autonomously managed the airspace for all participants in eight states as they flew operations (both real and simulated). The system allowed for common situational awareness across all stakeholders, kept traffic procedurally separated, offered messages to inform the participants of activity relevant to their operations. Over the 3- hour test, 102 flight operations connected to the central research platform with 17 different vehicle types and 8 distinct software client implementations while seamlessly interacting with simulated traffic.

Cognitive science speaks to the "common-sense" of chronic illness management.

PubMed

Leventhal, Howard; Leventhal, Elaine A; Breland, Jessica Y

2011-04-01

We describe the parallels between findings from cognitive science and neuroscience and Common-Sense Models in four areas: (1) Activation of illness representations by the automatic linkage of symptoms and functional changes with concepts (an integration of declarative and perceptual and procedural knowledge); (2) Action plans for the management of symptoms and disease; (3) Cognitive and behavioral heuristics (executive functions parallel to recent findings in cognitive science) involved in monitoring and modifying automatic control processes; (4) Perceiving and communicating to "other minds" during medical visits to address the declarative and non-declarative (perceptual and procedural) knowledge that comprise a patient's representations of illness and treatment (the transparency of other minds).

Management of complex glottic stenosis in children with recurrent respiratory papillomatosis.

PubMed

Siegel, Bianca; Smith, Lee P

2013-10-01

To describe our management of complex glottic stenosis in tracheotomy dependent children with severe recurrent respiratory papillomatosis. Retrospective chart review at a tertiary care children's hospital. Three children with complex glottic stenosis secondary to severe recurrent respiratory papillomatosis were treated at our institution since 2011. Two patients had complete stenosis, and the third had near-complete stenosis. Two patients were managed using balloon dilation alone, and the third also underwent laryngotracheal reconstruction with posterior costal cartilage grafting. Two patients have been successfully decannulated and the third has been tolerating continuous tracheotomy capping for greater than twelve months. All three patients underwent aggressive debridement of papillomatosis and balloon dilation every 4-6 weeks until their burden of disease was controlled. In two patients, the glottic airway was patent, and the third continued to have complete restenosis between procedures and required laryngotracheoplasty with multiple post-operative dilation procedures to establish an adequate glottic airway. Severe laryngeal stenosis is a well-described complication of recurrent respiratory papillomatosis, but its management is not well-defined. Aggressive management of papillomatosis with frequent debridement is critical in successfully managing laryngeal stenosis. Balloon dilation alone may be surprisingly effective in these patients, and laryngotracheoplasty can be used as an adjunct procedure in those patients who fail balloon dilation. Given the quality of life issues and concerns regarding distal spread of disease with tracheotomies in these patients, we feel that aggressive management and early decannulation is in the patient's best interest. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A Model of Risk Analysis in Analytical Methodology for Biopharmaceutical Quality Control.

PubMed

Andrade, Cleyton Lage; Herrera, Miguel Angel De La O; Lemes, Elezer Monte Blanco

2018-01-01

One key quality control parameter for biopharmaceutical products is the analysis of residual cellular DNA. To determine small amounts of DNA (around 100 pg) that may be in a biologically derived drug substance, an analytical method should be sensitive, robust, reliable, and accurate. In principle, three techniques have the ability to measure residual cellular DNA: radioactive dot-blot, a type of hybridization; threshold analysis; and quantitative polymerase chain reaction. Quality risk management is a systematic process for evaluating, controlling, and reporting of risks that may affects method capabilities and supports a scientific and practical approach to decision making. This paper evaluates, by quality risk management, an alternative approach to assessing the performance risks associated with quality control methods used with biopharmaceuticals, using the tool hazard analysis and critical control points. This tool provides the possibility to find the steps in an analytical procedure with higher impact on method performance. By applying these principles to DNA analysis methods, we conclude that the radioactive dot-blot assay has the largest number of critical control points, followed by quantitative polymerase chain reaction, and threshold analysis. From the analysis of hazards (i.e., points of method failure) and the associated method procedure critical control points, we conclude that the analytical methodology with the lowest risk for performance failure for residual cellular DNA testing is quantitative polymerase chain reaction. LAY ABSTRACT: In order to mitigate the risk of adverse events by residual cellular DNA that is not completely cleared from downstream production processes, regulatory agencies have required the industry to guarantee a very low level of DNA in biologically derived pharmaceutical products. The technique historically used was radioactive blot hybridization. However, the technique is a challenging method to implement in a quality control laboratory: It is laborious, time consuming, semi-quantitative, and requires a radioisotope. Along with dot-blot hybridization, two alternatives techniques were evaluated: threshold analysis and quantitative polymerase chain reaction. Quality risk management tools were applied to compare the techniques, taking into account the uncertainties, the possibility of circumstances or future events, and their effects upon method performance. By illustrating the application of these tools with DNA methods, we provide an example of how they can be used to support a scientific and practical approach to decision making and can assess and manage method performance risk using such tools. This paper discusses, considering the principles of quality risk management, an additional approach to the development and selection of analytical quality control methods using the risk analysis tool hazard analysis and critical control points. This tool provides the possibility to find the method procedural steps with higher impact on method reliability (called critical control points). Our model concluded that the radioactive dot-blot assay has the larger number of critical control points, followed by quantitative polymerase chain reaction and threshold analysis. Quantitative polymerase chain reaction is shown to be the better alternative analytical methodology in residual cellular DNA analysis. © PDA, Inc. 2018.

Safety climate and the distracted driving experiences of truck drivers.

PubMed

Swedler, David I; Pollack, Keshia M; Agnew, Jacqueline

2015-07-01

For truck drivers, distracted driving is a workplace behavior that increases occupational injury risk. We propose safety climate as an appropriate lens through which researchers can examine occupational distracted driving. Using a mixed methods study design, we surveyed truck drivers using the Safety Climate Questionnaire (SCQ) complemented by semi-structured interviews of experts on distracted driving and truck safety. Safety climate was assessed by using the entire SCQ as an overall climate score, followed by factor analysis that identified the following safety climate factors: Communications and Procedures; Management Commitment; and Work Pressure. In multivariate regression, the overall safety climate scale was associated with having ever experienced a crash and/or distraction-involved swerving. Interview participants described how these SCQ constructs could affect occupational distracted driving. To reduce distraction-related crashes in their organizations, management can adhere to safe policies and procedures, invest in engineering controls, and develop safer communication procedures. © 2015 Wiley Periodicals, Inc.

Report: Lack of Project Plan Resulted in Transition and Contractor Performance Problems for the Institutional Controls Tracking System

EPA Pesticide Factsheets

Report #09-P-0128, March 25, 2009. Lack of compliance with established project management procedures resulted in transitional problems in 2005 that delayed ICTS development and negatively affected contractor performance.

33 CFR 274.4 - Pesticide management.

Code of Federal Regulations, 2011 CFR

2011-07-01

... responsibility for using personal protective equipment and clothing provided and for following established health... from pesticide hazards. Basic health and safety practices and procedures including personal protective... maintenance of pest control equipment. Field Operating Agencies (FOA) will designate a single point of contact...

PARENTS’ UNDERSTANDING OF INFORMATION REGARDING THEIR CHILD’S POSTOPERATIVE PAIN MANAGEMENT

PubMed Central

Tait, Alan R.; Voepel-Lewis, Terri; Snyder, Robin M.; Malviya, Shobha

2009-01-01

Objectives Unlike information provided for research, information disclosed to patients for treatment or procedures is largely unregulated and, as such, there is likely considerable variability in the type and amount of disclosure. This study was designed to examine the nature of information provided to parents regarding options for postoperative pain control and their understanding thereof. Methods 187 parents of children scheduled to undergo a surgical procedure requiring inpatient postoperative pain control completed questionnaires that elicited information regarding their perceptions and understanding of, and satisfaction with, information regarding postoperative pain management. Results Results showed that there was considerable variability in the content and amount of information provided to parents based on the method of postoperative pain control provided. Parents whose child received Patient Controlled Analgesia (PCA) were given significantly (P< 0.025) more information on the risks and benefits compared to those receiving Nurse Controlled or intravenous-prn (NCA or IV) analgesia. Approximately one third of parents had no understanding of the risks associated with postoperative pain management. Parents who received pain information preoperatively and who were given information regarding the risks and benefits had improved understanding compared to parents who received no or minimal information (P< 0.001). Furthermore, information that was deemed unclear or insufficient resulted in decreased parental understanding. Discussion These results demonstrate the variability in the type and amount of information provided to parents regarding their child’s postoperative pain control and reinforce the importance of clear and full disclosure of pain information, particularly with respect to the risks and benefits. PMID:18716495

Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

PubMed

Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja

2018-03-16

The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources. The study is registered in the Clinical Trials.gov ( NCT02545257 ). Registration date September 9 2015.

Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

PubMed

Noordhuizen, J P; Welpelo, H J

1996-12-01

This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.

Quality of mass-reared codling moth (Lepidoptera: Tortricidae) after long distance transportation 1. Logistics of shipping procedures and quality parameters as measured in the laboratory.

USDA-ARS?s Scientific Manuscript database

The sterile insect technique is a proven effective control tactic against lepidopteran pests when applied in an area-wide integrated pest management programme. The construction of insect mass-rearing facilities requires considerable investment and moth control strategies that include the use of ster...

State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

Review of indicators for cross-sectoral optimization of nosocomial infection prophylaxis – a perspective from structurally- and process-oriented hygiene

PubMed Central

Hübner, Nils-Olaf; Fleßa, Steffen; Jakisch, Ralf; Assadian, Ojan; Kramer, Axel

2012-01-01

In the care of patients, the prevention of nosocomial infections is crucial. For it to be successful, cross-sectoral, interface-oriented hygiene quality management is necessary. The goal is to apply the HACCP (Hazard Assessment and Critical Control Points) concept to hospital hygiene, in order to create a multi-dimensional hygiene control system based on hygiene indicators that will overcome the limitations of a procedurally non-integrated and non-cross-sectoral view of hygiene. Three critical risk dimensions can be identified for the implementation of three-dimensional quality control of hygiene in clinical routine: the constitution of the person concerned, the surrounding physical structures and technical equipment, and the medical procedures. In these dimensions, the establishment of indicators and threshold values enables a comprehensive assessment of hygiene quality. Thus, the cross-sectoral evaluation of the quality of structure, processes and results is decisive for the success of integrated infection prophylaxis. This study lays the foundation for hygiene indicator requirements and develops initial concepts for evaluating quality management in hygiene. PMID:22558049

Controlling healthcare professionals: how human resource management influences job attitudes and operational efficiency.

PubMed

Cogin, Julie Ann; Ng, Ju Li; Lee, Ilro

2016-09-20

We assess how human resource management (HRM) is implemented in Australian hospitals. Drawing on role theory, we consider the influence HRM has on job attitudes of healthcare staff and hospital operational efficiency. We adopt a qualitative research design across professional groups (physicians, nurses, and allied health staff) at multiple levels (executive, healthcare managers, and employee). A total of 34 interviews were carried out and analyzed using NVivo. Findings revealed a predominance of a control-based approach to people management. Using Snell's control framework (AMJ 35:292-327, 1992), we found that behavioral control was the principal form of control used to manage nurses, allied health workers, and junior doctors. We found a mix between behavior, output, and input controls as well as elements of commitment-based HRM to manage senior physicians. We observed low levels of investment in people and a concentration on transactional human resource (HR) activities which led to negative job attitudes such as low morale and frustration among healthcare professionals. While hospitals used rules to promote conformity with established procedures, the overuse and at times inappropriate use of behavior controls restricted healthcare managers' ability to motivate and engage their staff. Excessive use of behavior control helped to realize short-term cost-cutting goals; however, this often led to operational inefficiencies. We suggest that hospitals reduce the profusion of behavior control and increase levels of input and output controls in the management of people. Poor perceptions of HR specialists and HR activities have resulted in HR being overlooked as a vehicle to address the strategic challenges required of health reform and to build an engaged workforce.

[Management of spine injuries in polytraumatized patients].

PubMed

Heyde, C E; Ertel, W; Kayser, R

2005-09-01

The management of spine injuries in polytraumatized patients remains a great challenge for the diagnostic procedures and institution of appropriate treatment by integrating spinal trauma treatment into the whole treatment concept as well as following the treatment steps for the injured spine itself. The established concept of "damage control" and criteria regarding the optimal time and manner for operative treatment of the injured spine in the polytrauma setting is presented and discussed.

Army Financial Improvement Plans Generally Managed Effectively, but Better Contract Management Needed

DTIC Science & Technology

2014-04-08

assertions are free of material misstatement . There are two types of substantive testing: substantive analytical procedures and tests of details...identified internal control weaknesses continue to exist and are significant enough to result in material misstatements or a conclusion that account...records properly. As a result, CEHNC personnel processed $21.5 million in contractor payments, citing an incorrect obligation, and was at increased risk

Employee reactions to the use of management control systems in hospitals: motivation vs. threat.

PubMed

Lopez-Valeiras, Ernesto; Gomez-Conde, Jacobo; Lunkes, Rogerio Joao

Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems. We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis. Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure. The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Assessing the compatibility of the management of standardized procedures with the complexity of a sociotechnical system: case study of a control room in an oil refinery.

PubMed

Saurin, Tarcisio Abreu; Gonzalez, Santiago Sosa

2013-09-01

Although the need for the management of complex socio-technical systems (STS) to be compatible with the nature of those systems is widely recognized, there are few guidelines on how to determine the actual extent of this compatibility. The purpose of this study is to assess how compatible the management of standardized procedures (SPs) is with the nature of a complex STS. To this end, a case study was made of a control room in an oil refinery, involving the following stages: (a) delimitation of the investigated STS; (b) description of the STS according to a set of characteristics of complex STS; (c) application of two types of questionnaires to thirty workers - one of them to assess their perceptions about the applicability of seven principles of SPs management in complex STS and the other to determine their perceptions about the actual use of these principles; and (d) a feedback meeting with workers to discuss the results of the assessment. The assessment is discussed in terms of its limitations, usefulness and ease of use of the data collection and analysis tools. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Economic Factors Impacting Food Allergen Management: Perspectives from the Food Industry.

PubMed

Gupta, Ruchi S; Taylor, Steve L; Baumert, Joseph L; Kao, Lauren M; Schuster, Erik; Smith, Bridget M

2017-10-01

Food allergies affect up to 8% of children in the United States and may occasionally lead to severe life-threatening reactions. Because there is currently no cure for food allergies, strict avoidance of the allergen-containing foods is the only means of preventing an allergic reaction. Consumers rely on food manufacturers to reliably track and declare the presence of food allergens in products. Over the past 10 to 20 years, the food industry has increasingly adopted allergen control approaches in its processing facilities. However, the major industry costs related to food allergen management have not been fully described. The objective of this study was to characterize the factors that contribute to the economic impact of food allergen control practices on the food industry. A focus group (n = 100) was conducted with food industry professionals to identify key areas of cost for food allergen management. A survey based on the domains identified was then developed and disseminated to a convenience sample (n = 50) of quality control food industry specialists with knowledge of their company's food allergen management practices. Nearly all companies (92%) produced food products containing one or more of the top eight allergenic foods recognized by the U.S. Food and Drug Administration or sesame seeds. Cleaning procedures, employee training, and the potential for a recall due to allergen cross-contact were most frequently rated as the important factors in food allergen management. Recalls due to food allergen cross-contact, cleaning procedures, equipment and premises design, and employee training were ranked as the greatest allergen management expenses. Although 96% of companies had a food allergen control plan in place, nearly half (42%) had at least one food allergen-related recall within the past 5 years. The industry appears to endorse a willingness to unify precautionary allergen labeling to communicate a clear message more effectively to consumers.

The hack attack - Increasing computer system awareness of vulnerability threats

NASA Technical Reports Server (NTRS)

Quann, John; Belford, Peter

1987-01-01

The paper discusses the issue of electronic vulnerability of computer based systems supporting NASA Goddard Space Flight Center (GSFC) by unauthorized users. To test the security of the system and increase security awareness, NYMA, Inc. employed computer 'hackers' to attempt to infiltrate the system(s) under controlled conditions. Penetration procedures, methods, and descriptions are detailed in the paper. The procedure increased the security consciousness of GSFC management to the electronic vulnerability of the system(s).

LINX®, a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report.

PubMed

Sriratanaviriyakul, Narin; Kivler, Celeste; Vidovszky, Tamas J; Yoneda, Ken Y; Kenyon, Nicholas J; Murin, Susan; Louie, Samuel

2016-05-24

Gastroesophageal reflux disease is one of the most common comorbidities in patients with asthma. Gastroesophageal reflux disease can be linked to difficult-to-control asthma. Current management includes gastric acid suppression therapy and surgical antireflux procedures. The LINX® procedure is a novel surgical treatment for patients with gastroesophageal reflux disease refractory to medical therapy. To the best of our knowledge, we report the first case of successful treatment of refractory asthma secondary to gastroesophageal reflux disease using the LINX® procedure. Our patient was a 22-year-old white woman who met the American Thoracic Society criteria for refractory asthma that had remained poorly controlled for 5 years despite progressive escalation to step 6 treatment as recommended by National Institutes of Health-National Asthma Education and Prevention Program guidelines, including high-dose oral corticosteroids, high-dose inhaled corticosteroid plus long-acting β2-agonist, leukotriene receptor antagonist, and monthly omalizumab. Separate trials with azithromycin therapy and roflumilast did not improve her asthma control, nor did bronchial thermoplasty help. Additional consultations with two other university health systems left the patient with few treatment options for asthma, which included cyclophosphamide. Instead, the patient underwent a LINX® procedure after failure of maximal medical therapy for gastroesophageal reflux disease with the additional aim of improving asthma control. After she underwent LINX® treatment, her asthma improved dramatically and was no longer refractory. She had normal exhaled nitric oxide levels and loss of peripheral eosinophilia after LINX® treatment. Prednisone was discontinued without loss of asthma control. The only immediate adverse effects due to the LINX® procedure were bloating, nausea, and vomiting. LINX® is a viable alternative to the Nissen fundoplication procedure for the treatment of patients with gastroesophageal reflux disease and poorly controlled concomitant refractory asthma.

23 CFR 630.1106 - Policy and procedures for work zone safety management.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Policy and procedures for work zone safety management... Policy and procedures for work zone safety management. (a) Each agency's policy and processes, procedures... established in accordance with 23 CFR 630.1006, shall include the consideration and management of road user...

A case of severe and rigid congenital thoracolumbar lordoscoliosis with diastematomyelia presenting with type 2 respiratory failure: managed by staged correction with controlled axial traction.

PubMed

Kanagaraju, Vijayanth; Chhabra, H S; Srivastava, Abhishek; Mahajan, Rajat; Kaul, Rahul; Bhatia, Pallav; Tandon, Vikas; Nanda, Ankur; Sangondimath, Gururaj; Patel, Nishit

2016-10-01

Congenital lordoscoliosis is an uncommon pathology and its management poses formidable challenge especially in the presence of type 2 respiratory failure and intraspinal anomalies. In such patients standard management protocols are not applicable and may require multistage procedure to minimize risk and optimize results. A 15-year-old girl presented in our hospital emergency services with severe breathing difficulty. She had a severe and rapidly progressing deformity in her back, noted since 6 years of age, associated with severe respiratory distress requiring oxygen and BiPAP support. She was diagnosed to have a severe and rigid congenital right thoracolumbar lordoscoliosis (coronal Cobb's angle: 105° and thoracic lordosis -10°) with type 1 split cord malformation with bony septum extending from T11 to L3. This leads to presentation of restrictive lung disease with type 2 respiratory failure. As her lung condition did not allow for any major procedure, we did a staged procedure rather than executing in a single stage. Controlled axial traction by halogravity was applied initially followed by halo-femoral traction. Four weeks later, this was replaced by halo-pelvic distraction device after a posterior release procedure with asymmetric pedicle substraction osteotomies at T7 and T10. Halo-pelvic distraction continued for 4 more weeks to optimize and correct the deformity. Subsequently definitive posterior stabilization and fusion was done. The detrimental effect of diastematomyelia resection in such cases is clearly evident from literature, so it was left unresected. A good scoliotic correction with improved respiratory function was achieved. Three years follow-up showed no loss of deformity correction, no evidence of pseudarthrosis and a good clinical outcome with reasonably balanced spine. The management of severe and rigid congenital lordoscoliotic deformities with intraspinal anomalies is challenging. Progressive reduction in respiratory volume in untreated cases can lead to acute respiratory failure. Such patients have a high rate of intraoperative and postoperative morbidity and mortality. Hence a staged procedure is recommended. Initially a less invasive procedure like halo traction helps to improve their respiratory function with simultaneous correction of the deformity, while allowing for monitoring of neurological deficit. Subsequently spinal osteotomies and combined halo traction helps further improve the correction, following which definitive instrumented fusion can be done.

Development of a methodology for strategic environmental assessment: application to the assessment of golf course installation policy in Taiwan.

PubMed

Chen, Ching-Ho; Wu, Ray-Shyan; Liu, Wei-Lin; Su, Wen-Ray; Chang, Yu-Min

2009-01-01

Some countries, including Taiwan, have adopted strategic environmental assessment (SEA) to assess and modify proposed policies, plans, and programs (PPPs) in the planning phase for pursuing sustainable development. However, there were only some sketchy steps focusing on policy assessment in the system of Taiwan. This study aims to develop a methodology for SEA in Taiwan to enhance the effectiveness associated with PPPs. The proposed methodology comprises an SEA procedure involving PPP management and assessment in various phases, a sustainable assessment framework, and an SEA management system. The SEA procedure is devised based on the theoretical considerations by systems thinking and the regulative requirements in Taiwan. The positive and negative impacts on ecology, society, and economy are simultaneously considered in the planning (including policy generation and evaluation), implementation, and control phases of the procedure. This study used the analytic hierarchy process, Delphi technique, and systems analysis to develop a sustainable assessment framework. An SEA management system was built based on geographic information system software to process spatial, attribute, and satellite image data during the assessment procedure. The proposed methodology was applied in the SEA of golf course installation policy in 2001 as a case study, which was the first SEA in Taiwan. Most of the 82 existing golf courses in 2001 were installed on slope lands and caused a serious ecological impact. Assessment results indicated that 15 future golf courses installed on marginal lands (including buffer zones, remedied lands, and wastelands) were acceptable because the comprehensive environmental (ecological, social, and economic) assessment value was better based on environmental characteristics and management regulations of Taiwan. The SEA procedure in the planning phase for this policy was completed but the implementation phase of this policy was not begun because the related legislation procedure could not be arranged due to a few senators' resistance. A self-review of the control phase was carried out in 2006 using this methodology. Installation permits for 12 courses on slope lands were terminated after 2001 and then 27 future courses could be installed on marginal lands. The assessment value of this policy using the data on ecological, social, and economic conditions from 2006 was higher than that using the data from 2001. The analytical results illustrate that the proposed methodology can be used to effectively and efficiently assist the related authorities for SEA.

15 CFR 400.25 - Application for subzone.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Establishment and Modification of Zone Projects § 400.25 Application for subzone. (a) In general. An application... procedures have been considered as a means of obtaining the benefits sought; (ix) Information on the industry... Office of Management and Budget under control number 0625-0139) ...

STORAGE/SEDIMENTATION FACILITIES FOR CONTROL OF STORM AND COMBINED SEWER OVERFLOW: DESIGN MANUAL

EPA Science Inventory

This manual describes applications of storage facilities in wet-weather flow management and presents step-by-step procedures for analysis and design of storage-treatment facilities. Retention, detention, and sedimentation storage information is classified and described. Internati...

Stochastic optimal control of ultradiffusion processes with application to dynamic portfolio management

NASA Astrophysics Data System (ADS)

Marcozzi, Michael D.

2008-12-01

We consider theoretical and approximation aspects of the stochastic optimal control of ultradiffusion processes in the context of a prototype model for the selling price of a European call option. Within a continuous-time framework, the dynamic management of a portfolio of assets is effected through continuous or point control, activation costs, and phase delay. The performance index is derived from the unique weak variational solution to the ultraparabolic Hamilton-Jacobi equation; the value function is the optimal realization of the performance index relative to all feasible portfolios. An approximation procedure based upon a temporal box scheme/finite element method is analyzed; numerical examples are presented in order to demonstrate the viability of the approach.

NASA Audit Follow-up Handbook

NASA Technical Reports Server (NTRS)

1990-01-01

This NASA Audit Follow-up Handbook is issued pursuant to the requirements of the Office of Management and Budget (OMB) Circular A-50, Audit Follow-up, dated September 29, 1982. It sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for use when considering reports issued by the Office of Inspector General (OIG), other executive branch audit organizations, the Defense Contract Audit Agency (DCAA), and the General Accounting Office (GAO). It is intended to: specify principal roles; strengthen the procedures for management decisions (resolution) on audit findings and corrective action on audit report recommendations; emphasize the importance of monitoring agreed upon corrective actions to assure actual accomplishment; and foster the use of audit reports as effective tools of management. A flow chart depicting the NASA audit and management decision process is in Appendix A. This handbook is a controlled handbook issued in loose-leaf form and will be revised by page changes. Additional copies for internal use may be obtained through normal distribution channels.

Road landslide information management and forecasting system base on GIS.

PubMed

Wang, Wei Dong; Du, Xiang Gang; Xie, Cui Ming

2009-09-01

Take account of the characters of road geological hazard and its supervision, it is very important to develop the Road Landslides Information Management and Forecasting System based on Geographic Information System (GIS). The paper presents the system objective, function, component modules and key techniques in the procedure of system development. The system, based on the spatial information and attribute information of road geological hazard, was developed and applied in Guizhou, a province of China where there are numerous and typical landslides. The manager of communication, using the system, can visually inquire all road landslides information based on regional road network or on the monitoring network of individual landslide. Furthermore, the system, integrated with mathematical prediction models and the GIS's strongpoint on spatial analyzing, can assess and predict landslide developing procedure according to the field monitoring data. Thus, it can efficiently assists the road construction or management units in making decision to control the landslides and to reduce human vulnerability.

Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.

The effectiveness of a web-based resource in improving postconcussion management in high schools.

PubMed

Glang, Ann E; Koester, Michael C; Chesnutt, James C; Gioia, Gerard A; McAvoy, Karen; Marshall, Sondra; Gau, Jeff M

2015-01-01

Because many sports concussions happen during school-sponsored sports events, most state concussion laws specifically hold schools accountable for coach training and effective concussion management practices. Brain 101: The Concussion Playbook is a Web-based intervention that includes training in sports concussion for each member of the school community, presents guidelines on creating a concussion management team, and includes strategies for supporting students in the classroom. The group randomized controlled trial examined the efficacy of Brain 101 in managing sports concussion. Participating high schools (N = 25) were randomly assigned to the Brain 101 intervention or control. Fall athletes and their parents completed online training, and Brain 101 school administrators were directed to create concussion management policy and procedures. Student athletes and parents at Brain 101 schools significantly outperformed those at control schools on sports concussion knowledge, knowledge application, and behavioral intention to implement effective concussion management practices. Students who had concussions in Brain 101 schools received more varied academic accommodations than students in control schools. Brain 101 can help schools create a comprehensive schoolwide concussion management program. It requires minimal expenditures and offers engaging and effective education for teachers, coaches, parents, and students. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

PubMed

Rüter, Anders; Vikstrom, Tore

2009-01-01

Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

Surgical perspectives in the management of atrial fibrillation

PubMed Central

Kyprianou, Katerina; Pericleous, Agamemnon; Stavrou, Antonio; Dimitrakaki, Inetzi A; Challoumas, Dimitrios; Dimitrakakis, Georgios

2016-01-01

Atrial fibrillation (AF) is the most common cardiac arrhythmia and a huge public health burden associated with significant morbidity and mortality. For decades an increasing number of patients have undergone surgical treatment of AF, mainly during concomitant cardiac surgery. This has sparked a drive for conducting further studies and researching this field. With the cornerstone Cox-Maze III “cut and sew” procedure being technically challenging, the focus in current literature has turned towards less invasive techniques. The introduction of ablative devices has revolutionised the surgical management of AF, moving away from the traditional surgical lesions. The hybrid procedure, a combination of catheter and surgical ablation is another promising new technique aiming to improve outcomes. Despite the increasing number of studies looking at various aspects of the surgical management of AF, the literature would benefit from more uniformly conducted randomised control trials. PMID:26839656

Using Civilian Supply Chain Management Best Practices to Improve Army Supply Chain Management Procedures

DTIC Science & Technology

2017-06-09

USING CIVILIAN SUPPLY CHAIN MANAGEMENT BEST PRACTICES TO IMPROVE ARMY SUPPLY CHAIN MANAGEMENT PROCEDURES A thesis presented to......Army Supply Chain Management Procedures 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Chief Warrant

44 CFR 206.202 - Application procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Application procedures. 206.202 Section 206.202 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Administration § 206.202 Application procedures. (a) General. This section describes the policies and procedures...

27 CFR 70.701 - Rules and regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

...). Procedures relating solely to matters of internal management are not published; however, regulations appearing in internal management documents and statements of internal practices and procedures that affect... management document or communication as is necessary for an understanding of the procedure. TTB Procedures...

Emergency department management of pain and anxiety related to orthopedic fracture care: a guide to analgesic techniques and procedural sedation in children.

PubMed

Kennedy, Robert M; Luhmann, Jan D; Luhmann, Scott J

2004-01-01

Orthopedic fractures and joint dislocations are among the most painful pediatric emergencies. Safe and effective management of fracture-related pain and anxiety in the emergency department reduces patient distress during initial evaluation and often allows definitive management of the fracture. No consensus exists on which pharmacologic regimens for procedural sedation/analgesia are safest and most effective. For some children, control of fracture pain is the primary goal, whereas for others, relief from anxiety is an additionally important objective. Furthermore, strategies for the management of fracture pain may vary by fracture location and patient characteristics; thus, no single regimen is likely to provide the best means of analgesia and anxiolysis for all patients. Effective analgesia can be provided by local or regional anesthesia, such as hematoma, Bier, or nerve blocks. Alternatively, induction of deep sedation with analgesic agents such as ketamine or fentanyl, often combined with sedative-anxiolytic agents such as midazolam, may be used to manage distress associated with fracture reduction. A combination of local anesthesia with moderate sedation, for example nitrous oxide, is another attractive option.

HH-65A Dolphin digital integrated avionics

NASA Technical Reports Server (NTRS)

Huntoon, R. B.

1984-01-01

Communication, navigation, flight control, and search sensor management are avionics functions which constitute every Search and Rescue (SAR) operation. Routine cockpit duties monopolize crew attention during SAR operations and thus impair crew effectiveness. The United States Coast Guard challenged industry to build an avionics system that automates routine tasks and frees the crew to focus on the mission tasks. The HH-64A SAR avionics systems of communication, navigation, search sensors, and flight control have existed independently. On the SRR helicopter, the flight management system (FMS) was introduced. H coordinates or integrates these functions. The pilot interacts with the FMS rather than the individual subsystems, using simple, straightforward procedures to address distinct mission tasks and the flight management system, in turn, orchestrates integrated system response.

Responding to the Medical Malpractice Insurance Crisis: A National Risk Management Information System

PubMed Central

Wess, Bernard P.; Jacobson, Gary

1987-01-01

In the process of forming a new medical malpractice reinsurance company, the authors analyzed thousands of medical malpractice cases, settlements, and verdicts. The evidence of those analyses indicated that the medical malpractice crisis is (1)emerging nation- and world-wide, (2)exacerbated by but not primarily a result of “predatory” legal action, (3)statistically determined by a small percentage of physicians and procedures, (4)overburdened with data but poor on information, (5)subject to classic forms of quality control and automation. The management information system developed to address this problem features a tiered data base architecture to accommodate medical, administrative, procedural, statistical, and actuarial analyses necessary to predict claims from untoward events, not merely to report them.

Automation in future air traffic management: effects of decision aid reliability on controller performance and mental workload.

PubMed

Metzger, Ulla; Parasuraman, Raja

2005-01-01

Future air traffic management concepts envisage shared decision-making responsibilities between controllers and pilots, necessitating that controllers be supported by automated decision aids. Even as automation tools are being introduced, however, their impact on the air traffic controller is not well understood. The present experiments examined the effects of an aircraft-to-aircraft conflict decision aid on performance and mental workload of experienced, full-performance level controllers in a simulated Free Flight environment. Performance was examined with both reliable (Experiment 1) and inaccurate automation (Experiment 2). The aid improved controller performance and reduced mental workload when it functioned reliably. However, detection of a particular conflict was better under manual conditions than under automated conditions when the automation was imperfect. Potential or actual applications of the results include the design of automation and procedures for future air traffic control systems.

The successful use of simple tube duodenostomy in large duodenal perforations from varied etiologies

PubMed Central

Kutlu, Onur C.; Garcia, Steven; Dissanaike, Sharmila

2012-01-01

INTRODUCTION Tube decompression of the duodenum is an old but underutilized technique known to decrease morbidity and mortality in patients with difficult to manage duodenal injuries. Broad arrays of techniques have been described in the literature and are reviewed, but most are complex procedures not appropriate for the management of an unstable patient. PRESENTATION OF CASE In this paper we describe the technique of tube duodenostomy and the successful application in three cases of large defects (>3 cm) which two of these cases had failed previous repair attempts. The defects were caused by very different etiologies, including blunt trauma, peptic ulcer disease and erosion from cancer. All were finally managed by application of tube duodenostomy with success. DISCUSSION Patients with “difficult to manage duodenum” usually present with hemodynamic instability with hostile abdomen. Complex procedures in an unstable patient are associated with adverse outcomes. In patients with significant comorbidities and instability the damage control principle of trauma surgery is gaining popularity. Tube duodenostomy technique described in this paper fits in well with that principle. CONCLUSION Application of tube duodenostomy instead of a complex procedure in an unstable patient provides an opportunity to stabilize the patient, converting an impending catastrophe to a future scheduled surgery. PMID:23357008

12 CFR 563.176 - Interest-rate-risk-management procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Interest-rate-risk-management procedures. 563... ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures... association's management of that risk. (b) The board of directors shall formerly adopt a policy for the...

12 CFR 563.176 - Interest-rate-risk-management procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Interest-rate-risk-management procedures. 563... ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures... association's management of that risk. (b) The board of directors shall formerly adopt a policy for the...

Department of Defense Office of the Inspector General FY 2013 Audit Plan

DTIC Science & Technology

2012-11-01

oversight procedures to review KPMG LLPs work; and if applicable disclose instances where KPMG LLP does not comply, in all material respects, with U.S...decisions. Pervasive material internal control weaknesses impact the accuracy, reliability and timeliness of budgetary and accounting data and...reported the same 13 material internal control weaknesses as in the previous year. These pervasive and longstanding financial management challenges

Evaluation of the Separation of Service Members Who Made a Report of Sexual Assault

DTIC Science & Technology

2016-05-09

2014, and Incorporating Change 1, Effective December 4, 2014, for the following non- disability mental conditions (NDMCs): • Personality Disorder...Adjustment Disorder • Disruptive Behavior Disorder • Impulse Control Disorder • Mental Condition, Other • Condition, Not a Disability Findings...the Services, update policy to establish management control procedures for separating service members for Non- Disability Mental Conditions to ensure

Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post-lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis.

PubMed

Manchikanti, Laxmaiah; Helm, Standiford; Pampati, Vidyasagar; Racz, Gabor B

2015-06-01

The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost-effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high-quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome or lumbar central spinal stenosis. This analysis is based on 2 previously published controlled studies. To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post-lumbar surgery syndrome and lumbar central spinal stenosis. A private, specialty referral interventional pain management center in the United States. Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post-lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2-year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status. The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2-year follow-up with the actual reimbursement data showed cost utility for 1 year of quality-adjusted life year (QALY) of USD $2,652 for post-lumbar surgery syndrome and USD $2,649 for lumbar central spinal stenosis. The results of this assessment show that the cost utility of managing chronic, intractable low back pain with percutaneous adhesiolysis at a QALY that is similar or lower in price than medical therapy only, physical therapy, manipulation, spinal cord stimulation, and surgery. The limitations of this cost utility analysis are that it is a single-center evaluation, with the inclusion of costs of adhesiolysis procedures in an ambulatory surgery center and physician visits, rather than all related costs including drug therapy and costs of disability in multiple settings. This cost utility analysis of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome and lumbar central spinal stenosis shows the clinical effectiveness and cost utility of these procedures at USD $2,650 per one year of QALY when performed in an ambulatory surgery center. © 2014 World Institute of Pain.

Fixed-Base Simulator Studies of the Ability of the Human Pilot to Provide Energy Management Along Abort and Deep-Space Entry Trajectories

NASA Technical Reports Server (NTRS)

Young, J. W.; Goode, M. W.

1962-01-01

A simulation study has been made to determine a pilot's ability to control a low L/D vehicle to a desired point on the earth with initial conditions ranging from parabolic orbits to abort conditions along the boost phase of a deep-space mission. The program was conducted to develop procedures which would allow the pilot to perform the energy management functions required while avoiding the high deceleration or skipout region and to determine the information display required to aid the pilot in flying these procedures. The abort conditions studied extend from a region of relatively high flight-path angles at suborbital velocities while leaving the atmosphere to a region between orbital and near-escape velocity outside the atmosphere. The conditions studied included guidance from suborbital and superorbital aborts as well as guidance following return from a deepspace mission. In this paper, the role of the human pilot?s ability to combine safe return abort procedures with guidance procedures has been investigated. The range capability from various abort and entry conditions is also presented.

A Systematic Review of Randomized Controlled Trials Examining Psychological Interventions for Needle-related Procedural Pain and Distress in Children and Adolescents: An Abbreviated Cochrane Review*

PubMed Central

Chambers, Christine T.; McGrath, Patrick J.; Kisely, Stephen

2008-01-01

Objective To report the results of a systematic review of randomized controlled trials (RCTs) of psychological interventions for children and adolescents undergoing needle-related procedures. Methods A variety of cognitive-behavioral psychological interventions for managing procedural pain and distress in children and adolescents between 2 and 19 years of age were examined. Outcome measures included pain and distress as assessed by self-report, observer report, behavioral/observational measures, and physiological correlates. Results Twenty-eight trials met the criteria for inclusion in the review and provided the data necessary for pooling the results. Together, the trials included 1,039 participants in treatment conditions and 951 in control conditions. The largest effect sizes for treatment improvement over control conditions were found for distraction, combined cognitive-behavioral interventions, and hypnosis, with promising but limited evidence for several other psychological interventions. Conclusions Recommendations for conducting future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted. PMID:18387963

Preharvest food safety.

PubMed

Childers, A B; Walsh, B

1996-07-23

Preharvest food safety is essential for the protection of our food supply. The production and transport of livestock and poultry play an integral part in the safety of these food products. The goals of this safety assurance include freedom from pathogenic microorganisms, disease, and parasites, and from potentially harmful residues and physical hazards. Its functions should be based on hazard analysis and critical control points from producer to slaughter plant with emphasis on prevention of identifiable hazards rather than on removal of contaminated products. The production goal is to minimize infection and insure freedom from potentially harmful residues and physical hazards. The marketing goal is control of exposure to pathogens and stress. Both groups should have functional hazard analysis and critical control points management programs which include personnel training and certification of producers. These programs must cover production procedures, chemical usage, feeding, treatment practices, drug usage, assembly and transportation, and animal identification. Plans must use risk assessment principles, and the procedures must be defined. Other elements would include preslaughter certification, environmental protection, control of chemical hazards, live-animal drug-testing procedures, and identification of physical hazards.

12 CFR 652.60 - Corporation board guidelines.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... (a) Your board of directors is responsible for ensuring that you maintain total capital at a level... developing the capital adequacy plan: (1) Capability of management; (2) Strategies and objectives in your business plan; (3) Quality of operating policies, procedures, and internal controls; (4) Quality and...

78 FR 72008 - Establishment of Class E Airspace; Aliceville, AL

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

...) Standard Instrument Approach Procedure (SIAP) serving George Downer Airport. This action enhances the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective 0901..., providing the controlled airspace required to accommodate the new RNAV (GPS) Standard Instrument Approach...

40 CFR 91.1011 - Submission of exemption requests.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) CONTROL OF EMISSIONS FROM MARINE SPARK-IGNITION ENGINES Exclusion and Exemption of Marine SI Engines § 91.1011 Submission of exemption requests. Requests for exemption or further information concerning exemptions and/or the exemption request review procedure should be addressed to: Manager, Engine...

78 FR 59622 - Establishment of Class E Airspace; Akutan, AK

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-27

... at Akutan Airport, Akutan, AK. Controlled airspace is necessary to accommodate aircraft using the new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at the airport. This action enhances the safety and management of aircraft operations at the airport. DATES...

12 CFR 652.60 - Corporation board guidelines.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (a) Your board of directors is responsible for ensuring that you maintain total capital at a level... developing the capital adequacy plan: (1) Capability of management; (2) Strategies and objectives in your business plan; (3) Quality of operating policies, procedures, and internal controls; (4) Quality and...

Flight Crew Factors for CTAS/FMS Integration in the Terminal Area

NASA Technical Reports Server (NTRS)

Crane, Barry W.; Prevot, Thomas; Palmer, Everett A.; Shafto, M. (Technical Monitor)

2000-01-01

Center TRACON Automation System (CTAS)/Flight Management System (FMS) integration on the flightdeck implies flight crews flying coupled in highly automated FMS modes [i.e. Vertical Navigation (VNAV) and Lateral Navigation (LNAV)] from top of descent to the final approach phase of flight. Pilots may also have to make FMS route edits and respond to datalink clearances in the Terminal Radar Approach Control (TRACON) airspace. This full mission simulator study addresses how the introduction of these FMS descent procedures affect crew activities, workload, and performance. It also assesses crew acceptance of these procedures. Results indicate that the number of crew activities and workload ratings are significantly reduced below current day levels when FMS procedures can be flown uninterrupted, but that activity numbers increase significantly above current day levels and workload ratings return to current day levels when FMS procedures are interrupted by common ATC interventions and CTAS routing advisories. Crew performance showed some problems with speed control during FMS procedures. Crew acceptance of the FMS procedures and route modification requirements was generally high; a minority of crews expressed concerns about use of VNAV in the TRACON airspace. Suggestions for future study are discussed.

Defense Management: How Do We Manage in an Era of Reduced Budgets?

DTIC Science & Technology

1990-05-01

effectively within the free market . Procurement regulations, policies and procedures should be tailored to suit the unique situation of the defense market . The...logistics and round, out ones study of military stategy and tactics. In light of the ongoing reorientation of Eastern Europe and the Soviet Union, one...economically within the free market . Yet, the laws, regulations, policies and practices controlling it are based on traditional free market tenets. The

Integrated Advanced Sounding Unit-A (AMSU-A). Configuration Management Plan

NASA Technical Reports Server (NTRS)

Cavanaugh, J.

1996-01-01

The purpose of this plan is to identify the baseline to be established during the development life cycle of the integrated AMSU-A, and define the methods and procedures which Aerojet will follow in the implementation of configuration control for each established baseline. Also this plan establishes the Configuration Management process to be used for the deliverable hardware, software, and firmware of the Integrated AMSU-A during development, design, fabrication, test, and delivery.

Decontamination and Management of Human Remains Following Incidents of Hazardous Chemical Release

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

Hauschild, Veronique; Watson, Annetta Paule; Bock, Robert Eldon

2012-01-01

Abstract Objective: To provide specific procedural guidance and resources for identification, assessment, control, and mitigation of compounds that may contaminate human remains resulting from chemical attack or release. Design: A detailed technical, policy, and regulatory review is summarized. Setting: Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present. Settings would include sites of transportation accidents, natural disasters, terrorist or military operations, mortuary affairs or medical examiner processing and decontamination points, and similar. Patients, Participants: While recommended procedures have not been validated with actual human remains, guidance has been developed frommore » data characterizing controlled experiments with fabrics, materiel, and laboratory animals. Main Outcome Measure(s): Presentation of logic and specific procedures for remains management, protection and decontamination of mortuary affairs personnel, as well as decision criteria for determining when remains are sufficiently decontaminated so as to pose no chemical health hazard. Results: Established procedures and existing equipment/materiel available for decontamination and verification provide appropriate and reasonable means to mitigate chemical hazards from remains. Extensive characterization of issues related to remains decontamination indicates that supra-lethal concentrations of liquid chemical warfare agent VX may prove difficult to decontaminate and verify in a timely fashion. Specialized personnel can and should be called upon to assist with monitoring necessary to clear decontaminated remains for transport and processing. Conclusions: Once appropriate decontamination and verification have been accomplished, normal procedures for remains processing and transport to the decedent s family and the continental United States can be followed.« less

Primary Definitive Procedure versus Conventional Three-staged Procedure for the Management of Low-type Anorectal Malformation in Females: A Randomized Controlled Trial.

PubMed

Gupta, Alisha; Agarwala, Sandeep; Sreenivas, Vishnubhatla; Srinivas, Madhur; Bhatnagar, Veereshwar

2017-01-01

Females with Krickenbeck low-type anorectal malformations - vestibular fistula (VF) and perineal fistula (PF) - are managed either by a primary definitive or conventional three-staged approach. Ultimate outcome in these children may be affected by wound dehiscence leading to healing by fibrosis. Most of the literature favors one approach over other based on retrospective analysis of their outcomes. Whether a statistically significant difference in wound dehiscence rates between these approaches exists needed to be seen. A randomized controlled trial for girls <14 years with VF or PF was done. Random tables were used to randomize 33 children to Group I (primary procedure) and 31 to Group II (three-staged procedure). Statistical analysis was done for significance of difference ( P < 0.05) in the primary outcome (wound dehiscence) and secondary outcomes (immediate and early postoperative complications). Of the 64 children randomized, 54 (84%) had VF. Both groups were comparable in demography, clinical profile and age at surgery. The incidence of wound dehiscence (39.4% vs. 18.2%; P = 0.04), immediate postoperative complications (51.5% vs. 12.9%; P = 0.001), and early postoperative complications (42.4% vs. 12.9%; P = 0.01) was significantly higher in Group I as compared to Group II. Six of 13 children (46.2%) with dehiscence in Group I required a diverting colostomy to be made. Females with VF or PF undergoing primary definitive procedure have a significantly higher incidence of wound dehiscence ( P = 0.04), immediate ( P = 0.001) and early postoperative complications ( P = 0.01).

EMS-physicians' self reported airway management training and expertise; a descriptive study from the Central Region of Denmark

PubMed Central

2011-01-01

Background Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway management-training and expertise from the regional physician-staffed emergency medical service (EMS). Methods The EMS in this part of The Central Region of Denmark is a two tiered system. The second tier comprises physician staffed Mobile Emergency Care Units. The medical directors of the programs supplied system data. A questionnaire addressing airway management experience, training and knowledge was sent to the EMS-physicians. Results There are no specific guidelines, standard operating procedures or standardised program for obtaining and maintaining skills regarding prehospital advanced airway management in the schemes covered by this study. 53/67 physicians responded; 98,1% were specialists in anesthesiology, with an average of 17,6 years of experience in anesthesiology, and 7,2 years experience as EMS-physicians. 84,9% reported having attended life support course(s), 64,2% an advanced airway management course. 24,5% fulfilled the curriculum suggested for Danish EMS physicians. 47,2% had encountered a difficult or impossible PHETI, most commonly in a patient in cardiac arrest or a trauma patient. Only 20,8% of the physicians were completely familiar with what back-up devices were available for airway management. Conclusions In this, the first Danish study of prehospital advanced airway management, we found a high degree of experience, education and training among the EMS-physicians, but their equipment awareness was limited. Check-outs, guidelines, standard operating procedures and other quality control measures may be needed. PMID:21303510

Global Forum: An International Perspective on Outpatient Surgical Procedures for Adult Hip and Knee Reconstruction.

PubMed

Argenson, Jean-Noël A; Husted, Henrik; Lombardi, Adolph; Booth, Robert E; Thienpont, Emmanuel

2016-07-06

Outpatient surgical procedures for adult hip and knee reconstruction are gaining interest on a worldwide basis and have been progressively increasing over the last few years. Preoperative screening needs to concentrate on both the patient's comorbidities and home environment to provide a proper alignment of expectations of the surgeon, the patient, and the patient's family. Preoperative multidisciplinary patient information covering all aspects of the upcoming treatment course is a mandatory step, focusing on pain management and early mobilization. Perioperative pain management includes both multimodal and preventive analgesia. Preemptive medications, minimization of narcotics, and combination of general and regional anesthesia are the techniques required in joint arthroplasty performed as an outpatient surgical procedure. A multimodal blood loss management program should be used with preoperative identification of anemia and attention directed toward minimizing blood loss, considering the use of tranexamic acid during the surgical procedure. Postoperative care extends from the initial recovery from anesthesia to the physical therapist's evaluation of the patient's ambulatory status. After the patient has met the criteria for discharge and has been discharged on the same day of the surgical procedure, a nurse should call the patient later at home to check on wound status, pain control, and muscle weakness, which will be further addressed by physiotherapy and education. Implementing outpatient arthroplasty requires monitoring safety, patient satisfaction, and economic impact. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Effect of management training in organizational justice: a randomized controlled trial

PubMed Central

NAKAMURA, Saki; SOMEMURA, Hironori; SASAKI, Norio; YAMAMOTO, Megumi; TANAKA, Mika; TANAKA, Katsutoshi

2016-01-01

Organizational justice (OJ) influences the well-being of employees of organizations. We conducted a randomized controlled trial to examine whether or not brief management training increases OJ for subordinates. Study participants were managers and subordinates working in the private manufacturing sector. Randomization at the departmental level generated an intervention group of 23 departments (93 managers and 248 subordinates) and a control group of 23 departments (91 managers and 314 subordinates). Managers in the intervention group received a 90-min training session to investigate the attitudes and behavior of managers and help increase OJ. Subordinates completed self-administered OJ questionnaire surveys on procedural, interpersonal, and informational justice before and 3 months after intervention. For all subordinates, the interaction between group and time in OJ scores obtained before and 3 months after intervention were not significant. However, in subgroup analyses of the lowest tertile group in relation to the baseline of each of the three OJ subscales and total scores, the lowest tertile group of the interpersonal justice subscale showed significant improvement. The results of this study suggest that brief management training in OJ for managers significantly improves a low rating from subordinates in interpersonal justice. Further studies are required to develop a specific intervention method to increase OJ. PMID:26860786

Effect of management training in organizational justice: a randomized controlled trial.

PubMed

Nakamura, Saki; Somemura, Hironori; Sasaki, Norio; Yamamoto, Megumi; Tanaka, Mika; Tanaka, Katsutoshi

2016-06-10

Organizational justice (OJ) influences the well-being of employees of organizations. We conducted a randomized controlled trial to examine whether or not brief management training increases OJ for subordinates. Study participants were managers and subordinates working in the private manufacturing sector. Randomization at the departmental level generated an intervention group of 23 departments (93 managers and 248 subordinates) and a control group of 23 departments (91 managers and 314 subordinates). Managers in the intervention group received a 90-min training session to investigate the attitudes and behavior of managers and help increase OJ. Subordinates completed self-administered OJ questionnaire surveys on procedural, interpersonal, and informational justice before and 3 months after intervention. For all subordinates, the interaction between group and time in OJ scores obtained before and 3 months after intervention were not significant. However, in subgroup analyses of the lowest tertile group in relation to the baseline of each of the three OJ subscales and total scores, the lowest tertile group of the interpersonal justice subscale showed significant improvement. The results of this study suggest that brief management training in OJ for managers significantly improves a low rating from subordinates in interpersonal justice. Further studies are required to develop a specific intervention method to increase OJ.

Guidance concepts for time-based flight operations

NASA Technical Reports Server (NTRS)

Vicroy, Dan D.

1990-01-01

Airport congestion and the associated delays are severe in today's airspace system and are expected to increase. NASA and the FAA is investigating various methods of alleviating this problem through new technology and operational procedures. One concept for improving airspace productivity is time-based control of aircraft. Research to date has focused primarily on the development of time-based flight management systems and Air Traffic Control operational procedures. Flight operations may, however, require special onboard guidance in order to satisfy the Air Traffic Control imposed time constraints. The results are presented of a simulation study aimed at evaluating several time-based guidance concepts in terms of tracking performance, pilot workload, and subjective preference. The guidance concepts tested varied in complexity from simple digital time-error feedback to an advanced time-referenced-energy guidance scheme.

Epidemiology and management of painful procedures in children in Canadian hospitals

PubMed Central

Stevens, Bonnie J.; Abbott, Laura K.; Yamada, Janet; Harrison, Denise; Stinson, Jennifer; Taddio, Anna; Barwick, Melanie; Latimer, Margot; Scott, Shannon D.; Rashotte, Judith; Campbell, Fiona; Finley, G. Allen

2011-01-01

Background Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. Methods We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ2) analyses. Results Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. Interpretation For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit. PMID:21464171

Ecological control line: A decade of exploration and an innovative path of ecological land management for megacities in China.

PubMed

Hong, Wuyang; Yang, Chengyun; Chen, Liuxin; Zhang, Fangfang; Shen, Shaoqing; Guo, Renzhong

2017-04-15

Ecological control line is a system innovation in the field of ecological environment protection in China and it has become as an important strategy of national ecological protection. Ten years have passed since the first ecological control line in Shenzhen was delimited in 2005. This study examines the connotations of ecological control line and the current study status in China and abroad, and then takes a brief description about the delimitation background and existing problems of the ecological control line in Shenzhen. The problem-solving strategy is gradually transforming from extensive management to refined management. This study proposes a differential ecological space management model that merges the space system, management system, and support system. The implementation paths include the following five aspects: delimiting ecological bottom lines to protect core ecological resources; formulating access systems for new construction projects to strictly control new construction; implementing construction land inventory reclamation assisted by market means; regulating boundary adjusting procedures and processes; and constructing ecological equity products by using multiple means to implement rights relief. Finally, this study illustrates the progress of the implementation and discusses the rigorousness and flexibility problems of ecological control line and calls for the promotion of the legislation. The management model and implementation paths proposed in this study have referential significance for developing countries and megacities to achieve ecological protection and sustainable development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Compendium of animal rabies prevention and control, 2011.

PubMed

2011-11-04

Rabies has one of the highest case-fatality ratios of any infectious disease. This report provides recommendations for public health officials, veterinarians, animal control officials, and other parties engaged in rabies prevention and control activities and should serve as the basis for standardizing procedures among jurisdictions. The recommendations regarding domestic animal vaccination, management of animals exposed to rabies, and management of animals that bite humans are the core elements of animal rabies control and human rabies prevention. These updated 2011 guidelines include the national case definition for animal rabies and clarify the role of the CDC rabies laboratory in providing confirmatory testing of suspect animals. The table of rabies vaccines licensed and marketed in the United States has been updated, and additional references have been included to provide scientific support for information in this report.

77 FR 31615 - Improving Mail Management Policies, Procedures, and Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... Mail Management Policies, Procedures, and Activities AGENCY: Office of Governmentwide Policy, General... Administration (GSA) has issued Federal Management Regulation (FMR) Bulletin G-03 which provides guidance to Executive Branch agencies for improving mail management policies, procedures, and activities. FMR Bulletin G...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

Profile negotiation: An air/ground automation integration concept for managing arrival traffic

NASA Technical Reports Server (NTRS)

Williams, David H.; Arbuckle, P. Douglas; Green, Steven M.; Denbraven, Wim

1993-01-01

NASA Ames Research Center and NASA Langley Research Center conducted a joint simulation study to evaluate a profile negotiation process (PNP) between a time-based air traffic control ATC system and an airplane equipped with a four dimensional flight management system (4D FMS). Prototype procedures were developed to support the functional implementation of this process. The PNP was designed to provide an arrival trajectory solution that satisfies the separation requirements of ATC while remaining as close as possible to the airplane's preferred trajectory. The Transport Systems Research Vehicle cockpit simulator was linked in real-time to the Center/TRACON Automation System (CTAS) for the experiment. Approximately 30 hours of simulation testing were conducted over a three week period. Active airline pilot crews and active Center controller teams participated as test subjects. Results from the experiment indicate the potential for successful incorporation of airplane preferred arrival trajectories in the CTAS automation environment. Controllers were able to consistently and effectively negotiate nominally conflict-free trajectories with pilots flying a 4D-FMS-equipped airplane. The negotiated trajectories were substantially closer to the airplane's preference than would have otherwise been possible without the PNP. Airplane fuel savings relative to baseline CTAS were achieved in the test scenarios. The datalink procedures and clearances developed for this experiment, while providing the necessary functionality, were found to be operationally unacceptable to the pilots. Additional pilot control and understanding of the proposed airplane-preferred trajectory and a simplified clearance procedure were cited as necessary for operational implementation of the concept. From the controllers' perspective, the main concerns were the ability of the 4D airplane to accurately track the negotiated trajectory and the workload required to support the PNP as implemented in this study.

Human Factors Considerations for Performance-Based Navigation

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Adams, Catherine A.

2006-01-01

A transition toward a performance-based navigation system is currently underway in both the United States and around the world. Performance-based navigation incorporates Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures that do not rely on the location of ground-based navigation aids. These procedures offer significant benefits to both operators and air traffic managers. Under sponsorship from the Federal Aviation Administration (FAA), the National Aeronautics and Space Administration (NASA) has undertaken a project to document human factors issues that have emerged during RNAV and RNP operations and propose areas for further consideration. Issues were found to include aspects of air traffic control and airline procedures, aircraft systems, and procedure design. Major findings suggest the need for human factors-specific instrument procedure design guidelines. Ongoing industry and government activities to address air-ground communication terminology, procedure design improvements, and chart-database commonality are strongly encouraged.

Acute normovolemic hemodilution is safe in neurosurgery.

PubMed

Oppitz, Paulo P; Stefani, Marco A

2013-01-01

To determine the safety of acute normovolemic hemodilution (ANH) for patients undergoing neurosurgical procedures. A group of 100 patients undergoing neurosurgical procedures was assigned prospectively to receive ANH. A group of 47 patients who underwent craniotomy for aneurysm clipping and standard anesthetic management was used as a control. Procedures conducted under ANH were performed without significant variations in physiologic parameters. Compared with controls, intraoperative blood loss, operative time, incidence and grade of complications, and length of hospital stay were similar between the two groups. Although the ANH group showed a difference in prothrombin levels before and after hemodilution procedures, the levels were still considered within physiologic parameters. Platelet counts and partial thromboplastin time (PTT) levels indicated no significant variations in either group. During the ANH procedure, a considerable reduction of brain oxygen extraction was observed in individuals with worse preoperative neurologic status (P < 0.05), indicating potential benefit. Among patients with cerebral aneurysm, patients with good initial clinical grades had better clinical results as indicated by Glasgow Outcome Scale scores (P < 0.02). ANH is a safe procedure for patients undergoing neurosurgical procedures. Further studies are necessary to confirm the improvement in brain oxygen extraction and the clinical impact. Nonetheless, patients undergoing aneurysm clipping with good clinical grades seem to profit from ANH. Copyright © 2013 Elsevier Inc. All rights reserved.

COSTS OF INTERSTITAL CYSTITIS IN A MANAGED CARE POPULATION

PubMed Central

Clemens, J. Quentin; Meenan, Richard T.; O’Keeffe Rosetti, Maureen C.; Kimes, Terry; Calhoun, Elizabeth A.

2008-01-01

Objective This study assessed the direct medical costs, medication and procedure use associated with interstitial cystitis (IC) in women in the Kaiser Permanente Northwest (KPNW) managed care population. Methods The KPNW electronic medical record was utilized to identify women diagnosed with interstitial cystitis (n=239). Each of these cases was matched with three controls based on age and duration in the health plan. Health plan cost accounting data were used to determine inpatient, outpatient, and pharmacy costs for 1998-2003. An analysis of prescription medication use, cystoscopic and urodynamic procedures commonly associated with IC was also performed. To evaluate for comorbidities, an automated risk-adjustment model (RxRisk) linked to 28 chronic medical conditions was applied to the administrative datasets from both groups. Results The mean duration from the date of IC diagnosis to the end of the study period was 36.6 months (range 1.4-60). Mean yearly costs were 2.4-fold greater in cases than controls ($7100 vs. $2994), and median yearly costs were 3.8-fold greater ($5000 vs. $1304). These cost differences were predominantly due to outpatient and pharmacy expenses. Medication and procedure use were significantly greater in cases than controls. These findings were consistent across RxRisk categories, which suggest that the observed cost differences are IC-specific. Conclusions The direct per-person costs of IC are high, with average yearly costs approximately $4000 greater than age-matched controls. This cost differential is an underestimate, as costs preceding the diagnosis, use of alternative therapies, indirect costs and costs of those with IC that is not diagnosed are not included. PMID:18329077

How to test herbicides at forest tree nurseries.

Treesearch

Roger E. Sandquist; Peyton W. Owston; Stephen E. McDonald

1981-01-01

Procedures developed in a cooperative westwide study of weed control in forest tree nurseries are described in a form modified for use by nursery managers. The proven, properly designed test and evaluation methods can be used to generate data needed for evaluation and registration of herbicides.

78 FR 56899 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-16

... Request; Requests for Clinical Laboratory Improvement Amendments Categorization AGENCY: Food and Drug... Laboratory Improvement Amendments of 1988 (CLIA) Categorization--42 CFR 493.17 (OMB Control Number 0910-0607)--Extension. A guidance document entitled ``Guidance for Administrative Procedures for CLIA Categorization...

76 FR 34075 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

...) determines, recommends, and implements procedural changes needed to maintain effective management of CDC... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and...

40 CFR 63.105 - Maintenance wastewater requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... National Emission Standards for Organic Hazardous Air Pollutants From the Synthetic Organic Chemical... for maintenance wastewaters containing those organic HAP's listed in table 9 of subpart G of this part... procedures that will be followed to properly manage the wastewater and control organic HAP emissions to the...

40 CFR 63.105 - Maintenance wastewater requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... National Emission Standards for Organic Hazardous Air Pollutants From the Synthetic Organic Chemical... for maintenance wastewaters containing those organic HAP's listed in table 9 of subpart G of this part... procedures that will be followed to properly manage the wastewater and control organic HAP emissions to the...

76 FR 25376 - Occupational Exposure to Hazardous Chemicals in Laboratories Standard; Extension of the Office of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... describes: Standard operating procedures for using hazardous chemicals; hazard-control techniques; equipment...] Occupational Exposure to Hazardous Chemicals in Laboratories Standard; Extension of the Office of Management... collection requirements specified in the Standard on Occupational Exposure to Hazardous Chemicals in...

Who Can You Trust? Protecting Your Organization from Internal Fraud.

ERIC Educational Resources Information Center

Lukaszewski, Thomas E.

1997-01-01

Discusses how to protect a child care organization from employee fraud. Differentiates employee and management fraud and examines reasons fraud is committed. Suggests procedures for protecting an organization from fraud, including establishing an effective internal control system, paying attention to unusual employee behavior, reviewing expense…

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2012 CFR

2012-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2011 CFR

2011-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2014 CFR

2014-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2013 CFR

2013-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

28 CFR 51.26 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Contents of Submissions § 51.26 General. (a) The source of any information... Management and Budget control number under the Paperwork Reduction Act applies to the collection of...

28 CFR 51.26 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Contents of Submissions § 51.26 General. (a) The source of any information... Management and Budget control number under the Paperwork Reduction Act applies to the collection of...

34 CFR 361.89 - Enforcement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... revisions until the DSU sustains satisfactory performance based on the current performance levels over a period of more than 1 year. (d) If the Secretary determines that a DSU with less than satisfactory... satisfactory level on the compliance indicators. (Approved by the Office of Management and Budget under control...

Use of NDT equipment for construction quality control of hot mix asphalt pavements

DOT National Transportation Integrated Search

2006-08-01

The focus of the study has been to evaluate the utility of seismic methods in the quality management of the hot mix asphalt layers. Procedures are presented to measure the target field moduli of hot mix asphalt (HMA) with laboratory seismic methods, ...

44 CFR 72.4 - Submittal/payment procedures and FEMA response.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Submittal/payment procedures and FEMA response. 72.4 Section 72.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... PROCEDURES AND FEES FOR PROCESSING MAP CHANGES § 72.4 Submittal/payment procedures and FEMA response. (a) The...

44 CFR 72.4 - Submittal/payment procedures and FEMA response.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Submittal/payment procedures and FEMA response. 72.4 Section 72.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... PROCEDURES AND FEES FOR PROCESSING MAP CHANGES § 72.4 Submittal/payment procedures and FEMA response. (a) The...

Is organizational justice associated with clinical performance in the care for patients with diabetes in primary care? Evidence from the improving Quality of care in Diabetes study.

PubMed

Elovainio, Marko; Steen, Nick; Presseau, Justin; Francis, Jill; Hrisos, Susan; Hawthorne, Gillian; Johnston, Marie; Stamp, Elaine; Hunter, Margaret; Grimshaw, Jeremy M; Eccles, Martin P

2013-02-01

Type 2 diabetes is an increasingly prevalent illness, and there is considerable variation in the quality of care provided to patients with diabetes in primary care. The aim of this study was to explore whether organizational justice and organizational citizenship behaviour are associated with the behaviours of clinical staff when providing care for patients with diabetes. The data were from an ongoing prospective multicenter study, the 'improving Quality of care in Diabetes' (iQuaD) study. Participants (N = 467) were clinical staff in 99 primary care practices in the UK. The outcome measures were six self-reported clinical behaviours: prescribing for glycaemic control, prescribing for blood pressure control, foot examination, giving advice about weight management, providing general education about diabetes and giving advice about self-management. Organizational justice perceptions were collected using a self-administered questionnaire. The associations between organizational justice and behavioural outcomes were tested using linear multilevel regression modelling. Higher scores on the procedural component of organizational justice were associated with more frequent weight management advice, self-management advice and provision of general education for patients with diabetes. The associations between justice and clinical behaviours were not explained by individual or practice characteristics, but evidence was found for the partial mediating role of organizational citizenship behaviour. Quality improvement efforts aimed at increasing advice and education provision in diabetes management in primary care could target also perceptions of procedural justice.

Integrating automated support for a software management cycle into the TAME system

NASA Technical Reports Server (NTRS)

Sunazuka, Toshihiko; Basili, Victor R.

1989-01-01

Software managers are interested in the quantitative management of software quality, cost and progress. An integrated software management methodology, which can be applied throughout the software life cycle for any number purposes, is required. The TAME (Tailoring A Measurement Environment) methodology is based on the improvement paradigm and the goal/question/metric (GQM) paradigm. This methodology helps generate a software engineering process and measurement environment based on the project characteristics. The SQMAR (software quality measurement and assurance technology) is a software quality metric system and methodology applied to the development processes. It is based on the feed forward control principle. Quality target setting is carried out before the plan-do-check-action activities are performed. These methodologies are integrated to realize goal oriented measurement, process control and visual management. A metric setting procedure based on the GQM paradigm, a management system called the software management cycle (SMC), and its application to a case study based on NASA/SEL data are discussed. The expected effects of SMC are quality improvement, managerial cost reduction, accumulation and reuse of experience, and a highly visual management reporting system.

Resolving Off-Nominal Situations in Schedule-Based Terminal Area Operations: Results from a Human-in-the-Loop Simulation

NASA Technical Reports Server (NTRS)

Mercer, Joey; Callantine, Todd; Martin, Lynne

2012-01-01

A recent human-in-the-loop simulation in the Airspace Operations Laboratory (AOL) at NASA's Ames Research Center investigated the robustness of Controller-Managed Spacing (CMS) operations. CMS refers to AOL-developed controller tools and procedures for enabling arrivals to conduct efficient Optimized Profile Descents with sustained high throughput. The simulation provided a rich data set for examining how a traffic management supervisor and terminal-area controller participants used the CMS tools and coordinated to respond to off-nominal events. This paper proposes quantitative measures for characterizing the participants responses. Case studies of go-around events, replicated during the simulation, provide insights into the strategies employed and the role the CMS tools played in supporting them.

Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements

PubMed Central

Mahmoud, Samer S.S.; Sukeik, Mohamed; Alazzawi, Sulaiman; Shaath, Mohammed; Sabri, Omar

2016-01-01

Background: The increasing load placed by joint replacement surgery on health care systems makes infection, even with the lowest rates, a serious concern that needs to be thoroughly studied and addressed using all possible measures. Methods: A comprehensive review of the current literature on salvage procedures for recurrent PJIs using PubMed, EMBASE and CINAHL has been conducted. Results: Prolonged suppressive antibiotic therapy (PSAT), resection arthroplasty and arthrodesis were the most common procedures performed. Suppressive antibiotic therapy is based on the use of well tolerated long term antibiotics in controlling sensitive organisms. Resection arthroplasty which should be reserved as a last resort provided more predictable outcomes in the hip whereas arthrodesis was associated with better outcomes in the knee. Various methods for arthrodesis including internal and external fixation have been described. Conclusion: Despite good union and infection control rates, all methods were associated with complications occasionally requiring further surgical interventions. PMID:28144373

Standard operating procedures improve acute neurologic care in a sub-Saharan African setting.

PubMed

Jaiteh, Lamin E S; Helwig, Stefan A; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman; Fassbender, Klaus

2017-07-11

Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p < 0.05) and assessments of respiratory rate (98.0% vs 81.9%, p < 0.001), temperature (60.0% vs 36.2%; p < 0.001), and glucose levels (73.0% vs 58.1%; p < 0.05), in addition to written directives by physicians (96.0% vs 88.6%, p < 0.05), whereas assessments of other vital signs remained unchanged. In stroke patients, rates of stroke-related procedures increased: early CT scanning (24.3% vs 9.9%; p < 0.05), blood count (73.0% vs 49.3%; p < 0.01), renal and liver function tests (50.0% vs 5.6%, p < 0.001), aspirin prophylaxis (47.3% vs 9.9%; p < 0.001), and physiotherapy (41.9% vs 4.2%; p < 0.001). Most effects persisted until the second-year evaluation. SOP implementation was similarly feasible and beneficial at the Brikama hospital. However, outcomes did not significantly differ in the hospitals. Implementing SOPs is a realistic, low-cost option for improving process quality of neurologic emergency management in under-resourced settings. This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Multi-Agent Diagnosis and Control of an Air Revitalization System for Life Support in Space

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Kowing, Jeffrey; Nieten, Joseph; Graham, Jeffrey s.; Schreckenghost, Debra; Bonasso, Pete; Fleming, Land D.; MacMahon, Matt; Thronesbery, Carroll

2000-01-01

An architecture of interoperating agents has been developed to provide control and fault management for advanced life support systems in space. In this adjustable autonomy architecture, software agents coordinate with human agents and provide support in novel fault management situations. This architecture combines the Livingstone model-based mode identification and reconfiguration (MIR) system with the 3T architecture for autonomous flexible command and control. The MIR software agent performs model-based state identification and diagnosis. MIR identifies novel recovery configurations and the set of commands required for the recovery. The AZT procedural executive and the human operator use the diagnoses and recovery recommendations, and provide command sequencing. User interface extensions have been developed to support human monitoring of both AZT and MIR data and activities. This architecture has been demonstrated performing control and fault management for an oxygen production system for air revitalization in space. The software operates in a dynamic simulation testbed.

Improving Managers' Psychophysical Well-Being: Effectiveness of Respiratory Sinus Arrhythmia Biofeedback.

PubMed

Munafò, Marianna; Patron, Elisabetta; Palomba, Daniela

2016-06-01

High work stress has been consistently associated with disturbed autonomic balance, specifically, lowered vagal cardiac control and increased sympathetic activity, which may lead to increased cardiovascular risk. Stress management procedures have been proposed to reduce autonomic dysfunctions related to work stress in different categories of workers exposed to heightened work demands, while a limited number of studies addressed this issue in managers. The present study was aimed at evaluating the effectiveness of a respiratory sinus arrhythmia (RSA) biofeedback (BF) intervention on psychological and physiological outcomes, in managers with high-level work responsibilities. Thirty-one managers leading outstanding private or public companies were randomly assigned to either a RSA-BF training (RSA-BF; N = 16) or a control group (N = 15). The RSA-BF training consisted of five weekly 45 min sessions, designed to increase RSA, whereas controls had to provide a daily stress diary once a week. After the training, managers in both groups reported reduced heart rate at rest, lower anxiety levels and improvement in health-related quality of life. More importantly, managers in the RSA-BF group showed increased vagal control (as indexed by increased RSA), decreased sympathetic arousal (as indexed by reduced skin conductance and systolic blood pressure) and lower emotional interferences, compared to managers in the control group. Results from this study showed that RSA-BF training was effective in improving cardiac autonomic balance at rest. Moreover, findings from this study underline the effectiveness of biofeedback in reducing psychophysiological negative outcomes associated with stress in managers.

Man-rated flight software for the F-8 DFBW program

NASA Technical Reports Server (NTRS)

Bairnsfather, R. R.

1975-01-01

The design, implementation, and verification of the flight control software used in the F-8 DFBW program are discussed. Since the DFBW utilizes an Apollo computer and hardware, the procedures, controls, and basic management techniques employed are based on those developed for the Apollo software system. Program Assembly Control, simulator configuration control, erasable-memory load generation, change procedures and anomaly reporting are discussed. The primary verification tools--the all-digital simulator, the hybrid simulator, and the Iron Bird simulator--are described, as well as the program test plans and their implementation on the various simulators. Failure-effects analysis and the creation of special failure-generating software for testing purposes are described. The quality of the end product is evidenced by the F-8 DFBW flight test program in which 42 flights, totaling 58 hours of flight time, were successfully made without any DFCS inflight software, or hardware, failures.

The Effects of Job Demands and Low Job Control on Work-Family Conflict: The Role of Fairness in Decision Making and Management

ERIC Educational Resources Information Center

Heponiemi, Tarja; Elovainio, Marko; Pekkarinen, Laura; Sinervo, Timo; Kouvonen, Anne

2008-01-01

The present study examined whether perceptions of organizational fairness (the procedural and interactional components) were able to diminish the negative effects of high job demands and low job control on the balance between work and family. The study participants were 713 women working in long-term care for elderly people in Finland. The results…

Drug procurement and management.

PubMed

Salhotra, V S

2003-03-01

A strong drug procurement and management system under the RNTCP is critical to programme success. Significant improvements in manufacturing, inspection, supply, storage and quality control practices and procedures have been achieved due to an intensive RNTCP network. Drugs used in RNTCP are rifampicin, isoniazid, ethambutol, pyrazinamide and streptomycin. Patients of TB are categorised into I, II and III and each category has a different standarised treatment. Procurement, distribution system and quality assurance of drugs are narrated in brief in this article.

Development of an integrated configuration management/flight director system for piloted STOL approaches

NASA Technical Reports Server (NTRS)

Hoh, R. H.; Klein, R. H.; Johnson, W. A.

1977-01-01

A system analysis method for the development of an integrated configuration management/flight director system for IFR STOL approaches is presented. Curved descending decelerating approach trajectories are considered. Considerable emphasis is placed on satisfying the pilot centered requirements (acceptable workload) as well as the usual guidance and control requirements (acceptable performance). The Augmentor Wing Jet STOL Research Aircraft was utilized to allow illustration by example, and to validate the analysis procedure via manned simulation.

The global economy and its influence on the Slovak construction sector

NASA Astrophysics Data System (ADS)

Jankovichová, E.

2010-03-01

For the construction industry, globalization is a trend that means two things: many opportunities and many threats. In the conditions of globalization many management approaches, such as organization structure, strategy forming, planning, motivation and control procedures, communication channels, risk management, etc., must transform. The aim of the paper is to analyze the influence of globalization on the construction industry in Slovakia and identify the impact of globalization on construction companies in this area.

Piloted simulation of an air-ground profile negotiation process in a time-based Air Traffic Control environment

NASA Technical Reports Server (NTRS)

Williams, David H.; Green, Steven M.

1993-01-01

Historically, development of airborne flight management systems (FMS) and ground-based air traffic control (ATC) systems has tended to focus on different objectives with little consideration for operational integration. A joint program, between NASA's Ames Research Center (Ames) and Langley Research Center (Langley), is underway to investigate the issues of, and develop systems for, the integration of ATC and airborne automation systems. A simulation study was conducted to evaluate a profile negotiation process (PNP) between the Center/TRACON Automation System (CTAS) and an aircraft equipped with a four-dimensional flight management system (4D FMS). Prototype procedures were developed to support the functional implementation of this process. The PNP was designed to provide an arrival trajectory solution which satisfies the separation requirements of ATC while remaining as close as possible to the aircraft's preferred trajectory. Results from the experiment indicate the potential for successful incorporation of aircraft-preferred arrival trajectories in the CTAS automation environment. Fuel savings on the order of 2 percent to 8 percent, compared to fuel required for the baseline CTAS arrival speed strategy, were achieved in the test scenarios. The data link procedures and clearances developed for this experiment, while providing the necessary functionality, were found to be operationally unacceptable to the pilots. In particular, additional pilot control and understanding of the proposed aircraft-preferred trajectory, and a simplified clearance procedure were cited as necessary for operational implementation of the concept.

Effectiveness of medical hypnosis for pain reduction and faster wound healing in pediatric acute burn injury: study protocol for a randomized controlled trial.

PubMed

Chester, Stephen J; Stockton, Kellie; De Young, Alexandra; Kipping, Belinda; Tyack, Zephanie; Griffin, Bronwyn; Chester, Ralph L; Kimble, Roy M

2016-04-29

Burns and the associated wound care procedures can be extremely painful and anxiety-provoking for children. Burn injured children and adolescents are therefore at greater risk of experiencing a range of psychological reactions, in particular posttraumatic stress disorder, which can persist for months to years after the injury. Non-pharmacological intervention is critical for comprehensive pain and anxiety management and is used alongside pharmacological analgesia and anxiolysis. However, effective non-pharmacological pain and anxiety management during pediatric burn procedures is an area still needing improvement. Medical hypnosis has received support as a technique for effectively decreasing pain and anxiety levels in adults undergoing burn wound care and in children during a variety of painful medical procedures (e.g., bone marrow aspirations, lumbar punctures, voiding cystourethrograms, and post-surgical pain). Pain reduction during burn wound care procedures is linked with improved wound healing rates. To date, no randomized controlled trials have investigated the use of medical hypnosis in pediatric burn populations. Therefore this study aims to determine if medical hypnosis decreases pain, anxiety, and biological stress markers during wound care procedures; improves wound healing times; and decreases rates of traumatic stress reactions in pediatric burn patients. This is a single-center, superiority, parallel-group, prospective randomized controlled trial. Children (4 to 16 years, inclusive) with acute burn injuries presenting for their first dressing application or change are randomly assigned to either the (1) intervention group (medical hypnosis) or (2) control group (standard care). A minimum of 33 participants are recruited for each treatment group. Repeated measures of pain, anxiety, stress, and wound healing are taken at every dressing change until ≥95 % wound re-epithelialization. Further data collection assesses impact on posttraumatic stress symptomatology, speed of wound healing, and parent perception of how easy the dressing change is for their child. Study results will elucidate whether the disease process can be changed by using medical hypnosis with children to decrease pain, anxiety, and stress in the context of acute burn wounds. Australian New Zealand Clinical Trials Registry ACTRN12615000419561.

Managed care cost-containment strategies and their impact on physician prescribing and treatment of depression. Based on a presentation by Robert K. Schreter, MD.

PubMed

2000-02-01

Pharmacy costs are outpacing other healthcare expenditures, with psychotropic medications accounting for 16% to 25% of the total pharmacy costs. Managed care organizations (MCOs) can be expected to exert considerable pressure to control such costs. Avenues for cost containment include changing the management and spending decisions of MCOs, influencing physician prescribing patterns, encouraging economically efficient pharmacy policies and procedures, and controlling patient access to prescription drugs. From the cost standpoint of an MCO, briefer approaches to treating depressed patients are desirable. The MCOs prefer a limited number of psychotherapeutic sessions, rapid titration and prescription of higher dosage levels of appropriate drugs, and a longer continuation phase of pharmacological treatment to avert a relapse.

Test, Control and Monitor System (TCMS) operations plan

NASA Technical Reports Server (NTRS)

Macfarlane, C. K.; Conroy, M. P.

1993-01-01

The purpose is to provide a clear understanding of the Test, Control and Monitor System (TCMS) operating environment and to describe the method of operations for TCMS. TCMS is a complex and sophisticated checkout system focused on support of the Space Station Freedom Program (SSFP) and related activities. An understanding of the TCMS operating environment is provided and operational responsibilities are defined. NASA and the Payload Ground Operations Contractor (PGOC) will use it as a guide to manage the operation of the TCMS computer systems and associated networks and workstations. All TCMS operational functions are examined. Other plans and detailed operating procedures relating to an individual operational function are referenced within this plan. This plan augments existing Technical Support Management Directives (TSMD's), Standard Practices, and other management documentation which will be followed where applicable.

The Associate Principal Astronomer for AI Management of Automatic Telescopes

NASA Technical Reports Server (NTRS)

Henry, Gregory W.

1998-01-01

This research program in scheduling and management of automatic telescopes had the following objectives: 1. To field test the 1993 Automatic Telescope Instruction Set (ATIS93) programming language, which was specifically developed to allow real-time control of an automatic telescope via an artificial intelligence scheduler running on a remote computer. 2. To develop and test the procedures for two-way communication between a telescope controller and remote scheduler via the Internet. 3. To test various concepts in Al scheduling being developed at NASA Ames Research Center on an automatic telescope operated by Tennessee State University at the Fairborn Observatory site in southern Arizona. and 4. To develop a prototype software package, dubbed the Associate Principal Astronomer, for the efficient scheduling and management of automatic telescopes.

What Can Your Accountant Do For You?

PubMed Central

Martin, R. F. J.

1977-01-01

Physicians who complain about accountants' exhorbitant fees may not be getting their money's worth - because they aren't asking enough of their accountants. Besides preparing tax returns, accountants can set up bookkeeping procedures, advise on financial management and generally put the doctor more in control of his own income.

40 CFR 63.11115 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

40 CFR 63.11115 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

40 CFR 63.11115 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

Modification of Decision-Making Behavior of Third-Year Medical Students.

ERIC Educational Resources Information Center

Spiegel, Chariklia T.; And Others

1982-01-01

Modification of physician behavior, one approach to controlling health care expenditures, was studied. Students were divided into two groups. The experimental group scored better in their ability to determine diagnoses, make patient-management decisions, and choose essential diagnostic procedures; average charges were half the amount generated by…

Herbicidal drift control: aerial spray equipment, formulations, and supervision.

Treesearch

H. Gratkowski

1974-01-01

Public concern over environmental pollution requires increasingly sophisticated procedures when herbicides are used in silviculture. Many specialized aerial application systems and spray additives have been developed to reduce drift of herbicidal sprays. This publication provides forest-land managers with a brief description of these aerial spray systems and additives...

75 FR 66301 - Amendment of Class E Airspace; Corpus Christi, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

... the Corpus Christi, TX, area. Additional controlled airspace is necessary to accommodate new Standard Instrument Approach Procedures (SIAP) at Corpus Christi International Airport, Corpus Christi, TX. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the...

76 FR 53636 - Amendment of Class E Airspace; Gary, IN

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-29

... accommodate new Area Navigation (RNAV) Standard Instrument Approach Procedures at Gary/Chicago International Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR... controlled airspace at Gary/Chicago International Airport (76 FR 28686) Docket No. FAA-2011-0427. Interested...

78 FR 25005 - Proposed Establishment of Class E Airspace; Port Townsend, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-29

... Jefferson County International Airport, Port Townsend, WA. Controlled airspace is necessary to accommodate... procedures at Jefferson County International Airport. The FAA is proposing this action to enhance the safety and management of aircraft operations at the airport. DATES: Comments must be received on or before...

Autonomy, Interdependence, and Social Control: NASA and the Space Shuttle "Challenger."

ERIC Educational Resources Information Center

Vaughan, Diane

1990-01-01

Shows that the organizations responsible for regulating safety at the National Aeronautics and Space Administration (NASA) failed to identify flaws in management procedures and technical design that, if corrected, might have prevented the "Challenger" tragedy. Regulatory effectiveness was inhibited by the autonomy and interdependence of…

Managing and Correcting Defiant Behavior through Music

ERIC Educational Resources Information Center

Lohmeyer, Aaron Z.

2017-01-01

The purpose of this article is to share principles and strategies that may be used to teach appropriate behaviors to students that that may struggle with an emotional behavior disorder. Operating from the principle that music is naturally rewarding, classroom procedures and lessons that address preparation, imagination, effortful control, pacing,…

77 FR 61248 - Establishment of Class E Airspace; Deer Lodge, MT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

...-0379; Airspace Docket No. 12-ANM-7 Establishment of Class E Airspace; Deer Lodge, MT AGENCY: Federal... at Deer Lodge-City- County Airport, Deer Lodge, MT. Controlled airspace is necessary to accommodate... procedures at Deer Lodge-City-County Airport. This improves the safety and management of Instrument Flight...

SPIRES Tailored to a Special Library: A Mainframe Answer for a Small Online Catalog.

ERIC Educational Resources Information Center

Newton, Mary

1989-01-01

Describes the design and functions of a technical library database maintained on a mainframe computer and supported by the SPIRES database management system. The topics covered include record structures, vocabulary control, input procedures, searching features, time considerations, and cost effectiveness. (three references) (CLB)

30 CFR 250.1506 - How often must I train my employees?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 250.1506 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL...) Establish procedures to verify adequate retention of the knowledge and skills that employees need to perform... programs provide for periodic training and verification of well control or production safety knowledge and...

17 CFR 240.17Ad-22 - Standards for clearing agencies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of the clearing agency's risk management procedures. (9) Provide market participants with sufficient... to its participants that would be expected to breach margin requirements or other risk control... net capital as defined in § 240.15c3-1 for broker-dealers or any similar risk adjusted capital...

49 CFR 176.700 - General stowage requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... materials requiring supplemental operational procedures, the shipper must furnish the master or person in charge of the vessel a copy of the necessary operational instructions. (d) A person may not remain... of Management and Budget under control numbers 2137-0534, 2137-0535 and 2137-0536) [Amdt. 176-15, 48...

Implementing a resource management program for accreditation process at the medical laboratory.

PubMed

Yenice, Sedef

2009-03-01

To plan for and provide adequate resources to meet the mission and goals of a medical laboratory in compliance with the requirements for laboratory accreditation by Joint Commission International. The related policies and procedures were developed based on standard requirements for resource management. Competency assessment provided continuing education and performance feedback to laboratory employees. Laboratory areas were designed for the efficient and safe performance of laboratory work. A physical environment was built up where hazards were controlled and personnel activities were managed to reduce the risk of injuries. An Employees Occupational Safety and Health Program (EOSHP) was developed to address all types of hazardous materials and wastes. Guidelines were defined to verify that the methods would produce accurate and reliable results. An active resource management program will be an effective way of assuring that systems are in control and continuous improvement is in progress.

Efficacy of spinal cord stimulators in treating peripheral neuropathy: a case series.

PubMed

Abd-Elsayed, Alaa; Schiavoni, Nick; Sachdeva, Harsh

2016-02-01

Peripheral neuropathy is a common cause of pain, and it is increasing in prevalence. Peripheral neuropathic pain is very hard to treat and can be resistant to multiple pain management modalities. Our series aimed at testing the efficacy of spinal cord stimulators (SCSs) in treating resistant painful peripheral neuropathy. Case 1: A 79-year-old man presented to our clinic with long-standing history of painful peripheral diabetic neuropathy resistant to conservative management. After failure of all possible modalities, we offered the patient an SCS trial that was very successful, and we proceeded with the permanent implant that continued to help with his pain and allowed the patient to wean down his medications. Case 2: A 60-year-old man presented with chronic peripheral neuropathy secondary to HIV, patient failed all conservative and procedural management. Patient then had an SCS trial that relieved his pain significantly. Unfortunately, we did not proceed with the implant due to deterioration of the patient general health. Case 3: A 39-year-old woman presented with painful peripheral neuropathy secondary to chemotherapy for breast cancer. After failure of medication management and procedures, patient had a SCS trial that improved her pain and we then proceeded with performing the permanent implant that controlled her pain. We presented 3 cases with chronic painful peripheral neuropathy secondary to HIV, diabetes mellitus, and chemotherapy that was resistant to conservative pain management and procedures that was successfully treated with neurostimulation. Copyright © 2016 Elsevier Inc. All rights reserved.

Applying industrial engineering practices to radiology.

PubMed

Rosen, Len

2004-01-01

Seven hospitals in Oregon and Washington have successfully adopted the Toyota Production System (TPS). Developed by Taiichi Ohno, TPS focuses on finding efficiencies and cost savings in manufacturing processes. A similar effort has occurred in Canada, where Toronto's Hospital for Sick Children has developed a database for its diagnostic imaging department built on the principles of TPS applied to patient encounters. Developed over the last 5 years, the database currently manages all interventional patient procedures for quality assurance, inventory, equipment, and labor. By applying industrial engineering methodology to manufacturing processes, it is possible to manage these constraints, eliminate the obstacles to achieving streamlined processes, and keep the cost of delivering products and services under control. Industrial engineering methodology has encouraged all stakeholders in manufacturing plants to become participants in dealing with constraints. It has empowered those on the shop floor as well as management to become partners in the change process. Using a manufacturing process model to organize patient procedures enables imaging department and imaging centers to generate reports that can help them understand utilization of labor, materials, equipment, and rooms. Administrators can determine the cost of individual procedures as well as the total and average cost of specific procedure types. When Toronto's Hospital for Sick Children first implemented industrial engineering methodology to medical imaging interventional radiology patient encounters, it focused on materials management. Early in the process, the return on investment became apparent as the department improved its management of more than 500,000 dollars of inventory. The calculated accumulated savings over 4 years for 10,000 interventional procedures alone amounted to more than 140,000 dollars. The medical imaging department in this hospital is only now beginning to apply what it has learned to other factors contributing to case cost. It has started to analyze its service contracts with equipment vendors. The department also is accumulating data to measure room, equipment, and labor utilization. The hospital now has a true picture of the real cost associated with each patient encounter in medical imaging. It can now begin to manage case costs, perform better capacity planning, create more effective relationships with its material suppliers, and optimize scheduling of patients and staff.

Attaining and maintaining data integrity with configuration management

NASA Astrophysics Data System (ADS)

Huffman, Dorothy J.; Jeane, Shirley A.

1993-08-01

Managers and scientists are concerned about data integrity because they draw conclusions from data that can have far reaching effects. Projects managers use Configuration Management to insure that hardware, software, and project information are controlled. They have not, as yet, applied its rigorously to data. However, there is ample opportunity in the data collection and production process to jeopardize data integrity. Environmental changes, tampering and production problems can all affect data integrity. There are four functions included in the Configuration Management process: configuration identification, control, auditing and status accounting. These functions provide management the means to attain data integrity and the visibility into engineering processes needed to maintain data integrity. When project managers apply Configuration Management processes to data, the data user can trace back through history to validate data integrity. The user knows that the project allowed only orderly changes to the data. He is assured that project personnel followed procedures to maintain data quality. He also has access to status information about the data. The user receives data products with a known integrity level and a means to assess the impact of past events ont he conclusions derived from the data. To obtain these benefits, project managers should apply the Configuration Management discipline to data.

Software-defined networking control plane for seamless integration of multiple silicon photonic switches in Datacom networks.

PubMed

Shen, Yiwen; Hattink, Maarten H N; Samadi, Payman; Cheng, Qixiang; Hu, Ziyiz; Gazman, Alexander; Bergman, Keren

2018-04-16

Silicon photonics based switches offer an effective option for the delivery of dynamic bandwidth for future large-scale Datacom systems while maintaining scalable energy efficiency. The integration of a silicon photonics-based optical switching fabric within electronic Datacom architectures requires novel network topologies and arbitration strategies to effectively manage the active elements in the network. We present a scalable software-defined networking control plane to integrate silicon photonic based switches with conventional Ethernet or InfiniBand networks. Our software-defined control plane manages both electronic packet switches and multiple silicon photonic switches for simultaneous packet and circuit switching. We built an experimental Dragonfly network testbed with 16 electronic packet switches and 2 silicon photonic switches to evaluate our control plane. Observed latencies occupied by each step of the switching procedure demonstrate a total of 344 µs control plane latency for data-center and high performance computing platforms.

Duties and functions of veterinary public health for the management of food safety: present needs and evaluation of efficiency.

PubMed

Trevisani, M; Rosmini, R

2008-09-01

Functions of veterinarians in the context of food safety assurance have changed very much in the last ten years as a consequence of new legislation. The aim of this review is to evaluate the management tools in veterinary public health that shall be used in response to the actual need and consider some possible key performance indicators. This review involved an examination of the legislation, guidelines and literature, which was then discussed to analyse the actual need, the strategies and the procedures with which the public veterinary service shall comply. The management of information gathered at different stages of the food chain, from both food production operators and veterinary inspectors operating in primary production, food processing and feed production should be exchanged and integrated in a database, not only to produce annual reports and plan national sampling plans, but also to verify and validate the effectiveness of procedures and strategies implemented by food safety operators to control risks. Further, the surveillance data from environmental agencies and human epidemiological units should be used for assessing risks and addressing management options.

Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

PubMed

Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

2014-07-01

The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

Improved near real-time data management procedures for the Mediterranean ocean Forecasting System-Voluntary Observing Ship program

NASA Astrophysics Data System (ADS)

Manzella, G. M. R.; Scoccimarro, E.; Pinardi, N.; Tonani, M.

2003-01-01

A "ship of opportunity" program was launched as part of the Mediterranean Forecasting System Pilot Project. During the operational period (September 1999 to May 2000), six tracks covered the Mediterranean from the northern to southern boundaries approximately every 15 days, while a long eastwest track from Haifa to Gibraltar was covered approximately every month. XBT data were collected, sub-sampled at 15 inflection points and transmitted through a satellite communication system to a regional data centre. It was found that this data transmission system has limitations in terms of quality of the temperature profiles and quantity of data successfully transmitted. At the end of the MFSPP operational period, a new strategy for data transmission and management was developed. First of all, VOS-XBT data are transmitted with full resolution. Secondly, a new data management system, called Near Real Time Quality Control for XBT (NRT.QC.XBT), was defined to produce a parallel stream of high quality XBT data for further scientific analysis. The procedure includes: (1) Position control; (2) Elimination of spikes; (3) Re-sampling at a 1 metre vertical interval; (4) Filtering; (5) General malfunctioning check; (6) Comparison with climatology (and distance from this in terms of standard deviations); (7) Visual check; and (8) Data consistency check. The first six steps of the new procedure are completely automated; they are also performed using a new climatology developed as part of the project. The visual checks are finally done with a free-market software that allows NRT final data assessment.

Principles and Practices for Quality Assurance and Quality Control

USGS Publications Warehouse

Jones, Berwyn E.

1999-01-01

Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.

Project management plan for asbestos control at Randolph Air Force Base

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

Broers, G.J.

1988-02-01

The United States Air Force Air Training Command (ATC) Headquarters requested assistance from the Idaho National Engineering Laboratory (INEL) in February, 1987 to develop processes and procedures and provide program management to minimize and control asbestos hazard at its thirteen bases. This effort was requested by the ATC to comply with Executive Order 12088 under which the USAF is directed to meet all applicable federal, state, and local environmental regulations. In response to that request the efforts identified within this document provide the ATC with a thorough base-wide Asbestos Survey Report, an Asbestos Management Plan and an Operations and Maintenancemore » Plan for Randolph AFB which, when implemented, will comply with current and anticipated federal laws and provide the base with accurate information needed for long range asbestos management. The other twelve bases will be surveyed and sampled in the four years to follow with appropriate asbestos management plans developed for each. 6 figs.« less

Application of SNMP on CATV

NASA Astrophysics Data System (ADS)

Huang, Hong-bin; Liu, Wei-ping; Chen, Shun-er; Zheng, Liming

2005-02-01

A new type of CATV network management system developed by universal MCU, which supports SNMP, is proposed in this paper. From the point of view in both hardware and software, the function and method of every modules inside the system, which include communications in the physical layer, protocol process, data process, and etc, are analyzed. In our design, the management system takes IP MAN as data transmission channel and every controlled object in the management structure has a SNMP agent. In the SNMP agent developed, there are four function modules, including physical layer communication module, protocol process module, internal data process module and MIB management module. In the paper, the structure and function of every module are designed and demonstrated while the related hardware circuit, software flow as well as the experimental results are tested. Furthermore, by introducing RTOS into the software programming, the universal MCU procedure can conducts such multi-thread management as fast Ethernet controller driving, TCP/IP process, serial port signal monitoring and so on, which greatly improves efficiency of CPU.

Clinical and angioarchitectural factors influencing the endovascular approach to galenic dural arteriovenous fistulas in adults: case series and review of the literature.

PubMed

Cohen, José E; Gomori, John Moshe; Rajz, Gustavo; Paldor, Iddo; Moscovici, Samuel; Itshayek, Eyal

2017-05-01

Galenic dural arteriovenous fistulas (DAVF) are rare; however, they are the most frequent type of DAVF to manifest aggressive clinical behavior and usually represent a diagnostic and therapeutic challenge for clinicians. We retrospectively reviewed clinical and imaging data of patients managed with neuroendovascular techniques for the treatment of galenic DAVFs from 2000 to 2016. We searched the 2000-2016 English-language literature for papers discussing neuroendovascular management of galenic DAVFs, with or without companion surgical procedures. Five patients were treated for galenic DAVFs during the study period (four males; mean age, 61 years). Three presented with progressive neurological deterioration due to venous congestion, two with acute intracranial hemorrhage. Three were treated by staged transarterial embolization procedures (three procedures in two, four procedures in one); two underwent a single transvenous embolization procedure. Four out of five fistulas were completely occluded. All patients improved clinically; the patient whose fistula was partially occluded remains angiographically stable at 2-year follow-up. Six reports describing 17 patients are reviewed. Embolization was performed via transvenous approach in 1/17 and transarterial approach in 16/17 with additional open surgery in 9/16. The trend toward the use of transarterial approaches is based primarily on advances on embolization techniques that allow better and more controllable penetration of the embolizing agents with improved clinical and angiographic results, as well as the technical complexity of the transvenous approach. Although transarterial embolization is the preferred endovascular route for the management of most galenic DAVFs, selected cases can be successfully treated by transvenous approach.

Security breaches: tips for assessing and limiting your risks.

PubMed

Coons, Leeanne R

2011-01-01

As part of their compliance planning, medical practices should undergo a risk assessment to determine any vulnerability within the practice relative to security breaches. Practices should also implement safeguards to limit their risks. Such safeguards include facility access controls, information and electronic media management, use of business associate agreements, and education and enforcement. Implementation of specific policies and procedures to address security incidents is another critical step that medical practices should take as part of their security incident prevention plan. Medical practices should not only develop policies and procedures to prevent, detect, contain, and correct security violations, but should make sure that such policies and procedures are actually implemented in their everyday operations.

Enterocutaneous fistulas: an overview.

PubMed

Whelan, J F; Ivatury, R R

2011-06-01

Enterocutaneous fistulas remain a difficult management problem. The basis of management centers on the prevention and treatment of sepsis, control of fistula effluent, and fluid and nutritional support. Early surgery should be limited to abscess drainage and proximal defunctioning stoma formation. Definitive procedures for a persistent fistula are indicated in the late postoperative period, with resection of the fistula segment and reanastomosis of healthy bowel. Even more complex are the enteroatmospheric fistulas in the open abdomen. These enteric fistulas require the highest level of multidisciplinary approach for optimal outcomes.

Virtual Planning at Work: A Tour of NASA Future Flight Central

NASA Technical Reports Server (NTRS)

McClenahen, Jim; Dorighi, Nancy S. (Technical Monitor)

2000-01-01

FutureFlight Central will permit integration of tomorrow's technologies in a risk-free simulation of any airport, airfield, and tower cab environment. The facility provides an opportunity for airlines to mitigate passenger delays by fine tuning airport hub operations, gate management and ramp movement procedures. It also allows airport managers an opportunity to study effects of various improvements at their airports. Finally, it enables air traffic controllers to provide feedback and to become familiar with new airport operations and technologies before final installation.

Quality-assurance plan for the analysis of suspended sediment by the U.S. Geological Survey in Montana

USGS Publications Warehouse

Dodge, Kent A.; Lambing, John H.

2006-01-01

A quality-assurance plan has been developed for use by the sediment laboratory of the U.S. Geological Survey Montana Water Science Center in conducting activities related to the analysis of suspended sediment. The plan documents quality-assurance policies for sediment-laboratory certification, personnel responsibilities and training, documentation requirements, and laboratory safety. The plan also documents quality-assurance procedures related to laboratory equipment and supplies, sample management, sample analysis, analytical quality control, and data management.

Experiments using electronic display information in the NASA terminal configured vehicle

NASA Technical Reports Server (NTRS)

Morello, S. A.

1980-01-01

The results of research experiments concerning pilot display information requirements and visualization techniques for electronic display systems are presented. Topics deal with display related piloting tasks in flight controls for approach-to-landing, flight management for the descent from cruise, and flight operational procedures considering the display of surrounding air traffic. Planned research of advanced integrated display formats for primary flight control throughout the various phases of flight is also discussed.

Design and verification by nonlinear simulation of a Mach/CAS control law for the NASA TCV B737 aircraft

NASA Technical Reports Server (NTRS)

Bruce, Kevin R.

1986-01-01

A Mach/CAS control system using an elevator was designed and developed for use on the NASA TCV B737 aircraft to support research in profile descent procedures and approach energy management. The system was designed using linear analysis techniques primarily. The results were confirmed and the system validated at additional flight conditions using a nonlinear 737 aircraft simulation. All design requirements were satisfied.

System status display evaluation

NASA Technical Reports Server (NTRS)

Summers, Leland G.

1988-01-01

The System Status Display is an electronic display system which provides the crew with an enhanced capability for monitoring and managing the aircraft systems. A flight simulation in a fixed base cockpit simulator was used to evaluate alternative design concepts for this display system. The alternative concepts included pictorial versus alphanumeric text formats, multifunction versus dedicated controls, and integration of the procedures with the system status information versus paper checklists. Twelve pilots manually flew approach patterns with the different concepts. System malfunctions occurred which required the pilots to respond to the alert by reconfiguring the system. The pictorial display, the multifunction control interfaces collocated with the system display, and the procedures integrated with the status information all had shorter event processing times and lower subjective workloads.

5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

20 CFR 670.960 - What are the procedures for management of student records?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Administrative and Management Provisions § 670.960 What are the procedures for management of student records? The Secretary issues... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the procedures for management of...

20 CFR 668.860 - What cash management procedures apply to INA grant funds?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What cash management procedures apply to INA... Administrative Requirements § 668.860 What cash management procedures apply to INA grant funds? INA grantees must... implement the Cash Management Improvement Act, found at 31 CFR part 205, apply by law to most recipients of...

20 CFR 668.860 - What cash management procedures apply to INA grant funds?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What cash management procedures apply to INA... Administrative Requirements § 668.860 What cash management procedures apply to INA grant funds? INA grantees must... implement the Cash Management Improvement Act, found at 31 CFR part 205, apply by law to most recipients of...

Therapeutic management of complex anal fistulas by installing a nitinol closure clip: study protocol of a multicentric randomised controlled trial—FISCLOSE

PubMed Central

Dubois, Anne; Carrier, Guillaume; Pereira, Bruno; Gillet, Brigitte; Faucheron, Jean-Luc; Pezet, Denis; Balayssac, David

2015-01-01

Introduction Complex anal fistulas are responsible for pain, faecal incontinence and impaired quality of life. The rectal mucosa advancement flap (RMAF) procedure to cover the internal opening of the fistula remains a strategy of choice. However, a new procedure for closing anal fistulas is now available with the use of a nitinol closure clip (OTSC Proctology, OVESCO), which should ensure a better healing rate. This procedure is currently becoming more widespread, though without robust scientific validation, and it is therefore essential to carry out a prospective evaluation in order to determine the efficacy and safety of this new medical device for complex anal fistulas. Methods and analysis The FISCLOSE trial is aimed at evaluating the efficacy and safety of a nitinol closure clip compared to the RMAF procedure for the management of complex anal fistulas. This trial is a prospective, randomised, controlled, single-blind, bicentre and interventional study. Patients (n=46 per group) will be randomly assigned for management with either a closure clip or RMAF. The main objectives are to improve the healing rate of the anal fistula, lessen the postoperative pain and faecal incontinency, enhance the quality of life, and lower the number of reinterventions and therapeutic management costs. The primary outcome is the proportion of patients with a healed fistula at 3 months. The secondary outcomes are anal fistula healing (6 and 12 months), proctological pain (visual analogue scale), the faecal incontinence score (Jorge and Wexner questionnaire), digestive disorders and quality of life (Gastrointestinal Quality of Life Index and Euroqol EQ5D-3 L) up to 1 year. Ethics and dissemination The study was approved by an independent medical ethics committee 1 (IRB00008526, CPP Sud-Est 6, Clermont-Ferrand, France) and registered by the competent French authority (ANSM, Saint Denis, France). The results will be disseminated in a peer-reviewed journal and presented at international congresses. Trial registration number NCT02336867; pre-result. PMID:26674505

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part II: Catheter Care and Management of Common Systemic Post-procedural Complications.

PubMed

Taslakian, Bedros; Sridhar, Divya

2017-09-01

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety. The aim of this second part, in conjunction with part 1, is to complete the comprehensive review of post-procedural care in patients undergoing interventional radiology procedures. We discuss common problems encountered after insertion of drainage and vascular catheters and describe effective methods of troubleshooting these problems. Commonly encountered systemic complications in IR are described, and ways for immediate identification and management of these complications are provided.

Biosecurity procedures for the environmental management of carcasses burial sites in Korea.

PubMed

Kim, Geon-Ha; Pramanik, Sudipta

2016-12-01

Avian influenza and foot-and-mouth disease are two main contagious pathogenic viral disease which are responsible for the massive burials of livestock in Korea since burial is the primary measure to control these outbreaks. Biosecurity is a set of preventive measures designed to prevent the risk of spreading of these infectious diseases. The main objective of this paper is to discuss about the requirements of biosecurity and develop protocol outlines for environmental management of burial sites in Korea. Current practice prescribes to minimize the potential for on-farm pollution and the spread of the infectious diseases. Specific biosecurity procedures such as proper assessment of leachate quality, safe handling and disposal of leachate, adequate leachate pollution monitoring, necessary seasonal management of burial site, and appropriate sterilization process must be carried out to prevent the indirect transmission of pathogens from the burial sites. Policy makers should acquire robust knowledge of biosecurity for establishing more effective future legislation for carcasses disposal in Korea.

The six critical attributes of the next generation of quality management software systems.

PubMed

Clark, Kathleen

2011-07-01

Driven by both the need to meet regulatory requirements and a genuine desire to drive improved quality, quality management systems encompassing standard operating procedure, corrective and preventative actions and related processes have existed for many years, both in paper and electronic form. The impact of quality management systems on 'actual' quality, however, is often reported as far less than desired. A quality management software system that moves beyond formal forms-driven processes to include a true closed loop design, manage disparate processes across the enterprise, provide support for collaborative processes and deliver insight into the overall state of control has the potential to close the gap between simply accomplishing regulatory compliance and delivering measurable improvements in quality and efficiency.

Detroit's avoidable mortality project: breast cancer control for inner-city women.

PubMed Central

Burack, R C; Gimotty, P A; Stengle, W; Eckert, D; Warbasse, L; Moncrease, A

1989-01-01

Mammography remains substantially under-used in low-income minority populations despite its well-established efficacy as a means of breast cancer control. The Metropolitan Detroit Avoidable Mortality Project is a 2-year controlled clinical trial of coordinated interventions which seek to improve the use of early breast cancer detection services at five clinical sites providing primary health care services to inner-city women. Baseline assessment for two of the five participating clinic populations demonstrated that only one-quarter of women who visited these clinics were referred for mammography in 1988, and only half of those who were referred were able to complete the procedure. Patient characteristics including age, marital status, ethnicity, and insurance status were not associated with use of mammography during the baseline period. Each of the project's intervention components is a cue to action: a physician prompt for mammography referral within the medical record of procedure-due women, a reminder postcard for scheduled appointments, and a telephone call to encourage rescheduling of missed appointments. The interventions are initiated by a computerized information management system in the existing network of health care services. The patient's out-of-pocket mammography expense has been eliminated in three of the five sites. Although their efficacy as individual interventions has been well established, a controlled trial of computer prompts to physicians, reduced expense for patients, and patient appointment reminders as an integrated system in inner-city medical care settings has not been previously described. We have implemented the prompting, facilitated rescheduling procedures, and eliminated patient expense for mammography at three of five eventual clinical sites. This report provides an overview of the study's design, data management system, and methodology for evaluation. PMID:2511584

Costs of interstitial cystitis in a managed care population.

PubMed

Clemens, J Quentin; Meenan, Richard T; Rosetti, Maureen C O'Keeffe; Kimes, Terry; Calhoun, Elizabeth A

2008-05-01

To assess the direct medical costs, medication, and procedure use associated with interstitial cystitis (IC) in women in the Kaiser Permanente Northwest (KPNW) managed care population. The KPNW electronic medical record was used to identify women diagnosed with IC (n = 239). Each of these patients was matched with three controls according to age and duration in the health plan. Health plan cost accounting data were used to determine the inpatient, outpatient, and pharmacy costs for 1998 to 2003. An analysis of the prescription medication use and cystoscopic and urodynamic procedures commonly associated with IC was also performed. To evaluate for co-morbidities, an automated risk-adjustment model linked to 28 chronic medical conditions was applied to the administrative data sets from both groups. The mean duration from the date of IC diagnosis to the end of the study period was 36.6 months (range 1.4 to 60). The mean yearly costs were 2.4-fold greater for the patients than for the controls ($7100 versus $2994), and the median yearly costs were 3.8-fold greater ($5000 versus $1304). These cost differences were predominantly due to outpatient and pharmacy expenses. Medication and procedure use were significantly greater for the patients than for the controls. These findings were consistent across risk-adjustment model categories, which suggest that the observed cost differences are IC specific. The direct per-person costs of IC are high, with average yearly costs approximately $4000 greater than for the age-matched controls. This cost differential is an underestimate, because the costs preceding the diagnosis, the use of alternative therapies, indirect costs, and the costs of those with IC that is not diagnosed were not included.

Preliminary Investigation of Time Remaining Display on the Computer-based Emergency Operating Procedure

NASA Astrophysics Data System (ADS)

Suryono, T. J.; Gofuku, A.

2018-02-01

One of the important thing in the mitigation of accidents in nuclear power plant accidents is time management. The accidents should be resolved as soon as possible in order to prevent the core melting and the release of radioactive material to the environment. In this case, operators should follow the emergency operating procedure related with the accident, in step by step order and in allowable time. Nowadays, the advanced main control rooms are equipped with computer-based procedures (CBPs) which is make it easier for operators to do their tasks of monitoring and controlling the reactor. However, most of the CBPs do not include the time remaining display feature which informs operators of time available for them to execute procedure steps and warns them if the they reach the time limit. Furthermore, the feature will increase the awareness of operators about their current situation in the procedure. This paper investigates this issue. The simplified of emergency operating procedure (EOP) of steam generator tube rupture (SGTR) accident of PWR plant is applied. In addition, the sequence of actions on each step of the procedure is modelled using multilevel flow modelling (MFM) and influenced propagation rule. The prediction of action time on each step is acquired based on similar case accidents and the Support Vector Regression. The derived time will be processed and then displayed on a CBP user interface.

Spacecraft momentum management procedures. [large space telescope

NASA Technical Reports Server (NTRS)

Chen, L. C.; Davenport, P. B.; Sturch, C. R.

1980-01-01

Techniques appropriate for implementation onboard the space telescope and other spacecraft to manage the accumulation of momentum in reaction wheel control systems using magnetic torquing coils are described. Generalized analytical equations are derived for momentum control laws that command the magnetic torquers. These control laws naturally fall into two main categories according to the methods used for updating the magnetic dipole command: closed loop, in which the update is based on current measurements to achieve a desired torque instantaneously, and open-loop, in which the update is based on predicted information to achieve a desired momentum at the end of a period of time. Physical interpretations of control laws in general and of the Space Telescope cross product and minimum energy control laws in particular are presented, and their merits and drawbacks are discussed. A technique for retaining the advantages of both the open-loop and the closed-loop control laws is introduced. Simulation results are presented to compare the performance of these control laws in the Space Telescope environment.

Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial.

PubMed

Oates, Aris; Benedict, Kelly A; Sun, Karen; Brakeman, Paul R; Lim, Jessica; Kim, Cynthia

2017-01-01

Evaluate laser acupuncture (LA) as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7 to 26 years admitted to a children's hospital for percutaneous kidney biopsy. Patients received LA to treatment points (acupuncture group) or sham points (control group) before the procedure. The laser delivered a dose of 42 J/cm over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient's biopsy experience were secondary outcomes. Sixty-nine treatments (33 in the acupuncture group and 36 in the control group) were eligible for analysis. Patients in the acupuncture group reported a significantly improved change in the pain score after the biopsy compared with the controls (0.8 vs -0.5, P = 0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (-1.8 vs 5.6, P = 0.043) and respiratory rate (-2.4 vs 0.4, P = 0.045) when compared with controls. Parents also perceived a correspondingly greater improvement in their child's pain for those in the acupuncture group compared with the controls (2.3 vs 0.3, P = 0.04). Adjunctive LA significantly improved pain after pediatric percutaneous kidney biopsies.

Using Vicarious Experience and Verbal Persuasion to Enhance Self-Efficacy in Pre-Service Teachers: "Priming the Pump" for Consultation.

ERIC Educational Resources Information Center

Hagen, Kenneth M.; Gutkin, Terry B.; Wilson, Caryll Palmer; Oats, Robert G.

1998-01-01

Investigates whether self-efficacy perceptions pertaining to working with difficult-to-teach children could be increased for preservice teachers using vicarious experience and verbal persuasion. Experimental group viewed a videotape demonstrating behavior management procedures while the control group viewed a placebo video. Experimental group…

76 FR 4918 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0357...; Hazard Analysis and Critical Control Point Procedures for the Safe and Sanitary Processing and Importing of Juice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug...

Self-Regulation for Students with Emotional and Behavioral Disorders: Preliminary Effects of the "I Control" Curriculum

ERIC Educational Resources Information Center

Smith, Stephen W.; Daunic, Ann P.; Algina, James; Pitts, Donna L.; Merrill, Kristen L.; Cumming, Michelle M.; Allen, Courtney

2017-01-01

Maladaptive adolescent behavior patterns often create escalating conflict with adults and peers, leading to poor long-term social trajectories. To address this, school-based behavior management often consists of contingent reinforcement for appropriate behavior, behavior reduction procedures, and placement in self-contained or alternative…

Wisconsin Elementary Teacher Education Project. Volumes I-IV.

ERIC Educational Resources Information Center

Kean, John M., Ed.

This four-volume report includes position papers and specifications for the elementary teacher education program of the University of Wisconsin in the year 1975 and beyond. Volume 1 includes a series of 12 position papers which cover topics ranging from teacher roles and systems approaches to instruction to control and management procedures for…

77 FR 46213 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-02

.... Monitoring Impact of FY 2012 Policy Changes and Certain SNF Practices A. RUG Distributions B. Group Therapy... Common Procedure Coding System HR-III Hybrid Resource Utilization Groups, Version 3 IHS IGI (Information... OCN OMB Control Number OMB Office of Management and Budget OMRA Other Medicare-Required Assessment PPS...

43 CFR 9268.2 - Natural history resource management procedures. [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

43 CFR 9268.2 - Natural history resource management procedures. [Reserved

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

43 CFR 9268.2 - Natural history resource management procedures. [Reserved

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

43 CFR 9268.2 - Natural history resource management procedures. [Reserved

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...