Concept of Operations for RCO SPO

NASA Technical Reports Server (NTRS)

Matessa, Michael; Strybel, Thomas; Vu, Kim; Battiste, Vernol; Schnell, Thomas

2017-01-01

Reduced crew operations (RCO) refers to the reduction of crew members flying long-haul or military operations with more than one pilot onboard. Single pilot operations (SPO) refers to flying a commercial transport aircraft with only one pilot on board the aircraft, assisted by advanced onboard automation andor ground operators providing piloting support services. Properly implemented, RCO/SPO could provide operating cost savings while maintaining a level of safety no less than conventional two-pilot commercial operations. A concept of operations (ConOps) for any paradigm describes the characteristics of its various components and their integration in a multi-dimensional design space. This paper presents key options for humanautomation function allocation being considered by NASA in its ongoing development of RCO/SPO ConOps.

CHEMICAL/BIOLOGICAL-CAPABLE RPA THREATS AND NATIONAL SECURITY IMPLICATIONS

DTIC Science & Technology

2016-02-07

iv Abstract The technological landscape of the 21st century is evolving at an ever-increasing pace . Autonomous remotely piloted...chemical and biological conventions must occur to address existing coverage gaps in an effort to keep pace with the ongoing advances of science and...21st century is evolving at an ever-increasing pace . Autonomous remotely piloted aircrafts (RPAs) continue to become increasingly sophisticated in

Social and Individual Aspects of Classroom Learning in Students with Autism Spectrum Disorder: An Action Research Pilot Study on Assessment

ERIC Educational Resources Information Center

Asberg, Jakob; Zander, Ulla; Zander, Eric; Sandberg, Annika Dahlgren

2012-01-01

The current paper reports on the outcome of an ongoing action research project at a school for higher-functioning students with Autism Spectrum Disorder (ASD) in Sweden. The overall aim of the study was to develop and evaluate a questionnaire that captures social and individual aspects of classroom learning suitable for use with students with ASD.…

Maintain and Regain Well Clear: Maneuver Guidance Designs for Pilots Performing the Detect-and-Avoid Task

NASA Technical Reports Server (NTRS)

Monk, Kevin J.; Roberts, Zachary

2017-01-01

In order to support the future expansion and integration of Unmanned Aircraft Systems (UAS), ongoing research efforts have sought to produce findings that inform the minimum display information elements required for acceptable UAS pilot response times and traffic avoidance. Previous simulations have revealed performance benefits associated with DAA displays containing predictive information and suggestive maneuver guidance tools in the form of banding. The present study investigated the impact of various maneuver guidance display configurations on detect-and-avoid (DAA) task performance in a simulated airspace environment. UAS pilots ability to maintain DAA well clear was compared between displays with either the presence or absence of green DAA bands, which indicated conflict-free flight regions. Additional display comparisons assessed pilots ability to regain DAA well clear with two different guidance presentations designed to aid in DAA well clear recovery during critical encounters. Performance implications and display considerations for future UAS DAA systems are discussed.

Development of a virtual flight simulator.

PubMed

Kuntz Rangel, Rodrigo; Guimarães, Lamartine N F; de Assis Correa, Francisco

2002-10-01

We present the development of a flight simulator that allows the user to interact in a created environment by means of virtual reality devices. This environment simulates the sight of a pilot in an airplane cockpit. The environment is projected in a helmet visor and allows the pilot to see inside as well as outside the cockpit. The movement of the airplane is independent of the movement of the pilot's head, which means that the airplane might travel in one direction while the pilot is looking at a 30 degrees angle with respect to the traveled direction. In this environment, the pilot will be able to take off, fly, and land the airplane. So far, the objects in the environment are geometrical figures. This is an ongoing project, and only partial results are available now.

Pilot Study of the Pharmacokinetics (PK) and Pharmacodynamics (PD) of Tranexamic Acid (TXA) in a Swine (Sus scrofa) and Sheep (Ovis aries) Model

DTIC Science & Technology

2016-04-05

There were differences in bioavailability depending on route and species, and the drug half-life was shorter in pigs, compared to sheep. CONCLUSIONS...expanded to human studies to further explore these alternative routes of administration of TXA. More data is needed to determine ideal dosages via these novel routes as well as the bioavailability profile during ongoing hemorrhage.

Pharmacy-based interventions for initiating effective contraception following the use of emergency contraception: a pilot study.

PubMed

Michie, L; Cameron, S T; Glasier, A; Larke, N; Muir, A; Lorimer, A

2014-10-01

In Scotland most women get emergency contraception (EC) from pharmacies. Pharmacists currently cannot provide effective ongoing contraception after EC. In this pilot study, we aimed to determine the feasibility of a larger study designed to ascertain if pharmacy-based interventions can increase the uptake of effective contraception after EC. This is a pilot study of women presenting for levonorgestrel EC to community pharmacies in Edinburgh, UK, in 2012. Pharmacies were cluster randomized to provide either standard care or one of two interventions: (a) one packet of progestogen-only pills (POPs), giving women 1 month to arrange ongoing contraception; (b) invitation to present the empty EC packet to a family planning clinic (FPC) for contraceptive advice (rapid access). One hundred sixty-eight women were recruited from 11 pharmacies to POP (n=56), rapid access (n=58) and standard care (N=54) groups, respectively. Telephone follow-up was conducted successfully in 102 women (61%) 6-8 weeks later to determine current contraceptive use. In the POP arm, 35/39 (90%) women used the pills provided, and 9/28 women (32%) in the rapid access arm attended the FPC. The proportion of women using effective contraception at follow-up was significantly greater in both POP [56% (22/39), p=<0.001] and rapid access [52% (13/25), p=0.006] groups compared to standard care [16% (5/31)]. The relative probability of a woman using an effective method of contraception versus barrier/no method, after use of EC, was 3.13 [95% confidence interval (CI), 1.90-5.13] in the POP group and 2.57 (95% CI, 1.55-4.27) in the rapid access group. This promising pilot study suggests that simple pharmacy-based interventions may increase the uptake of effective contraception after EC. A larger study is required to provide further validation of these findings. For women obtaining EC from a pharmacy, simple interventions such as supplying 1 month of a POP, or offering rapid access to a FPC, hold promise as strategies to increase the uptake of effective contraception after EC. Copyright © 2014 Elsevier Inc. All rights reserved.

Absorbing and Developing Qualified Fighter Pilots. The Role of the Advanced Simulator

DTIC Science & Technology

2007-01-01

This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work . This electronic...NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) RAND Corporation,1776 Main Street,Santa Monica,CA,90401-3208 8...should be available to all pilots working with given a mission design series. Funding for fielding new systems, providing ongoing essential software

Absorbing and Developing Qualified Fighter Pilots. The Role of the Advanced Simulator

DTIC Science & Technology

2007-01-01

This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work . This electronic...NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Rand Corporation...be available to all pilots working with given a mission design series. Funding for fielding new systems, providing ongoing essential software

Ontology-driven data integration and visualization for exploring regional geologic time and paleontological information

NASA Astrophysics Data System (ADS)

Wang, Chengbin; Ma, Xiaogang; Chen, Jianguo

2018-06-01

Initiatives of open data promote the online publication and sharing of large amounts of geologic data. How to retrieve information and discover knowledge from the big data is an ongoing challenge. In this paper, we developed an ontology-driven data integration and visualization pilot system for exploring information of regional geologic time, paleontology, and fundamental geology. The pilot system (http://www2.cs.uidaho.edu/%7Emax/gts/)

Connecting NASA Airborne Scientists, Engineers, and Pilots to K-12 Classrooms

NASA Astrophysics Data System (ADS)

Schaller, E. L.

2015-12-01

The NASA Airborne Science Program (ASP) conducts Earth system science research missions with NASA aircraft all over the world. During ASP missions, NASA scientists, engineers and pilots are deployed to remote parts of the world such as Greenland, Antarctica, Chile, and Guam. These ASP mission personnel often have a strong desire to share the excitement of their mission with local classrooms near their deployment locations as well as classrooms back home in the United States. Here we discuss ongoing efforts to connect NASA scientists, engineers and pilots in the field directly with K-12 classrooms through both in-person interactions and remotely via live web-based chats.

Feasibility Testing and Refinement of a Supportive Educational Intervention for Carers of Patients with High-Grade Glioma - a Pilot Study.

PubMed

Halkett, Georgia K B; Lobb, Elizabeth A; Miller, Lisa; Shaw, Thérèse; Moorin, Rachael; Long, Anne; King, Anne; Clarke, Jenny; Fewster, Stephanie; Nowak, Anna K

2017-02-11

The aim of this pilot study was to test the feasibility and acceptability of a family carer intervention for carers of patients with high-grade glioma (HGG). The intervention consisted of: (1) an initial telephone assessment of carer needs; (2) a personalised tabbed resource file; (3) nurse-led home visit; and (4) ongoing telephone support. Two consumer representatives reviewed the intervention resources. The intervention was then piloted with participants who were the primary carer for patients undergoing treatment for HGG in Western Australia. Two consumers provided feedback on the resource, and 10 carers participated in the pilot. Positive feedback was received about the resource manual and intervention. Suggestions were also made for changes which were implemented into the trial. The surveys were shortened based on feedback. Participants identified a large range of issues during nursing assessments which would not otherwise be identified or addressed for carers receiving routine care. As a result of providing the intervention, the nurse was able to make referrals to address needs that were identified. This pilot study enabled us to refine and test the Care-IS intervention and test the feasibility and acceptability of proposed survey instruments. We were also able to estimate recruitment and retention and the overall study timeline required for the randomised controlled trial we are now conducting. It has also demonstrated the role of the nurse who delivered the intervention and allowed us to refine communication and referral pathways.

Probing the Initial Mass Function in Extended Ultraviolet (XUV) Disks

NASA Astrophysics Data System (ADS)

Koda, Jin

2014-01-01

The GALEX UV satellite discovered tantalizing evidence of star formation (SF) far beyond the optical edge of galactic disks (i.e. XUV disk). This discovery provides a new opportunity for studying SF in the exceedingly low-density environment (~1/10 of typical SF density), spurring intense debate on the universality of the initial mass function (IMF) in such exceptional environments. Our pilot study led to support for the universal IMF at least in M83’s XUV disk (Koda et al. 2012). We propose an expansion of the pilot study by about an order of magnitude, by observing total ~ 10 XUV disks (6 disks in S14A) in NA656(Halpha), B, I, and R-band with S-Cam. In conjunction with GALEX UV bands, these images will reveal the presence of O stars (Halpha) and O&B stars (UV) in stellar clusters -thus, constraining the high-mass end of the IMF. These multi-broadband images will enable us to determine the masses of the clusters with much improved accuracy (previously, relied only on R). This project will not only increase the statistical significance of our previous result, but also enable us to analyze the stochastic effect of IMF sampling in very low-mass clusters (102-3 Msun) - the regime of ongoing debate. This proposal will complete this on-going project with S-Cam.

Improving awareness, accountability, and access through health coaching

PubMed Central

Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

2015-01-01

Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

Design of a Multi-mode Flight Deck Decision Support System for Airborne Conflict Management

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Krishnamurthy, Karthik

2004-01-01

NASA Langley has developed a multi-mode decision support system for pilots operating in a Distributed Air-Ground Traffic Management (DAG-TM) environment. An Autonomous Operations Planner (AOP) assists pilots in performing separation assurance functions, including conflict detection, prevention, and resolution. Ongoing AOP design has been based on a comprehensive human factors analysis and evaluation results from previous human-in-the-loop experiments with airline pilot test subjects. AOP considers complex flight mode interactions and provides flight guidance to pilots consistent with the current aircraft control state. Pilots communicate goals to AOP by setting system preferences and actively probing potential trajectories for conflicts. To minimize training requirements and improve operational use, AOP design leverages existing alerting philosophies, displays, and crew interfaces common on commercial aircraft. Future work will consider trajectory prediction uncertainties, integration with the TCAS collision avoidance system, and will incorporate enhancements based on an upcoming air-ground coordination experiment.

A Pilot Study to Test the Efficacy of Psychologically Based Physical Therapy Training for Treating Deployed U.S. Sailors and Marines with Musculoskeletal Injuries

DTIC Science & Technology

2016-10-01

purpose of this study is to demonstrate the effectiveness of a PBPT intervention for the prevention of disability in ADSM who sustain an MSI during...intervention, pain coping skills, outcome, randomized controlled trial, risk factor, disability , attrition. 16. SECURITY CLASSIFICATION OF: Unclassified 17...help all service members who sustain MSI by improving care, reducing the need for ongoing medical utilization and reducing disability . 2. Keywords

Collaborative Data Publication Utilizing the Open Data Repository's (ODR) Data Publisher

NASA Technical Reports Server (NTRS)

Stone, N.; Lafuente, B.; Bristow, T.; Keller, R. M.; Downs, R. T.; Blake, D.; Fonda, M.; Dateo, C.; Pires, A.

2017-01-01

Introduction: For small communities in diverse fields such as astrobiology, publishing and sharing data can be a difficult challenge. While large, homogenous fields often have repositories and existing data standards, small groups of independent researchers have few options for publishing standards and data that can be utilized within their community. In conjunction with teams at NASA Ames and the University of Arizona, the Open Data Repository's (ODR) Data Publisher has been conducting ongoing pilots to assess the needs of diverse research groups and to develop software to allow them to publish and share their data collaboratively. Objectives: The ODR's Data Publisher aims to provide an easy-to-use and implement software tool that will allow researchers to create and publish database templates and related data. The end product will facilitate both human-readable interfaces (web-based with embedded images, files, and charts) and machine-readable interfaces utilizing semantic standards. Characteristics: The Data Publisher software runs on the standard LAMP (Linux, Apache, MySQL, PHP) stack to provide the widest server base available. The software is based on Symfony (www.symfony.com) which provides a robust framework for creating extensible, object-oriented software in PHP. The software interface consists of a template designer where individual or master database templates can be created. A master database template can be shared by many researchers to provide a common metadata standard that will set a compatibility standard for all derivative databases. Individual researchers can then extend their instance of the template with custom fields, file storage, or visualizations that may be unique to their studies. This allows groups to create compatible databases for data discovery and sharing purposes while still providing the flexibility needed to meet the needs of scientists in rapidly evolving areas of research. Research: As part of this effort, a number of ongoing pilot and test projects are currently in progress. The Astrobiology Habitable Environments Database Working Group is developing a shared database standard using the ODR's Data Publisher and has a number of example databases where astrobiology data are shared. Soon these databases will be integrated via the template-based standard. Work with this group helps determine what data researchers in these diverse fields need to share and archive. Additionally, this pilot helps determine what standards are viable for sharing these types of data from internally developed standards to existing open standards such as the Dublin Core (http://dublincore.org) and Darwin Core (http://rs.twdg.org) metadata standards. Further studies are ongoing with the University of Arizona Department of Geosciences where a number of mineralogy databases are being constructed within the ODR Data Publisher system. Conclusions: Through the ongoing pilots and discussions with individual researchers and small research teams, a definition of the tools desired by these groups is coming into focus. As the software development moves forward, the goal is to meet the publication and collaboration needs of these scientists in an unobtrusive and functional way.

Results of a Formal Methods Demonstration Project

NASA Technical Reports Server (NTRS)

Kelly, J.; Covington, R.; Hamilton, D.

1994-01-01

This paper describes the results of a cooperative study conducted by a team of researchers in formal methods at three NASA Centers to demonstrate FM techniques and to tailor them to critical NASA software systems. This pilot project applied FM to an existing critical software subsystem, the Shuttle's Jet Select subsystem (Phase I of an ongoing study). The present study shows that FM can be used successfully to uncover hidden issues in a highly critical and mature Functional Subsystem Software Requirements (FSSR) specification which are very difficult to discover by traditional means.

A pilot project using evidence-based clinical pathways and payment reform in China's rural hospitals shows early success.

PubMed

Cheng, Tsung-Mei

2013-05-01

Reforming China's public hospitals to curb widespread overtreatment and improve the quality and affordability of care has been the most challenging aspect of that nation's ambitious health reform, which began in 2009. This article describes a pilot project under way in several of China's provinces that combines payment reform with the implementation of evidence-based clinical pathways at a few hospitals serving rural areas. Results to date include reduced length-of-stay and prescription drug use and higher patient and provider satisfaction. These early results suggest that the pilot may be achieving its goals, which may have far-reaching and positive implications for China's ongoing reform.

Instrument Development of Integrative Health and Wellness Assessment™.

PubMed

McElligott, Deborah; Eckardt, Sarah; Montgomery Dossey, Barbara; Luck, Susan; Eckardt, Patricia

2017-12-01

The nurse coach role was developed to address the needs of our nation and the world for health and wellbeing. The Theory of Integrative Nurse Coaching provides a foundation for coaching interventions supporting health promotion, and a framework for the development of the Integrative Health and Wellness Assessment (IHWA) short form. This 36-question Likert-type scale self-reporting tool assists participants in assessing healthy behaviors through a self-reflection process, provides information for the coaching relationship, and may be an outcome measurement. This article describes the history of the IHWA tool and the development and pilot testing of the IHWA short form using guidelines provided by DeVellis. Results of the Kaiser-Meyer-Olkin test yielded a value of .520, and the Bartlett's test of sphericity was significant. Cronbach's alpha overall scale internal consistency was .88 ( n = 36). Pilot study results indicate that the scale could be improved through additional revision, and an ongoing study is in progress.

Training Community Mental Health Therapists to Deliver a Package of Evidence-Based Practice Strategies for School-Age Children with Autism Spectrum Disorders: A Pilot Study

PubMed Central

Drahota, Amy; Stadnick, Nicole

2012-01-01

Research on moving evidence-based practice (EBP) intervention strategies to community service settings for children with autism spectrum disorders (ASD) is urgently needed. The current pilot study addresses this need by examining the feasibility, acceptability and preliminary outcomes of training therapists practicing in community mental health (CMH) clinics to deliver a package of EBP strategies aimed to reduce challenging behaviors in school-age children with ASD. Results indicate that CMH therapists participated in both initial and ongoing training, were able to deliver the intervention with fidelity, and perceived the intervention strategies as useful. Parents participated in almost all sessions with their children and remained in therapy when therapists delivered the intervention. Meaningful reductions in child problem behaviors occurred over 5 months providing promising support for the intervention. PMID:22102293

Improving vocational rehabilitation services for injured workers in Washington State.

PubMed

Sears, Jeanne M; Wickizer, Thomas M; Schulman, Beryl A

2014-06-01

Workers who incur permanent impairments or have ongoing medical restrictions due to injuries or illnesses sustained at work may require support from vocational rehabilitation programs in order to return to work. Vocational rehabilitation programs implemented within workers' compensation settings are costly, and effective service delivery has proven challenging. The Vocational Improvement Project, a 5.5-year pilot program beginning in 2008, introduced major changes to the Washington State workers' compensation-based vocational rehabilitation program. In the evaluation of this pilot program, set within a large complex system characterized by competing stakeholder interests, we assessed effects on system efficiency and employment outcomes for injured workers. While descriptive in nature, this evaluation provided evidence that several of the intended outcomes were attained, including: (1) fewer repeat referrals, (2) fewer delays, (3) increased choice for workers, and (4) establishment of statewide partnerships to improve worker outcomes. There remains substantial room for further improvement. Retraining plan completion rates remain under 60% and only half of workers earned any wages within two years of completing their retraining plan. Ongoing communication with stakeholders was critical to the successful conduct and policy impact of this evaluation, which culminated in a 3-year extension of the pilot program through June 2016. Copyright © 2013 Elsevier Ltd. All rights reserved.

Computer simulation of a pilot in V/STOL aircraft control loops

NASA Technical Reports Server (NTRS)

Vogt, William G.; Mickle, Marlin H.; Zipf, Mark E.; Kucuk, Senol

1989-01-01

The objective was to develop a computerized adaptive pilot model for the computer model of the research aircraft, the Harrier II AV-8B V/STOL with special emphasis on propulsion control. In fact, two versions of the adaptive pilot are given. The first, simply called the Adaptive Control Model (ACM) of a pilot includes a parameter estimation algorithm for the parameters of the aircraft and an adaption scheme based on the root locus of the poles of the pilot controlled aircraft. The second, called the Optimal Control Model of the pilot (OCM), includes an adaption algorithm and an optimal control algorithm. These computer simulations were developed as a part of the ongoing research program in pilot model simulation supported by NASA Lewis from April 1, 1985 to August 30, 1986 under NASA Grant NAG 3-606 and from September 1, 1986 through November 30, 1988 under NASA Grant NAG 3-729. Once installed, these pilot models permitted the computer simulation of the pilot model to close all of the control loops normally closed by a pilot actually manipulating the control variables. The current version of this has permitted a baseline comparison of various qualitative and quantitative performance indices for propulsion control, the control loops and the work load on the pilot. Actual data for an aircraft flown by a human pilot furnished by NASA was compared to the outputs furnished by the computerized pilot and found to be favorable.

Understanding Treatment Burden and Quality of Life Impact of Participating in an Early-Phase Pediatric Oncology Clinical Trial: A Pilot Study.

PubMed

Crane, Stacey; Backus, Lori; Stockman, Beth; Carpenter, Janet S; Lin, Li; Haase, Joan

Early-phase clinical trials (EPTs) have led to new, more effective treatment options for children with cancer. Despite the extensive use of EPTs in pediatric oncology, little is known about parent and child experiences during EPT participation. The purposes of this pilot study were to assess the feasibility and preliminary results of having children with cancer and their parents complete measures of treatment burden and quality of life (QOL) concurrent with EPT participation. In this descriptive, longitudinal, pilot study, parents and children were followed for the first 60 days of an EPT. Feasibility was assessed by participant enrollment and retention and completion of measures. Measures completed included the following: demographic form (completed at baseline); Diary of Trial Experiences to capture treatment burden (completed ongoing); and PedsQL™ Quality of Life Inventories, Cancer Modules, and Family Impact Module (completed at baseline, post-first disease evaluation, and off-study). Data were analyzed using descriptive statistics. Feasibility goals of enrollment, retention, and measure completion were partially met. Preliminary treatment burden and QOL results are provided. While QOL assessments may provide insight into EPT experiences, future studies need to be conducted at multiple sites and enrollment goals must account for participant attrition.

Understanding Treatment Burden and Quality of Life Impact of Participating in an Early Phase Pediatric Oncology Clinical Trial: A Pilot Study

PubMed Central

BACKUS, LORI; STOCKMAN, BETH; CARPENTER, JANET S.; LIN, LI; HAASE, JOAN

2017-01-01

Purpose Early phase clinical trials (EPTs) have led to new, more effective treatment options for children with cancer. Despite the extensive use of EPTs in pediatric oncology, little is known about parent and child experiences during EPT participation. The purposes of this pilot study were to assess the feasibility and preliminary results of having children with cancer and their parents complete measures of treatment burden and quality of life (QOL) concurrent with EPT participation. Methods In this descriptive, longitudinal, pilot study, parents and children were followed for the first 60 days of an EPT. Feasibility was assessed by participant enrollment and retention, and completion of measures. Measures completed included: Demographic form (completed at baseline); Diary of Trial Experiences to capture treatment burden (completed ongoing); and PedsQL™ Quality of Life Inventories, Cancer Modules, and Family Impact Module (completed at baseline, post-first disease evaluation, and off-study). Data were analyzed using descriptive statistics. Results Feasibility goals of enrollment, retention, and measure completion were partially met. Preliminary treatment burden and QOL results are provided. Conclusions While QOL assessments may provide insight into EPT experiences, future studies need to be conducted at multiple sites and enrollment goals must account for participant attrition. PMID:28849701

Crew coordination concepts: Continental Airlines CRM training

NASA Technical Reports Server (NTRS)

Christian, Darryl; Morgan, Alice

1987-01-01

The outline of the crew coordination concepts at Continental airlines is: (1) Present relevant theory: Contained in a pre-work package and in lecture/discussion form during the work course, (2) Discuss case examples: Contained in the pre-work for study and use during the course; and (3) Simulate practice problems: Introduced during the course as the beginning of an ongoing process. These concepts which are designed to address the problem pilots have in understanding the interaction between situations and their own theories of practice are briefly discussed.

Andragogy as a didactic perspective in the attitudes of nurse instructors in Finland.

PubMed

Janhonen, S

1991-08-01

In this article the didactic perspectives of nurse instructors (NIs) is examined with the help of andragogy defined by the concepts of self-directed learning, learning as a process and lifelong learning. The results of a pilot study of ongoing research on the educational perspective of NIs, are used as examples to discuss how far NIs have accepted the features of andragogy as their didactic perspective both in their public stance and in their actions as described by NIs themselves.

Sustaining Change in Every Classroom

ERIC Educational Resources Information Center

Heidemann, Sandra; Chang, Claire; Hewitt, Deb; Menninga, Beth

2007-01-01

Words Work! and Community Action Head Start have been working together for seven years to provide training, consultation, mentoring, and resources to teachers in pilot classrooms as they learned to implement effective early literacy strategies. In its work with teachers, Words Work! developed a culture "where ongoing assessment, reflective…

Cockpit weather information needs

NASA Technical Reports Server (NTRS)

Scanlon, Charles H.

1992-01-01

The primary objective is to develop an advanced pilot weather interface for the flight deck and to measure its utilization and effectiveness in pilot reroute decision processes, weather situation awareness, and weather monitoring. Identical graphical weather displays for the dispatcher, air traffic control (ATC), and pilot crew should also enhance the dialogue capabilities for reroute decisions. By utilizing a broadcast data link for surface observations, forecasts, radar summaries, lightning strikes, and weather alerts, onboard weather computing facilities construct graphical displays, historical weather displays, color textual displays, and other tools to assist the pilot crew. Since the weather data is continually being received and stored by the airborne system, the pilot crew has instantaneous access to the latest information. This information is color coded to distinguish degrees of category for surface observations, ceiling and visibilities, and ground radar summaries. Automatic weather monitoring and pilot crew alerting is accomplished by the airborne computing facilities. When a new weather information is received, the displays are instantaneously changed to reflect the new information. Also, when a new surface or special observation for the intended destination is received, the pilot crew is informed so that information can be studied at the pilot's discretion. The pilot crew is also immediately alerted when a severe weather notice, AIRMET or SIGMET, is received. The cockpit weather display shares a multicolor eight inch cathode ray tube and overlaid touch panel with a pilot crew data link interface. Touch sensitive buttons and areas are used for pilot selection of graphical and data link displays. Time critical ATC messages are presented in a small window that overlays other displays so that immediate pilot alerting and action can be taken. Predeparture and reroute clearances are displayed on the graphical weather system so pilot review of weather along the route can be accomplished prior to pilot acceptance of the clearance. An ongoing multiphase test series is planned for testing and modifying the graphical weather system. Preliminary data shows that the nine test subjects considered the graphical presentation to be much better than their current weather information source for situation awareness, flight safety, and reroute decision making.

SURF - SUrvey of Risk Factor management: first report of an international audit.

PubMed

Cooney, Mt; Reiner, Z; Sheu, W; Ryden, L; Sutter, J de; De Bacquer, D; DeBacker, G; Mithal, A; Chung, N; Lim, Yt; Dudina, A; Reynolds, A; Dunney, K; Graham, I

2014-07-01

Despite the fact that subjects with established coronary heart disease (CHD) are at high risk of further events and deserve meticulous secondary prevention, current audits such as EUROASPIRE show poor control of major risk factors. Ongoing monitoring is required. We present a new risk factor audit system, SURF (Survey of Risk Factor management), that can be conducted much more quickly and easily than existing audit systems and has the potential to allow hospitals of all sizes to participate in a unified international audit system that will complement EUROASPIRE. Initial experience indicates that SURF is truly simple to undertake in an international setting, and this is illustrated with the results of a substantive pilot project conducted in Europe and Asia. The data collection system was designed to allow rapid and easy data collection as part of routine clinic work. Consecutive patients (aged 18 and over) with established CHD attending outpatient cardiology clinics were included. Information on demographics, previous coronary medical history, smoking history, history of hypertension, dyslipidaemia or diabetes, physical activity, attendance at cardiac rehabilitation, cardiac medications, lipid and glucose levels (and HbA1c in diabetics) if available within the last year, blood pressure, heart rate, body mass index, and waist circumference were collected using a one-page data collection sheet. Years spent in full time education was added as an additional question during the pilot phase. Three European countries - Ireland (n = 251), Belgium (n = 122), and Croatia (n = 124) - and four Asian countries - Singapore (n = 142), Taiwan (n = 334), India (n = 97), and Korea (n = 45) - were included in the pilot study. The results of initial field testing were confirmed in that it proved possible to collect data within 60-90 seconds per subject. There was poor control of several risk factors including high levels of physical inactivity (41-45%), overweight and obesity (59-78%), and ongoing smoking (15%). There were lower levels of individuals attending cardiac rehabilitation in Asia. More Europeans than Asians reached the low-density lipoprotein cholesterol target of <2.5 mmol/l (66 vs. 59%) reflecting differences in medication usage. However, blood pressure control was superior in Asia, with 71% <140/90 compared with 66% of Europeans (NS). This phase of SURF has confirmed its ease of use which should allow wide participation and the collection of representative risk factor data in subjects with CHD as well as ongoing data collection to monitor secular trends in risk factor control. Notwithstanding that this is a pilot study, the results suggest that risk factor control, particularly for lifestyle-related measures, is poor in both Europe and Asia. © The European Society of Cardiology 2012.

The Promoting Effective Advance Care for Elders (PEACE) randomized pilot study: theoretical framework and study design.

PubMed

Allen, Kyle R; Hazelett, Susan E; Radwany, Steven; Ertle, Denise; Fosnight, Susan M; Moore, Pamela S

2012-04-01

Practice guidelines are available for hospice and palliative medicine specialists and geriatricians. However, these guidelines do not adequately address the needs of patients who straddle the 2 specialties: homebound chronically ill patients. The purpose of this article is to describe the theoretical basis for the Promoting Effective Advance Care for Elders (PEACE) randomized pilot study. PEACE is an ongoing 2-group randomized pilot study (n=80) to test an in-home interdisciplinary care management intervention that combines palliative care approaches to symptom management, psychosocial and emotional support, and advance care planning with geriatric medicine approaches to optimizing function and addressing polypharmacy. The population comprises new enrollees into PASSPORT, Ohio's community-based, long-term care Medicaid waiver program. All PASSPORT enrollees have geriatric/palliative care crossover needs because they are nursing home eligible. The intervention is based on Wagner's Chronic Care Model and includes comprehensive interdisciplinary care management for these low-income frail elders with chronic illnesses, uses evidence-based protocols, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. Our model, with its standardized, evidence-based medical and psychosocial intervention protocols, will transport easily to other sites that are interested in optimizing outcomes for community-based, chronically ill older adults. © Mary Ann Liebert, Inc.

Steel dust in the New York City subway system as a source of manganese, chromium, and iron exposures for transit workers.

PubMed

Chillrud, Steven N; Grass, David; Ross, James M; Coulibaly, Drissa; Slavkovich, Vesna; Epstein, David; Sax, Sonja N; Pederson, Dee; Johnson, David; Spengler, John D; Kinney, Patrick L; Simpson, H James; Brandt-Rauf, Paul

2005-03-01

The United States Clean Air Act Amendments of 1990 reflected increasing concern about potential effects of low-level airborne metal exposure on a wide array of illnesses. Here we summarize results demonstrating that the New York City (NYC) subway system provides an important microenvironment for metal exposures for NYC commuters and subway workers and also describe an ongoing pilot study of NYC transit workers' exposure to steel dust. Results from the TEACH (Toxic Exposure Assessment, a Columbia and Harvard) study in 1999 of 41 high-school students strongly suggest that elevated levels of iron, manganese, and chromium in personal air samples were due to exposure to steel dust in the NYC subway. Airborne concentrations of these three metals associated with fine particulate matter were observed to be more than 100 times greater in the subway environment than in home indoor or outdoor settings in NYC. While there are currently no known health effects at the airborne levels observed in the subway system, the primary aim of the ongoing pilot study is to ascertain whether the levels of these metals in the subway air affect concentrations of these metals or related metabolites in the blood or urine of exposed transit workers, who due to their job activities could plausibly have appreciably higher exposures than typical commuters. The study design involves recruitment of 40 transit workers representing a large range in expected exposures to steel dust, the collection of personal air samples of fine particulate matter, and the collection of blood and urine samples from each monitored transit worker.

Connecting Primary Health Care: A Comprehensive Pilot Study.

PubMed

Maghsoudloo, Mehran; Abolhassani, Farid; Lotfibakhshaiesh, Nasrin

2016-07-01

The collection of data within the primary health care facilities in Iran is essentially paper-based. It is focused on family's health, monitoring of non-infectious and infectious diseases. Clearly due to the paper-based nature of the tasks, timely decision making at most can be difficult if not impossible. As part of an on-going electronic health record implementation project at Tehran University of Medical Sciences, for the first time in the region, based on a comprehensive pilot project, four urban healthcare facilities are connected to their headquarters and beyond, covering all aspects of primary health care, for the last four years. Without delving into the technical aspects of its software engineering processes, the progress of the implementation is reported, selection of summarized data is presented, and experience gained thus far are discussed. Four years passed and if time is any important reason to go by, then it is safe to accept that the software architecture and electronic health record structural model implemented are robust and yet extensible. Aims and duration of a pilot study should be clearly defined prior to start and managed till its completion. Resistance to change and particularly to information technology, apart from its technical aspects, is also based on human factors.

Developing a Multimedia, Computer-Based Spanish Placement Test

ERIC Educational Resources Information Center

Zabaleta, Francisco

2007-01-01

Placing students of a foreign language within a basic language program constitutes an ongoing problem, particularly for large university departments when they have many incoming freshmen and transfer students. This article outlines the author's experience designing and piloting a language placement test for a university level Spanish program. The…

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2015-02-26

2 • Pilot House – Electrical and joiner work is ongoing, however carpenters are waiting for HVAC to finish before Norac...STD Report - TEST REPORT ( 320-001-2 MCCS Design Verification Test Report)(R/ASR) 108/0 AGOR27 A059 STD Report - STUDENT GUIDES ( DI-059 (Student

Expérience de fréquentation des lieux publics par des personnes âgées ayant subi un TCC en présence d'un accompagnateur-citoyen: projet pilote.

PubMed

Levert, Marie-Josée; Lefebvre, Hélène; Gélinas, Isabelle; McKerall, Michelle; Roy, Odette; Proulx, Michelle

2016-06-01

This pilot project aims to test and see the relevance of the direct observation method to collect data on the barriers and facilitators to attending public places by seniors with TBI. The study is based on the conceptual framework VADA WHO which focuses on the development of friendly built and technological environments for seniors. Three elderly people participated in the study, recruited from an ongoing project, The Citizen Intervention in Community Living (APIC), in the presence of their personalized attendant. The study shows the feasibility of the method in terms of its acceptability and resources mobilized. It shows its relevance to access additional data that would have been difficult to obtain using others methods (e.g., semi-structured interview), such as the identification of the strategies used by the participants to address the obstacles encountered (avoidance, travel planning, use of physical and preventative support of the personalized attendant).

Deep Brain Stimulation in Early Parkinson’s Disease: Enrollment Experience from a Pilot Trial

PubMed Central

Charles, PD; Dolhun, RM; Gill, CE; Davis, TL; Bliton, MJ; Tramontana, MG; Salomon, RM; Wang; Hedera, P; Phibbs, FT; Neimat, JS; Konrad, PE

2011-01-01

Background Deep brain stimulation (DBS) of the subthalamic nucleus is an accepted therapy for advanced Parkinson’s disease (PD). In animal models, pharmacologic ablation and stimulation of the subthalamic nucleus have resulted in clinical improvement and, in some cases, improved survival of dopaminergic neurons. DBS has not been studied in the early stages of PD, but early application should be explored to evaluate safety, efficacy, and the potential to alter disease progression. Methods We are conducting a prospective, randomized, single-blind clinical trial of optimal drug therapy (ODT) compared to medication plus DBS (ODT + DBS) in subjects with Hoehn & Yahr Stage II idiopathic PD who are without motor fluctuations or dementia. We report here subject screening, enrollment, baseline characteristics, and adverse events. Results 30 subjects (average age 60 ± 6.9 years, average duration of medicine 2.1 ± 1.3 years, average UPDRS-III scores 14.9 on medication and 27.0 off medication) are enrolled in the ongoing study. Twelve of 15 subjects randomized to DBS experienced perioperative adverse events, the majority of which were related to the procedure or device and resolved without sequelae. Frequently reported adverse events included wound healing problems, headache, edema, and confusion. Conclusion This report demonstrates that subjects with early stage PD can be successfully recruited, consented and retained in a long term clinical trial of DBS. Our ongoing pilot investigation will provide important preliminary safety and tolerability data concerning the application of DBS in early stage PD. PMID:22104012

Cloudy with a Chance of Pain: Engagement and Subsequent Attrition of Daily Data Entry in a Smartphone Pilot Study Tracking Weather, Disease Severity, and Physical Activity in Patients With Rheumatoid Arthritis.

PubMed

Reade, Samuel; Spencer, Karen; Sergeant, Jamie C; Sperrin, Matthew; Schultz, David M; Ainsworth, John; Lakshminarayana, Rashmi; Hellman, Bruce; James, Ben; McBeth, John; Sanders, Caroline; Dixon, William G

2017-03-24

The increasing ownership of smartphones provides major opportunities for epidemiological research through self-reported and passively collected data. This pilot study aimed to codesign a smartphone app to assess associations between weather and joint pain in patients with rheumatoid arthritis (RA) and to study the success of daily self-reported data entry over a 60-day period and the enablers of and barriers to data collection. A patient and public involvement group (n=5) and 2 focus groups of patients with RA (n=9) supported the codesign of the app collecting self-reported symptoms. A separate "capture app" was designed to collect global positioning system (GPS) and continuous raw accelerometer data, with the GPS-linking providing local weather data. A total of 20 patients with RA were then recruited to collect daily data for 60 days, with entry and exit interviews. Of these, 17 were loaned an Android smartphone, whereas 3 used their own Android smartphones. Of the 20 patients, 6 (30%) withdrew from the study: 4 because of technical challenges and 2 for health reasons. The mean completion of daily entries was 68% over 2 months. Patients entered data at least five times per week 65% of the time. Reasons for successful engagement included a simple graphical user interface, automated reminders, visualization of data, and eagerness to contribute to this easily understood research question. The main barrier to continuing engagement was impaired battery life due to the accelerometer data capture app. For some, successful engagement required ongoing support in using the smartphones. This successful pilot study has demonstrated that daily data collection using smartphones for health research is feasible and achievable with high levels of ongoing engagement over 2 months. This result opens important opportunities for large-scale longitudinal epidemiological research. ©Samuel Reade, Karen Spencer, Jamie C Sergeant, Matthew Sperrin, David M Schultz, John Ainsworth, Rashmi Lakshminarayana, Bruce Hellman, Ben James, John McBeth, Caroline Sanders, William G Dixon. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 24.03.2017.

Development of a Field-Deployable Psychomotor Vigilance Test to Monitor Helicopter Pilot Performance.

PubMed

McMahon, Terry W; Newman, David G

2016-04-01

Flying a helicopter is a complex psychomotor skill. Fatigue is a serious threat to operational safety, particularly for sustained helicopter operations involving high levels of cognitive information processing and sustained time on task. As part of ongoing research into this issue, the object of this study was to develop a field-deployable helicopter-specific psychomotor vigilance test (PVT) for the purpose of daily performance monitoring of pilots. The PVT consists of a laptop computer, a hand-operated joystick, and a set of rudder pedals. Screen-based compensatory tracking task software includes a tracking ball (operated by the joystick) which moves randomly in all directions, and a second tracking ball which moves horizontally (operated by the rudder pedals). The 5-min test requires the pilot to keep both tracking balls centered. This helicopter-specific PVT's portability and integrated data acquisition and storage system enables daily field monitoring of the performance of individual helicopter pilots. The inclusion of a simultaneous foot-operated tracking task ensures divided attention for helicopter pilots as the movement of both tracking balls requires simultaneous inputs. This PVT is quick, economical, easy to use, and specific to the operational flying task. It can be used for performance monitoring purposes, and as a general research tool for investigating the psychomotor demands of helicopter operations. While reliability and validity testing is warranted, data acquired from this test could help further our understanding of the effect of various factors (such as fatigue) on helicopter pilot performance, with the potential of contributing to helicopter operational safety.

Breast cancer and personal environmental risk factors in Marin County - Pilot study

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

Erdmann, C.A.; Farren, G.; Baltzell, K.

The purpose of the Personal Environmental Risk Factor Study (PERFS) pilot project was to develop methodologies and a questionnaire for a future population-based case-control study to investigate the role of selected environmental exposures in breast cancer development. Identification of etiologically relevant exposures during a period of potential vulnerability proximate to disease onset offers the possibility of clinical disease prevention even when disease initiation may have already occurred many years earlier. Certain personal environmental agents or combinations of agents may influence disease promotion. Therefore, this pilot study focused on exposures that occurred during the ten-year period prior to diagnosis for casesmore » and the last ten years for controls, rather than more historic exposures. For this pilot study, they used a community-based research approach. In the collaborative efforts, community members participated with academic researchers in all phases of the research, including research question identification, study design, development of research tools, development of the human subjects protocol, and report writing. Community member inclusion was based upon the concept that community participation could improve the relevance of scientific studies and ultimate success of the research by encouraging an ongoing dialogue between community members and academic representatives. Early activities of this project focused on the collection of input from the community regarding the possible role of environmental factors in the incidence of breast cancer in Marin County. The intent was to inform the scientists of community concerns, enhance the research team's understanding of the community being studied, and provide interested community members with a better understanding of the strengths and weaknesses of traditional research methods through active participation in the research process.« less

The Touchstone Process: an ongoing critical evaluation of reiki in the scientific literature.

PubMed

Baldwin, Ann L; Vitale, Anne; Brownell, Elise; Scicinski, Jan; Kearns, Mary; Rand, William

2010-01-01

Reiki is used by a growing number of people but little is known about the scientific basis for its use. The Touchstone Process was developed as an ongoing process to systematically analyze published, peer-reviewed studies of Reiki, the results being made accessible to the public online. Thirteen scientifically qualified experts in the field of Reiki were assembled into 3 teams to retrieve, evaluate, and summarize articles using standardized, piloted evaluation forms. Summaries of 26 Reiki articles, including strengths and weaknesses, were posted on a newly developed Web site (www.centerforreikiresearch.org), together with an overall summary of the status of Reiki research and guidelines for future research: The Touchstone Process determined that only 12 articles were based on a robust experimental design and utilized well-established outcome parameters. Of these articles, 2 provided no support, 5 provided some support, and 5 demonstrated strong evidence for the use of Reiki as a healing modality. There is a need for further high-quality studies in this area.

Rhetoric and the Death of a Top Gun: Technology, Gender, and the Military.

ERIC Educational Resources Information Center

Sadler, Tori

1999-01-01

Discusses the author's ongoing research analyzing several sites of discourse related to a military training accident that resulted in the death of the first female military pilot assigned to a combat position. Contributes to scholarship discussing interactions of technology, gender, and military culture. Explores how language influences…

Comprehensive Computer-Based Instructional Programs: What Works for Educationally Disadvantaged Students?

ERIC Educational Resources Information Center

Swan, Karen; And Others

The Computer Pilot Program of the Division of Computer Information Services of the New York City Board of Education was designed to investigate the claim that comprehensive computer-based instruction (CBI) might best be used to improve the basic skills of educationally disadvantaged students. This ongoing project is designed to identify…

Pilot Guidelines for Improving Instructional Materials Through the Process of Learner Verification and Revision.

ERIC Educational Resources Information Center

Educational Products Information Exchange Inst., Stony Brook, NY.

Learner Verification and Revision (LVR) Process of Instructional Materials is an ongoing effort for the improvement of instructional materials based on systematic feedback from learners who have used the materials. This evaluation gives publishers a method of identifying instructional strengths and weaknesses of a product and provides an…

Centrifuge-induced neck and back pain in F-16 pilots: a report of four cases.

PubMed

Lange, Britt; Nielsen, René Tyranski; Skejø, Pernille Bro; Toft, Palle

2013-07-01

Early in their careers, as an important part of their training to become fighter pilots, pilots undergo centrifuge training in order to learn effective anti-G straining maneuvers (AGSM) and to test their G tolerance. The exposure of pilots, especially early in their careers, to training that could lead to injuries should be avoided. This is a report of four cases of neck pain experienced during G-tolerance training, some of which may have caused ongoing problems for the pilot. Four cases, describing four different injuries experienced during G-tolerance training, are presented, including the history of the incident, radiographic description, and physical examination. Three main questions were identified in regards to the training of fighter pilots in centrifuges: 1) should the seat be positioned to imitate a specific aircraft's seat? 2) should the pilot wear a helmet and a mask? 3) what is the appropriate amount of head support? Based on the four cases reported it is recommended that pilots should be given the best possible conditions concerning neck support and load on the neck and the back for G-tolerance testing. Training the pilot in an anatomical neutral sitting position, without a helmet, and with maximal neck support minimizes head movements in cases of conscious or unconscious loss of muscle control. To test the stability of the neck in a setup similar to the environment where the pilot is going to operate, the pilot should be given the opportunity to prepare himself or herself accordingly in advance.

A novel smart lighting clinical testbed.

PubMed

Gleason, Joseph D; Oishi, Meeko; Simkulet, Michelle; Tuzikas, Arunas; Brown, Lee K; Brueck, S R J; Karlicek, Robert F

2017-07-01

A real-time, feedback-capable, variable spectrum lighting system was recently installed at the University of New Mexico Hospital to facilitate biomedical research on the health impacts of lighting. The system consists of variable spectrum troffers, color sensors, occupancy sensors, and computing and communication infrastructure, and is the only such clinical facility in the US. The clinical environment posed special challenges for installation as well as for ongoing maintenance and operations. Pilot studies are currently underway to evaluate the effectiveness of the system to regulate circadian phase in subjects with delayed sleep-wake phase disorder.

Reflective dialogue in clinical supervision: A pilot study involving collaborative review of supervision videos.

PubMed

Hill, Hamish R M; Crowe, Trevor P; Gonsalvez, Craig J

2016-01-01

To pilot an intervention involving reflective dialogue based on video recordings of clinical supervision. Fourteen participants (seven psychotherapists and their supervisors) completed a reflective practice protocol after viewing a video of their most recent supervision session, then shared their reflections in a second session. Thematic analysis of individual reflections and feedback resulted in the following dominant themes: (1) Increased discussion of supervisee anxiety and the tensions between autonomy and dependence; (2) intentions to alter supervisory roles and practice; (3) identification of and reflection on parallel process (defined as the dynamic transmission of relationship patterns between therapy and supervision); and (4) a range of perceived impacts including improvements in supervisory alliance. The results suggest that reflective dialogue based on supervision videos can play a useful role in psychotherapy supervision, including with relatively inexperienced supervisees. Suggestions are provided for the encouragement of ongoing reflective dialogue in routine supervision practice.

Impact of Ada in the Flight Dynamics Division: Excitement and frustration

NASA Technical Reports Server (NTRS)

Bailey, John; Waligora, Sharon; Stark, Mike

1993-01-01

In 1985, NASA Goddard's Flight Dynamics Division (FDD) began investigating how the Ada language might apply to their software development projects. Although they began cautiously using Ada on only a few pilot projects, they expected that, if the Ada pilots showed promising results, they would fully transition their entire development organization from FORTRAN to Ada within 10 years. However, nearly 9 years later, the FDD still produces 80 percent of its software in FORTRAN, despite positive results on Ada projects. This paper reports preliminary results of an ongoing study, commissioned by the FDD, to quantify the impact of Ada in the FDD, to determine why Ada has not flourished, and to recommend future directions regarding Ada. Project trends in both languages are examined as are external factors and cultural issues that affected the infusion of this technology. This paper is the first public report on the Ada assessment study, which will conclude with a comprehensive final report in mid 1994.

Are all after-hours diagnostic imaging appropriate? An Australian Emergency Department pilot study.

PubMed

Gardiner, Fergus William; Zhai, Shaun

2016-12-01

This study was aimed at determining the extent to which after-hours diagnostic imaging is appropriate within the case hospital's Emergency Department. This was amid growing concerns of the inappropriateness of some medical investigations within the Australian health-care system. After-hours referral data and patient notes were used in reviewing the clinical case. Diagnostic imaging was deemed appropriate if reflective of clinical guidelines, and if not reflective, whether the investigation changed the patient's ongoing management. Results indicated that 96.37% of after-hours diagnostic imaging adhered to clinical guidelines and was appropriately requested, with 95.85% changing the ongoing management of the patient. The most sought after diagnostic imaging procedures were Chest X-Ray (30.83%), and CT Brain (16.58%), with 99.16% and 98.44 appropriateness respectively. Chest pain (14.49%) and motor vehicle accidents (8.12%) were the leading reason for ordering after-hours imaging. This study provided an Emergency Department example as it relates to after-hours diagnostic imaging appropriateness. This study found that most after-hours referrals were appropriate.

Pilot study of the impact sacroiliac joint manipulation has on walking kinematics using motion analysis technology

PubMed Central

Ward, John S.; Coats, Jesse; Sorrels, Kenneth; Walters, Mathew; Williams, Trevor

2013-01-01

Objective The purpose of this study was to evaluate the feasibility of engaging in a series of larger studies measuring the effect of sacroiliac joint manipulation on walking kinematics using motion analysis technology. Methods Twelve college students engaged in a baseline 90-second gait analysis at 1.5 mph using infrared VICON cameras. Following this, they underwent a prone heel comparison test for functional leg length inequality. Upon examination, participants were then classified as follows: left short leg, right short leg, or no short leg. Participants in each of the 2 short leg branches of this study were then randomized to receive either chiropractic manipulative therapy to the posterior superior iliac spine on the short limb side or no manipulation. Recruitment was ongoing for this pilot study until 1 participant was recruited in each of the following 5 comparative study groups: left short leg—manipulation, left short leg—no manipulation (control 1), right short leg—manipulation, right short leg—no manipulation (control 2), and no short leg (control 3). All participants then underwent another 90-second gait analysis. Data were then grouped and submitted to a blinded biomechanist to determine if there were any unique biomechanical differences between the groups. Results No statistically significant differences were measured because of this being a pilot study with a small sample size. Conclusions The data from this study indicate that a series of larger studies with this design is feasible. PMID:24396314

A qualitative pilot study of food insecurity among Maasai women in Tanzania

PubMed Central

Fenton, Carol; Hatfield, Jennifer; McIntyre, Lynn

2012-01-01

Background Food insecurity is an ongoing threat in rural sub-Saharan Africa and is complicated by cultural practices, the rise of chronic conditions such as HIV and land use availability. In order to develop a successful food security intervention program, it is important to be informed of the realities and needs of the target population. The purpose of this study was to pilot a qualitative method to understand food insecurity based on the lived experience of women of the Maasai population in the Ngorongoro Conservation Area of Tanzania. Methods Short semi-structured qualitative interviews with 4 Maasai women. Results Food insecurity was present in the Maasai community: the participants revealed that they did not always have access to safe and nutritious food that met the needs of themselves and their families. Themes that emerged from the data fell into three categories: Current practices (food sources, planning for enough, food preparation, and food preservation), food Insecurity (lack of food, emotions, coping strategies, and possible solutions), and division (co-wives, food distribution, and community relationships). Conclusion This pilot study suggested the presence of food insecurity in the Maasai community. Larger sample studies are needed to clarify the extent and severity of food insecurity among this population. Having a detailed understanding of the various aspects of the food insecurity lived experience could inform a targeted intervention program. PMID:23077702

Perspective on intelligent avionics

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

Jones, H.L.

1987-01-01

Technical issues which could potentially limit the capability and acceptibility of expert systems decision-making for avionics applications are addressed. These issues are: real-time AI, mission-critical software, conventional algorithms, pilot interface, knowledge acquisition, and distributed expert systems. Examples from on-going expert system development programs are presented to illustrate likely architectures and applications of future intelligent avionic systems. 13 references.

78 FR 13344 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-27

... an ongoing manner, most of the more than 4,500 hospitals now reporting to the CDC's current HAI... acute care hospitals in one U.S. city. This pilot phase was followed in 2010 by a phase 2, limited roll..., Minnesota, New Mexico, New York, Oregon, and Tennessee). Experience gained in the phase 1 and phase 2...

77 FR 71798 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... ongoing manner, most of the more than 4,500 hospitals now reporting to the CDC's current HAI surveillance... of nine acute care hospitals in one U.S. city. This pilot phase was followed in 2010 by a phase 2..., Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee). Experience gained in the phase 1 and...

Turning an Undergraduate Class into a Professional Research Community

ERIC Educational Resources Information Center

Chang, Hasok

2005-01-01

I describe here an ongoing pilot project aimed at a full integration of teaching and research at the undergraduate level. Our chief innovation is the mechanism of inheritance: each year students receive a body of work produced by the previous group of students and make improvements and additions to it; this process can be repeated until…

76 FR 65698 - Magnuson-Stevens Act Provisions; General Provisions for Domestic Fisheries; Application for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-24

... Atlantic surfclam and ocean quahog Georges Bank Closure Area to continue testing the safety and efficacy of... research project that has been ongoing since 2006. NMS has made a preliminary determination that the...: http://www.nero.noaa.gov/sfd/clams . This project is a pilot program with the goal of determining if...

Effects on Task Performance and Psychophysiological Measures of Performance During Normobaric Hypoxia Exposure

NASA Technical Reports Server (NTRS)

Stephens, Chad; Kennedy, Kellie; Napoli, Nicholas; Demas, Matthew; Barnes, Laura; Crook, Brenda; Williams, Ralph; Last, Mary Carolyn; Schutte, Paul

2017-01-01

Human-autonomous systems have the potential to mitigate pilot cognitive impairment and improve aviation safety. A research team at NASA Langley conducted an experiment to study the impact of mild normobaric hypoxia induction on aircraft pilot performance and psychophysiological state. A within-subjects design involved non-hypoxic and hypoxic exposures while performing three 10-minute tasks. Results indicated the effect of 15,000 feet simulated altitude did not induce significant performance decrement but did produce increase in perceived workload. Analyses of psychophysiological responses evince the potential of biomarkers for hypoxia onset. This study represents on-going work at NASA intending to add to the current knowledge of psychophysiologically-based input to automation to increase aviation safety. Analyses involving coupling across physiological systems and wavelet transforms of cortical activity revealed patterns that can discern between the simulated altitude conditions. Specifically, multivariate entropy of ECG/Respiration components were found to be significant predictors (p< 0.02) of hypoxia. Furthermore, in EEG, there was a significant decrease in mid-level beta (15.19-18.37Hz) during the hypoxic condition in thirteen of sixteen sites across the scalp. Task performance was not appreciably impacted by the effect of 15,000 feet simulated altitude. Analyses of psychophysiological responses evince the potential of biomarkers for mild hypoxia onset.The potential for identifying shifts in underlying cortical and physiological systems could serve as a means to identify the onset of deteriorated cognitive state. Enabling such assessment in future flightdecks could permit increasingly autonomous systems-supported operations. Augmenting human operator through assessment of cognitive impairment has the potential to further improve operator performance and mitigate human error in safety critical contexts. This study represents ongoing work at NASA intending to add to the current knowledge of psychophysiologically-based input to automation to increase aviation safety.

Pain, health-related quality of life and health care utilization after inpatient surgery: A pilot study

PubMed Central

VanDenKerkhof, Elizabeth G; Hopman, Wilma M; Towheed, Tanveer; Wilson, Rosemary; Murdoch, John; Rimmer, Michael; Stutzman, Sherri Schmidt; Tod, Debbie; Dagnone, Vico; Goldstein, David H

2006-01-01

BACKGROUND Little is known about pain-related outcomes in surgical inpatients after discharge from the hospital. An ongoing risk and outcomes monitoring system would provide valuable feedback to improve the quality of patient care. OBJECTIVES The purpose of the present pilot study was to describe postoperative pain, medication use, health care utilization and health-related quality of life (HRQOL) immediately and four weeks after surgery; merge clinically captured data with Web-based follow-up data; and examine patients’ willingness to complete Web-based health questionnaires. METHODS One hundred two consecutive surgical inpatients were approached for participation. Perioperative data were abstracted from the acute pain management service clinical database and linked to follow-up data captured four weeks postoperatively. RESULTS Follow-up questionnaires were completed by 88 participants. Clinical assessment data were successfully linked to Web-based follow-up data. Average pain intensity (3.7) four weeks following discharge fell just short of the acute pain management service active pain score of 3.9. At four weeks, all 88 participants reported significantly impaired HRQOL, 36 were still taking pain medications and 15 had visited an emergency room. Two-thirds of the participants had access to the Internet at home and approximately one-half were willing to complete on-line health questionnaires. DISCUSSION The study indicates that it is feasible to link clinical and research data, and shows a significant burden of pain and reduced HRQOL in the weeks following discharge. This approach to converting clinically captured data into meaningful information about surgical outcomes is valuable in the development of an ongoing risk and outcomes monitoring system. PMID:16511613

A pilot study of distributed knowledge management and clinical decision support in the cloud.

PubMed

Dixon, Brian E; Simonaitis, Linas; Goldberg, Howard S; Paterno, Marilyn D; Schaeffer, Molly; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford

2013-09-01

Implement and perform pilot testing of web-based clinical decision support services using a novel framework for creating and managing clinical knowledge in a distributed fashion using the cloud. The pilot sought to (1) develop and test connectivity to an external clinical decision support (CDS) service, (2) assess the exchange of data to and knowledge from the external CDS service, and (3) capture lessons to guide expansion to more practice sites and users. The Clinical Decision Support Consortium created a repository of shared CDS knowledge for managing hypertension, diabetes, and coronary artery disease in a community cloud hosted by Partners HealthCare. A limited data set for primary care patients at a separate health system was securely transmitted to a CDS rules engine hosted in the cloud. Preventive care reminders triggered by the limited data set were returned for display to clinician end users for review and display. During a pilot study, we (1) monitored connectivity and system performance, (2) studied the exchange of data and decision support reminders between the two health systems, and (3) captured lessons. During the six month pilot study, there were 1339 patient encounters in which information was successfully exchanged. Preventive care reminders were displayed during 57% of patient visits, most often reminding physicians to monitor blood pressure for hypertensive patients (29%) and order eye exams for patients with diabetes (28%). Lessons learned were grouped into five themes: performance, governance, semantic interoperability, ongoing adjustments, and usability. Remote, asynchronous cloud-based decision support performed reasonably well, although issues concerning governance, semantic interoperability, and usability remain key challenges for successful adoption and use of cloud-based CDS that will require collaboration between biomedical informatics and computer science disciplines. Decision support in the cloud is feasible and may be a reasonable path toward achieving better support of clinical decision-making across the widest range of health care providers. Published by Elsevier B.V.

Continuous Groundwater Monitoring Collocated at USGS Streamgages

NASA Astrophysics Data System (ADS)

Constantz, J. E.; Eddy-Miller, C.; Caldwell, R.; Wheeer, J.; Barlow, J.

2012-12-01

USGS Office of Groundwater funded a 2-year pilot study collocating groundwater wells for monitoring water level and temperature at several existing continuous streamgages in Montana and Wyoming, while U.S. Army Corps of Engineers funded enhancement to streamgages in Mississippi. To increase spatial relevance with in a given watershed, study sites were selected where near-stream groundwater was in connection with an appreciable aquifer, and where logistics and cost of well installations were considered representative. After each well installation and surveying, groundwater level and temperature were easily either radio-transmitted or hardwired to existing data acquisition system located in streamgaging shelter. Since USGS field personnel regularly visit streamgages during routine streamflow measurements and streamgage maintenance, the close proximity of observation wells resulted in minimum extra time to verify electronically transmitted measurements. After field protocol was tuned, stream and nearby groundwater information were concurrently acquired at streamgages and transmitted to satellite from seven pilot-study sites extending over nearly 2,000 miles (3,200 km) of the central US from October 2009 until October 2011, for evaluating the scientific and engineering add-on value of the enhanced streamgage design. Examination of the four-parameter transmission from the seven pilot study groundwater gaging stations reveals an internally consistent, dynamic data suite of continuous groundwater elevation and temperature in tandem with ongoing stream stage and temperature data. Qualitatively, the graphical information provides appreciation of seasonal trends in stream exchanges with shallow groundwater, as well as thermal issues of concern for topics ranging from ice hazards to suitability of fish refusia, while quantitatively this information provides a means for estimating flux exchanges through the streambed via heat-based inverse-type groundwater modeling. In June USGS Fact Sheet 2012-3054 was released online, summarizing the results of the pilot project.

Preliminary Testing of an Asthma Distance Education Program (ADEP) for School Nurses in Appalachia

ERIC Educational Resources Information Center

Putman-Casdorph, Heidi; Pinto, Susan

2011-01-01

Asthma remains one of the most challenging chronic illnesses faced by school nurses both nationally and in the State of West Virginia. There is a clear need to provide ongoing continuing asthma education to school nurses. However, nurses face many barriers to receiving this education. The purpose of this pilot project was to develop and evaluate…

Handheld computers in nursing education: PDA pilot project.

PubMed

Koeniger-Donohue, Rebecca

2008-02-01

Interest in the use and application of handheld technology at undergraduate and graduate nursing programs across the country is growing rapidly. Personal digital assistants (PDAs) are often referred to as a "peripheral brain" because they can save time, decrease errors, and simplify information retrieval at the point of care. In addition, research results support the notion that PDAs enhance nursing clinical education and are an effective student learning resource. However, most nursing programs lack the full range of technological resources to implement and provide ongoing support for handheld technology use by faculty and students. This article describes a 9-month pilot project for the initial use of PDAs by novice faculty and students at Simmons College.

Update on the LAMOST-PLUS Collaboration

NASA Astrophysics Data System (ADS)

Carlin, Jeffrey L.; Newberg, H. J.; Deng, L.; Bai, Z.; Beers, T. C.; Chen, J.; Chen, L.; Chu, Y.; Fu, X.; Gao, S.; Grillmair, C. J.; Guhathakurta, P.; Hou, J.; Lepine, S.; Li, H.; Li, J.; Liu, C.; Liu, X.; Luo, A.; Peng, E.; Sellwood, J.; Xu, Y.; Xue, X.; Yang, F.; Yang, L.; Yanny, B.; Yu, J.; Zhang, H.; Zhang, Y.; Zhao, G.; Zhao, Y.; Zheng, Z.; Zhong, J.

2013-01-01

Participants in LAMOST, US (PLUS) is an ongoing collaboration of US scientists with the Galactic structure component of the Chinese LAMOST project on the 4-meter class Guo Shou Jing Telescope in China. A LAMOST Pilot Survey was carried out from October 2011 to June 2012, gathering roughly half a million stellar spectra with sufficient signal-to-noise for radial velocity measurement. PLUS members assisted in preparing papers for a special LAMOST Pilot Survey "mini-volume" of the journal Research in Astronomy and Astrophysics that was issued in mid-2012. This volume contains articles detailing the target selection algorithms and processes, as well as discussion of the science goals of the survey. Scientific results from collaborations (funded by the NSF grant that created the PLUS team) between Chinese visiting scholars and their American counterparts have been fruitful, leading to seven research papers published or submitted in 2012, and more to come soon. As with most large-scale efforts in their early stages, there are issues with data quality; in particular, the limiting magnitude currently achieved by the system do not yet meet the design goals. However, with nearly half a million useful spectra of bright stars (typically brighter than 17th magnitude in SDSS r-band) available, we are beginning to explore science with LAMOST Pilot Survey data. In particular, (sub-)structure in the Galactic disk can be probed deeply with such large kinematical datasets as that provided by LAMOST (see, e.g., the Delaunay et al. and Gole et al. posters at this meeting). PLUS team members are also examining the Pilot Survey data to assess data quality. We present some of the Pilot Survey spectra, and briefly discuss some ongoing projects undertaken with these data. The main LAMOST survey is slated to begin in late 2012 or early 2013, and will ultimately collect spectra of at least 5 million stars over the next five years. More information can be found at http://lamost.us. This collaboration is funded by NSF grant AST 09-37523 and NSFC grants 10973015 and 11061120454.

Critical reappraisal of embryo quality as a predictive parameter for pregnancy outcome: a pilot study.

PubMed

Campo, R; Binda, M M; Van Kerkhoven, G; Frederickx, V; Serneels, A; Roziers, P; Lopes, A S; Gordts, S; Puttemans, P; Gordts, S

2010-01-01

Pilot study to analyse the efficacy and embryo morphology using a new human embryo culture medium (GM501) versus the conventional used medium (ISM1). Over a four-month period, all patients at the Leuven Institute of Fertility and Embryology (LIFE) were -randomly allocated to have their embryos cultured in either the standard sequential culture medium ISM1 (control) or in a new universal medium (GM501) (study group). Primary outcome parameters were clinical pregnancy and live birth rate. The secondary outcome parameter was the correlation of embryo fragmentation rate with pregnancy outcome. We did not observe any differences between the ISM1 control group and GM501 study group with regard to fertilization, pregnancy, implantation rates, ongoing pregnancy, and babies born. The number of embryos with a minimal fragmentation rate (less than 30%) was significantly higher in the GM501 study group. Although a significant higher embryo fragmentation rate was seen in In vitro culture of embryos in GM501, pregnancy outcome results were comparable to those of embryos cultured in ISM1. According to our results the value of embryo morphological criteria as a parameter for pregnancy outcome should be examined and discussed again.

Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence.

PubMed

Varcoe, Colleen; Browne, Annette J; Ford-Gilboe, Marilyn; Dion Stout, Madeleine; McKenzie, Holly; Price, Roberta; Bungay, Victoria; Smye, Victoria; Inyallie, Jane; Day, Linda; Khan, Koushambhi; Heino, Angela; Merritt-Gray, Marilyn

2017-06-01

Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo-colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory-based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6-8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre- to post-intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Project IMPACT: A pharmacotherapy pilot trial investigating the abstinence and treatment adherence of Latino light smokers

PubMed Central

de Dios, Marcel A.; Anderson, Bradley J.; Stanton, Cassandra; Audet, Daniel A.; Stein, Michael

2012-01-01

Light smoking is particularly prevalent among Latino smokers. Nicotine replacement (NRT) and varenicline are effective medications for smoking cessation for moderate-heavy smokers, but have not been tested in light smokers and thus there are no treatment guidelines for use with light smokers. This pilot trial tested the efficacy of NRT and varenicline in increasing smoking abstinence among Latino light smokers. A 3-group (NRT, varenicline, varenicline-placebo) randomized design was used and Latino light smokers (≤10 cpd) received 12 weeks of treatment which included a culturally-informed behavioral health session and ongoing medication management visits. At follow-up, there were no abstinent participants in the placebo and NRT groups. However, 30% of participants in the varenicline group were abstinent at the 3, 4, and 6 month follow-up. This study represents the only investigation that specifically targets Latino light smokers using these treatments and characterizing their treatment adherence. PMID:22377389

Pregnancy and Parenting Support for Incarcerated Women: Lessons Learned

PubMed Central

Shlafer, Rebecca J.; Gerrity, Erica; Duwe, Grant

2017-01-01

Background There are more than 200,000 incarcerated women in U.S. prisons and jails, and it is estimated that 6% to 10% are pregnant. Pregnant incarcerated women experience complex risks that can compromise their health and the health of their offspring. Objectives Identify lessons learned from a community–university pilot study of a prison-based pregnancy and parenting support program. Methods A community–university–corrections partnership was formed to provide education and support to pregnant incarcerated women through a prison-based pilot program. Evaluation data assessed women’s physical and mental health concerns and satisfaction with the program. Between October 2011 and December 2012, 48 women participated. Lessons Learned We learned that providing services for pregnant incarcerated women requires an effective partnership with the Department of Corrections, adaptations to traditional community-based participatory research (CBPR) approaches, and resources that support both direct service and ongoing evaluation. Conclusions Effective services for pregnant incarcerated women can be provided through a successful community– university–corrections partnership. PMID:26548788

Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot.

PubMed

Chronis-Tuscano, Andrea; Wang, Christine H; Strickland, Jennifer; Almirall, Daniel; Stein, Mark A

2016-01-01

Young children of mothers with adult attention-deficit/hyperactivity disorder (ADHD) are at risk for ADHD by virtue of genetics and environmental factors. Moreover, parent ADHD is associated with maladaptive parenting and poor child behavioral treatment response. Thus, a combined approach consisting of behavioral parent training (BPT) and maternal stimulant medication (MSM) may be needed to effectively treat ADHD within families. However, providing combined BPT+MSM initially to all families may be unnecessarily burdensome because not all families likely need combined treatment. The purpose of this study is to examine how to combine, sequence, and personalize treatment for these multiplex families in order to yield benefits to both the parent and child, thereby impacting the course of child ADHD and disruptive behavior symptoms. This article presents our rationale for, design of, and preliminary experiences (based on 26 participants) with an ongoing pilot Sequential Multiple Assessment Randomized Trial (SMART) designed to answer questions regarding the feasibility and acceptability of study protocols and interventions. This article also describes how the subsequent full-scale SMART might change based on what is learned in the SMART pilot and illustrates how the full-scale SMART could be used to inform clinical decision making about how to combine, sequence, and personalize treatment for complex children and families in which a parent has ADHD.

Report of the Computer Assisted Instruction Project in the Faculty of Nursing at the University of Calgary.

ERIC Educational Resources Information Center

Hannah, Kathryn

Since August of 1976, the Faculty of Nursing at the University of Calgary has developed and implemented a four-phase computer assisted instruction (CAI) project. In Phase I, the pilot project to demonstrate effectiveness of CAI as an alternative teaching strategy in that setting has been completed and replication is on-going. In Phase II,…

STS-87 Day 10 Highlights

NASA Technical Reports Server (NTRS)

1997-01-01

On this tenth day of the STS-87 mission, the flight crew, Cmdr. Kevin R. Kregel, Pilot Steven W. Lindsey, Mission Specialists Winston E. Scott, Kalpana Chawla, and Takao Doi, and Payload Specialist Leonid K. Kadenyuk receive a call from Ukrainian President Leonid Kuchma and answer questions from media in Kiev. The conversations focus on Kadenyuk's first flight into space and the work ongoing to support the mission objectives.

Flying the Needles: Flight Deck Automation Erodes Fine-Motor Flying Skills Among Airline Pilots.

PubMed

Haslbeck, Andreas; Hoermann, Hans-Juergen

2016-06-01

The aim of this study was to evaluate the influence of practice and training on fine-motor flying skills during a manual instrument landing system (ILS) approach. There is an ongoing debate that manual flying skills of long-haul crews suffer from a lack of flight practice due to conducting only a few flights per month and the intensive use of automation. However, objective evidence is rare. One hundred twenty-six randomly selected airline pilots had to perform a manual flight scenario with a raw data precision approach. Pilots were assigned to four equal groups according to their level of practice and training by fleet (short-haul, long-haul) and rank (first officer, captain). Average ILS deviation scores differed significantly in relation to the group assignments. The strongest predictor variable was fleet, indicating degraded performance among long-haul pilots. Manual flying skills are subject to erosion due to a lack of practice on long-haul fleets: All results support the conclusion that recent flight practice is a significantly stronger predictor for fine-motor flying performance than the time period since flight school or even the total or type-specific flight experience. Long-haul crews have to be supported in a timely manner by adequate training tailored to address manual skills or by operational provisions like mixed-fleet flying or more frequent transitions between short-haul and long-haul operation. © 2016, Human Factors and Ergonomics Society.

[The mentalizing vocational training - first results from a pilot study with adolescents with learning disabilities].

PubMed

Curth, Christian; Kotte, Silja; Taubner, Svenja; Unger, Agnieszka

2014-01-01

In this report first results are presented from a pilot study on the Mentalizing Vocational Training that aims to increase the effectiveness of vocational rehabilitation programs with adolescents diagnosed with learning disabilities. The prevention program was based on the hypothesis that adolescents' difficulties in motivation and relationships are related to deficits in mentalizing. Thus, we created a prevention program that supports an enduring mentalizing social system following Twemlow's and Fonagy's suggestions for peaceful schools. The program consists of four modules: a psychoeducative training for all professionals within the rehabilitation program, an ongoing supervision for two selected teams, two mentalizing training groups for selected adolescents and a weekly intervision group for the research team analyzing the organizational perspective. During the pilot study, mentalization interest and attachment styles were assessed from all adolescents and professionals. Additionally, adolescents' mentalization capacities were assessed using an objective videobased test as well as general intelligence. Results showed that participants had significantly more attachment anxiety and avoidance as well as less interest to think about themselves and others in a complex way. Furthermore, participants achieved very low scores in the mentalization test (comparable to the autistic spectrum) which were independent from general cognitive deficits. On the organizational level, professionals appeared to be conflicted about the changes in management towards more economic efficiency and overwhelmed by participants with traumatic backgrounds. This led to a regression of the whole organization on the teleological mode.

Experiences of recruiting to a pilot trial of Cardiac Rehabilitation In patients with Bowel cancer (CRIB) with an embedded process evaluation: lessons learned to improve recruitment.

PubMed

Hubbard, Gill; Campbell, Anna; Davies, Zoe; Munro, Julie; Ireland, Aileen V; Leslie, Stephen; Watson, Angus Jm; Treweek, Shaun

2015-01-01

Recruitment to randomised controlled trials (RCTs) is a perennial problem. Calls have been made for trialists to make recruitment performance publicly available. This article presents our experience of recruiting to a pilot RCT of cardiac rehabilitation for patients with bowel cancer with an embedded process evaluation. Recruitment took place at three UK hospitals. Recruitment figures were based on the following: i) estimated number of patient admissions, ii) number of patients likely to meet inclusion criteria from clinician input and iii) recruitment rates in previous studies. The following recruitment procedure was used:Nurse assessed patients for eligibility.Patients signed a screening form indicating interest in and agreement to be approached by a researcher about the study.An appointment was made at which the patient signed a consent form and was randomised to the intervention or control group. Information about all patients considered for the study and subsequently included or excluded at each stage of the recruitment process and reasons given were recorded. There were variations in the time taken to award Research Management approval to run the study at the three sites (45-359 days). Sixty-two percent of the original recruitment estimate was reached. The main reason for under-recruitment was due to over-estimation of the number of patient admissions; other reasons were i) not assessing all patients for eligibility, ii) not completing a screening form for eligible patients and iii) patients who signed a screening form being lost to the study before consenting and randomisation. Pilot trials should not simply aim to improve recruitment estimates but should also identify factors likely to influence recruitment performance in a future trial and inform the development of that trial's recruitment strategies. Pilot trials are a crucial part of RCT design. Nevertheless, pilot trials are likely to be small scale, involving only a small number of sites, and contextual differences between sites are likely to impact recruitment performance in any future trial. This means that ongoing monitoring and evaluation in trials are likely to be required. ISRCTN63510637; UKCRN id 14092.

Petroleum contaminated water and health symptoms: a cross-sectional pilot study in a rural Nigerian community.

PubMed

Kponee, Kalé Zainab; Chiger, Andrea; Kakulu, Iyenemi Ibimina; Vorhees, Donna; Heiger-Bernays, Wendy

2015-11-06

The oil-rich Niger Delta suffers from extensive petroleum contamination. A pilot study was conducted in the region of Ogoniland where one community, Ogale, has drinking water wells highly contaminated with a refined oil product. In a 2011 study, the United Nations Environment Programme (UNEP) sampled Ogale drinking water wells and detected numerous petroleum hydrocarbons, including benzene at concentrations as much as 1800 times higher than the USEPA drinking water standard. UNEP recommended immediate provision of clean drinking water, medical surveillance, and a prospective cohort study. Although the Nigerian government has provided emergency drinking water, other UNEP recommendations have not been implemented. We aimed to (i) follow up on UNEP recommendations by investigating health symptoms associated with exposure to contaminated water; and (ii) assess the adequacy and utilization of the government-supplied emergency drinking water. We recruited 200 participants from Ogale and a reference community, Eteo, and administered questionnaires to investigate water use, perceived water safety, and self-reported health symptoms. Our multivariate regression analyses show statistically significant associations between exposure to Ogale drinking water and self-reported health symptoms consistent with petroleum exposure. Participants in Ogale more frequently reported health symptoms related to neurological effects (OR = 2.8), hematological effects (OR = 3.3), and irritation (OR = 2.7). Our results are the first from a community relying on drinking water with such extremely high concentrations of benzene and other hydrocarbons. The ongoing exposure and these pilot study results highlight the need for more refined investigation as recommended by UNEP.

Three-dimensional computed tomography reconstruction for operative planning in robotic segmentectomy: a pilot study

PubMed Central

Le Moal, Julien; Peillon, Christophe; Dacher, Jean-Nicolas

2018-01-01

Background The objective of our pilot study was to assess if three-dimensional (3D) reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy. Methods Between 2014 and 2015, 3D reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain 3D reconstruction, the surgeon uploaded the anonymized computed tomography (CT) image of the patient to the secured Visible Patient™ server and then downloaded the model after completion. Results Nine segmentectomies were performed between 2014 and 2015 using a pre-operative 3D model. All 3D reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique. Conclusions We have shown that operative planning by 3D CT using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. Its impact on reducing complications and improving surgical efficiency is the object of an ongoing study. PMID:29600049

Three-dimensional computed tomography reconstruction for operative planning in robotic segmentectomy: a pilot study.

PubMed

Le Moal, Julien; Peillon, Christophe; Dacher, Jean-Nicolas; Baste, Jean-Marc

2018-01-01

The objective of our pilot study was to assess if three-dimensional (3D) reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy. Between 2014 and 2015, 3D reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain 3D reconstruction, the surgeon uploaded the anonymized computed tomography (CT) image of the patient to the secured Visible Patient™ server and then downloaded the model after completion. Nine segmentectomies were performed between 2014 and 2015 using a pre-operative 3D model. All 3D reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique. We have shown that operative planning by 3D CT using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. Its impact on reducing complications and improving surgical efficiency is the object of an ongoing study.

Using synchronous software in Web-based nursing courses.

PubMed

Little, Barbara Battin; Passmore, Denise; Schullo, Shauna

2006-01-01

To promote learning and enhance immediacy and satisfaction, a college of nursing at a large research I southern university undertook a pilot project to incorporate synchronous classroom software into an ongoing online program. Two synchronous class sessions using voice over Internet protocol were offered in the Community/Public Health Nursing course through Elluminate Live! Upon conclusion of the lecture, students were divided into breakout groups to work on group projects. Surveys were administered to the students and faculty before and after the class sessions. Evaluation of the pedagogical strategies used in the synchronous sessions was conducted by instructional technology faculty. Students in the pilot group reported higher levels of satisfaction with the Web-based course with synchronous sessions. In addition, students reported that group time at the end of the session was helpful for completing group projects. A majority responded that synchronous session activities and assignments facilitated their understanding of course content. This article presents a description of the synchronous classroom pilot project along with recommendations for implementation and pedagogical approaches.

SupportNet for Frontline Behavioral Health Providers

DTIC Science & Technology

2015-07-01

and job burnout among military behavioral health providers and to provide a pilot support system for providers working at with military trauma...survivors. In the fourth year of the project, we completed the RCT and data analysis of behavioral health. Job burnout and secondary trauma are serious...issues for military behavioral health providers who are continually exposed to extensive traumatic material on an on-going basis. Job burnout and STS

Implementation and evolution of a regional chronic disease self-management program.

PubMed

Liddy, Clare; Johnston, Sharon; Nash, Kate; Irving, Hannah; Davidson, Rachel

2016-08-15

To establish a comprehensive, community-based program to improve and sustain self-management support for individuals with chronic diseases and complement office-based strategies to support behaviour change. Health service delivery organizations. The Champlain Local Health Integration Network (LHIN), a health district in Eastern Ontario. We created Living Healthy Champlain (LHC), a regional organization providing peer leader training and coordination for the group Stanford Chronic Disease Self-Management Program (CDSMP); skills training and mentorship in behaviour change approaches for health care providers; and support to organizations to integrate self-management support into routine practice. We used the RE-AIM framework to evaluate the overall program's impact by exploring its reach, effectiveness, adoption, implementation and maintenance. A total of 232 Stanford CDSMP sessions (63 during the pilot project and 169 post-pilot) have been held at 127 locations in 24 cities across the Champlain LHIN, reaching approximately 4,000 patients. The effectiveness of the service was established through ongoing evidence reviews, a focus group and a pre-post utilization study of the pilot. LHC trained over 300 peer volunteers to provide the Stanford CDSMP sessions, 98 of whom continue to activelyhost workshops. An additional 1,327 providers have been trained in other models of self-management support, such as Health Coaching and Motivational Interviewing. Over the study period, LHC grew from a small pilot project to a regional initiative with sustainable provincial funding and was adopted by the province as a model for similar service delivery across Ontario. A community-based self-management program working in partnership with primary care can be effectively and broadly implemented in support of patients living with chronic conditions.

Critical reappraisal of embryo quality as a predictive parameter for pregnancy outcome: a pilot study

PubMed Central

Campo, R.; Binda, M.M.; Van Kerkhoven, G.; Frederickx, V.; Serneels, A.; Roziers, P.; Lopes, A.S.; Gordts, S.; Puttemans, P.; Gordts, S.

2010-01-01

Aim of the study: Pilot study to analyse the efficacy and embryo morphology using a new human embryo culture medium (GM501) versus the conventional used medium (ISM1). Methods: Over a four-month period, all patients at the Leuven Institute of Fertility and Embryology (LIFE) were randomly allocated to have their embryos cultured in either the standard sequential culture medium ISM1 (control) or in a new universal medium (GM501) (study group). Primary outcome parameters were clinical pregnancy and live birth rate. The secondary outcome parameter was the correlation of embryo fragmentation rate with pregnancy outcome. Results: We did not observe any differences between the ISM1 control group and GM501 study group with regard to fertilization, pregnancy, implantation rates, ongoing pregnancy, and babies born. The number of embryos with a minimal fragmentation rate (less than 30%) was significantly higher in the GM501 study group. Conclusion: Although a significant higher embryo fragmentation rate was seen in In vitro culture of embryos in GM501, pregnancy outcome results were comparable to those of embryos cultured in ISM1. According to our results the value of embryo morphological criteria as a parameter for pregnancy outcome should be examined and discussed again. PMID:25009716

A National Partnership-Based Summer Learning Initiative to Engage Underrepresented Students with Science, Technology, Engineering and Mathematics

NASA Technical Reports Server (NTRS)

Melvin, Leland

2010-01-01

In response to the White House Educate to Innovate campaign, NASA developed a new science, technology, engineering, and mathematics (STEM) education program for non-traditional audiences that also focused on public-private partnerships and nationwide participation. NASA recognized that summer break is an often overlooked but opportune time to engage youth in STEM experiences, and elevated its ongoing commitment to the cultivation of diversity. The Summer of Innovation (SoI) is the resulting initiative that uses NASA's unique missions and resources to boost summer learning, particularly for students who are underrepresented, underserved and underperforming in STEM. The SoI pilot, launched in June 2010, is a multi-faceted effort designed to improve STEM teaching and learning through partnership, multi-week summer learning programs, special events, a national concluding event, and teacher development. The SoI pilot features strategic infusion of NASA content and educational resource materials, sustainability through STEM Learning Communities, and assessments of effectiveness of SoI interventions with other pilot efforts. This paper examines the inception and development of the Summer of Innovation pilot project, including achievements and effectiveness, as well as lessons learned for future efforts.

Harnessing the power of enhanced data for healthcare quality improvement: lessons from a Minnesota Hospital Association Pilot Project.

PubMed

Pine, Michael; Sonneborn, Mark; Schindler, Joe; Stanek, Michael; Maeda, Jared Lane; Hanlon, Carrie

2012-01-01

The imperative to achieve quality improvement and cost-containment goals is driving healthcare organizations to make better use of existing health information. One strategy, the construction of hybrid data sets combining clinical and administrative data, has strong potential to improve the cost-effectiveness of hospital quality reporting processes, improve the accuracy of quality measures and rankings, and strengthen data systems. Through a two-year contract with the Agency for Healthcare Research and Quality, the Minnesota Hospital Association launched a pilot project in 2007 to link hospital clinical information to administrative data. Despite some initial challenges, this project was successful. Results showed that the use of hybrid data allowed for more accurate comparisons of risk-adjusted mortality and risk-adjusted complications across Minnesota hospitals. These increases in accuracy represent an important step toward targeting quality improvement efforts in Minnesota and provide important lessons that are being leveraged through ongoing projects to construct additional enhanced data sets. We explore the implementation challenges experienced during the Minnesota Pilot Project and their implications for hospitals pursuing similar data-enhancement projects. We also highlight the key lessons learned from the pilot project's success.

Emotional wellbeing of blind patients in a pilot trial with subretinal implants.

PubMed

Peters, Tobias; Klingberg, Stefan; Zrenner, Eberhart; Wilhelm, Barbara

2013-06-01

Participation in first human applications of retinal neuroprosthesis may create psychological stress for blind retinitis pigmentosa patients. The aim of this study was to assess the emotional wellbeing of patients undergoing implantation of a subretinal implant. Nine blind patients participating in a pilot trial with subretinal implants were enlisted. The Brief Symptom Inventory (BSI), a short self-report scale of nine primary symptoms, was used to assess reaction to the psychological distress related to study participation. The number and the intensity of symptoms were analysed, and global scores for overall psychological distress (tGSI), severity of reported symptoms (tPDSI), and level number of self-reported symptoms (tPST) were calculated. The questionnaire was administered before implantation, 2-3 times during the trial and before explantation. There were no significant alterations during the trial for the average scores of the nine primary symptoms. One patient, however, showed values higher than the norm, for six subscores before implantation and for eight subscores before explantation. A significant improvement was found in both the overall psychological distress level (tGSI) and the severity of reported symptoms (tPDSI) at the final visit, compared to those at the study start. The number of self-reported symptoms (tPST) was not significantly altered. In the first ongoing pilot trial with an active, cable-bound subretinal implant, we found that trial participation and the implant procedure and subsequent testing did not have any adverse effects on the participants' emotional wellbeing. Their distress generally improved during study participation, rather than showing signs of decreased wellbeing.

Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation

PubMed Central

Campbell, Stephen M; Chauhan, Umesh; Lester, Helen

2010-01-01

Background While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the UK. Aim To describe the development, content and piloting of version 1 of the Primary Medical Care Provider Accreditation (PMCPA) scheme, which includes 112 separate criteria across six domains: health inequalities and health promotion; provider management; premises, records, equipment, and medicines management; provider teams; learning organisation; and patient experience/involvement, and to present the results from the pilot service evaluation focusing on the achievement of the 30 core criteria and feedback from practice staff. Design of study Observational service evaluation using evidence uploaded onto an extranet system in support of 30 core summative pilot PMCPA accreditation criteria. Setting Thirty-six nationally representative practices across England, between June and December 2008. Method Study population: interviews with GPs, practice managers, nurses and other relevant staff from the participating practices were conducted, audiotaped, transcribed, and analysed using a thematic approach. For each practice, the number of core criteria that had received either a‘good’or‘satisfactory’rating from a RCGP-trained assessment team, was counted and expressed as a percentage. Results Thirty-two practices completed the scheme, with nine practices passing 100% of core criteria (range: 27–100%). There were no statistical differences in achievement between practices of different sizes and in different localities. Practice feedback highlighted seven key issues: (1) overall view of PMCPA; (2) the role of accreditation; (3) different motivations for taking part; (4) practice managers dominated the workload associated with implementing the scheme; (5) facilitators for implementation; (6) patient benefit — relevance of PMCPA to quality improvement; (7) recommendations for improving the scheme. Conclusion Version 1 of PMCPA has been piloted as a primary care accreditation scheme and shown to be relevant to different types of practice. The scheme is undergoing revision in accordance with the findings from the pilot and ongoing consultation.

The role of autologous hematopoietic progenitor and cell reinfusion for intensive chemotherapy in women with poor-prognosis breast cancer. Clinical studies with ex-vivo expanded cells produced with the Aastrom Replicell technology.

PubMed

Chabannon, C; Novakovitch, G; Blache, J L; Olivero, S; Camerlo, J; Genre, D; Maraninchi, D; Viens, P

1999-04-01

In recent years, we have initiated two clinical studies, to evaluate the usefulness of ex-vivo expanded cells in patients with breast cancer who receive sequential high-dose chemotherapy. Ex-vivo expanded cells were produced from autologous cryopreserved bone marrow nucleated cells, using a biomedical device. The Aastrom Replicell system cultures cells in animal serum-replete medium, with a combination of flt3-L, PIXY321 and Epo, for 12 days. The initial pilot trial was set up to establish the feasibility and safety of the technique: 6 patients completed the study. An ongoing randomized study searches to establish whether ex-vivo expanded cells provide a clinical benefit.

Cost of Transformation among Primary Care Practices Participating in a Medical Home Pilot.

PubMed

Martsolf, Grant R; Kandrack, Ryan; Gabbay, Robert A; Friedberg, Mark W

2016-07-01

Medical home initiatives encourage primary care practices to invest in new structural capabilities such as patient registries and information technology, but little is known about the costs of these investments. To estimate costs of transformation incurred by primary care practices participating in a medical home pilot. We interviewed practice leaders in order to identify changes practices had undertaken due to medical home transformation. Based on the principles of activity-based costing, we estimated the costs of additional personnel and other investments associated with these changes. The Pennsylvania Chronic Care Initiative (PACCI), a statewide multi-payer medical home pilot. Twelve practices that participated in the PACCI. One-time and ongoing yearly costs attributed to medical home transformation. Practices incurred median one-time transformation-associated costs of $30,991 per practice (range, $7694 to $117,810), equivalent to $9814 per clinician ($1497 to $57,476) and $8 per patient ($1 to $30). Median ongoing yearly costs associated with transformation were $147,573 per practice (range, $83,829 to $346,603), equivalent to $64,768 per clinician ($18,585 to $93,856) and $30 per patient ($8 to $136). Care management activities accounted for over 60% of practices' transformation-associated costs. Per-clinician and per-patient transformation costs were greater for small and independent practices than for large and system-affiliated practices. Error in interviewee recall could affect estimates. Transformation costs in other medical home interventions may be different. The costs of medical home transformation vary widely, creating potential financial challenges for primary care practices-especially those that are small and independent. Tailored subsidies from payers may help practices make these investments. Agency for Healthcare Research and Quality.

3D ultrasound computer tomography: update from a clinical study

NASA Astrophysics Data System (ADS)

Hopp, T.; Zapf, M.; Kretzek, E.; Henrich, J.; Tukalo, A.; Gemmeke, H.; Kaiser, C.; Knaudt, J.; Ruiter, N. V.

2016-04-01

Ultrasound Computer Tomography (USCT) is a promising new imaging method for breast cancer diagnosis. We developed a 3D USCT system and tested it in a pilot study with encouraging results: 3D USCT was able to depict two carcinomas, which were present in contrast enhanced MRI volumes serving as ground truth. To overcome severe differences in the breast shape, an image registration was applied. We analyzed the correlation between average sound speed in the breast and the breast density estimated from segmented MRIs and found a positive correlation with R=0.70. Based on the results of the pilot study we now carry out a successive clinical study with 200 patients. For this we integrated our reconstruction methods and image post-processing into a comprehensive workflow. It includes a dedicated DICOM viewer for interactive assessment of fused USCT images. A new preview mode now allows intuitive and faster patient positioning. We updated the USCT system to decrease the data acquisition time by approximately factor two and to increase the penetration depth of the breast into the USCT aperture by 1 cm. Furthermore the compute-intensive reflectivity reconstruction was considerably accelerated, now allowing a sub-millimeter volume reconstruction in approximately 16 minutes. The updates made it possible to successfully image first patients in our ongoing clinical study.

A lesson program for schoolchildren about a clean and healthy life-style: a pilot study.

PubMed

Hollander, C

1997-05-01

A health education project is underway in primary schools in the Wonogiri district of Indonesia. This project, implemented by the Yayasan Indonesia Sejahtera (YIS), is related to the Perilaku Hidup Bersih dan Sehat (PHBS) campaign developed by the Provincial Health Office of central Java to promote a healthy life-style. The PHBS campaign, which will eventually target households, industry, and schools, is currently promoting only 10 household-level indicators. Thus, YIS developed a curriculum for PHBS that includes those indicators that are relevant to primary school students. The longterm YIS project group includes the fifth-grade (11- and 12-year-old students) at every elementary school in the district. A single class in a village school is serving as the target group for the pilot study. Development of the pilot curriculum involved a pre/post test as well as a field test, and an evaluation is planned. The health topics chosen for the project are: clean water, use of family sanitation facilities, garbage disposal, mosquitoes, personal hygiene, dental hygiene, nutrition, smoking and alcohol, and family planning. The curriculum consists of seven lessons and is taught using visual aids and a participatory approach. Post-test results were disappointing because answers improved over pretest answers for only 5 out of 21 questions. One of the reasons may have been that the project had to begin before all of the supporting materials were ready. Evaluation is currently ongoing, and plans are underway to expand the program.

Effects of Virtual Walking Treatment on Spinal Cord Injury-Related Neuropathic Pain: Pilot Results and Trends Related to Location of Pain and at-level Neuronal Hypersensitivity.

PubMed

Jordan, Melissa; Richardson, Elizabeth J

2016-05-01

Previous studies have shown that virtual walking to treat spinal cord injury-related neuropathic pain (SCI-NP) can be beneficial, although the type of SCI-NP that may benefit the most is unclear. This study's aims were to (1) determine the effect of location of SCI-NP on pain outcomes after virtual walking treatment and (2) examine the potential relationship between neuronal hyperexcitability, as measured by quantitative sensory testing, and pain reduction after virtual walking treatment. Participants were recruited from a larger ongoing trial examining the benefits of virtual walking in SCI-NP. Neuropathic pain was classified according to location of pain (at- or below-level). In addition, quantitative sensory testing was performed on a subset of individuals at a nonpainful area corresponding to the level of their injury before virtual walking treatment and was used to characterize treatment response. These pilot results suggest that when considered as a group, SCI-NP was responsive to treatment irrespective of the location of pain (F1, 44 = 4.82, P = 0.03), with a trend for the greatest reduction occurring in at-level SCI-NP (F1, 44 = 3.18, P = 0.08). These pilot results also potentially implicate cold, innocuous cool, and pressure hypersensitivity at the level of injury in attenuating the benefits of virtual walking to below-level pain, suggesting certain SCI-NP sensory profiles may be less responsive to virtual walking.

Leveraging Social Networking Sites for an Autoimmune Hepatitis Genetic Repository: Pilot Study to Evaluate Feasibility.

PubMed

Comerford, Megan; Fogel, Rachel; Bailey, James Robert; Chilukuri, Prianka; Chalasani, Naga; Lammert, Craig Steven

2018-01-18

Conventional approaches to participant recruitment are often inadequate in rare disease investigation. Social networking sites such as Facebook may provide a vehicle to circumvent common research limitations and pitfalls. We report our preliminary experience with Facebook-based methodology for participant recruitment and participation into an ongoing study of autoimmune hepatitis (AIH). The goal of our research was to conduct a pilot study to assess whether a Facebook-based methodology is capable of recruiting geographically widespread participants into AIH patient-oriented research and obtaining quality phenotypic data. We established a Facebook community, the Autoimmune Hepatitis Research Network (AHRN), in 2014 to provide a secure and reputable distillation of current literature and AIH research opportunities. Quarterly advertisements for our ongoing observational AIH study were posted on the AHRN over 2 years. Interested and self-reported AIH participants were subsequently enrolled after review of study materials and completion of an informed consent by our study coordinator. Participants returned completed study materials, including epidemiologic questionnaires and genetic material, to our facility via mail. Outside medical records were obtained and reviewed by a study physician. We successfully obtained all study materials from 29 participants with self-reported AIH within 2 years from 20 different states. Liver biopsy results were available for 90% (26/29) of participants, of which 81% (21/29) had findings consistent with AIH, 15% (4/29) were suggestive of AIH with features of primary biliary cholangitis (PBC), and 4% (1/29) had PBC alone. A total of 83% (24/29) had at least 2 of 3 proposed criteria: positive autoimmune markers, consistent histologic findings of AIH on liver biopsy, and reported treatment with immunosuppressant medications. Self-reported and physician records were discrepant for immunosuppressant medications or for AIH/PBC diagnoses in 4 patients. Facebook can be an effective ancillary tool for facilitating patient-oriented research in rare diseases. A social media-based approach transcends established limitations in rare disease research and can further develop research communities. ©Megan Comerford, Rachel Fogel, James Robert Bailey, Prianka Chilukuri, Naga Chalasani, Craig Steven Lammert. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.01.2018.

Leveraging Social Networking Sites for an Autoimmune Hepatitis Genetic Repository: Pilot Study to Evaluate Feasibility

PubMed Central

Bailey, James Robert; Chilukuri, Prianka; Chalasani, Naga

2018-01-01

Background Conventional approaches to participant recruitment are often inadequate in rare disease investigation. Social networking sites such as Facebook may provide a vehicle to circumvent common research limitations and pitfalls. We report our preliminary experience with Facebook-based methodology for participant recruitment and participation into an ongoing study of autoimmune hepatitis (AIH). Objective The goal of our research was to conduct a pilot study to assess whether a Facebook-based methodology is capable of recruiting geographically widespread participants into AIH patient-oriented research and obtaining quality phenotypic data. Methods We established a Facebook community, the Autoimmune Hepatitis Research Network (AHRN), in 2014 to provide a secure and reputable distillation of current literature and AIH research opportunities. Quarterly advertisements for our ongoing observational AIH study were posted on the AHRN over 2 years. Interested and self-reported AIH participants were subsequently enrolled after review of study materials and completion of an informed consent by our study coordinator. Participants returned completed study materials, including epidemiologic questionnaires and genetic material, to our facility via mail. Outside medical records were obtained and reviewed by a study physician. Results We successfully obtained all study materials from 29 participants with self-reported AIH within 2 years from 20 different states. Liver biopsy results were available for 90% (26/29) of participants, of which 81% (21/29) had findings consistent with AIH, 15% (4/29) were suggestive of AIH with features of primary biliary cholangitis (PBC), and 4% (1/29) had PBC alone. A total of 83% (24/29) had at least 2 of 3 proposed criteria: positive autoimmune markers, consistent histologic findings of AIH on liver biopsy, and reported treatment with immunosuppressant medications. Self-reported and physician records were discrepant for immunosuppressant medications or for AIH/PBC diagnoses in 4 patients. Conclusions Facebook can be an effective ancillary tool for facilitating patient-oriented research in rare diseases. A social media-based approach transcends established limitations in rare disease research and can further develop research communities. PMID:29348111

A Pilot Study of Determinants of Ongoing Participation in EnhanceFitness: A Community-Based Group Exercise Program for Older Adults.

PubMed

Gillette, David B; Petrescu-Prahova, Miruna; Herting, Jerald R; Belza, Basia

2015-01-01

Physical activity has many benefits for older adults, but adherence is often low. The purposes of this study were to (1) identify motivators and barriers for participation in EnhanceFitness (EF), a group-based exercise program; and (2) quantitatively examine the association between motivators, barriers and individual characteristics, and ongoing participation in the program. This was a prospective, cross-sectional study. We mailed a pilot, investigator-developed survey to assess motivators and barriers to exercising to 340 adults who started a new EF class, regardless of their attendance rate. We precoded surveys on the basis of class attendance, with former participants defined as having no attendance a month or more before a 4-month fitness check. Of the 241 respondents (71% response rate), 61 (25%) were precoded as former participants and 180 (75%) as current participants. The mean age of respondents was 71 years and they were predominately female (89%). More than half of respondents were whites (58%), and almost half were married (46%). Former participants reported lower total motivation scores than current participants (P < .01) and had a significantly higher mean total barrier score (P < .001). The effects of 5 barriers ("Class was too hard," "Class was too easy," "I don't like to exercise," "Personal illness," and "Exercise caused pain") and 2 motivators ("I want to exercise" and "I plan exercise as part of my day") were significantly different between current and former participants. Discrete event history models show that dropout was related positively to ethnicity (whites were more likely to drop out) and health-related barriers. In newly formed EF classes, participants who drop out report more program, psychosocial, and health barriers, and fewer program and psychosocial motivators. Total barrier score and health barriers significantly predict a participant's dropping out, and white ethnicity is associated with a higher likelihood of dropping out. Employing strategies that address health barriers to participation could improve attendance rates for group-based exercise programs.

Idiopathic Syringomyelia in a Military Helicopter Pilot.

PubMed

Schiemer, Anthony

2017-10-01

A syrinx is a fluid-filled cavity within the spinal cord. They can lead to a variety of symptoms, including limb weakness and back pain. Incidental finding of syringomyelia provides a challenge for clinicians due to the wide variety of possible symptoms. In military aviation, neurological findings in pilots can result in extensive investigation that can lead to potentially invasive management. Conversely, the potential for chronic progression of a spinal syrinx and subsequent neurological deterioration makes early identification critical. Ultimately, the discovery of a lesion may have implications for flying status and operational capability. A 25-yr-old man working as a navy Seahawk helicopter pilot presented with episodes of right arm paraesthesia and pain between the scapulae. On at least one occasion, these symptoms woke him at night. Upon magnetic resonance imaging, dilatation of the central canal in a syrinx-like pattern in the lower cervical region was noted. Neurology review suggested the finding was persistent and unlikely to be responsible for his symptoms. No surgical input was recommended. His symptoms were attributed to mild cervical spondylosis, which resolved with ongoing physiotherapy, and he was returned to flying status. This case highlights several issues involved with the incidental finding of a syringomyelia. Surgical intervention has been known to worsen symptoms. Conversely, studies have identified minimal radiological progression in cases of idiopathic syringomyelia, with fewer individuals displaying neurological deterioration. For aircrew, potentially unnecessary neurosurgical intervention poses risks to a flying career and overall operational capability.Schiemer A. Idiopathic syringomyelia in a military helicopter pilot. Aerosp Med Hum Perform. 2017; 88(10):962-965.

Expert cognitive control and individual differences associated with frontal and parietal white matter microstructure

PubMed Central

Roberts, R.E.; Anderson, E. J.; Husain, M.

2011-01-01

Although many functional imaging studies have reported frontal activity associated with ‘cognitive control’ tasks, little is understood about factors underlying individual differences in performance. Here we compared the behaviour and brain structure of healthy controls with fighter pilots, an expert group trained to make precision choices at speed in the presence of conflicting cues. Two different behavioural paradigms – Eriksen Flanker and Change of plan tasks – were used to assess the influence of distractors and the ability to update ongoing action plans. Fighter pilots demonstrated superior cognitive control as indexed by accuracy and post-conflict adaptation on the flanker task, but also showed increased sensitivity to irrelevant, distracting choices. By contrast, when pilots were examined on their ability to inhibit a current action plan in favour of an alternative response, their performance was no better than the control group. Diffusion weighted imaging revealed differences in white matter radial diffusivity between pilots and controls not only in the right dorsomedial frontal region but also in the right parietal lobe. Moreover, analysis of individual differences in reaction time costs for conflict trials on the flanker task demonstrated significant correlations with radial diffusivity at these locations, but in different directions. Post-conflict adaptation effects, however, were confined to the dorsomedial frontal locus. The findings demonstrate that in humans expert cognitive control may surprisingly be mediated by enhanced response gain to both relevant and irrelevant stimuli, and is accompanied by structural alterations in the white matter of the frontal and parietal lobe. PMID:21159976

Criteria for successful uptake of AAL technologies: lessons learned from Norwegian pilot projects.

PubMed

Svagård, Ingrid; Ausen, Dag; Standal, Kristin

2013-01-01

Implementation of AAL-technology as an integrated part of public health and care services requires a systematic and multidisciplinary approach. There are several challenges that need to be handled in parallel and with sustained effort over time, to tackle the multidimensional problem of building the value chain that is required for widespread uptake of AAL technology. Several pilot projects are on-going in Norway, involving municipalities, technology providers and research partners. Examples are "Home Safety" (NO: Trygghetspakken) and "Safe Tracks" (NO: Trygge spor). This paper will elaborate on our lessons learned with focus on five main points: 1) User-friendly and robust technology 2) Technology adapted organization 3) Service oriented technology providers 4) Care service organizations as demanding customer and 5) Sustainable financial model.

Simulation of a weather radar display for over-water airborne radar approaches

NASA Technical Reports Server (NTRS)

Clary, G. R.

1983-01-01

Airborne radar approach (ARA) concepts are being investigated as a part of NASA's Rotorcraft All-Weather Operations Research Program on advanced guidance and navigation methods. This research is being conducted using both piloted simulations and flight test evaluations. For the piloted simulations, a mathematical model of the airborne radar was developed for over-water ARAs to offshore platforms. This simulated flight scenario requires radar simulation of point targets, such as oil rigs and ships, distributed sea clutter, and transponder beacon replies. Radar theory, weather radar characteristics, and empirical data derived from in-flight radar photographs are combined to model a civil weather/mapping radar typical of those used in offshore rotorcraft operations. The resulting radar simulation is realistic and provides the needed simulation capability for ongoing ARA research.

Sibutramine in the treatment of antipsychotic-induced weight gain: a pilot study in patients with schizophrenia.

PubMed

Biedermann, Falko; Fleischhacker, W Wolfgang; Kemmler, Georg; Ebenbichler, Christoph F; Lechleitner, Monika; Hofer, Alex

2014-05-01

Weight gain represents a frequent side effect of antipsychotic drug treatment. The current trial investigated the effect of add-on treatment with sibutramine in schizophrenia outpatients who had gained more than 7% of weight during the course of treatment. This 24-week placebo-controlled study evaluated the effects of sibutramine added to ongoing antipsychotic treatment. Weight, waist-hip ratio, BMI, blood pressure/pulse and ECG were monitored regularly. In addition, several laboratory tests were performed. Psychopathological symptoms and side effects were assessed frequently. Fifteen patients were assigned randomly to add-on treatment with sibutramine 10 mg or placebo. The two groups did not differ in weight, sociodemographic, or clinical data. Eleven patients were considered for statistical analysis. Significant weight loss was observed in the sibutramine group (mean = -6.1 kg), whereas patients on placebo experienced a mean weight gain of 1.9 kg. A reduction in HbA1c was apparent in the sibutramine but not in the placebo group. No significant between-group differences were found in changes in psychopathology or drug safety. This pilot trial suggests that adjunctive treatment with sibutramine may be safe and effective in schizophrenic patients with antipsychotic-induced weight gain.

Quality of Life and Compassion Satisfaction in Clinicians: A Pilot Intervention Study for Reducing Compassion Fatigue.

PubMed

Klein, Colleen J; Riggenbach-Hays, Jami J; Sollenberger, Laura M; Harney, Diane M; McGarvey, Jeremy S

2018-06-01

Compassion fatigue (CF) is prevalent in healthcare professionals, particularly in those caring for chronic, acutely ill, and/or those patients who might be moving toward comfort care. Over time, CF can lead to burnout (BO) and secondary traumatic stress and an overall decrease in professional quality of life. In this pilot study, participants completed a resiliency program focused on education about CF and self-awareness of its individualized impact and were expected to develop ongoing self-care practices to prevent/address the untoward effects. Healthcare professionals ( N = 15) participated in a formalized educational program consisting of three 90-minute educational sessions held 2 weeks apart. Preassessment and postintervention data were collected electronically in survey format. A postprogram evaluation was also offered. Upon completion of the program, participants noted an increase in compassion satisfaction (CS) and a small reduction in BO. Secondary traumatic stress remained unchanged. Feedback about the program was positive, and participants reported the impact on their clinical practice and life to be moderately high. At 6 months, over half of the participants continued to report positive impact on their personal/professional lives. While the small sample size of this pilot study limits the generalizability of the findings, there were positive effects for CS and BO in participants over time, indicating possible benefits of providing self-care education to healthcare providers. Additional research with a larger sample size is needed to address how healthcare providers might further benefit from resiliency education and interventions to improve professional quality of life.

Adaptive Interventions in Drug Court: A Pilot Experiment

PubMed Central

Marlowe, Douglas B.; Festinger, David S.; Arabia, Patricia L.; Dugosh, Karen L.; Benasutti, Kathleen M.; Croft, Jason R.; McKay, James R.

2009-01-01

This pilot study (N = 30) experimentally examined the effects of an adaptive intervention in an adult misdemeanor drug court. The adaptive algorithm adjusted the frequency of judicial status hearings and clinical case-management sessions according to pre-specified criteria in response to participants' ongoing performance in the program. Results revealed the adaptive algorithm was acceptable to both clients and staff, feasible to implement with greater than 85% fidelity, and showed promise for eliciting clinically meaningful improvements in drug abstinence and graduation rates. Estimated effect sizes ranged from 0.40 to 0.60 across various dependent measures. Compared to drug court as-usual, participants in the adaptive condition were more likely to receive responses from the drug court team for inadequate performance in the program and received those responses after a substantially shorter period of time. This suggests the adaptive algorithm may have more readily focused the drug court team's attention on poorly-performing individuals, thus allowing the team to “nip problems in the bud” before they developed too fully. These preliminary data justify additional research evaluating the effects of the adaptive algorithm in a fully powered experimental trial. PMID:19724664

The use of smartphones to influence lifestyle changes in overweight and obese youth with congenital heart disease: a single-arm study: Pilot and feasibility study protocol: Smart Heart Trial.

PubMed

Rombeek, Meghan; De Jesus, Stefanie; Altamirano-Diaz, Luis; Welisch, Eva; Prapavessis, Harry; Seabrook, Jamie A; Norozi, Kambiz

2017-01-01

Both obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD. This is a pilot and feasibility study which utilizes a single-arm, prospective design with a goal to recruit 40 overweight and obese patients. The feasibility metrics will evaluate the integrity of the study protocol, data collection and questionnaires, recruitment and consent, and acceptability of the intervention protocol and primary outcome measures. The primary clinical outcome metrics are anthropometry, body composition, and cardiorespiratory exercise capacity. The secondary clinical metrics include quality of life, nutrition and physical activity behavior, lung and muscle function, and cardio-metabolic risk factors. Outcomes are assessed at baseline, 6 months, and 1 year. To date, a total of 36 children and youth (11 girls), aged 7-17 years (mean = 14.4 years), have commenced the intervention. Recruitment for the study was initiated in June 2012 and is currently ongoing. The information provided in this paper is intended to help researchers and health professionals with the development and evaluation of similar lifestyle intervention programs. Since the application of smartphones to pediatric cardiac health and obesity management is a novel approach, and continued research in this area is warranted, this paper may serve as a foundation for further exploration of this health frontier and inform the development of a broader strategy for obesity management in pediatric cardiology. This pilot study was retrospectively registered at the www.ClinicalTrials.gov registry as NCT02980393 in November 2016, with the study commencing in May 2012. Study protocol version 15OCT2014.

Participation of informal caregivers in the hospital care of elderly patients and their evaluations of the care given: pilot study in three different hospitals.

PubMed

Laitinen, P

1992-10-01

This action research is an ongoing study which will last from 1991 to 1993. The main purpose of the study is to increase the participation of informal caregivers in the hospital care of elderly patients without decreasing the quality of care. The data reported here are from a pilot study. This study had three aims: (a) to test reliability and validity of the measure used, (b) to investigate the current participation of informal caregivers in the hospital care of elderly patients (aged over 75), and (c) to evaluate and compare the quality of care from both the patients' and the informal caregivers' point of view in three different hospitals. The measure of quality of care was developed on the basis of need theories, mainly those of Maslow and Alderfer. Patients and caregivers were also asked to rate the participation of the caregivers in the hospital care of elderly patients. Participation consisted of 18 activities of daily living. The pilot test with 18 elderly hospital patients and seven family members or significant others showed differences between the two groups in perception of care received. Statistically significant differences (P < 0.001) were found in the following categories: mainly social needs, psychic and spiritual needs and totals. The results supported earlier findings that elderly patients are satisfied with and do not criticize their care. The younger generation (i.e. their children) is more demanding and has precise perceptions about the care given. Relatives could be used more in planning, evaluation and even implementation of care; however, their current participation in patient hospital care is minimal.

Obesity Prevalence in Nepal: Public Health Challenges in a Low-Income Nation during an Alarming Worldwide Trend

PubMed Central

Vaidya, Abhinav; Shakya, Suraj; Krettek, Alexandra

2010-01-01

The future toll of the obesity epidemic will likely hit hardest in low- and middle-income countries. Ongoing urbanization promotes risk factors including sedentary lifestyle and fat- and sugar-laden diets. Low-income countries like Nepal experience a double disease burden: infectious diseases as well as rising incidence of noncommunicable diseases (e.g., cardiovascular disease and diabetes mellitus) frequently characterized by obesity. Nepal currently directs efforts towards curing disease but pays little attention to preventive actions. This article highlights obesity prevalence in Nepal, delineates the challenges identified by our pilot study (including low health literacy rates), and suggests strategies to overcome this trend. PMID:20644698

Characterizing the Hazard of a Wake Vortex Encounter

NASA Technical Reports Server (NTRS)

Vicroy, Dan D.; Brandon, Jay; Greene, George; Rivers, Robert; Shah, Gautam; Stewart, Eric; Stuever, Robert

1998-01-01

The National Aeronautics and Space Administration (NASA) is conducting research with the goal of enabling safe improvements in the capacity of the nation's air transportation system. The wake vortex upset hazard is an important factor in establishing the minimum safe spacing between aircraft during landing and take-off operations, thus impacting airport capacity. Static and free-flight wind tunnel tests and flight tests have provided an extensive data set for improved understanding of vortex encounter dynamics and simulation. Piloted and batch simulation studies are also ongoing to establish a first-order hazard metric and determine the limits of an operationally acceptable wake induced upset. This paper outlines NASA's research in these areas.

Obesity prevalence in Nepal: public health challenges in a low-income nation during an alarming worldwide trend.

PubMed

Vaidya, Abhinav; Shakya, Suraj; Krettek, Alexandra

2010-06-01

The future toll of the obesity epidemic will likely hit hardest in low- and middle-income countries. Ongoing urbanization promotes risk factors including sedentary lifestyle and fat- and sugar-laden diets. Low-income countries like Nepal experience a double disease burden: infectious diseases as well as rising incidence of noncommunicable diseases (e.g., cardiovascular disease and diabetes mellitus) frequently characterized by obesity. Nepal currently directs efforts towards curing disease but pays little attention to preventive actions. This article highlights obesity prevalence in Nepal, delineates the challenges identified by our pilot study (including low health literacy rates), and suggests strategies to overcome this trend.

Online anatomy and physiology: piloting the use of an anatomy and physiology e-book-VLE hybrid in pre-registration and post-qualifying nursing programmes at the University of Salford.

PubMed

Raynor, Michael; Iggulden, Helen

2008-06-01

Anatomy and physiology (A&P) teaching and learning in nursing curricula poses problems for educators because of the often varying levels of students' background knowledge. This study reports on a pilot project that attempted to normalize these differentials by delivering A&P teaching using an online interactive e-book-virtual learning environment (VLE) hybrid. Evaluate the effectiveness of using an online interactive resource to deliver A&P teaching. Data were collected from pre-registration and post-qualifying students by questionnaire and observation, and from lecturers by structured interviews. Scale-up issues were identified and documented as part of support for the ongoing pilot. The pre-registration group encountered problems accessing the resource and yielded evidence to suggest that inexperienced learners require a high level of direction to use the resource effectively. The post-qualifying group benefited from the resource's interactive elements and 24/7 availability. There was clear evidence that the group were able to relate knowledge gained from the resource to practice. This hybrid has great potential to add value to A&P learning on nursing programmes at post-qualifying level. The resource could replace its printed equivalent; however, negotiations need to take place between institutions and publishers in order to resolve scale-up issues.

Radio Transients in 1333 deg2 of the VLA Sky Survey Pilot

NASA Astrophysics Data System (ADS)

Dong, Dillon; Hallinan, Gregg; Myers, Steven T.; Mooley, Kunal; VLASS Survey Team, VLASS Survey Science Group (SSG)

2018-01-01

The VLA Sky Survey (VLASS) is an ongoing project by the NRAO to map ~34,000 deg2 of the sky at 3GHz, over 3 epochs spanning 6 years. In preparation for the full survey, a set of fields covering 2480 deg2 was recently observed as the VLASS pilot project. We searched 1333 deg2 of the VLASS pilot for radio transients with characteristic decay timescales between weeks and years, such as the synchrotron afterglows of supernovae, tidal disruption events, and long/short gamma ray bursts. These radio afterglows are thought to be roughly isotropic and extinction-free, allowing us to observe transients that would be missed by optical/high energy surveys due to obscuration or off-axis jetting.Within the searched area, we identified 215 VLASS sources that have no counterpart in the FIRST survey and have a projected distance of < 50kpc from the nearest galaxy by angular distance in the CLU and GWENs galaxy catalogs. By selection, these targets are predominently located near low redshift (z < 0.05) galaxies, allowing us to study their host environments with a sub-kiloparsec spatial resolution. Prioritizing based on visual association with SDSS galaxies, we imaged and/or took spectra of the host environment of 60 targets with the Low Resolution Imaging Spectrometer (LRIS) on Keck 1. In this talk, we present the radio and optical results for the most exciting VLASS transients.

Condom Use Following a Pilot Test of the Popular Opinion Leader Intervention in the Barbados Defence Force

DTIC Science & Technology

2013-01-01

and if it exhibited effects on condom use in the BDF population. The POL intervention was originally designed to reduce sexual risk behavior in...increase condom use in the BDF. We adapted the POL intervention as an improvement to the peer educator model in the context of the BDF’s ongoing prevention...measuring respondent demographics, detailed questions regarding specific sexual behaviors and condom use, alcohol abuse, and psychoso- cial measurements

Considerations for preparing collaborative international research: a Ugandan experience.

PubMed

Musil, Carol M; Mutabaazi, Jemimah; Walusimbi, Mariam; Okonsky, Jennifer G; Biribonwa, Yedidah; Eagan, Sabrina; Dimarco, Marguerite A; Mbaballi, Speciosa; Fitzpatrick, Joyce J

2004-08-01

This article describes issues to consider when planning and conducting international research projects. Key considerations include building collaboration, developing a comprehensive and feasible research plan, funding and budgets, addressing human subjects concerns, and analyzing and disseminating project findings. These considerations and related methodological issues are discussed in the context of a replication pilot project conducted outside Kampala, Uganda. Ongoing dialog, flexibility, and collaboration, in addition to good science, are critical to developing successful international research projects.

Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care

PubMed Central

Bobb, Jennifer F.; Lee, Amy K.; Lapham, Gwen T.; Oliver, Malia; Ludman, Evette; Achtmeyer, Carol; Parrish, Rebecca; Caldeiro, Ryan M.; Lozano, Paula; Richards, Julie E.; Bradley, Katharine A.

2017-01-01

Alcohol use is a major cause of disability and death worldwide. To improve prevention and treatment addressing unhealthy alcohol use, experts recommend that alcohol-related care be integrated into primary care (PC). However, few healthcare systems do so. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). Here, we describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. Across the three sites (N = 74,225 PC patients), alcohol screening increased from 8.9% of patients pre-implementation to 62% post-implementation (p < 0.0001), with a corresponding increase in assessment for alcohol use disorders (AUD) from 1.2 to 75 patients per 10,000 seen (p < 0.0001). Increases were sustained over a year later, with screening at 84.5% and an assessment rate of 81 patients per 10,000 seen across all sites. In addition, there was a 50% increase in the number of new AUD diagnoses (p = 0.0002), and a non-statistically significant 54% increase in treatment within 14 days of new diagnoses (p = 0.083). The pilot informed an ongoing stepped-wedge trial in the remaining 22 PC sites. PMID:28885557

Probing the Initial Mass Function in Extended Ultraviolet (XUV) Disks

NASA Astrophysics Data System (ADS)

Koda, Jin

2012-01-01

"The GALEX UV satellite discovered tantalizing evidence of star formation (SF) far beyond the optical edge of galactic disks (i.e. extended UV disk, or XUV disk). This discovery provides a new opportunity for studying SF in the exceedingly low-density environment (˜1/10 of typical SF density), spurring intense debate on the universality of the initial mass function (IMF) in such exceptional environments. Our pilot S-Cam study of M83’s XUV disk led to support for the universal IMF at least in M83 (Koda et al. 2012). We propose an expansion of the pilot study, observing 6 XUV disks in NA656(Hα), B, I, and R-band with S-Cam. In conjunction with GALEX UV bands, these images will reveal the presence of O stars (Hα; NA656-R) and O&B stars (UV) in stellar clusters -thus, constraining the high-mass end of the IMF. The multi-broadband images will enable us to determine the masses of the clusters with much improved accuracy (previously, relied only on R). The proposed observations will not only increase the statistical significance of our previous result, but also enable us to analyze the stochastic effect of IMF sampling in very low-mass clusters (10^{2+3} M_sun) - the regime about which there is much ongoing debate."

Non-invasive brain stimulation of the right inferior frontal gyrus may improve attention in early Alzheimer's disease: a pilot study.

PubMed

Eliasova, Ilona; Anderkova, Lubomira; Marecek, Radek; Rektorova, Irena

2014-11-15

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive tool for modulating cortical activity. In this pilot study, we evaluated the effects of high frequency rTMS applied over the right inferior frontal gyrus (IFG) on cognitive functions in patients with amnestic mild cognitive impairment (MCI) or incipient dementia due to Alzheimer's disease (AD). Ten patients (6 men; 4 women, mean age of 72 ± 8 years; MMSE 23 ± 3.56) were enrolled in a randomized, placebo-controlled study with a crossover design. All participants received 2 sessions of 10 Hz rTMS over the non-dominant right hemisphere in random order: IFG (active stimulation site) and vertex (control stimulation site). Intensities were adjusted to 90% of resting motor threshold. A total of 2250 pulses were applied in a session. The Trail Making Test (TMT), the Stroop test, and the complex visual scene encoding task (CVSET) were administered before and immediately after each session. The Wilcoxon paired test was used for data analysis. Stimulation applied over the IFG induced improvement in the TMT parts A (p = 0.037) and B (p = 0.049). No significant changes were found in the Stroop test or the CVSET after the IFG stimulation. We observed no significant cognitive aftereffects of rTMS applied over the vertex. High frequency rTMS of the right IFG induced significant improvement of attention and psychomotor speed in patients with MCI/mild dementia due to AD. This pilot study is part of a more complex protocol and ongoing research. Copyright © 2014 Elsevier B.V. All rights reserved.

Systematic Braiding of Two Evidence-Based Parent Training Programs: Qualitative Results from the Pilot Phase

PubMed Central

Guastaferro, Kate; Miller, Katy; Shanley Chatham, Jenelle R.; Whitaker, Daniel J.; McGilly, Kate; Lutzker, John R.

2017-01-01

An effective approach in early intervention for children and families, including child maltreatment prevention, is home-based services. Though several evidence-based programs exist, they are often grouped together, despite having different foci. This paper describes an ongoing cluster randomized trial systematically braiding two evidence-based home-based models, SafeCare® and Parents as Teachers (PAT)®, to better meet the needs of families at-risk. We describe the methodology for braiding model implementation and curriculum, specifically focusing on how structured qualitative feedback from pilot families and providers was used to create the braided curriculum and implementation. Systematic braiding of two models at the implementation and curriculum levels is a mechanism that has the potential to meet the more comprehensive needs of families at-risk for maltreatment. PMID:27870760

REDD+ on the rocks? Conflict Over Forest and Politics of Justice in Vietnam.

PubMed

Sikor, Thomas; Cầm, Hoàng

In Vietnam, villagers involved in a REDD+ (reduced emissions from deforestation and forest degradation) pilot protect areas with rocks which have barely a tree on them. The apparent paradox indicates how actual practices differ from general ideas about REDD+ due to ongoing conflict over forest, and how contestations over the meaning of justice are a core element in negotiations over REDD+. We explore these politics of justice by examining how the actors involved in the REDD+ pilot negotiate the particular subjects, dimensions, and authority of justice considered relevant, and show how politics of justice are implicit to practical decisions in project implementation. Contestations over the meaning of justice are an important element in the practices and processes constituting REDD+ at global, national and local levels, challenging uniform definitions of forest justice and how forests ought to be managed.

A Methodology for Conducting Integrative Mixed Methods Research and Data Analyses

PubMed Central

Castro, Felipe González; Kellison, Joshua G.; Boyd, Stephen J.; Kopak, Albert

2011-01-01

Mixed methods research has gained visibility within the last few years, although limitations persist regarding the scientific caliber of certain mixed methods research designs and methods. The need exists for rigorous mixed methods designs that integrate various data analytic procedures for a seamless transfer of evidence across qualitative and quantitative modalities. Such designs can offer the strength of confirmatory results drawn from quantitative multivariate analyses, along with “deep structure” explanatory descriptions as drawn from qualitative analyses. This article presents evidence generated from over a decade of pilot research in developing an integrative mixed methods methodology. It presents a conceptual framework and methodological and data analytic procedures for conducting mixed methods research studies, and it also presents illustrative examples from the authors' ongoing integrative mixed methods research studies. PMID:22167325

Pilot users in agile development processes: motivational factors.

PubMed

Johannessen, Liv Karen; Gammon, Deede

2010-01-01

Despite a wealth of research on user participation, few studies offer insights into how to involve multi-organizational users in agile development methods. This paper is a case study of user involvement in developing a system for electronic laboratory requisitions using agile methodologies in a multi-organizational context. Building on an interpretive approach, we illuminate questions such as: How does collaboration between users and developers evolve and how might it be improved? What key motivational aspects are at play when users volunteer and continue contributing in the face of considerable added burdens? The study highlights how agile methods in themselves appear to facilitate mutually motivating collaboration between user groups and developers. Lessons learned for leveraging the advantages of agile development processes include acknowledging the substantial and ongoing contributions of users and their roles as co-designers of the system.

E-learning to improve the drug prescribing in the hospitalized elderly patients: the ELICADHE feasibility pilot study.

PubMed

Franchi, C; Mari, D; Tettamanti, M; Pasina, L; Djade, C D; Mannucci, P M; Onder, G; Bernabei, R; Gussoni, G; Bonassi, S; Nobili, A

2014-08-01

E-learning is an efficient and cost-effective educational method. This study aimed at evaluating the feasibility of an educational e-learning intervention, focused on teaching geriatric pharmacology and notions of comprehensive geriatric assessment, to improve drug prescribing to hospitalized elderly patients. Eight geriatric and internal medicine wards were randomized to intervention (e-learning educational program) or control. Clinicians of the two groups had to complete a specific per group e-learning program in 30 days. Then, ten patients (aged ≥75 years) had to be consecutively enrolled collecting clinical data at hospital admission, discharge, and 3 months later. The quality of prescription was evaluated comparing the prevalence of potentially inappropriate medications through Beer's criteria and of potential drug-drug interactions through a specific computerized database. The study feasibility was confirmed by the high percentage (90 %) of clinicians who completed the e-learning program, the recruitment, and follow-up of all planned patients. The intervention was well accepted by all participating clinicians who judged positively (a mean score of >3 points on a scale of 5 points: 0 = useless; 5 = most useful) the specific contents, the methodology applied, the clinical relevance and utility of e-learning contents and tools for the evaluation of the appropriateness of drug prescribing. The pilot study met all the requested goals. The main study is currently ongoing and is planned to finish on July 2015.

Determining the feasibility of robotic courier medication delivery in a hospital setting.

PubMed

Kirschling, Thomas E; Rough, Steve S; Ludwig, Brad C

2009-10-01

The feasibility of a robotic courier medication delivery system in a hospital setting was evaluated. Robotic couriers are self-guiding, self-propelling robots that navigate hallways and elevators to pull an attached or integrated cart to a desired destination. A robotic courier medication delivery system was pilot tested in two patient care units at a 471-bed tertiary care academic medical center. Average transit for the existing manual medication delivery system hourly hospitalwide deliveries was 32.6 minutes. Of this, 32.3% was spent at the patient care unit and 67.7% was spent pushing the cart or waiting at an elevator. The robotic courier medication delivery system traveled as fast as 1.65 ft/sec (52% speed of the manual system) in the absence of barriers but moved at an average rate of 0.84 ft/sec (26% speed of the manual system) during the study, primarily due to hallway obstacles. The robotic courier was utilized for 50% of the possible 1750 runs during the 125-day pilot due to technical or situational difficulties. Of the runs that were sent, a total of 79 runs failed, yielding an overall 91% success rate. During the final month of the pilot, the success rate reached 95.6%. Customer satisfaction with the traditional manual delivery system was high. Customer satisfaction with deliveries declined after implementation of the robotic courier medication distribution system. A robotic courier medication delivery system was implemented but was not expanded beyond the two pilot units. Challenges of implementation included ongoing education on how to properly move the robotic courier and keeping the hallway clear of obstacles.

Mortuary based injury surveillance for low-mid income countries: process evaluation of pilot studies.

PubMed

Kipsaina, Chebiwot; Ozanne-Smith, Joan; Bartolomeos, Kidist; Routley, Virginia

2015-08-01

Globally, injury is the fourth major cause of death and the third leading contributor to Disability Adjusted Life Years lost due to health conditions, with the greatest burden borne by low-middle income countries (LMICs) where injury data is scarce. In the absence of effective vital registration systems, mortuaries have been shown to provide an alternative source of cause of death information for practitioners and policy makers to establish strategic injury prevention policies and programs. This evaluation sought to assess the feasibility of implementing a standardised fatal injury data collection process to systematically collect relevant fatal injury data from mortuaries. The process evaluation is described. A manual including a one page data collection form, coding guide, data dictionary, data entry and analysis program was developed through World Health Organization and Monash University Australia collaboration, with technical advice from an International Advisory Group. The data collection component was piloted in multiple mortuaries, in five LMICs (Egypt, India, Sri-Lanka, Tanzania and Zambia). Process evaluation was based on a questionnaire completed by each country's Principal Investigator. Questionnaires were completed for data collections in urban and rural mortuaries between September 2010 and February 2011. Of the 1795 reported fatal injury cases registered in the participating mortuaries, road traffic injury accounted for the highest proportion of cases, ranging from 22% to 87%. Other causes included burns, poisoning, drowning and falls. Positive system attributes were feasibility, acceptability, usefulness, timeliness, and simplicity and data field completeness. Some limitations included short duration of the pilot studies, limited injury data collector training and apparent underreporting of cases to the medico-legal system or mortuaries. The mortuary has been shown to be a potential data source for identifying injury deaths and their circumstances and monitoring injury trends and risk factors in LMICs. However, further piloting is needed, including in rural areas and training of forensic pathologists and data-recorders to overcome some of the difficulties experienced in the pilot countries. The key to attracting ongoing funding and support from governments and donors in LMICs for fatal injury surveillance lies in further demonstrating the usefulness of collected data. Copyright © 2015 Elsevier Ltd. All rights reserved.

National Land Imaging Requirements (NLIR) Pilot Project summary report: summary of moderate resolution imaging user requirements

USGS Publications Warehouse

Vadnais, Carolyn; Stensaas, Gregory

2014-01-01

Under the National Land Imaging Requirements (NLIR) Project, the U.S. Geological Survey (USGS) is developing a functional capability to obtain, characterize, manage, maintain and prioritize all Earth observing (EO) land remote sensing user requirements. The goal is a better understanding of community needs that can be supported with land remote sensing resources, and a means to match needs with appropriate solutions in an effective and efficient way. The NLIR Project is composed of two components. The first component is focused on the development of the Earth Observation Requirements Evaluation System (EORES) to capture, store and analyze user requirements, whereas, the second component is the mechanism and processes to elicit and document the user requirements that will populate the EORES. To develop the second component, the requirements elicitation methodology was exercised and refined through a pilot project conducted from June to September 2013. The pilot project focused specifically on applications and user requirements for moderate resolution imagery (5–120 meter resolution) as the test case for requirements development. The purpose of this summary report is to provide a high-level overview of the requirements elicitation process that was exercised through the pilot project and an early analysis of the moderate resolution imaging user requirements acquired to date to support ongoing USGS sustainable land imaging study needs. The pilot project engaged a limited set of Federal Government users from the operational and research communities and therefore the information captured represents only a subset of all land imaging user requirements. However, based on a comparison of results, trends, and analysis, the pilot captured a strong baseline of typical applications areas and user needs for moderate resolution imagery. Because these results are preliminary and represent only a sample of users and application areas, the information from this report should only be used to indicate general user needs for the applications covered. Users of the information are cautioned that use of specific numeric results may be inappropriate without additional research. Any information used or cited from this report should specifically be cited as preliminary findings.

[Integrated skills laboratory concept for undergraduate training in internal medicine].

PubMed

Nikendei, C; Schilling, T; Nawroth, P; Hensel, M; Ho, A D; Schwenger, V; Zeier, M; Herzog, W; Schellberg, D; Katus, H A; Dengler, T; Stremmel, W; Müller, M; Jünger, J

2005-05-06

An amendment to the German medical curriculum in April 2002 will place basic practical skills at the centre of medical training. We report here on the implementation and evaluation of an obligatory, tutor-guided, and integrated skills laboratory concept in the field of internal medicine. To test the effectiveness of a skills laboratory training on OSCE performance a pilot study was carried out. The experimental group, of 77 students, participated in seven sessions of communication training, skills laboratory training, and bedside teaching, each lasting one and a half hours. The control group of 66 students had as many sessions but was only offered bedside-teaching. The evaluation of acceptance of skills' training as well as the related increase in individual competence is on-going (summer term 2004: n = 176 students). The integrated skills laboratory concept was rated at 3.5 (SD = 1.2) on a 5-point scale and was acknowledged as practice-oriented (M = 4.2; SD = 1.0) and relevant for doctors' everyday lives (M = 3.6; SD = 1.1). Increased levels of competence according to individual self-evaluations proved to be highly significant (p<.001), and results of the pilot study showed that the experimental group had a significantly better OSCE performance than the control group (p<.001). This pilot study shows that curriculum changes promoting basic clinical skills are effective and lead to an improved practical education of tomorrow's physicians. The integrated skills laboratory concept is well accepted and leads to a relevant increase in competence in the practice of internal medical. The presented skills laboratory concept in internal medicine is proving to be a viable and efficient learning tool.

Online Teaching Efficacy: A Product of Professional Development and Ongoing Support.

PubMed

Richter, Sally; Idleman, Lynda

2017-08-22

The purpose of the pilot study was to investigate the perceptions of online teaching efficacy of nursing faculty who teach courses in which 51% or more of the content is offered online. Bandura's psychological construct of self-efficacy served as the conceptual framework. The research survey was administered to nursing faculty in a state university system located in the southeastern United States of America, plus two private universities. The Michigan Nurse Educator's Sense of Efficacy for Online Teaching Scale, which contains 32 items that measure how nurse educators judge their current capabilities for teaching online nursing courses, was used to gather data. Overall, the scores reflected that faculty perceived themselves as quite a bit efficacious on a scale that ranged from 1 to 9. As nursing educators received more support in designing and implementing online courses, their efficacy increased. It is critical that faculty are supported on an ongoing basis to increase and develop online teaching skills in order to teach high-quality courses in online programs. Faculty members must also be recognized for their work, time, and commitment required to be effective online educators. The findings of this study revealed those participants who had a number of professional development supports and release time to develop online courses have a greater sense of efficacy.

Optimisation of Critical Infrastructure Protection: The SiVe Project on Airport Security

NASA Astrophysics Data System (ADS)

Breiing, Marcus; Cole, Mara; D'Avanzo, John; Geiger, Gebhard; Goldner, Sascha; Kuhlmann, Andreas; Lorenz, Claudia; Papproth, Alf; Petzel, Erhard; Schwetje, Oliver

This paper outlines the scientific goals, ongoing work and first results of the SiVe research project on critical infrastructure security. The methodology is generic while pilot studies are chosen from airport security. The outline proceeds in three major steps, (1) building a threat scenario, (2) development of simulation models as scenario refinements, and (3) assessment of alternatives. Advanced techniques of systems analysis and simulation are employed to model relevant airport structures and processes as well as offences. Computer experiments are carried out to compare and optimise alternative solutions. The optimality analyses draw on approaches to quantitative risk assessment recently developed in the operational sciences. To exploit the advantages of the various techniques, an integrated simulation workbench is build up in the project.

Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior.

PubMed

Williams, J Mark G; Duggan, Danielle S; Crane, Catherine; Fennell, Melanie J V

2006-02-01

Once suicidal thoughts have emerged as a feature of depression they are likely to be reactivated as part of a suicidal mode of mind whenever sad mood reappears. This article reviews the methods and the usefulness of mindfulness-based cognitive therapy (MBCT) as a treatment for the prevention of the reactivation of the suicidal mode. MBCT integrates mindfulness meditation practices and cognitive therapy techniques. It teaches participants to develop moment-by-moment awareness, approaching ongoing experience with an attitude of nonjudgment and acceptance. Participants are increasingly able to see their thoughts as mental events rather than facts (metacognitive awareness). A case example illustrates how mindfulness skills develop with MBCT and how they relate to the cognitive processes that fuel suicidal crises. An ongoing controlled trial will provide further evidence, but pilot work suggests that MBCT is a promising intervention for those who have experienced suicidal ideation in the past. (c) 2005 Wiley Periodicals, Inc.

Individuals with Alzheimer's learn to play a tile placement game: Results of a pilot study.

PubMed

Miltiades, Helen B; Thatcher, W Gregory

2016-10-25

With the ongoing need to determine effective memory interventions for persons with dementia and other memory impairments, the purpose of this study was to create a unique learning opportunity, where persons with early to moderate Alzheimer's engaged in game play activity. Six female participants, diagnosed with early to moderate dementia, were recruited from an adult day care center and participated in a 10-week study. The participants were placed in groups of three and were taught a tile placement game. Results indicate playing the game yielded inconsistent, but some significant, increases and eventual plateauing of knowing when it was their turn. The results also indicate the participant's maintained improvement in tile placement over the study period. Tile placement accuracy increased over rounds, which points to the importance of practice to maintain learned behavior. The game provided a platform for learning, social engagement, and occupied their time meaningfully. © The Author(s) 2016.

Training peers to provide ongoing diabetes self-management support (DSMS): Results from a pilot study

PubMed Central

Tang, Tricia S.; Funnell, Martha M.; Gillard, Marylou; Nwankwo, Robin; Heisler, Michele

2013-01-01

Objective This study determined the feasibility of training adults with diabetes to lead diabetes self-management support (DSMS) interventions, examined whether participants can achieve the criteria required for successful graduation, and assessed perceived efficacy of and satisfaction with the peer leader training (PLT) program. Methods We recruited nine African-American adults with diabetes for a 46-hour PLT pilot program conducted over 12 weeks. The program utilized multiple instructional methods, reviewed key diabetes education content areas, and provided communication, facilitation, and behavior change skills training. Participants were given three attempts to achieve the pre-established competency criteria for diabetes knowledge, empowerment-based facilitation, active listening, and self-efficacy. Results On the first attempt 75%, 75%, 63%, and 75% passed diabetes knowledge, empowerment-based facilitation, active listening, and self-efficacy, respectively. Those participants who did not pass on first attempt passed on the second attempt. Participants were highly satisfied with the program length, balance between content and skills development, and preparation for leading support activities. Conclusion Findings suggest that it is feasible to train and graduate peer leaders with the necessary knowledge and skills to facilitate DSMS interventions. Practical Implications With proper training, peer support may be a viable model for translating and sustaining DSMS interventions into community-based settings. PMID:21292425

Removal of organic micropollutants from drinking water by a novel electro-Fenton filter: Pilot-scale studies.

PubMed

Plakas, Konstantinos V; Sklari, Stella D; Yiankakis, Dimitrios A; Sideropoulos, Georgios Th; Zaspalis, Vassilis T; Karabelas, Anastasios J

2016-03-15

To assess the performance of a novel 'filter'-type electro-Fenton (EF) device, results are reported from pilot-scale studies of continuous water treatment, to degrade diclofenac (DCF), a typical organic micro-pollutant, with no addition of oxidants. The novel 'filter' consisted of three pairs of anode/cathode electrodes made of carbon felt, with cathodes impregnated with iron nanoparticles (γ-Fe2O3/F3O4 oxides). The best 'filter' performance was obtained at applied potential of 2 V and low water superficial velocities (∼0.09 cm/s), i.e., the mineralization current efficiency (MCE) was >20%, during continuous steady state treatment of tap water with low DCF concentrations (16 μg/L). The EF 'filter' exhibited satisfactory stability regarding both electrode integrity (no iron leaching) and removal efficiency, even after multiple filtration/oxidation treatment cycles, achieving (under steady conditions) DCF and TOC removal 85% and 36%, respectively. This performance is considered satisfactory because the EF process took place under rather unfavorable conditions, such as neutral pH, low dissolved O2 concentration, low electrical conductivity, and presence of natural organic matter and inorganic ions in tap water. Ongoing R&D is aimed at 'filter' development and optimization for practical applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Differing perspectives on parent access to their child's electronic medical record during neonatal intensive care hospitalization: a pilot study.

PubMed

Chung, Rebecca K; Kim, Una Olivia; Basir, Mir Abdul

2018-04-01

To improve informed medical decision-making, principles for family-centered neonatal care recommend that parents have access to their child's medical record on an ongoing basis during neonatal intensive unit care (NICU) hospitalization. Currently, many NICUs do not allow independent parent access to their child's electronic medical record (EMR) during hospitalization. We undertook a cross-sectional survey pilot study of medical professionals and parents to explore opinions regarding this practice. Inclusion criteria: 18-years old, English-literate, legal guardian of patients admitted to the NICU for 14 days. NICU medical professionals included physicians, nurse practitioners, nurses, and respiratory therapists. Medical professionals believed parent access would make their work more difficult, increase time documenting and updating families, making them more liable to litigation and hesitant to chart sensitive information. However, parents felt that they lacked control over their child's care and desired direct access to the EMR. Parents believed this would improve accuracy of their child's medical chart, and increase advocacy and understanding of their child's illness. NICU parents and medical professionals have differing perspectives on independent parental access to their child's EMR. More research is needed to explore the potential of independent parental EMR access to further improve family-centered neonatal care.

Improving clinician competency in communication about schizophrenia: a pilot educational program for psychiatry trainees.

PubMed

Loughland, Carmel; Kelly, Brian; Ditton-Phare, Philippa; Sandhu, Harsimrat; Vamos, Marina; Outram, Sue; Levin, Tomer

2015-04-01

Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.

STS-77 Flight Day 6

NASA Technical Reports Server (NTRS)

1996-01-01

On this sixth day of the STS-77 mission, the flight crew, Cmdr. John H. Casper, Pilot Curtis L. Brown, Jr., and Mission Specialists Andrew S.W. Thomas, Ph.D., Daniel W. Bursch, Mario Runco, Jr., and Marc Garneau, Ph.D., spend some time relaxing, then go back to working in the Spacehab module and preparing to revisit a small cylindrical satellite that they deployed on the mission's third day. Commander John Casper and Pilot Curt Brown monitor Endeavour's systems. Mission Specialist Mario Runco tests an attitude determination system using the GPS attitude and navigation experiment called GANE. The remaining crew members, Mission Specialists Andy Thomas, Dan Bursch and Marc Garneau monitor the health of experiments ongoing in the Spacehab and on the middeck of the orbiter. The crew also conduct a health check of the Aquatic Research Facility (ARF) which contains starfish, mussels and sea urchins.

US/Brazil joint pilot project objectives

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

NONE

1997-12-01

This paper describes a joint US/Brazil pilot project for rural electrification, whose major goals are: to establish technical, institutional, and economic confidence in using renewable energy (PV and wind) to meet the needs of the citizens of rural Brazil; to establish on-going institutional, individual and business relationships necessary to implement sustainable programs and commitments; to lay the groundwork for larger scale rural electrification through the use of distributed renewable technologies. The projects have supported low power home lighting systems, lighting and refrigeration for schools and medical centers, and water pumping systems. This is viewed as a long term project, wheremore » much of the equipment will come from the US, but Brazil will be responsible for program management, and sharing data gained from the program. The paper describes in detail the Brazilian program which was instituted to support this phased project.« less

A pilot randomized trial teaching mindfulness-based stress reduction to traumatized youth in foster care.

PubMed

Jee, Sandra H; Couderc, Jean-Philippe; Swanson, Dena; Gallegos, Autumn; Hilliard, Cammie; Blumkin, Aaron; Cunningham, Kendall; Heinert, Sara

2015-08-01

This article presents a pilot project implementing a mindfulness-based stress reduction program among traumatized youth in foster and kinship care over 10 weeks. Forty-two youth participated in this randomized controlled trial that used a mixed-methods (quantitative, qualitative, and physiologic) evaluation. Youth self-report measuring mental health problems, mindfulness, and stress were lower than anticipated, and the relatively short time-frame to teach these skills to traumatized youth may not have been sufficient to capture significant changes in stress as measured by electrocardiograms. Main themes from qualitative data included expressed competence in managing ongoing stress, enhanced self-awareness, and new strategies to manage stress. We share our experiences and recommendations for future research and practice, including focusing efforts on younger youth, and using community-based participatory research principles to promote engagement and co-learning. CLINICALTRIALS.GOV: Protocol Registration System ID NCT01708291. Copyright © 2015 Elsevier Ltd. All rights reserved.

A one-year practice-based learning programme for new general practice nurses in Scotland: evaluation of the pilot.

PubMed

Wakeling, Judy; Ferguson, Julie; Kennedy, Susan

2016-01-01

This paper summarises the evaluation of a pilot programme introduced by NHS Education for Scotland to provide education and skills training for nurses new to general practice. The programme was developed through extensive consultation with existing general practice nurses and was educationally accredited by the Royal College of General Practitioners and the Royal College of Nursing in 2013. Twelve nurses embarked upon the programme 2012-2013 and nine completed it. The programme was extensively evaluated through questionnaires (with supervisors, practice staff and participants), analysis of programme documentation and interviews with participants. Based on the evaluation feedback, alterations have been made to subsequent deliveries of the programme. These include removing some topic areas and lengthening the programme by three months. The programme continues to be successfully delivered and evaluation is ongoing to ensure it continues to meet nurses' needs.

The Strathclyde Evaluation of Children's Active Travel (SE-CAT): study rationale and methods.

PubMed

McMinn, David; Rowe, David A; Murtagh, Shemane; Nelson, Norah M

2011-12-30

The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG) is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children. Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years) over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male) aged 8-9 years from 5 primary schools. Two schools (n = 79 children) received TG in September/October 2009. Three schools (n = 87 children) acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up. The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including 5 and 12 month follow-up, have been collected and processed. Data analysis is ongoing. Results will indicate whether TG successfully increases active commuting in a sample of Scottish school children and will inform future efforts in school active travel promotion.

The Strathclyde Evaluation of Children's Active Travel (SE-CAT): study rationale and methods

PubMed Central

2011-01-01

Background The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG) is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children. Methods/Design Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years) over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male) aged 8-9 years from 5 primary schools. Two schools (n = 79 children) received TG in September/October 2009. Three schools (n = 87 children) acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up. Discussion The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including 5 and 12 month follow-up, have been collected and processed. Data analysis is ongoing. Results will indicate whether TG successfully increases active commuting in a sample of Scottish school children and will inform future efforts in school active travel promotion. PMID:22208498

Sequential Design of Experiments to Maximize Learning from Carbon Capture Pilot Plant Testing

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

Soepyan, Frits B.; Morgan, Joshua C.; Omell, Benjamin P.

Pilot plant test campaigns can be expensive and time-consuming. Therefore, it is of interest to maximize the amount of learning and the efficiency of the test campaign given the limited number of experiments that can be conducted. This work investigates the use of sequential design of experiments (SDOE) to overcome these challenges by demonstrating its usefulness for a recent solvent-based CO2 capture plant test campaign. Unlike traditional design of experiments methods, SDOE regularly uses information from ongoing experiments to determine the optimum locations in the design space for subsequent runs within the same experiment. However, there are challenges that needmore » to be addressed, including reducing the high computational burden to efficiently update the model, and the need to incorporate the methodology into a computational tool. We address these challenges by applying SDOE in combination with a software tool, the Framework for Optimization, Quantification of Uncertainty and Surrogates (FOQUS) (Miller et al., 2014a, 2016, 2017). The results of applying SDOE on a pilot plant test campaign for CO2 capture suggests that relative to traditional design of experiments methods, SDOE can more effectively reduce the uncertainty of the model, thus decreasing technical risk. Future work includes integrating SDOE into FOQUS and using SDOE to support additional large-scale pilot plant test campaigns.« less

Comfort Care Rounds: a staff capacity-building initiative in long-term care homes.

PubMed

Wickson-Griffiths, Abigail; Kaasalainen, Sharon; Brazil, Kevin; McAiney, Carrie; Crawshaw, Diane; Turner, Mickey; Kelley, Mary Lou

2015-01-01

This article reports a pilot evaluation of Comfort Care Rounds (CCRs)--a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation. Copyright 2015, SLACK Incorporated.

The Ancient Maya Landscape: Facing the Challenges and Embracing the Promise of Integrating Archaeology, Remote Sensing, Soil Science and Hydrologic Modeling for Coupled Natural and Human Systems.

NASA Astrophysics Data System (ADS)

Murtha, T., Jr.; Duffy, C.; Cook, B. D.; Schroder, W.; Webster, D.; French, K. D.; Alcover, O.; Golden, C.; Balzotti, C.; Shaffer, D.

2016-12-01

Relying on a niche inheritance perspective, this paper discusses the long-term spatial and temporal dynamics of land-use management, agricultural decision making and patterns of resource availability in the tropical lowlands of Central America. We introduce and describe ongoing research that addresses a series of long standing questions about coupled natural and human history dynamics in the Central Maya lowlands, emphasizing the role of landscape and region to address these questions. First, we summarize the results of a CNH pilot study focused on the evolution of the regional landscape of Tikal, Guatemala. Particular attention is centered on how we integrated landscape survey, traditional archaeology and soil studies to understand the spatial and temporal dynamics of agricultural land use and intensification over a two thousand period. Additionally, we discuss how these results were integrated into remote sensing, hydrological and erosion models to better understand how past changes in available water and productive land compare to what we know about settlement patterns in the Tikal Region over that same time period. We not only describe how the Maya transformed this landscape, but also how the region influenced changing patterns of settlement and land use. We finish this section with a discussion of some of the unique challenges integrating archaeological information to study CNH dynamics during this pilot study. Second, we introduce a new project designed to `scale up' the pilot study for a macro-regional analysis of the lowland Maya landscape. The new project leverages a uniquely sampled LIDAR data set designed to refine measurements of above ground carbon storage. Our new project quantitatively examines these data for evidence for past human activity. Preliminary results offer a promising path for tightly integrating archaeology, natural science, remote sensing and modeling for studying CNH dynamics in the deep and recent past.

Probing the Initial Mass Function in Extended Ultraviolet (XUV) Disks

NASA Astrophysics Data System (ADS)

Koda, Jin

2013-01-01

"The GALEX UV satellite discovered tantalizing evidence of star formation (SF) far beyond the optical edge of galactic disks (i.e. extended UV disk, or XUV disk). This discovery provides a new opportunity for studying SF in the exceedingly low-density environment (˜1/10 of typical SF density), spurring intense debate on the universality of the initial mass function (IMF) in such exceptional environments. Our pilot S-Cam study of M83’s XUV disk led to support for the universal IMF at least in M83 (Koda et al. 2012). We propose an expansion of the pilot study by an order of magnitude, by observing additional 6 XUV disks in NA656(Hα), B, I, and R-band with S-Cam in S13A. In conjunction with GALEX UV bands, these images will reveal the presence of O stars (Hα; NA656-R) and O&B stars (UV) in stellar clusters -thus, constraining the high-mass end of the IMF. These multi-broadband images will enable us to determine the masses of the clusters with much improved accuracy (previously, relied only on R). The proposed observations will not only increase the statistical significance of our previous result, but also enable us to analyze the stochastic effect of IMF sampling in very low-mass - clusters (10^(2+3) M_sun) - the regime about which there is much ongoing debate."

Probing the Initial Mass Function in Extended Ultraviolet (XUV) Disks

NASA Astrophysics Data System (ADS)

Koda, Jin

2013-01-01

"The GALEX UV satellite discovered tantalizing evidence of star formation (SF) far beyond the optical edge of galactic disks (i.e. extended UV disk, or XUV disk). This discovery provides a new opportunity for studying SF in the exceedingly low-density environment (˜1/10 of typical SF density), spurring intense debate on the universality of the initial mass function (IMF) in such exceptional environments. Our pilot S-Cam study of M83’s XUV disk led to support for the universal IMF at least in M83 (Koda et al. 2012). We propose an expansion of the pilot study by about an order of magnitude, by observing 6 XUV disks in NA656(Hα), B, I, and R-band with S-Cam in S13B. In conjunction with GALEX UV bands, these images will reveal the presence of O stars (Hα) and O&B stars (UV) in stellar clusters -thus, constraining the high-mass end of the IMF. These multi-broadband images will enable us to determine the masses of the clusters with much improved accuracy (previously, relied only on R). The proposed observations will not only increase the statistical significance of our previous result, but also enable us to analyze the stochastic effect of IMF sampling in very low-mass - clusters (10^{2+3} M_sun) - the regime of ongoing debate. Previously allocated 1+2 nights were cancelled (telescope failures)."

Integrative exercise and lifestyle intervention increases leisure-time activity in breast cancer patients.

PubMed

Casla, Soraya; Hojman, Pernille; Cubedo, Ricardo; Calvo, Isabel; Sampedro, Javier; Barakat, Ruben

2014-11-01

Physical activity has been demonstrated to increase survival in breast cancer patients, but few breast cancer patients meet the general recommendations for physical activity. The aim of this pilot study was to investigate if a supervised integrated counseling and group-based exercise program could increase leisure-time activity in women with breast cancer. This pilot project, designed as a single-arm study with pre-post testing, consisted of 24 classes of combined aerobic and strength exercise training as well as classes on dietary and health behavior. A total of 48 women with breast cancer who were undergoing or had recently completed anticancer treatment completed the study. Leisure-time physical activity, grip strength, functional capacity, quality of life (QoL), and depression were assessed at baseline, after intervention, and at the 12-week follow-up after intervention. The breast cancer patients increased their leisure-time physical activity (P = .004), global strength (P = .004), functional capacity (P = .001), and QoL (P = .009), and their depression score (P = .004) significantly decreased. These improvements were independent of whether the patients were in ongoing therapy or had completed their treatment. This integrated intervention may produce lifestyle changes in breast cancer patients and survivors using the teachable moment to increase their leisure-time physical activity and, thereby, their QoL. © The Author(s) 2014.

Dental Disease Prevalence among Methamphetamine and Poly-drug Users in an Urban Setting: A Pilot Study

PubMed Central

Brown, Carolyn; Krishnan, Sumathi; Hursh, Kevin; Yu, Michelle; Johnson, Paul; Page, Kimberly; Shiboski, Caroline H.

2013-01-01

Background/Objectives Rampant tooth decay has been reported among methamphetamine users. We investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared to heroin users. Methods This pilot project is a cross-sectional study of an on-going cohort of young adult injection-drug users (IDUs) in San Francisco. An oral health questionnaire was administered by a research-assistant, and two dentists performed clinical examinations to record the Decayed-Missing-Filled-Surfaces (DMFS) index, presence of residual roots, the Simplified Oral Hygiene Index, and salivary hypofunction. Results The prevalence of dental disease among 58 young adult IDUs was strikingly high compared to the U.S. general population, however, there was no difference in the level of dental disease between the methamphetamine and heroin users in this study. The mean DMFS and number of decayed surfaces exceeded 28 in both groups. Conclusions While no difference in dental disease between methamphetamine and heroin users was detected, we found a high prevalence of caries and caries-associated behaviors in this sample of young adult IDUs. Clinical Implications Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventative measures (e.g., distribution of chlorhexidine rinses, xylitol gum, application of fluoride varnishes) through outreach workers. PMID:22942146

The feasibility and acceptability of screening for hypertension in private drug retail outlets: a pilot study in Mwanza region, Tanzania.

PubMed

Michael, Denna; Kezakubi, Dotto; Juma, Adinan; Todd, Jim; Reyburn, Hugh; Renju, Jenny

2016-09-01

Hypertension is a major contributor to ill health in sub-Saharan Africa. Developing countries need to increase access for screening. This study assesses the feasibility and acceptability of using private sector drug retail outlets to screen for hypertension in Mwanza region, Tanzania. A pilot study took place in eight drug retail outlets from August 2013 to February 2014. Customers ≥18 years were invited for screening. Socio-demographic characteristics, hypertension knowledge, hypertension screening and treatment history were collected. Subjects with systolic blood pressure over 140 mmHg were referred for follow up. Referral slips captured attendance. Mystery client visits and follow up phone calls were conducted to assess service quality. A total of 971 customers were screened, one person refused; 109 (11.2%) had blood pressure over 140/90 mmHg and were referred for ongoing assessment; 85/109 (78.0%) were newly diagnosed. Customers reported that the service was acceptable. Service providers were able to follow the protocol. Only 18/85 (21%) newly diagnosed participants visited the referral clinic within two weeks. Blood pressure screening was feasible and acceptable to customers of private drug retail outlets. However many who were referred failed to attend at a referral centre and further research is needed in this area. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Development and psychometric evaluation of the Primary Health Care Engagement (PHCE) Scale: a pilot survey of rural and remote nurses.

PubMed

Kosteniuk, Julie G; Wilson, Erin C; Penz, Kelly L; MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Karunanayake, Chandima P; Kilpatrick, Kelley

2016-01-01

To report the development and psychometric evaluation of a scale to measure rural and remote (rural/remote) nurses' perceptions of the engagement of their workplaces in key dimensions of primary health care (PHC). Amidst ongoing PHC reforms, a comprehensive instrument is needed to evaluate the degree to which rural/remote health care settings are involved in the key dimensions that characterize PHC delivery, particularly from the perspective of professionals delivering care. This study followed a three-phase process of instrument development and psychometric evaluation. A literature review and expert consultation informed instrument development in the first phase, followed by an iterative process of content evaluation in the second phase. In the final phase, a pilot survey was undertaken and item discrimination analysis employed to evaluate the internal consistency reliability of each subscale in the preliminary 60-item Primary Health Care Engagement (PHCE) Scale. The 60-item scale was subsequently refined to a 40-item instrument. The pilot survey sample included 89 nurses in current practice who had experience in rural/remote practice settings. Participants completed either a web-based or paper survey from September to December, 2013. Following item discrimination analysis, the 60-item instrument was refined to a 40-item PHCE Scale consisting of 10 subscales, each including three to five items. Alpha estimates of the 10 refined subscales ranged from 0.61 to 0.83, with seven of the subscales demonstrating acceptable reliability (α ⩾ 0.70). The refined 40-item instrument exhibited good internal consistency reliability (α=0.91). The 40-item PHCE Scale may be considered for use in future studies regardless of locale, to measure the extent to which health care professionals perceive their workplaces to be engaged in key dimensions of PHC.

Mobile direct observation of therapy (MDOT) - A rapid systematic review and pilot study in children with asthma

PubMed Central

Shields, Michael D.; ALQahtani, Fahad; Rivey, Michael P.

2018-01-01

We describe, for the first time, the use of a mobile device platform for remote direct observation of inhaler use and technique. The research programme commenced with a rapid systematic review of mobile device (or videophone) use for direct observation of therapy (MDOT). Ten studies (mainly pilots) were identified involving patients with tuberculosis, sickle cell disease and Alzheimer's disease. New studies are ongoing (ClinicalTrials.gov website) in TB, stroke, sickle cell disease, HIV and opioid dependence. Having identified no prior use of MDOT in inhaler monitoring, we implemented a feasibility study in 12 healthy volunteer children (2–12 years; 8 females and 4 males) over a period of 14 days, with twice daily video upload of their 'dummy' inhaler use. Two children uploaded 100% of the requested videos, with only one child having an inhaler upload rate of <75%. The quality of uploaded videos was generally good (only 1.7% of unacceptable quality for evaluation). The final aspect of the research was a pilot study using MDOT (6 weeks) in 22 children with difficult to treat asthma. Healthcare professionals evaluated inhaler technique using uploaded videos and provided telephone instruction on improving inhaler use. The main outcomes were assessed at week 12 post initiation of MDOT. By week 5, all children still engaging in MDOT (n = 18) were judged to have effective inhaler technique. Spirometry values did not vary to a significantly significant degree between baseline and 12 weeks (P>0.05), however, mean fraction of exhaled nitric oxide (FeNO) values normalised (mean 38.7 to 19.3ppm) and mean Asthma Control Test values improved (13.1 to mean 17.8). Feedback from participants was positive. Overall the findings open up a new paradigm in device independent (can be used for any type of inhaler device) monitoring, providing a platform for evaluating / improving inhaler use at home. PMID:29401500

The quest for an accurate accounting of public health expenditures.

PubMed

Atchison, C; Barry, M A; Kanarek, N; Gebbie, K

2000-09-01

This article describes one effort to develop management tools that will help public health administrators and policy makers implement comprehensive public health strategies. It recounts the ongoing development of a methodology through which the Essential Public Health Services can be related to public health budgets, appropriations, and expenditures. Through three pilot projects involving: (1) nine state health agencies, (2) three local health agencies, and (3) all local jurisdictions and the state health agency in one state, a workable methodology for identifying public expenditures for comprehensive public health programming has been identified.

The NASA research and technology program on space power: A key element of the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Bennett, Gary L.; Brandhorst, Henry W., Jr.; Atkins, Kenneth L.

1991-01-01

In July 1989, President Bush announced his space exploration initiative of going back to the Moon to stay and then going to Mars. Building upon its ongoing research and technology base, NASA has established an exploration technology program to develop the technologies needed for piloted missions to the Moon and Mars. A key element for the flights and for the planned bases is power. The NASA research and technology program on space power encompasses power sources, energy storage, and power management.

Development of a quiet supersonic wind tunnel with a cryogenic adaptive nozzle

NASA Technical Reports Server (NTRS)

Wolf, Stephen D.

1991-01-01

The main objectives of this work is to demonstrate the potential of a cryogenic adaptive nozzle to generate quiet (low disturbance) supersonic flow. A drive system was researched for the Fluid Mechanics Laboratory (FML) Laminar Flow Supersonic Wind Tunnel (LFSWT) using a pilot tunnel. A supportive effort for ongoing Proof of Concept (PoC) research leading to the design of critical components of the LFSWT was maintained. The state-of-the-art in quiet supersonic wind tunnel design was investigated. A supersonic research capability was developed within the FML.

Manager's assistant systems for space system planning

NASA Technical Reports Server (NTRS)

Bewley, William L.; Burnard, Robert; Edwards, Gary E.; Shoop, James

1992-01-01

This paper describes a class of knowledge-based 'assistant' systems for space system planning. Derived from technology produced for the DARPA/USAF Pilot's Associate program, these assistant systems help the human planner by doing the bookkeeping to maintain plan data and executing the procedures and heuristics currently used by the human planner to define, assess, diagnose, and revise plans. Intelligent systems for Space Station Freedom assembly sequence planning and Advanced Launch System modeling will be presented as examples. Ongoing NASA-funded work on a framework supporting the development of such tools will also be described.

Strengths, weaknesses, opportunities, threats.

PubMed

2002-12-01

Meeting fellow older people enthusiasts is always a pleasure and this month's encounters particularly so. The annual conference of the two RCN older people forums offered its usual blend of innovative ideas, stimulating debate, esoteric humour and a camaraderie shared with strangers as well as friends. Working with multidisciplinary colleagues on the West Midlands pilot development programme for leaders of older people services was equally inspiring. Despite the ongoing challenges of competing priorities, inadequate resources and ageist attitudes, committed teams around the UK are striving to offer high quality services to older people.

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease.

PubMed

Middelveen, Marianne J; Sapi, Eva; Burke, Jennie; Filush, Katherine R; Franco, Agustin; Fesler, Melissa C; Stricker, Raphael B

2018-04-14

Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi , in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.

Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy.

PubMed

Dahne, Jennifer; Kustanowitz, Jacob; Lejuez, C W

2018-02-01

Depressive symptoms are the most frequently treated psychiatric condition in the United States. Brief behavioral activation treatment for depression (BATD) is a popular, evidence-based psychotherapy with strong research support for the treatment of depression. In this paper, we describe the development and initial pilot feasibility testing of a BATD mobile application (Behavioral Apptivation) to be used by patients and therapists in conjunction with BATD therapy. We present information regarding the app development process as well as results from a small open-label feasibility trial of the app utilized in conjunction with individual BATD. We include a case series from the open-label trial highlighting how Behavioral Apptivation can be utilized in clinical practice.

Professional monitoring and critical incident reporting using personal digital assistants.

PubMed

Bent, Paul D; Bolsin, Stephen N; Creati, Bernie J; Patrick, Andrew J; Colson, Mark E

2002-11-04

To assess the practicality of using personal digital assistants (PDAs) for the collection of logbook data, procedural performance data and critical incident reports in anaesthetic trainees. Pilot study. Two tertiary referral centres (in Victoria and New Zealand) and a large district hospital in Queensland. Six accredited Australian and New Zealand College of Anaesthetists (ANZCA) registrars and their ANZCA training supervisors. Registrars and supervisors underwent initial training for one hour, and supervisors were provided with ongoing support. Reliable use of the program, average time for data entry and number of procedures logged. ANZCA trainees reliably enter data into PDAs. The data can be transferred to a central database, where they can be remotely analysed before results are fed back to trainees. This technology can be used to monitor professional performance in ANZCA trainees.

Human-Centered Design of Human-Computer-Human Dialogs in Aerospace Systems

NASA Technical Reports Server (NTRS)

Mitchell, Christine M.

1998-01-01

A series of ongoing research programs at Georgia Tech established a need for a simulation support tool for aircraft computer-based aids. This led to the design and development of the Georgia Tech Electronic Flight Instrument Research Tool (GT-EFIRT). GT-EFIRT is a part-task flight simulator specifically designed to study aircraft display design and single pilot interaction. ne simulator, using commercially available graphics and Unix workstations, replicates to a high level of fidelity the Electronic Flight Instrument Systems (EFIS), Flight Management Computer (FMC) and Auto Flight Director System (AFDS) of the Boeing 757/767 aircraft. The simulator can be configured to present information using conventional looking B757n67 displays or next generation Primary Flight Displays (PFD) such as found on the Beech Starship and MD-11.

Apprenticeships, Collaboration and Scientific Discovery in Academic Field Studies

NASA Astrophysics Data System (ADS)

Madden, Derek Scott; Grayson, Diane J.; Madden, Erinn H.; Milewski, Antoni V.; Snyder, Cathy Ann

2012-11-01

Teachers may use apprenticeships and collaboration as instructional strategies that help students to make authentic scientific discoveries as they work as amateur researchers in academic field studies. This concept was examined with 643 students, ages 14-72, who became proficient at field research through cognitive apprenticeships with the Smithsonian Institute, School for Field Studies and Earthwatch. Control student teams worked from single research goals and sets of methods, while experimental teams varied goals, methods, and collaborative activities in Kenya, Costa Rica, Panama, and Ecuador. Results from studies indicate that students who conducted local pilot studies, collaborative symposia, and ongoing, long-term fieldwork generated significantly more data than did control groups. Research reports of the experimental groups were ranked highest by experts, and contributed the most data to international science journals. Data and anecdotal information in this report indicate that structured collaboration in local long-term studies using apprenticeships may increase the potential for students' academic field studies contribution of new information to science.

Diversity of Cervical Microbiota in Asymptomatic Chlamydia trachomatis Genital Infection: A Pilot Study.

PubMed

Filardo, Simone; Di Pietro, Marisa; Porpora, Maria G; Recine, Nadia; Farcomeni, Alessio; Latino, Maria A; Sessa, Rosa

2017-01-01

Chlamydia trachomatis genital infection continues to be an important public health problem worldwide due to its increasing incidence. C. trachomatis infection can lead to severe sequelae, such as pelvic inflammatory disease, obstructive infertility, and preterm birth. Recently, it has been suggested that the cervico-vaginal microbiota may be an important defense factor toward C. trachomatis infection as well as the development of chronic sequelae. Therefore, the investigation of microbial profiles associated to chlamydial infection is of the utmost importance. Here we present a pilot study aiming to characterize, through the metagenomic analysis of sequenced 16s rRNA gene amplicons, the cervical microbiota from reproductive age women positive to C. trachomatis infection. The main finding of our study showed a marked increase in bacterial diversity in asymptomatic C. trachomatis positive women as compared to healthy controls in terms of Shannon's diversity and Shannon's evenness ( P = 0.031 and P = 0.026, respectively). More importantly, the cervical microbiota from C. trachomatis positive women and from healthy controls significantly separated into two clusters in the weighted UniFrac analysis ( P = 0.0027), suggesting that differences between the two groups depended entirely on the relative abundance of bacterial taxa rather than on the types of bacterial taxa present. Furthermore, C. trachomatis positive women showed an overall decrease in Lactobacillus spp. and an increase in anaerobes. These findings are part of an ongoing larger epidemiological study that will evaluate the potential role of distinct bacterial communities of the cervical microbiota in C. trachomatis infection.

Recruiting and retaining family caregivers to a randomized controlled trial on mindfulness-based stress reduction.

PubMed

Whitebird, Robin R; Kreitzer, Mary Jo; Lewis, Beth A; Hanson, Leah R; Crain, A Lauren; Enstad, Chris J; Mehta, Adele

2011-09-01

Caregivers for a family member with dementia experience chronic long-term stress that may benefit from new complementary therapies such as mindfulness-based stress reduction. Little is known however, about the challenges of recruiting and retaining family caregivers to research on mind-body based complementary therapies. Our pilot study is the first of its kind to successfully recruit caregivers for a family member with dementia to a randomized controlled pilot study of mindfulness-based stress reduction. The study used an array of recruitment strategies and techniques that were tailored to fit the unique features of our recruitment sources and employed retention strategies that placed high value on establishing early and ongoing communication with potential participants. Innovative recruitment methods including conducting outreach to health plan members and generating press coverage were combined with standard methods of community outreach and paid advertising. We were successful in exceeding our recruitment goal and retained 92% of the study participants at post-intervention (2 months) and 90% at 6 months. Recruitment and retention for family caregiver interventions employing mind-body based complementary therapies can be successful despite many challenges. Barriers include cultural perceptions about the use and benefit of complementary therapies, cultural differences with how the role of family caregiver is perceived, the use of group-based designs requiring significant time commitment by participants, and travel and respite care needs for busy family caregivers. Copyright © 2011 Elsevier Inc. All rights reserved.

Why are people downloading the freeware AIDA diabetes computing software program: a pilot study.

PubMed

Lehmann, Eldon D

2002-01-01

The purpose of this paper is to report a pilot survey about why people are downloading the AIDA interactive educational diabetes simulator. AIDA is a diabetes computer program that permits the interactive simulation of plasma insulin and blood glucose profiles for teaching, demonstration, and self-learning purposes. It has been made freely available, without charge, on the Internet as a noncommercial contribution to continuing diabetes education. Since its launch in 1996 well over 200,000 visits have been logged at the main AIDA Website--www.2aida.org--and over 40,000 copies of the AIDA program have been downloaded free-of-charge. This article documents a pilot survey of comments left by Website visitors while they were downloading the AIDA software, before they had a chance to actually use the program. The overall paradigm adopted for this study has endeavored to establish why people are resorting to the Internet to obtain diabetes information. Specific intended goals of the study were: (1) to demonstrate ongoing use of the World Wide Web for surveying diabetes software users by obtaining their free-text comments; (2) to identify what sort of things people were planning to do with the AIDA software simulator; and (3) to more generally gain some insight into why people are turning to the Web for healthcare-related information. The Internet-based survey methodology was found to be robust and reliable. Over an 8-month period (from February 2, 2001 to October 1, 2001) 642 responses were received. During the corresponding period 2,248 actual visits were made to the Website survey page--giving a response rate to this pilot study of 28.6%. Responses were received from participants in over 56 countries--although over half of these (n = 343; 53.4%) originated from the United States and United Kingdom. Two hundred forty-four responses (38.0%) were received from patients with diabetes, and 73 (11.4%) from relatives of patients, with fewer responses from doctors, students, diabetes educators, nurses, pharmacists, and other end users. This pilot survey has confirmed the feasibility of using the Internet to obtain free-text comments, at no real cost, from a large number of medical software downloaders/users. The survey has also offered a valuable insight into why members of the public are turning to the Internet for medical information. Furthermore it has provided useful information about why people are actually downloading the AIDA interactive educational "virtual diabetes patient" simulator.

Methodology of the Stroke Self-Management Rehabilitation Trial: an international, multisite pilot trial.

PubMed

Jones, Kelly M; Bhattacharjee, Rohit; Krishnamurthi, Rita; Blanton, Sarah; Theadom, Alice; Barker-Collo, Suzanne; Thrift, Amanda; Parmar, Priya; Maujean, Annick; Ranta, Annemarei; Sanya, Emmanuel; Feigin, Valery L

2015-02-01

Stroke is a major cause of long-term adult disability with many survivors living in the community relying on family members for on-going support. However, reports of inadequate understanding of rehabilitation techniques are common. A self-management DVD-based observational learning tool may help improve functional outcomes for survivors of stroke and reduce caregivers' burden. This article describes the methodology of the stroke self-management rehabilitation trial. The overall aim of this pilot trial is to assess the feasibility and preliminary efficacy of a DVD-based intervention for improving functional outcomes of survivors of stroke 2 months postrandomization to inform the design of a full-scale randomized clinical trial. Recruitment of a minimum of 20 survivors of stroke and their informal caregivers (where available) in each of the participating centers will occur across multiple international sites. After baseline assessments, participants will be randomly assigned to an intervention or standard care group. The intervention comprises a structured DVD observation and practice schedule over 8 weeks. All participants will complete follow-up assessments. The outcome measures will include a global shift in the Rankin Scale scores and dichotomized scores, changes in quality of life, general health, depression, and caregiver burden at 2 months postrandomization. A qualitative analysis of the effects of the intervention will also be undertaken. The results of the pilot study will provide knowledge of whether observational learning techniques delivered via DVD can effectively improve recovery after stroke and reduce caregiver burden. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, L Kay; Schlief, Angelique; Oostendorp, Rob A B; de Vries, Nanne K

2013-05-25

Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme's effectiveness and the fidelity, acceptability and feasibility of its implementation. A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines' main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen's d). Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (-15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme's multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial.

A study of role expansion: a new GP role in cardiology care

PubMed Central

2014-01-01

Background The National Health Service is reconfiguring health care services in order to meet the increasing challenge of providing care for people with long-term conditions and to reduce the demand on specialised outpatient hospital services by enhancing primary care. A review of cardiology referrals to specialised care and the literature on referral management inspired the development of a new GP role in Cardiology. This new extended role was developed to enable GPs to diagnose and manage patients with mild to moderate heart failure or atrial fibrillation and to use a range of diagnostics effectively in primary care. This entailed GPs participating in a four-session short course with on-going clinical supervision. The new role was piloted in a small number of GP practices in one county in England for four months. This study explores the impact of piloting the Extended Cardiology role on the GP’s role, patients’ experience, service delivery and quality. Methods A mixed methods approach was employed including semi-structured interviews with GPs, a patient experience survey, a quality review of case notes, and analysis on activity and referral data. Results The participating GPs perceived the extended GP role as a professional development opportunity that had the potential to reduce healthcare utilisation and costs, through a reduction in referrals, whilst meeting the patient’s wishes for the provision of care closer to home. Patient experience of the new GP service was positive. The standard of clinical practice was judged acceptable. There was a fall in referrals during the study period. Conclusion This new role in cardiology was broadly welcomed as a model of care by the participating GPs and by patients, because of the potential to improve the quality of care for patients in primary care and reduce costs. As this was a pilot study further development and continuing evaluation of the model is recommended. PMID:24885826

Magnetic resonance imaging investigation of the bone conduction implant – a pilot study at 1.5 Tesla

PubMed Central

Jansson, Karl-Johan Fredén; Håkansson, Bo; Reinfeldt, Sabine; Rigato, Cristina; Eeg-Olofsson, Måns

2015-01-01

Purpose The objective of this pilot study was to investigate if an active bone conduction implant (BCI) used in an ongoing clinical study withstands magnetic resonance imaging (MRI) of 1.5 Tesla. In particular, the MRI effects on maximum power output (MPO), total harmonic distortion (THD), and demagnetization were investigated. Implant activation and image artifacts were also evaluated. Methods and materials One implant was placed on the head of a test person at the position corresponding to the normal position of an implanted BCI and applied with a static pressure using a bandage and scanned in a 1.5 Tesla MRI camera. Scanning was performed both with and without the implant, in three orthogonal planes, and for one spin-echo and one gradient-echo pulse sequence. Implant functionality was verified in-between the scans using an audio processor programmed to generate a sequence of tones when attached to the implant. Objective verification was also carried out by measuring MPO and THD on a skull simulator as well as retention force, before and after MRI. Results It was found that the exposure of 1.5 Tesla MRI only had a minor effect on the MPO, ie, it decreased over all frequencies with an average of 1.1±2.1 dB. The THD remained unchanged above 300 Hz and was increased only at lower frequencies. The retention magnet was demagnetized by 5%. The maximum image artifacts reached a distance of 9 and 10 cm from the implant in the coronal plane for the spin-echo and the gradient-echo sequence, respectively. The test person reported no MRI induced sound from the implant. Conclusion This pilot study indicates that the present BCI may withstand 1.5 Tesla MRI with only minor effects on its performance. No MRI induced sound was reported, but the head image was highly distorted near the implant. PMID:26604836

Magnetic resonance imaging investigation of the bone conduction implant - a pilot study at 1.5 Tesla.

PubMed

Jansson, Karl-Johan Fredén; Håkansson, Bo; Reinfeldt, Sabine; Rigato, Cristina; Eeg-Olofsson, Måns

2015-01-01

The objective of this pilot study was to investigate if an active bone conduction implant (BCI) used in an ongoing clinical study withstands magnetic resonance imaging (MRI) of 1.5 Tesla. In particular, the MRI effects on maximum power output (MPO), total harmonic distortion (THD), and demagnetization were investigated. Implant activation and image artifacts were also evaluated. One implant was placed on the head of a test person at the position corresponding to the normal position of an implanted BCI and applied with a static pressure using a bandage and scanned in a 1.5 Tesla MRI camera. Scanning was performed both with and without the implant, in three orthogonal planes, and for one spin-echo and one gradient-echo pulse sequence. Implant functionality was verified in-between the scans using an audio processor programmed to generate a sequence of tones when attached to the implant. Objective verification was also carried out by measuring MPO and THD on a skull simulator as well as retention force, before and after MRI. It was found that the exposure of 1.5 Tesla MRI only had a minor effect on the MPO, ie, it decreased over all frequencies with an average of 1.1±2.1 dB. The THD remained unchanged above 300 Hz and was increased only at lower frequencies. The retention magnet was demagnetized by 5%. The maximum image artifacts reached a distance of 9 and 10 cm from the implant in the coronal plane for the spin-echo and the gradient-echo sequence, respectively. The test person reported no MRI induced sound from the implant. This pilot study indicates that the present BCI may withstand 1.5 Tesla MRI with only minor effects on its performance. No MRI induced sound was reported, but the head image was highly distorted near the implant.

iMidwife: midwifery students' use of smartphone technology as a mediated educational tool in clinical environments.

PubMed

DeLeo, Annemarie; Geraghty, Sadie

2017-12-18

The increasing use of smartphone technology in health care provides midwifery students with unprecedented access to online resources that facilitates the optimal care of women and supports ongoing learning. A small pilot study was conducted in Western Australia, with 29 undergraduate and postgraduate midwifery students to explore the use of smartphone technology whilst in clinical practice. This study aimed to define the impact of smartphones in clinical decision-making and learning whilst in clinical areas, by midwifery students at the point of care. An online survey was used to collect data. Five consistent themes were identified from the results. Smartphone technology encourages self-directed learning, consolidation of theory, engagement through blended learning, complements online education in clinical practice and is a trend in the future of midwifery curriculum. Smartphones enhance the learning and mobility of supportive resources that consolidate midwifery students' clinical experience in workplace environments.

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

Rashdan, Ahmad Al; Oxstrand, Johanna; Agarwal, Vivek

As part of the ongoing efforts at the U.S. Department of Energy’s Light Water Reactor Sustainability Program, Idaho National Laboratory is conducting several pilot projects in collaboration with the nuclear industry to improve the reliability, safety, and economics of the nuclear power industry, especially as the nuclear power plants extend their operating licenses to 80 years. One of these pilot projects is the automated work package (AWP) pilot project. An AWP is an electronic intelligent and interactive work package. It uses plant condition, resources status, and user progress to adaptively drive the work process in a manner that increases efficiencymore » while reducing human error. To achieve this mission, the AWP acquires information from various systems of a nuclear power plant’s and incorporates several advanced instrumentation and control technologies along with modern human factors techniques. With the current rapid technological advancement, it is possible to envision several available or soon-to-be-available capabilities that can play a significant role in improving the work package process. As a pilot project, the AWP project develops a prototype of an expanding set of capabilities and evaluates them in an industrial environment. While some of the proposed capabilities are based on using technological advances in other applications, others are conceptual; thus, require significant research and development to be applicable in an AWP. The scope of this paper is to introduce a set of envisioned capabilities, their need for the industry, and the industry difficulties they resolve.« less

Designing a multifaceted survivorship care plan to meet the information and communication needs of breast cancer patients and their family physicians: results of a qualitative pilot study.

PubMed

Haq, Rashida; Heus, Lineke; Baker, Natalie A; Dastur, Daisy; Leung, Fok-Han; Leung, Eman; Li, Benjamin; Vu, Kathy; Parsons, Janet A

2013-07-25

Following the completion of treatment and as they enter the follow-up phase, breast cancer patients (BCPs) often recount feeling 'lost in transition', and are left with many questions concerning how their ongoing care and monitoring for recurrence will be managed. Family physicians (FPs) also frequently report feeling ill-equipped to provide follow-up care to BCPs. In this three-phase qualitative pilot study we designed, implemented and evaluated a multi-faceted survivorship care plan (SCP) to address the information needs of BCPs at our facility and of their FPs. In Phase 1 focus groups and individual interviews were conducted with 35 participants from three stakeholder groups (BCPs, FPs and oncology specialist health care providers (OHCPs)), to identify specific information needs. An SCP was then designed based on these findings, consisting of both web-based and paper-based tools (Phase 2). For Phase 3, both sets of tools were subsequently evaluated via focus groups and interviews with 26 participants. Interviews and focus groups were audio taped, transcribed and content analysed for emergent themes and patterns. In Phase 1 patients commented that web-based, paper-based and human resources components were desirable in any SCP. Patients did not focus exclusively on the post-treatment period, but instead spoke of evolving needs throughout their cancer journey. FPs indicated that any tools to support them must distill important information in a user-friendly format. In Phase 2, a pilot SCP was subsequently designed, consisting of both web-based and paper-based materials tailored specifically to the needs of BCPs as well as FPs. During Phase 3 (evaluation) BCPs indicated that the SCP was effective at addressing many of their needs, and offered suggestions for future improvements. Both patients and FPs found the pilot SCP to be an improvement from the previous standard of care. Patients perceived the quality of the BCP-FP relationship as integral to their comfort with FPs assuming follow-up responsibilities. This pilot multi-component SCP shows promise in addressing the information needs of BCPs and the FPs who care for them. Next steps include refinement of the different SCP components, further evaluation (including usability testing), and planning for more extensive implementation.

The impact of inclusion criteria in health economic assessments.

PubMed

Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

2011-05-01

The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive inclusion criteria and can enable researchers to search for population subgroups in which the intervention remains cost effective. When the pilot study does not indicate sufficiently strong cost-effectiveness results, the broader trade-offs between clinical heterogeneity and the strength of the submission package to the reimbursement agency can be discussed by all parties. Payer concerns about the ability to generalize the results beyond the clinical trial can also be discussed at this time. Applicability then depends on the ability to enforce inclusion criteria similar to those used in the trials in the real world.

Preceptor/mentor education: a world of possibilities through e-learning technology.

PubMed

Myrick, Florence; Caplan, Wendy; Smitten, Jayne; Rusk, Kerry

2011-04-01

Preceptorship/mentorship is designed to socialize students into the nursing profession, promote their confidence/competence and foster their critical thinking ability. In today's global context, opportunities exist for local, rural, national and international student placements which provide exciting and mutually rewarding preceptorship experiences. Despite the recognized value of those involved in preceptorship/mentorship, however, little progress has been made regarding the development of an infrastructure that effectively supports their ongoing education. This project, piloted from October 2008 to February 2009, leveraged our established research and teaching experience in preceptorship with technologies that allowed us to create an accessible and engaging e-learning space designed to support preceptors in a seamless fashion, improve the quality of the student preceptorship and enhance professional teaching capacity. A purposive sample of 25 preceptors was selected with a total of 18 preceptors successfully completing the five month program. Upon completion, participants were surveyed and individually interviewed. Data analysis revealed the program to be informative, supportive and highly valued. Knowledge derived from this study can: a) further enrich the substantive nature and infrastructure of online preceptor education; and b) contribute to clarifying best practices for preceptor support, facilitation, and ongoing professional development with a view to enhancing the preceptorship experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

Estimating the Population Impact of a New Pediatric Influenza Vaccination Program in England Using Social Media Content.

PubMed

Wagner, Moritz; Lampos, Vasileios; Yom-Tov, Elad; Pebody, Richard; Cox, Ingemar J

2017-12-21

The rollout of a new childhood live attenuated influenza vaccine program was launched in England in 2013, which consisted of a national campaign for all 2 and 3 year olds and several pilot locations offering the vaccine to primary school-age children (4-11 years of age) during the influenza season. The 2014/2015 influenza season saw the national program extended to include additional pilot regions, some of which offered the vaccine to secondary school children (11-13 years of age) as well. We utilized social media content to obtain a complementary assessment of the population impact of the programs that were launched in England during the 2013/2014 and 2014/2015 flu seasons. The overall community-wide impact on transmission in pilot areas was estimated for the different age groups that were targeted for vaccination. A previously developed statistical framework was applied, which consisted of a nonlinear regression model that was trained to infer influenza-like illness (ILI) rates from Twitter posts originating in pilot (school-age vaccinated) and control (unvaccinated) areas. The control areas were then used to estimate ILI rates in pilot areas, had the intervention not taken place. These predictions were compared with their corresponding Twitter-based ILI estimates. Results suggest a reduction in ILI rates of 14% (1-25%) and 17% (2-30%) across all ages in only the primary school-age vaccine pilot areas during the 2013/2014 and 2014/2015 influenza seasons, respectively. No significant impact was observed in areas where two age cohorts of secondary school children were vaccinated. These findings corroborate independent assessments from traditional surveillance data, thereby supporting the ongoing rollout of the program to primary school-age children and providing evidence of the value of social media content as an additional syndromic surveillance tool. ©Moritz Wagner, Vasileios Lampos, Elad Yom-Tov, Richard Pebody, Ingemar J Cox. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.12.2017.

Tell Me Your Story: A Pilot Narrative Medicine Curriculum During the Medicine Clerkship.

PubMed

Chretien, Katherine C; Swenson, Rebecca; Yoon, Bona; Julian, Ricklie; Keenan, Jonathan; Croffoot, James; Kheirbek, Raya

2015-07-01

Narrative medicine educational interventions may enhance patient-centered care, yet most educational interventions do not involve actual patient-provider interactions, nor do they assess narrative competence, a key skill for its practice. An experiential narrative medicine curriculum for medical students was developed and piloted. The purpose of the study was to develop narrative competence, practice attentive listening, and stimulate reflection. Participants were third-year medicine clerkship students. The curriculum involved 1) an introductory session, 2) a patient storytelling activity, and 3) a group reflection session. For the storytelling activity, students elicited illness narratives in storytelling form from patients, listened attentively, wrote their versions of the story, and then read them back to patients. Five student focus groups were conducted between July 2011 and March 2012 (n = 31; 66%) to explore students' experiences, student-patient dynamics, challenges, and what they learned. Patient interviews (n = 17) on their experience were conducted in January 2013. Thematic analysis of the audiotaped stories of ten patients and corresponding student-written stories helped gauge narrative competence. The curriculum was found to be feasible and acceptable to both patients and students. Some patients and students were profoundly moved. Ongoing focus groups resulted in continual process improvement. Students' stories showed attainment of narrative competence.

Flight Evaluation of an Aircraft with Side and Center Stick Controllers and Rate-Limited Ailerons

NASA Technical Reports Server (NTRS)

Deppe, P. R.; Chalk, C. R.; Shafer, M. F.

1996-01-01

As part of an ongoing government and industry effort to study the flying qualities of aircraft with rate-limited control surface actuators, two studies were previously flown to examine an algorithm developed to reduce the tendency for pilot-induced oscillation when rate limiting occurs. This algorithm, when working properly, greatly improved the performance of the aircraft in the first study. In the second study, however, the algorithm did not initially offer as much improvement. The differences between the two studies caused concern. The study detailed in this paper was performed to determine whether the performance of the algorithm was affected by the characteristics of the cockpit controllers. Time delay and flight control system noise were also briefly evaluated. An in-flight simulator, the Calspan Learjet 25, was programmed with a low roll actuator rate limit, and the algorithm was programmed into the flight control system. Side- and center-stick controllers, force and position command signals, a rate-limited feel system, a low-frequency feel system, and a feel system damper were evaluated. The flight program consisted of four flights and 38 evaluations of test configurations. Performance of the algorithm was determined to be unaffected by using side- or center-stick controllers or force or position command signals. The rate-limited feel system performed as well as the rate-limiting algorithm but was disliked by the pilots. The low-frequency feel system and the feel system damper were ineffective. Time delay and noise were determined to degrade the performance of the algorithm.

Insights from transformations under way at four Brookings-Dartmouth accountable care organization pilot sites.

PubMed

Larson, Bridget K; Van Citters, Aricca D; Kreindler, Sara A; Carluzzo, Kathleen L; Gbemudu, Josette N; Wu, Frances M; Nelson, Eugene C; Shortell, Stephen M; Fisher, Elliott S

2012-11-01

This cross-site comparison of the early experience of four provider organizations participating in the Brookings-Dartmouth Accountable Care Organization Collaborative identifies factors that sites perceived as enablers of successful ACO formation and performance. The four pilots varied in size, with between 7,000 and 50,000 attributed patients and 90 to 2,700 participating physicians. The sites had varying degrees of experience with performance-based payments; however, all formed collaborative new relationships with payers and created shared savings agreements linked to performance on quality measures. Each organization devoted major efforts to physician engagement. Policy makers now need to consider how to support and provide incentives for the successful formation of multipayer ACOs, and how to align private-sector and CMS performance measures. Linking providers to learning networks where payers and providers can address common technical issues could help. These sites' transitions to the new payment model constitutes an ongoing journey that will require continual adaptation in the structure of contracts and organizational attributes.

Advanced Engineering Environment FY09/10 pilot project.

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

Lamph, Jane Ann; Kiba, Grant W.; Pomplun, Alan R.

2010-06-01

The Advanced Engineering Environment (AEE) project identifies emerging engineering environment tools and assesses their value to Sandia National Laboratories and our partners in the Nuclear Security Enterprise (NSE) by testing them in our design environment. This project accomplished several pilot activities, including: the preliminary definition of an engineering bill of materials (BOM) based product structure in the Windchill PDMLink 9.0 application; an evaluation of Mentor Graphics Data Management System (DMS) application for electrical computer-aided design (ECAD) library administration; and implementation and documentation of a Windchill 9.1 application upgrade. The project also supported the migration of legacy data from existing corporatemore » product lifecycle management systems into new classified and unclassified Windchill PDMLink 9.0 systems. The project included two infrastructure modernization efforts: the replacement of two aging AEE development servers for reliable platforms for ongoing AEE project work; and the replacement of four critical application and license servers that support design and engineering work at the Sandia National Laboratories/California site.« less

Co-Learning With Home Care Aides and Their Clients: Collaboratively Increasing Individual and Organizational Capacities

PubMed Central

MURAMATSU, NAOKO; MADRIGAL, JESSICA; BERBAUM, MICHAEL L.; HENDERSON, VIDA A.; JURIVICH, DONALD A.; ZANONI, JOSEPH; MARQUEZ, DAVID X.; MADRID, KATYA CRUZ

2015-01-01

Changes in health care provide unprecedented opportunities for collaboration across research, education, and practice for the common goal of enhancing the well-being of older adults and their caregivers. This article describes how a pilot project, “Promoting Seniors’ Health with Home Care Aides,” has synergistic education, research and practice effects that enhance individual and organizational capacities. This pilot is an innovative partnership with home care aides to deliver a safe physical activity program appropriate for frail seniors in a real-life public home care program. The intervention and research occur in older adults’ homes and thus provide rare opportunities for the research team and partners to learn from each other about dynamics of home care in older adults’ life contexts. Co-learning is essential for continuous quality improvement in education, research and practice. We propose to establish “Teaching Home Care” to ensure ongoing co-learning in gerontology and geriatrics. PMID:25671492

Orion Orbit Control Design and Analysis

NASA Technical Reports Server (NTRS)

Jackson, Mark; Gonzalez, Rodolfo; Sims, Christopher

2007-01-01

The analysis of candidate thruster configurations for the Crew Exploration Vehicle (CEV) is presented. Six candidate configurations were considered for the prime contractor baseline design. The analysis included analytical assessments of control authority, control precision, efficiency and robustness, as well as simulation assessments of control performance. The principles used in the analytic assessments of controllability, robustness and fuel performance are covered and results provided for the configurations assessed. Simulation analysis was conducted using a pulse width modulated, 6 DOF reaction system control law with a simplex-based thruster selection algorithm. Control laws were automatically derived from hardware configuration parameters including thruster locations, directions, magnitude and specific impulse, as well as vehicle mass properties. This parameterized controller allowed rapid assessment of multiple candidate layouts. Simulation results are presented for final phase rendezvous and docking, as well as low lunar orbit attitude hold. Finally, on-going analysis to consider alternate Service Module designs and to assess the pilot-ability of the baseline design are discussed to provide a status of orbit control design work to date.

Weird-World, Weird-World

NASA Astrophysics Data System (ADS)

Schuller, Ivan; Wargo, Rich

2014-03-01

We will present the first in a series of videos designed and produced specifically as a pilot for the YouTube audience to playfully explore interesting and unusual phenomena that physics reveals, and their uses in modern life. No talking heads, no pedants, no complicated theory - but rather a visually captivating and often kooky comical look at exclusion principle, entanglement, tunneling and the retinue of exceedingly strange things that happen in classical and quantum physics and how we understand and actually use this weirdness each and everyday. Produced by the UC San Diego-based creative partnership between an active physicist and established university based science media producer responsible for the highly successful and comical nanoscience caper When Things Get Small, this will pilot an on-going series with the specific goal of entertaining and engaging audiences of all ages. The series has planned distribution and marketing on YouTube though the unique programming and distribution capacities of University of California Television to commence in 2013. Supported by APS, UCSD-Center for Advanced Nanoscience and UCTV.

Feasibility of the Dutch ICF Activity Inventory: a pilot study

PubMed Central

2010-01-01

Background Demographic ageing will lead to increasing pressure on visual rehabilitation services, which need to be efficiently organised in the near future. The Dutch ICF Activity Inventory (D-AI) was developed to assess the rehabilitation needs of visually impaired persons. This pilot study tests the feasibility of the D-AI using a computer-assisted telephone interview. Methods In addition to the regular intake, the first version of the D-AI was assessed in 20 patients. Subsequently, patients and intake assessors were asked to fill in an evaluation form. Based on these evaluations, a new version of the D-AI was developed. Results Mean administration time of the D-AI was 88.8 (± 41.0) minutes. Overall, patients and assessors were positive about the D-AI assessment. However, professionals and 60% of the patients found the administration time to be too long. All included items were considered relevant and only minor adjustments were recommended. Conclusion The systematic character of the revised D-AI will prevent topics from being overlooked and indicate which needs have the highest priority from a patient-centred perspective. Moreover, ongoing assessment of the D-AI will enhance evaluation of the rehabilitation process. To decrease administration time, in the revised D-AI only the top priority goals will be fully assessed. Using the D-AI, a rehabilitation plan based on individual needs can be developed for each patient. Moreover, it enables better evaluation of the effects of rehabilitation. A larger validation study is planned. PMID:21110871

Security aspects of electronic data interchange between a state health department and a hospital emergency department.

PubMed

Magnuson, J A; Klockner, Rocke; Ladd-Wilson, Stephen; Zechnich, Andrew; Bangs, Christopher; Kohn, Melvin A

2004-01-01

Electronic emergency department reporting provides the potential for enhancing local and state surveillance capabilities for a wide variety of syndromes and reportable conditions. The task of protecting data confidentiality and integrity while developing electronic data interchange between a hospital emergency department and a state public health department proved more complex than expected. This case study reports on the significant challenges that had to be resolved to accomplish this goal; these included application restrictions and incompatibilities, technical malfunctions, changing standards, and insufficient dedicated resources. One of the key administrative challenges was that of coordinating project security with enterprise security. The original project has evolved into an ongoing pilot, with the health department currently receiving secure data from the emergency department at four-hour intervals. Currently, planning is underway to add more emergency departments to the project.

Exploring Digital Encounters in the Public Arena

NASA Astrophysics Data System (ADS)

Schieck, Ava Fatah Gen.; Kostakos, Vassilis; Penn, Alan

In this chapter, we explore the types of encounters that technology enables. We consider the differences between digital and nondigital encounters through two pilot studies carried out in the city of Bath, United Kingdom. We investigate how technology can be appropriated for shared interactions that support conscious (or unconscious) social encounters, and highlight the importance of space and the role of place in providing temporal and spatial mechanisms facilitating different types of shared encounters. Here, we apply a method based on intervention through "sensing and projecting" Bluetooth names and digital identity in the public arena, and describe initial observations about people's reaction toward the projection of their Bluetooth names in public. In particular, we note the significance of constructing socially meaningful relations between people mediated by these technologies. We discuss initial results and outline issues raised in detail before finally describing the ongoing work.

Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

PubMed

Simmons, R; Phillips, J F; Rahman, M

1984-01-01

An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

UAS Integration into the NAS: Detect and Avoid Display Evaluations in Support of SC-228 MOPS Development

NASA Technical Reports Server (NTRS)

Fern, Lisa; Rorie, Conrad; Shively, Jay

2015-01-01

This presentation provides an overview of the work the Human Systems Integration (HSI) sub-project has done on detect and avoid (DAA) displays while working on the UAS Integration into the NAS project. Much of the work has been used to support the ongoing development of minimum operational performance standards (MOPS) for UAS by RTCA Special Committee 228. The design and results of three different human-in-the-loop simulations are discussed, with particular emphasis on the role of the UAS pilot in the Self Separation Timeline.

The Federal Aviation Administration/Massachusetts Institute of Technology (FAA/MIT) Lincoln Laboratory Doppler weather radar program

NASA Technical Reports Server (NTRS)

Evans, James E.

1988-01-01

The program focuses on providing real-time information on hazardous aviation weather to end users such as air traffic control and pilots. Existing systems will soon be replaced by a Next Generation Weather Radar (NEXRAD), which will be concerned with detecting such hazards as heavy rain and hail, turbulence, low-altitude wind shear, and mesocyclones and tornadoes. Other systems in process are the Central Weather Processor (CWP), and the terminal Doppler weather radar (TDWR). Weather measurements near Memphis are central to ongoing work, especially in the area of microbursts and wind shear.

Implementation of New Technologies to Monitor Phytoplankton Blooms in the South of Chile

NASA Astrophysics Data System (ADS)

Rodríguez-Benito, C.; Haag, C.; Alvial, A.

2004-05-01

A pilot project has been carried out to demonstrate the applicability of remote sensing in the Xth region of Chile, related to the monitoring of algal blooms. Most of the fish farms of the country are located in this area, where considerable economic losses for this activity are the consequence of algal blooms. The implementation of new technologies to monitor this natural disaster is one of the main goals of local institutions. The project has been developed using ENVISAT/MERIS and AATSR images and oceanographic instrumentation in order to improve the information of the ongoing coastal monitoring programs.

The 1992 catalog of space science and applications education programs and activities

NASA Technical Reports Server (NTRS)

1992-01-01

This catalog provides information on current, ongoing and pilot programs conducted at precollege through postdoctoral levels which are primarily funded or managed by the Office of Space Science Applications (OSSA). The directory of programs section includes teacher and faculty preparation and enhancement, student enrichment opportunities, student research opportunities, postdoctoral and advanced research opportunities, initiatives to strengthen educational institution involvement in research and initiatives to strengthen research community involvement in education. The Educational Products appendices include tabular data of OSSA activities, NASA Spacelink, NASA education satellites videoconferences, the Teacher Resource Center Network, and a form for requesting further information.

Towards Certification of a Space System Application of Fault Detection and Isolation

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Markosian, Lawrence Z.

2008-01-01

Advanced fault detection, isolation and recovery (FDIR) software is being investigated at NASA as a means to the improve reliability and availability of its space systems. Certification is a critical step in the acceptance of such software. Its attainment hinges on performing the necessary verification and validation to show that the software will fulfill its requirements in the intended setting. Presented herein is our ongoing work to plan for the certification of a pilot application of advanced FDIR software in a NASA setting. We describe the application, and the key challenges and opportunities it offers for certification.

Advanced helmet tracking technology developments for naval aviation

NASA Astrophysics Data System (ADS)

Brindle, James H.

1996-06-01

There is a critical need across the Services to improve the effectiveness of aircrew within the crewstation by capitalizing on the natural psycho-motor skills of the pilot through the use of a variety of helmet-mounted visual display and control techniques. This has resulted in considerable interest and significant ongoing research and development efforts on the part of the Navy, as well as the Army and the Air Force, in the technology building blocks associated with this area, such as advanced head position sensing or head tracking technologies, helmet- mounted display optics and electronics, and advanced night vision or image intensification technologies.

Long-term personality data collection in support of spaceflight and analogue research.

PubMed

Musson, David M; Helmreich, Robert L

2005-06-01

This is a review of past and present research into personality and performance at the University of Texas (UT) Human Factors Research Project. Specifically, personality trait data collected from astronauts, pilots, Antarctic personnel, and other groups over a 15-yr period is discussed with particular emphasis on research in space and space analogue environments. The UT Human Factors Research Project conducts studies in personality and group dynamics in aviation, space, and medicine. Current studies include personality determinants of professional cultures, team effectiveness in both medicine and aviation, and personality predictors of long-term astronaut performance. The Project also studies the design and effectiveness of behavioral strategies used to minimize error and maximize team performance in safety-critical work settings. A multi-year personality and performance dataset presents many opportunities for research, including long-term and follow-up studies of human performance, analyses of trends in recruiting and attrition, and the ability to adapt research design to operational changes and methodological advances. Special problems posed by such long-duration projects include issues of confidentiality and security, as well as practical limitations imposed by current peer-review and short-term funding practices. Practical considerations for ongoing dataset management include consistency of assessment instruments over time, variations in data acquisition from one year to the next, and dealing with changes in theory and practice that occur over the life of the project. A fundamental change in how research into human performance is funded would be required to ensure the ongoing development of such long-duration research databases.

A pilot study of spatial patterns in referrals to a multicentre cancer genetics service.

PubMed

Tempest, Vanessa; Higgs, Gary; McDonald, Kevin; Iredale, Rachel; Bater, Tony; Gray, Jonathon

2005-01-01

To analyse spatial and temporal patterns in patients referred to a cancer genetics service in order to monitor service utilization and accessibility. Postcodes of patients during a 4-year period were used to examine spatial patterns using a Geographical Information System (GIS). Referral rates were compared visually and statistically to explore yearly variation for administrative areas in Wales. There has been a four-fold increase in actual referrals to the service over the period of study. The variance between unitary authority referral rates has decreased from the inception of the service from an almost ten-fold difference between lowest and highest in year 1 to less than a three-fold difference in year 4. This study shows the potential of GIS to highlight spatial variations in referral rates across Wales. Although the disparity in referral rates has decreased, trends in referral rates are not consistent. Ongoing research will examine those referral and referrer characteristics affecting uptake. Copyright 2005 S. Karger AG, Basel.

Diagnosis of Dementia by Machine learning methods in Epidemiological studies: a pilot exploratory study from south India.

PubMed

Bhagyashree, Sheshadri Iyengar Raghavan; Nagaraj, Kiran; Prince, Martin; Fall, Caroline H D; Krishna, Murali

2018-01-01

There are limited data on the use of artificial intelligence methods for the diagnosis of dementia in epidemiological studies in low- and middle-income country (LMIC) settings. A culture and education fair battery of cognitive tests was developed and validated for population based studies in low- and middle-income countries including India by the 10/66 Dementia Research Group. We explored the machine learning methods based on the 10/66 battery of cognitive tests for the diagnosis of dementia based in a birth cohort study in South India. The data sets for 466 men and women for this study were obtained from the on-going Mysore Studies of Natal effect of Health and Ageing (MYNAH), in south India. The data sets included: demographics, performance on the 10/66 cognitive function tests, the 10/66 diagnosis of mental disorders and population based normative data for the 10/66 battery of cognitive function tests. Diagnosis of dementia from the rule based approach was compared against the 10/66 diagnosis of dementia. We have applied machine learning techniques to identify minimal number of the 10/66 cognitive function tests required for diagnosing dementia and derived an algorithm to improve the accuracy of dementia diagnosis. Of 466 subjects, 27 had 10/66 diagnosis of dementia, 19 of whom were correctly identified as having dementia by Jrip classification with 100% accuracy. This pilot exploratory study indicates that machine learning methods can help identify community dwelling older adults with 10/66 criterion diagnosis of dementia with good accuracy in a LMIC setting such as India. This should reduce the duration of the diagnostic assessment and make the process easier and quicker for clinicians, patients and will be useful for 'case' ascertainment in population based epidemiological studies.

Republished: Building a culture of safety through team training and engagement.

PubMed

Thomas, Lily; Galla, Catherine

2013-07-01

Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.

Building a culture of safety through team training and engagement.

PubMed

Thomas, Lily; Galla, Catherine

2013-05-01

Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.

Geologic input to enhanced oil recovery project planning in south Oman

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

Watts, N.L.; Ellis, D.; Heward, A.P.

1986-05-01

South Oman clastic reservoirs contain a combined stock-tank oil in place of more than 1.9 billion m/sup 3/ of predominantly heavy oil distributed in almost 40 fields of varying size. Successful early application of such enhanced oil recovery (EOR) methods as steam flood, polymer drive, and steam soak could realize undiscounted incremental recoveries of 244 million m/sup 3/ of oil. Target oil is contained in three reservoir intervals with distinct characteristics relevant to EOR. (1) The Cambrian-Ordovician Haima Group is a thick monotonous sequence of continental and coastal sands; major problems are steam-rock reactions, recovery factors, effective kv/kh (ratio ofmore » vertical to horizontal permeability), and aquifer strength. (2) The Permian-Carboniferous Al Khlata Formation is a glacial package showing severe heterogeneity, strong permeability anisotropy, and poor predictability. (3) The Permian Gharif Formation is a coastal to fluvial sequence with isolated and multilayer channel sands, smectitic clays, and anomalous primary production performance. Several EOR pilot projects are either ongoing or in preparation as part of a longer term EOR strategy. Geologic input is important at four essential stages of pilot planning: initial project ranking, optimization of pilot location, definition of pilot size, and predictive/history match simulations. Each stage is illustrated using a specific project example from south Oman to show the diverse geologic and logistic problems of the area. Although geologic aspects are highlighted, EOR project planning in south Oman is multidisciplinary, with integration being aided by a dedicated EOR coordination department.« less

Using the Inflammacheck Device to Measure the Level of Exhaled Breath Condensate Hydrogen Peroxide in Patients With Asthma and Chronic Obstructive Pulmonary Disease (The EXHALE Pilot Study): Protocol for a Cross-Sectional Feasibility Study

PubMed Central

Fogg, Carole; Brown, Thomas P; Jones, Thomas L; Lanning, Eleanor; Bassett, Paul; Chauhan, Anoop J

2018-01-01

Background Asthma and Chronic Obstructive Pulmonary Disease (COPD) are common conditions that affect over 5 million people in the United Kingdom. These groups of patients suffer significantly from breathlessness and recurrent exacerbations that can be difficult to diagnose and go untreated. A common feature of COPD and asthma is airway inflammation that increases before and during exacerbations. Current methods of assessing airway inflammation can be invasive, difficult to perform, and are often inaccurate. In contrast, measurement of exhaled breath condensate (EBC) hydrogen peroxide (H2O2) is performed during normal tidal breathing and is known to reflect the level of global inflammation in the airways. There is a need for novel tools to diagnose asthma and COPD earlier and to detect increased airway inflammation that precedes an exacerbation. Objective The aim of this study was to explore the use of a new handheld device (called Inflammacheck) in measuring H2O2 levels in EBC. We will study whether it can measure EBC H2O2 levels consistently and whether it can be used to differentiate asthma and COPD from healthy controls. Methods We will perform a cross-sectional, feasibility, pilot study of EBC H2O2 levels, as measured by Inflammacheck, and other markers of disease severity and symptom control in patients with asthma and COPD and volunteers with no history of lung disease. Participants will be asked to provide an exhaled breath sample for measurement of their EBC H2O2 using Inflammacheck. The result will be correlated with disease stage, spirometry, fractional exhaled nitric oxide (FeNO), and symptom control scores. Results This study’s recruitment is ongoing; it is anticipated that the results will be available in 2018. Conclusions The EXhaled Hydrogen peroxide As a marker of Lung diseasE (EXHALE) pilot study will provide an evaluation of a new method of measuring EBC H2O2. It will assess the device’s consistency and ability to distinguish airway inflammation in asthma and COPD compared with healthy controls. PMID:29382628

Measuring outcomes in psychiatry: an inpatient model.

PubMed

Davis, D E; Fong, M L

1996-02-01

This article describes a system for measuring outcomes recently implemented in the department of psychiatry of Baptist Memorial Hospital, a 78-bed inpatient and day treatment unit that represents one service line of a large, urban teaching hospital in Memphis. In June 1993 Baptist Hospital began a 15-month pilot test of PsychSentinel, a measurement tool developed by researchers in the Department of Community Medicine at the University of Connecticut. The hospital identified the following four primary goals for this pilot project: provide data for internal hospital program evaluation, provide data for external marketing in a managed care environment, satisfy requirements of the Joint Commission on Accreditation of Health Care Organizations, and generate studies that add to the literature in psychiatry and psychology. PsychSentinel is based on the standardized diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The outcome measure assesses the change in the number of symptoms of psychopathology that occurs between admission and discharge from the hospital. Included in the nonproprietary system are risk adjustment factors, as well as access to a national reference database for comparative analysis purposes. Data collection can be done by trained ancillary staff members, with as much or as little direct physician involvement as desired. The system has proven to be both time effective and cost effective, and it provides important outcome information both at the program level and at the clinician level. After the pilot test, the staff at Baptist Memorial Hospital determined that the system met all initial objectives identified and recently adopted the system as an ongoing measure of quality patient care in the department of psychiatry.

Monitoring of persistent organic pollutants in Africa. Part 2: design of a network to monitor the continental and intercontinental background.

PubMed

Lammel, G; Dobrovolný, P; Dvorská, A; Chromá, K; Brázdil, R; Holoubek, I; Hosek, J

2009-11-01

A network for the study of long-term trends of the continental background in Africa and the intercontinental background of persistent organic pollutants as resulting from long-range transport of contaminants from European, South Asian, and other potential source regions, as well as by watching supposedly pristine regions, i.e. the Southern Ocean and Antarctica is designed. The results of a pilot phase sampling programme in 2008 and meteorological and climatological information from the period 1961-2007 was used to apply objective criteria for the selection of stations for the monitoring network: out the original 26 stations six have been rejected because of suggested strong local sources of POPs and three others because of local meteorological effects, which may prevent part of the time long-range transported air to reach the sampling site. Representativeness of the meteorological patterns during the pilot phase with respect to climatology was assessed by comparison of the more local airflow situation as given by climatological vs. observed wind roses and by comparison of backward trajectories with the climatological wind (NCEP/NCAR re-analyses). With minor exceptions advection to nine inspected stations was typical for present-day climate during the pilot phase, 2008. Six to nine stations would cover satisfyingly large and densely populated regions of North-eastern, West and East Africa and its neighbouring seas, the Mediterranean, Northern and Equatorial Atlantic Ocean, the Western Indian Ocean and the Southern Ocean. Among the more densely populated areas Southern Cameroon, parts of the Abessinian plateau and most of the Great Lakes area would not be covered. The potential of the network is not hampered by on-going long-term changes of the advection to the selected stations, as these do hardly affect the coverage of target areas.

[Criteria for a medical specialty in crisis: a case study of general surgery and internal medicine].

PubMed

Nirel, Nurit; Birkenfeld, Shlomo; Benbassat, Jochanan

2008-06-01

Several clinical specialties in Israel appear to be experiencing an ongoing crisis. Recently, a Public Committee addressed this problem and recommended its further study. In this paper, the authors report a pilot case study of general surgery and internal medicine, which have been identified as "clinical specialties in crisis" in the medical literature, in the testimonies presented to the Public Committee, and during our preliminary interviews. to identify (a) the criteria for a "medical specialty in crisis" and (b) measures for the assessment of the extent of the crisis. (a) Qualitative analysis of interviews and written testimonies of hospital directors, departmental heads of general surgery and internal medicine, and key personnel in the health care system; (b) Analysis of data derived from national administrative data databases and (c) Secondary analysis of data from a nationwide survey of board certified Israeli specialists. We identified five criteria of "medical specialties in crisis": shortage of "good" applicants for residency training; difficulties in filling vacant positions; excessive workload due to the limited number of staff physician and residents; a perceived low remuneration and limited opportunities for additional income; poor quality of professional working life. Some of these criteria can be used as a proxy for measuring the extent of the crisis. It is possible to identify criteria defining clinical specialties in crisis, as well as its extent, as a first step toward identification of possible ways of coping with it. The findings of this pilot study justify a broader survey of additional medical specialties and a larger number of physicians.

Diversity of Cervical Microbiota in Asymptomatic Chlamydia trachomatis Genital Infection: A Pilot Study

PubMed Central

Filardo, Simone; Di Pietro, Marisa; Porpora, Maria G.; Recine, Nadia; Farcomeni, Alessio; Latino, Maria A.; Sessa, Rosa

2017-01-01

Chlamydia trachomatis genital infection continues to be an important public health problem worldwide due to its increasing incidence. C. trachomatis infection can lead to severe sequelae, such as pelvic inflammatory disease, obstructive infertility, and preterm birth. Recently, it has been suggested that the cervico-vaginal microbiota may be an important defense factor toward C. trachomatis infection as well as the development of chronic sequelae. Therefore, the investigation of microbial profiles associated to chlamydial infection is of the utmost importance. Here we present a pilot study aiming to characterize, through the metagenomic analysis of sequenced 16s rRNA gene amplicons, the cervical microbiota from reproductive age women positive to C. trachomatis infection. The main finding of our study showed a marked increase in bacterial diversity in asymptomatic C. trachomatis positive women as compared to healthy controls in terms of Shannon's diversity and Shannon's evenness (P = 0.031 and P = 0.026, respectively). More importantly, the cervical microbiota from C. trachomatis positive women and from healthy controls significantly separated into two clusters in the weighted UniFrac analysis (P = 0.0027), suggesting that differences between the two groups depended entirely on the relative abundance of bacterial taxa rather than on the types of bacterial taxa present. Furthermore, C. trachomatis positive women showed an overall decrease in Lactobacillus spp. and an increase in anaerobes. These findings are part of an ongoing larger epidemiological study that will evaluate the potential role of distinct bacterial communities of the cervical microbiota in C. trachomatis infection. PMID:28770172

An expansion of glider observation strategies to systematically transmit and analyze preferred waypoints of underwater gliders

NASA Astrophysics Data System (ADS)

Smedstad, Lucy F.; Barron, Charlie N.; Bourg, Rachel N.; Brooking, Michael W.; Bryant, Danielle A.; Carr, Robert J.; Heaney, Kevin D.; Holmberg, Edward A.; Mask, Andrea C.; Mensi, Bryan L.

2015-05-01

The Glider Observation STrategies (GOST) system provides real-time assistance to ocean glider pilots by suggesting preferred ocean glider waypoints based on ocean forecasts and their uncertainties. Restrictions on waterspace, preferred operational areas, and other glider trajectories are also taken into account. Using existing operational regional Navy Coastal Ocean Model (RNCOM) output, demonstrations of glider waypoint calculation are ongoing in Navy operational areas. After the ocean forecast models and GOST components run at the Navy DoD Supercomputing Resource Center (Navy DSRC), GOST-suggested glider paths are transferred to the Glider Operations Center (GOC). The glider pilots at the GOC import this information into their Unmanned Systems Interface (USI), developed at the University of Washington, Applied Physics Laboratory (APL-UW) to evaluate the suggested glider paths, make adjustments, and update waypoints for the gliders. The waypoints being sent are visualized and analyzed using graphic capabilities to convey guidance uncertainty developed under a grant to the University of New Orleans (UNO) and added under the Environmental Measurements Path Planner (EMPath) system within GOST. USI forwards automatic messages from the gliders with recent glider location, speed, and depth to GOST for the next cycle. Over the course of these demonstrations, capabilities were added or modified including use of initial glider bearing, preferred path, refinement of glider turn frequency, correction of glider speed, and introduction of glider rendezvous locations. Automation has been added with help from the modeling group at the Naval Oceanographic Office (NAVOCEANO). GOST supports NAVOCEANO's ongoing efforts to direct and recover gliders, to safely navigate in changing ocean conditions, and to provide feedback to improve ocean model prediction.

The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

PubMed

Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

2014-01-01

The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.

Application of a pilot control banding tool for risk level assessment and control of nanoparticle exposures.

PubMed

Paik, Samuel Y; Zalk, David M; Swuste, Paul

2008-08-01

Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or 'CB Nanotool' that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.

Dental disease prevalence among methamphetamine and heroin users in an urban setting: a pilot study.

PubMed

Brown, Carolyn; Krishnan, Sumathi; Hursh, Kevin; Yu, Michelle; Johnson, Paul; Page, Kimberly; Shiboski, Caroline H

2012-09-01

Researchers have reported rampant caries among methamphetamine users. The authors investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared with those in heroin users. This pilot project was a cross-sectional study of an ongoing cohort of young adult injection-drug users (IDUs) in San Francisco. Participants completed an oral health questionnaire administered by a research assistant, and dentists performed clinical examinations to record the participants' data in terms of scores on the decayed-missing-filled surfaces (DMFS) index, presence of residual roots, scores on an oral hygiene index and whether any salivary hypofunction was observed. The prevalence of dental disease among 58 young adult IDUs was strikingly high compared with that in the U.S. general population; however, the authors found no difference in the level of dental disease between users of methamphetamine and users of heroin. The mean DMFS score and number of decayed surfaces exceeded 28 in both groups. Although the authors detected no difference in dental disease between methamphetamine and heroin users, they found a high prevalence of caries and caries-associated behaviors in the sample of young adult IDUs. Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventive measures (such as distribution of chlorhexidine rinses or xylitol gum or application of fluoride varnishes) through outreach workers.

[Ongoing, flexible distance learning through the Internet: course on decentralized management of human resources in health care].

PubMed

Struchiner, Miriam; Roschke, Maria Alice; Ricciardi, Regina Maria Vieira

2002-03-01

This paper describes the Course on Decentralized Management of Human Resources in Health Care, which is an Internet-based distance learning program to train and provide continuing education for health care professionals. The program is an initiative of the Pan American Health Organization, and it was organized in response to the growing need for self-reliant professionals who can constantly upgrade their knowledge without having to leave their place of work. The proposed model promotes an educational process that brings together theory and practice in realistic and relevant contexts and that maximizes the participation of students, both individually and in groups. The program has been evaluated in pilot studies in Brazil, Chile, and Peru. Following these assessments, the course has been adapted to facilitate its implementation and to adjust its contents to fit each country's circumstances.

Satellite Delivery of Aviation Weather Data

NASA Technical Reports Server (NTRS)

Kerczewski, Robert J.; Haendel, Richard

2001-01-01

With aviation traffic continuing to increase worldwide, reducing the aviation accident rate and aviation schedule delays is of critical importance. In the United States, the National Aeronautics and Space Administration (NASA) has established the Aviation Safety Program and the Aviation System Capacity Program to develop and test new technologies to increase aviation safety and system capacity. Weather is a significant contributor to aviation accidents and schedule delays. The timely dissemination of weather information to decision makers in the aviation system, particularly to pilots, is essential in reducing system delays and weather related aviation accidents. The NASA Glenn Research Center is investigating improved methods of weather information dissemination through satellite broadcasting directly to aircraft. This paper describes an on-going cooperative research program with NASA, Rockwell Collins, WorldSpace, Jeppesen and American Airlines to evaluate the use of satellite digital audio radio service (SDARS) for low cost broadcast of aviation weather information, called Satellite Weather Information Service (SWIS). The description and results of the completed SWIS Phase 1 are presented, and the description of the on-going SWIS Phase 2 is given.

Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care.

PubMed

Avery, Leah; Sniehotta, Falko F; Denton, Sarah J; Steen, Nick; McColl, Elaine; Taylor, Roy; Trenell, Michael I

2014-02-03

Physical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care. This study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care. Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence-base, that is, the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes. The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents, to the best of our knowledge, the first of its kind in the United Kingdom. This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care. Movement as Medicine for Type 2 Diabetes (MaMT2D) was registered with Current Controlled Trials on the 14th January 2012: ISRCTN67997502. The first primary care practice was randomised on the 5th October 2012.

A training approach to improve stepping automaticity while dual-tasking in Parkinson's disease: A prospective pilot study.

PubMed

Chomiak, Taylor; Watts, Alexander; Meyer, Nicole; Pereira, Fernando V; Hu, Bin

2017-02-01

Deficits in motor movement automaticity in Parkinson's disease (PD), especially during multitasking, are early and consistent hallmarks of cognitive function decline, which increases fall risk and reduces quality of life. This study aimed to test the feasibility and potential efficacy of a wearable sensor-enabled technological platform designed for an in-home music-contingent stepping-in-place (SIP) training program to improve step automaticity during dual-tasking (DT). This was a 4-week prospective intervention pilot study. The intervention uses a sensor system and algorithm that runs off the iPod Touch which calculates step height (SH) in real-time. These measurements were then used to trigger auditory (treatment group, music; control group, radio podcast) playback in real-time through wireless headphones upon maintenance of repeated large amplitude stepping. With small steps or shuffling, auditory playback stops, thus allowing participants to use anticipatory motor control to regain positive feedback. Eleven participants were recruited from an ongoing trial (Trial Number: ISRCTN06023392). Fear of falling (FES-I), general cognitive functioning (MoCA), self-reported freezing of gait (FOG-Q), and DT step automaticity were evaluated. While we found no significant effect of training on FES-I, MoCA, or FOG-Q, we did observe a significant group (music vs podcast) by training interaction in DT step automaticity (P<0.01). Wearable device technology can be used to enable musically-contingent SIP training to increase motor automaticity for people living with PD. The training approach described here can be implemented at home to meet the growing demand for self-management of symptoms by patients.

A state policy framework for integrating health and social services.

PubMed

McGinnis, Tricia; Crawford, Maia; Somers, Stephen A

2014-07-01

Recognizing that health is determined by a variety of interrelated factors, states are looking to connect health care, public health, and social services to help achieve improved population health, better care, and reduced cost of care. This issue brief describes three essential components for integrating health, including physical and behavioral health services and public health, and social services: (1) a coordinating mechanism, (2) quality measurement and data-sharing tools, and (3) aligned financing and payment. It also presents a five-step policy framework to help states move beyond isolated pilot efforts and establish the infrastructure necessary to support ongoing integration of health and social services, particularly for Medicaid beneficiaries.

Developing visualisation software for rehabilitation: investigating the requirements of patients, therapists and the rehabilitation process

PubMed Central

Loudon, David; Macdonald, Alastair S.; Carse, Bruce; Thikey, Heather; Jones, Lucy; Rowe, Philip J.; Uzor, Stephen; Ayoade, Mobolaji; Baillie, Lynne

2012-01-01

This paper describes the ongoing process of the development and evaluation of prototype visualisation software, designed to assist in the understanding and the improvement of appropriate movements during rehabilitation. The process of engaging users throughout the research project is detailed in the paper, including how the design of the visualisation software is being adapted to meet the emerging understanding of the needs of patients and professionals, and of the rehabilitation process. The value of the process for the design of the visualisation software is illustrated with a discussion of the findings of pre-pilot focus groups with stroke survivors and therapists. PMID:23011812

Mindfulness-based stress reduction for overweight/obese women with and without polycystic ovary syndrome: design and methods of a pilot randomized controlled trial.

PubMed

Raja-Khan, Nazia; Agito, Katrina; Shah, Julie; Stetter, Christy M; Gustafson, Theresa S; Socolow, Holly; Kunselman, Allen R; Reibel, Diane K; Legro, Richard S

2015-03-01

Mindfulness-based stress reduction (MBSR) may be beneficial for overweight/obese women, including women with polycystic ovary syndrome (PCOS), as it has been shown to reduce psychological distress and improve quality of life in other patient populations. Preliminary studies suggest that MBSR may also have salutary effects on blood pressure and blood glucose. This paper describes the design and methods of an ongoing pilot randomized controlled trial evaluating the feasibility and effects of MBSR in PCOS and non-PCOS women who are overweight or obese (NCT01464398). Eighty six (86) women with body mass index ≥ 25 kg/m(2), including 31 women with PCOS, have been randomized to 8 weeks of MBSR or health education control, and followed for 16 weeks. The primary outcome is mindfulness assessed with the Toronto Mindfulness Scale. Secondary outcomes include measures of blood pressure, blood glucose, quality of life, anxiety and depression. Our overall hypothesis is that MBSR will increase mindfulness and ultimately lead to favorable changes in blood pressure, blood glucose, psychological distress and quality of life in PCOS and non-PCOS women. This would support the integration of MBSR with conventional medical treatments to reduce psychological distress, cardiovascular disease and diabetes in PCOS and non-PCOS women who are overweight or obese. Copyright © 2015 Elsevier Inc. All rights reserved.

Mindfulness-Based Stress Reduction for Overweight/Obese Women With and Without Polycystic Ovary Syndrome: Design and Methods of a Pilot Randomized Controlled Trial

PubMed Central

Raja-Khan, Nazia; Agito, Katrina; Shah, Julie; Stetter, Christy M.; Gustafson, Theresa S.; Socolow, Holly; Kunselman, Allen R.; Reibel, Diane K.; Legro, Richard S.

2015-01-01

Mindfulness-based stress reduction (MBSR) may be beneficial for overweight/obese women, including women with polycystic ovary syndrome (PCOS), as it has been shown to reduce psychological distress and improve quality of life in other patient populations. Preliminary studies suggest that MBSR may also have salutary effects on blood pressure and blood glucose. This paper describes the design and methods of an ongoing pilot randomized controlled trial evaluating the feasibility and effects of MBSR in PCOS and non-PCOS women who are overweight or obese. Eighty six (86) women with body mass index ≥25 kg/m2, including 31 women with PCOS, have been randomized to 8 weeks of MBSR or health education control, and followed for 16 weeks. The primary outcome is mindfulness assessed with the Toronto Mindfulness Scale. Secondary outcomes include measures of blood pressure, blood glucose, quality of life, anxiety and depression. Our overall hypothesis is that MBSR will increase mindfulness and ultimately lead to favorable changes in blood pressure, blood glucose, psychological distress and quality of life in PCOS and non-PCOS women. This would support the integration of MBSR with conventional medical treatments to reduce psychological distress, cardiovascular disease and diabetes in PCOS and non-PCOS women who are overweight or obese. PMID:25662105

Pilot Scale Production of Activated Carbon Spheres Using Fluidized Bed Reactor and Its Evaluation for the Removal of Hexavalent Chromium from Aqueous Solutions

NASA Astrophysics Data System (ADS)

Tripathi, Nagesh Kumar; Sathe, Manisha

2017-12-01

Large scale production of activated carbon is need of ongoing research due to its excellent adsorption capacity for removal of heavy metals from contaminated solutions. In the present study, polymeric precursor polystyrene beads [Brunauer Emmett Teller (BET) surface area, 46 m2/g; carbon content, 40.64%; crushing strength, 0.32 kg/sphere] were used to produce a new variant of activated carbon, Activated Carbon Spheres (ACS) in a pilot scale fluidized bed reactor. ACS were prepared by carbonization of polymeric precursor at 850 °C followed by activation of resultant material with steam. Prepared ACS were characterized using scanning electron microscope, CHNS analyzer, thermogravimetric analyzer, surface area analyzer and crushing strength tester. The produced ACS have 1009 m2/g BET surface area, 0.89 cm3/g total pore volume, 92.32% carbon content and 1.1 kg/sphere crushing strength with less than 1% of moisture and ash content. The ACS were also evaluated for its potential to remove hexavalent chromium [Cr(VI)] from contaminated solutions. The chromium removal is observed to be 99.1% at initial concentration 50 mg/l, pH 2, ACS dose 1 g/l, contact time 2 h, agitation 120 rpm and temperature 30 °C. Thus ACS can be used as an adsorbent material for the removal of Cr(VI) from contaminated solutions.

Controlled Sonar Exposure Experiments on Cetaceans in Norwegian Waters: Overview of the 3S-Project.

PubMed

Lam, Frans-Peter A; Kvadsheim, Petter H; Miller, Patrick J O; Tyack, Peter L; Ainslie, Michael A; Curé, Charlotte; Kleivane, Lars; Sivle, Lise Doksæter; van Ijsselmuide, Sander P; Visser, Fleur; von Benda-Beckmann, Alexander M; Wensveen, Paul J; Dekeling, René P A

2016-01-01

In mitigating the risk of sonar operations, the behavioral response of cetaceans is one of the major knowledge gaps that needs to be addressed. The 3S-Project has conducted a number of controlled exposure experiments with a realistic sonar source in Norwegian waters from 2006 to 2013. In total, the following six target species have been studied: killer, long-finned pilot, sperm, humpback, minke, and northern bottlenose whales. A total of 38 controlled sonar exposures have been conducted on these species. Responses from controlled and repeated exposure runs have been recorded using acoustic and visual observations as well as with electronic tags on the target animal. So far, the first dose-response curves as well as an overview of the scored severity of responses have been revealed. In this paper, an overview is presented of the approach for the study, including the results so far as well as the current status of the ongoing analysis.

Preanalytical considerations in detection of colorectal cancer in blood serum using Raman molecular imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Treado, Patrick J.; Stewart, Shona D.; Smith, Aaron; Kirschner, Heather; Post, Christopher; Overholt, Bergein F.

2016-03-01

Colorectal cancer (CRC) is the third most common cancer in men and women in the United States. Raman Molecular Imaging (RMI) is an effective technique to evaluate human tissue, cells and bodily fluids, including blood serum for disease diagnosis. ChemImage Corporation, in collaboration with clinicians, has been engaged in development of an in vitro diagnostic Raman assay focused on CRC detection. The Raman Assay for Colorectal Cancer (RACC) exploits the high specificity of Raman imaging to distinguish diseased from normal dried blood serum droplets without additional reagents. Pilot Study results from testing of hundreds of biobank patient samples have demonstrated that RACC detects CRC with high sensitivity and specificity. However, expanded clinical trials, which are ongoing, are revealing a host of important preanalytical considerations associated with sample collection, sample storage and stability, sample shipping, sample preparation and sample interferents, which impact detection performance. Results from recent clinical studies will be presented.

Clinicians, security and information technology support services in practice settings--a pilot study.

PubMed

Fernando, Juanita

2010-01-01

This case study of 9 information technology (IT) support staff in 3 Australian (Victoria) public hospitals juxtaposes their experiences at the user-level of eHealth security in the Natural Hospital Environment with that previously reported by 26 medical, nursing and allied healthcare clinicians. IT support responsibilities comprised the entire hospital, of which clinician eHealth security needs were only part. IT staff believed their support tasks were often fragmented while work responsibilities were hampered by resources shortages. They perceived clinicians as an ongoing security risk to private health information. By comparison clinicians believed IT staff would not adequately support the private and secure application of eHealth for patient care. Preliminary data analysis suggests the tension between these cohorts manifests as an eHealth environment where silos of clinical work are disconnected from silos of IT support work. The discipline-based silos hamper health privacy outcomes. Privacy and security policies, especially those influencing the audit process, will benefit by further research of this phenomenon.

Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study

PubMed Central

2013-01-01

Background Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme’s effectiveness and the fidelity, acceptability and feasibility of its implementation. Methods A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines’ main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen’s d). Results Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (−15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme’s multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. Conclusions The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial. PMID:23705912

An irreplaceable safety culture.

PubMed

Render, Marta L; Hirschhorn, Larry

2005-01-01

Intensive care unit (ICU) clinicians are sources of errors and of resilience. When they learn how to juggle many competing goals, remain vigilant, and tell safety stories--all in the context of changing technologies and demand--they can create safe settings of care. Other strategies (eg, using computerized tools and implementing safety procedures) are important, but alone they are not sufficient. An ICU needs a safety culture that is rooted in a committed leadership, the acknowledgment that error is inevitable, a reporting system, and continuous learning. The all too common norm, "no harm no foul," is an obstacle. ICU leaders can use a campaign strategy to spread the safety practices that sustain a safety culture. They should attend to the political, marketing, and military aspects of such campaigns and recognize that people's time and attention are limited and built projects from existing ongoing pilots. Pilots can compete for people's attention; it has pull when it exemplifies a moral idea, simplifies work, and gives the health care professional more control and feedback. Under these conditions, the campaign will release individuals' passions and add energy and insight to the campaign itself.

Preliminary Validation of the Small Aircraft Transportation System Higher Volume Operations (SATS HVO) Concept

NASA Technical Reports Server (NTRS)

Williams, Daniel; Consiglio, Maria; Murdoch, Jennifer; Adams, Catherine

2004-01-01

This document provides a preliminary validation of the Small Aircraft Transportation System (SATS) Higher Volume Operations (HVO) concept for normal conditions. Initial results reveal that the concept provides reduced air traffic delays when compared to current operations without increasing pilot workload. Characteristic to the SATS HVO concept is the establishment of a newly defined area of flight operations called a Self-Controlled Area (SCA) which would be activated by air traffic control (ATC) around designated non-towered, non-radar airports. During periods of poor visibility, SATS pilots would take responsibility for separation assurance between their aircraft and other similarly equipped aircraft in the SCA. Using onboard equipment and simple instrument flight procedures, they would then be better able to approach and land at the airport or depart from it. This concept would also require a new, ground-based automation system, typically located at the airport that would provide appropriate sequencing information to the arriving aircraft. Further validation of the SATS HVO concept is required and is the subject of ongoing research and subsequent publications.

“Nurses Eat Their Young”: A Novel Bullying Educational Program for Student Nurses

PubMed Central

Gillespie, Gordon L.; Grubb, Paula L.; Brown, Kathryn; Boesch, Maura C.; Ulrich, Deborah

2017-01-01

Bullying is a known and ongoing problem against nurses. Interventions are needed to prepare nursing students to prevent and mitigate the bullying they will experience in their nursing practice. The purpose of this article is to describe the development process and utility of one such intervention for use by nursing faculty with nursing students prior to their students’ entry into the profession. The educational program was critiqued by an advisory board and deemed to be relevant, clear, simple, and non-ambiguous indicating the program to have adequate content validity. The program then was pilot tested on five university campuses. Faculty members who implemented the educational program discussed (1) the program having value to faculty members and students, (2) challenges to continued program adoption, and (3) recommendations for program delivery. The proposed multicomponent, multiyear bullying educational program has the potential to positively influence nursing education and ultimately nursing practice. Findings from the pilot implementation of the program indicate the need to incorporate the program into additional nursing courses beginning during the sophomore year of the nursing curricula. PMID:28781715

Pilot Evaluation of an In-Store Nutrition Label Education Program.

PubMed

Dukeshire, Steven; Nicks, Emily; Ferguson, Jennifer

2014-12-01

To describe and provide recommendations for the implementation of an evaluation for an already existing, in-store Nutrition Label Education Program (NLEP). We describe the development and implementation of an evaluation consisting of a pre- and postsurvey and one month follow-up. The evaluation was designed to assess satisfaction with the NLEP as well as changes in participant nutrition label knowledge, confidence in using nutrition labels, and actual changes in nutrition label use. Nineteen participants took part in the pilot evaluation. The evaluation was successful in demonstrating high levels of satisfaction with the NLEP as well as positive changes in participant confidence and some increased knowledge in using nutrition labels. However, only 3 people participated in the follow-up, limiting the ability to assess behaviour change. Ideally, NLEPs should include ongoing evaluation that extends beyond just assessing participant satisfaction. Recommendations are provided for conducting such evaluations, including the importance of incorporating the evaluation into the program itself, using existing questionnaires when possible, and employing pre- and postsurveys as well as follow-up interviews to assess change.

Reinforcement Learning with Autonomous Small Unmanned Aerial Vehicles in Cluttered Environments

NASA Technical Reports Server (NTRS)

Tran, Loc; Cross, Charles; Montague, Gilbert; Motter, Mark; Neilan, James; Qualls, Garry; Rothhaar, Paul; Trujillo, Anna; Allen, B. Danette

2015-01-01

We present ongoing work in the Autonomy Incubator at NASA Langley Research Center (LaRC) exploring the efficacy of a data set aggregation approach to reinforcement learning for small unmanned aerial vehicle (sUAV) flight in dense and cluttered environments with reactive obstacle avoidance. The goal is to learn an autonomous flight model using training experiences from a human piloting a sUAV around static obstacles. The training approach uses video data from a forward-facing camera that records the human pilot's flight. Various computer vision based features are extracted from the video relating to edge and gradient information. The recorded human-controlled inputs are used to train an autonomous control model that correlates the extracted feature vector to a yaw command. As part of the reinforcement learning approach, the autonomous control model is iteratively updated with feedback from a human agent who corrects undesired model output. This data driven approach to autonomous obstacle avoidance is explored for simulated forest environments furthering autonomous flight under the tree canopy research. This enables flight in previously inaccessible environments which are of interest to NASA researchers in Earth and Atmospheric sciences.

PRELIMINARY RESULTS OF A PROSPECTIVE FEASIBILITY PILOT STUDY OF “GEMPOX” (GEMCITABINE, OXALIPLATIN, AND PACLITAXEL) IN PEDIATRIC AND ADULT PATIENTS WITH REFRACTORY OR RECURRENT CENTRAL NERVOUS SYSTEM (CNS) GERM CELL TUMORS (GCT): THE INTERNATIONAL CNS GCT CONSORTIUM TRIAL, CNS GCT-4

PubMed Central

Finlay, Jonathan L.; Liu, Yin; Haley, Kelley; Erdreich-Epstein, Anat; Rushing, Teresa; Grimm, John; Wong, Kenneth E.; Kiehna, Erin; Krieger, Mark D.; Gilles, Floyd; Badie, Benham; D'Apuzzo, Massimo; Dhall, Girish

2014-01-01

BACKGROUND: The optimal management of patients with recurrent CNS GCT, especially those with non-germinomatous (mixed malignant) GCT (MMGCT), remains unclear. Preliminary results are presented on the response rate, toxicity and early outcomes of a re-induction regimen of gemcitabine, oxaliplatin and paclitaxel (GEMPOX) administered, in responsive patients, prior to myeloablative chemotherapy and autologous hematopoietic cell rescue (HDCx + AuHCR). METHODS: Since December 2004, 13 recurrent or refractory patients (12 MMGCT, 1 germinoma; 12 males; mean age 16.5 years, range 7-34 years) have been treated with up to 4 cycles of gemcitabine (800 mg/m2), oxaliplatin (100 mg/m2) and paclitaxel (170 mg/m2), administered on one day at 14 days intervals. RESULTS: Of 13 patients, five were treated on a preceding feasibility pilot with 1-3 cycles of GEMPOX, and seven have been formally enrolled on an ongoing prospective multi-center trial. Six patients achieved complete remissions (tumor marker and/or imaging studies), five achieved partial remissions and two developed progressive disease (PD) while on GEMPOX; one patient with PD after 1 cycle had pathologically confirmed malignant transformation to pure embryonal rhabdomyosarcoma.; the second patient, with pure pineal choriocarcinoma, progressed following the second cycle of GEMPOX. Eleven of the 13 patents subsequently underwent HDCx + AuHCR. Six of them subsequently received irradiation. Transient hepatotoxicity and pancytopenia were the most commonly observed toxicities. Other toxicities included: paclitaxel anaphylaxis (1), transient encephalopathy (1), peripheral neuropathy (1), hyperesthesia (4), mucositis (2) and electrolyte imbalances (3). Four of the 12 patients with MMGCT continue alive and disease-free for 8+ , 10+ , 14+ and 16+ months since discontinuation of all therapy. One patient (with pure yolk sac tumor) relapsed in a loco-regional extra-CNS location (cavernous and ethmoid/sphenoid sinuses) and remains alive with progressive disease on therapy now 12+ months post-HDCx + AuHCR. CONCLUSIONS: GEMPOX appears to be an effective re-induction regimen for patients with recurrent CNS MMGCT, with acceptable toxicities. The ongoing multi-center, international trial should confirm this and demonstrate the contribution of GEMPOX towards improved survival when followed by HDCx + AuHCR with or without further irradiation, in the setting of minimal residual disease. SECONDARY CATEGORY: Pediatrics.

Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study.

PubMed

Farren, Jessica; Jalmbrant, Maria; Ameye, Lieveke; Joash, Karen; Mitchell-Jones, Nicola; Tapp, Sophie; Timmerman, Dirk; Bourne, Tom

2016-11-02

This is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with a control group with ongoing pregnancies. The secondary aim was to assess whether miscarriage or ectopic pregnancy impacted differently on the type and severity of psychological morbidity. This was a prospective survey study. Consecutive women were recruited between January 2012 and July 2013. We emailed women a link to a survey 1, 3 and 9 months after a diagnosis of EPL, and 1 month after the diagnosis of a viable ongoing pregnancy. The Early Pregnancy Assessment Unit (EPAU) of a central London teaching hospital. We recruited 186 women. 128 had a diagnosis of EPL, and 58 of ongoing pregnancies. 11 withdrew consent, and 11 provided an illegible or invalid email address. Post-traumatic stress disorder (PTSD) was measured using the Post-traumatic Diagnostic Scale (PDS), and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Response rates were 69/114 at 1 month and 44/68 at 3 months in the EPL group, and 20/50 in controls. Psychological morbidity was higher in the EPL group with 28% meeting the criteria for probable PTSD, 32% for anxiety and 16% for depression at 1 month and 38%, 20% and 5%, respectively, at 3 months. In the control group, no women met criteria for PTSD and 10% met criteria for anxiety and depression. There was little difference in type or severity of distress following ectopic pregnancy or miscarriage. We have shown a large number of women having experienced a miscarriage or ectopic pregnancy fulfil the diagnostic criteria for probable PTSD. Many suffer from moderate-to-severe anxiety, and a lesser number depression. Psychological morbidity, and in particular PTSD symptoms, persists at least 3 months following pregnancy loss. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Randomized comparison of next-generation sequencing and array comparative genomic hybridization for preimplantation genetic screening: a pilot study.

PubMed

Yang, Zhihong; Lin, James; Zhang, John; Fong, Wai Ieng; Li, Pei; Zhao, Rong; Liu, Xiaohong; Podevin, William; Kuang, Yanping; Liu, Jiaen

2015-06-23

Recent advances in next-generation sequencing (NGS) have provided new methods for preimplantation genetic screening (PGS) of human embryos from in vitro fertilization (IVF) cycles. However, there is still limited information about clinical applications of NGS in IVF and PGS (IVF-PGS) treatments. The present study aimed to investigate the effects of NGS screening on clinical pregnancy and implantation outcomes for PGS patients in comparison to array comparative genomic hybridization (aCGH) screening. This study was performed in two phases. Phase I study evaluated the accuracy of NGS for aneuploidy screening in comparison to aCGH. Whole-genome amplification (WGA) products (n = 164) derived from previous IVF-PGS cycles (n = 38) were retrospectively analyzed with NGS. The NGS results were then compared with those of aCGH. Phase II study further compared clinical pregnancy and implantation outcomes between NGS and aCGH for IVF-PGS patients. A total of 172 patients at mean age 35.2 ± 3.5 years were randomized into two groups: 1) NGS (Group A): patients (n = 86) had embryos screened with NGS and 2) aCGH (Group B): patients (n = 86) had embryos screened with aCGH. For both groups, blastocysts were vitrified after trophectoderm biopsy. One to two euploid blastocysts were thawed and transferred to individual patients primarily based on the PGS results. Ongoing pregnancy and implantation rates were compared between the two study groups. NGS detected all types of aneuploidies of human blastocysts accurately and provided a 100 % 24-chromosome diagnosis consistency with the highly validated aCGH method. Moreover, NGS screening identified euploid blastocysts for transfer and resulted in similarly high ongoing pregnancy rates for PGS patients compared to aCGH screening (74.7 % vs. 69.2 %, respectively, p >0.05). The observed implantation rates were also comparable between the NGS and aCGH groups (70.5 % vs. 66.2 %, respectively, p >0.05). While NGS screening has been recently introduced to assist IVF patients, this is the first randomized clinical study on the efficiency of NGS for preimplantation genetic screening in comparison to aCGH. With the observed high accuracy of 24-chromosome diagnosis and the resulting high ongoing pregnancy and implantation rates, NGS has demonstrated an efficient, robust high-throughput technology for PGS.

Effects of peer social interaction on performance during computerized cognitive remediation therapy in patients with early course schizophrenia: A pilot study.

PubMed

Sandoval, Luis R; González, Betzamel López; Stone, William S; Guimond, Synthia; Rivas, Cristina Torres; Sheynberg, David; Kuo, Susan S; Eack, Shaun; Keshavan, Matcheri S

2017-09-04

Recent studies show that computer-based training enhances cognition in schizophrenia; furthermore, socialization has also been found to improve cognitive functions. It is generally believed that non-social cognitive remediation using computer exercises would be a pre-requisite for therapeutic benefits from social cognitive training. However, it is also possible that social interaction by itself enhances non-social cognitive functions; this possibility has scarcely been explored in schizophrenia patients. This pilot study examined the effects of computer-based neurocognitive training, along with social interaction either with a peer (PSI) or without one (N-PSI). We hypothesized that PSI will enhance cognitive performance during computerized exercises in schizophrenia, as compared with N-PSI. Sixteen adult participants diagnosed with schizophrenia or schizoaffective disorder participating in an ongoing trial of Cognitive Enhancement Therapy completed several computerized neurocognitive remediation training sessions (the Orientation Remedial Module©, or ORM), either with a peer or without a peer. We observed a significant interaction between the effect of PSI and performance on the different cognitive exercises (p<0.05). More precisely, when patients performed the session with PSI, they demonstrated better cognitive performances than with N-PSI in the ORM exercise that provides training in processing speed, alertness, and reaction time (the standard Attention Reaction Conditioner, or ARC) (p<0.01, corrected). PSI did not significantly affect other cognitive domains such as target detection and spatial attention. Our findings suggest that PSI could improve cognitive performance, such as processing speed, during computerized cognitive training in schizophrenia. Additional studies investigating the effect of PSI during cognitive remediation are needed to further evaluate this hypothesis. Copyright © 2017. Published by Elsevier B.V.

Proton Beam Therapy as a Nonsurgical Approach to Mucosal Melanoma of the Head and Neck: A Pilot Study

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

Zenda, Sadamoto, E-mail: szenda@east.ncc.go.jp; Kawashima, Mitsuhiko; Nishio, Teiji

2011-09-01

Purpose: The aim of this pilot study was to assess the clinical benefit of proton beam therapy for mucosal melanoma of the head and neck. Methods and Materials: Patients with mucosal melanoma of the head and neck with histologically confirmed malignant melanoma and N0 and M0 disease were enrolled. Proton therapy was delivered three times per week with a planned total dose of 60 Gy equivalents (GyE) in 15 fractions. Results: Fourteen consecutive patients were enrolled from January 2004 through February 2008. Patient characteristics were as follows: median age 73 years old (range, 56 to 79 years); male/female ratio, 7/7;more » and T stage 1/2/3/4, 3/2/0/9. All patients were able to receive the full dose of proton therapy. The most common acute toxicities were mucositis (grade 3, 21%) and mild dermatitis (grade 3, 0%). As for late toxicity, 2 patients had a unilateral decrease in visual acuity, although blindness did not occur. No treatment-related deaths occurred throughout the study. Initial local control rate was 85.7%, and, with a median follow-up period of 36.7 months, median progression-free survival was 25.1 months, and 3-year overall survival rates were 58.0%. The most frequent site of first failure was cervical lymph nodes (6 patients), followed by local failure in 1 patient and lung metastases in 1 patient. On follow-up, 5 patients died of disease, 4 died due to cachexia caused by distant metastases, and 1 patient by carotid artery perforation cause by lymph nodes metastases. Conclusions: Proton beam radiotherapy showed promising local control benefits and would benefit from ongoing clinical study.« less

Pilot Field Test of Electrokinetically-Delivered and Thermally Activated Persulfate (EKTAP) for Remediation of Chlorinated Solvents in Clay

NASA Astrophysics Data System (ADS)

O'Carrol, D. M.; Head, N.; Chowdhury, A. I.; Inglis, A.; Garcia, A. N.; Reynolds, D. A.; Hayman, J.; Hogberg, D.; Austrins, L. M.; Sidebottom, A.; Auger, M.; Eimers, J.; Gerhard, J.

2017-12-01

Remediation of low-permeability soils that are contaminated with chlorinated solvents is challenging. In-situ chemical oxidation (ISCO) with persulfate is promising, however, the delivery of the oxidant by hydraulic gradient is limited in low-permeability soils. Electrokinetic (EK) enhanced transport of amendments has shown the potential to overcome these limitations. In particular, the combined technology of EK-delivered and thermally activated persulfate (EKTAP) has been recently demonstrated in the laboratory as promising in these challenging environments (Chowdhury A. I. (2016) Hydraulic and Electrokinetic Delivery of Remediants for In-situ Remediation. Electronic Thesis and Dissertation Repository, Paper 4135). This study presents the first pilot field test to evaluate EKTAP to enhance the distribution and effectiveness of persulfate in clayey soil. The pilot field test was conducted at a contaminated site formerly occupied by a chlorinated solvent production facility. In the EK transport phase, 925 L of 40 g/L persulfate was injected over 57 days, during which 9A of direct current (DC) was applied between two electrodes spaced 3 m apart. In the subsequent heating phase, 10A of alternate current (AC) was applied across the same electrodes for an additional 70 days. Extensive sampling of soil and groundwater in this EKTAP cell were compared to those from two parallel control cells, one with EK only and one with no electrodes. Results indicated that EK can significantly increase transport rates of persulfate in clayey soil. Persulfate activation primarily occurred in the period of DC application, indicating that the natural reduction capacity of the clay soil had a significant impact on persulfate decomposition. Temperature mapping indicated that AC current was able to increase soil temperatures, validating the EKTAP concept. Degradation of chlorinated compounds, in particular, 1-2, dichloroethane (1,2- DCA), was observed to be substantial in areas of persulfate delivery. Studies are ongoing to evaluate the mineral oxidation of the persulfate and how to optimize the system for both EK and ERH applications. This study nevertheless demonstrates for the first time at the field scale that EKTAP can result in enhanced amendment transport and remediation of low permeability strata.

A pilot study of yoga as self-care for arthritis in minority communities

PubMed Central

2013-01-01

Background While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis. Methods/design In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months. Discussion There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis. Trial registration ClinicalTrials.gov: NCT01617421 PMID:23548052

A pilot study of yoga as self-care for arthritis in minority communities.

PubMed

Middleton, Kimberly R; Ward, Michael M; Haaz, Steffany; Velummylum, Sinthujah; Fike, Alice; Acevedo, Ana T; Tataw-Ayuketah, Gladys; Dietz, Laura; Mittleman, Barbara B; Wallen, Gwenyth R

2013-04-02

While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis. In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months. There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis. ClinicalTrials.gov: NCT01617421.

Joint Applications Pilot of the National Climate Predictions and Projections Platform and the North Central Climate Science Center: Delivering climate projections on regional scales to support adaptation planning

NASA Astrophysics Data System (ADS)

Ray, A. J.; Ojima, D. S.; Morisette, J. T.

2012-12-01

The DOI North Central Climate Science Center (NC CSC) and the NOAA/NCAR National Climate Predictions and Projections (NCPP) Platform and have initiated a joint pilot study to collaboratively explore the "best available climate information" to support key land management questions and how to provide this information. NCPP's mission is to support state of the art approaches to develop and deliver comprehensive regional climate information and facilitate its use in decision making and adaptation planning. This presentation will describe the evolving joint pilot as a tangible, real-world demonstration of linkages between climate science, ecosystem science and resource management. Our joint pilot is developing a deliberate, ongoing interaction to prototype how NCPP will work with CSCs to develop and deliver needed climate information products, including translational information to support climate data understanding and use. This pilot also will build capacity in the North Central CSC by working with NCPP to use climate information used as input to ecological modeling. We will discuss lessons to date on developing and delivering needed climate information products based on this strategic partnership. Four projects have been funded to collaborate to incorporate climate information as part of an ecological modeling project, which in turn will address key DOI stakeholder priorities in the region: Riparian Corridors: Projecting climate change effects on cottonwood and willow seed dispersal phenology, flood timing, and seedling recruitment in western riparian forests. Sage Grouse & Habitats: Integrating climate and biological data into land management decision models to assess species and habitat vulnerability Grasslands & Forests: Projecting future effects of land management, natural disturbance, and CO2 on woody encroachment in the Northern Great Plains The value of climate information: Supporting management decisions in the Plains and Prairie Potholes LCC. NCCSC's role in these projects is to provide the connections between climate data and running ecological models, and prototype these for future work. NCPP will develop capacities to provide enhanced climate information at relevant spatial and temporal scales, both for historical climate and projections of future climate, and will work to link expert guidance and understanding of modeling processes and evaluation of modeling with the use of numerical climate data. Translational information thus is a suite of information that aids in translation of numerical climate information into usable knowledge for applications, e.g. ecological response models, hydrologic risk studies. This information includes technical and scientific aspects including, but not limited to: 1) results of objective, quantitative evaluation of climate models & downscaling techniques, 2) guidance on appropriate uses and interpretation, i.e., understanding the advantages and limitations of various downscaling techniques for specific user applications, 3) characterizing and interpreting uncertainty, 4) Descriptions meaningful to applications, e.g. narratives. NCPP believes that translational information is best co-developed between climate scientists and applications scientists, such as the NC-CSC pilot.

The effect of a perioperative ketamine infusion on the incidence of chronic postsurgical pain-a pilot study.

PubMed

Peyton, P J; Wu, C; Jacobson, T; Hogg, M; Zia, F; Leslie, K

2017-07-01

Chronic postsurgical pain (CPSP) is a common and debilitating complication of major surgery. We undertook a pilot study at three hospitals to assess the feasibility of a proposed large multicentre placebo-controlled randomised trial of intravenous perioperative ketamine to reduce the incidence of CPSP. Ketamine, 0.5 mg/kg pre-incision, 0.25 mg/kg/hour intraoperatively and 0.1 mg/kg/hour for 24 hours, or placebo, was administered to 80 patients, recruited over a 15-month period, undergoing abdominal or thoracic surgery under general anaesthesia. The primary endpoint was CPSP in the area of the surgery reported at six-month telephone follow-up using a structured questionnaire. Fourteen patients (17.5%) reported CPSP (relative risk [95% confidence interval] if received ketamine 1.18 [0.70 to 1.98], P =0.56). Four patients in the treatment group and three in the control group reported ongoing analgesic use to treat CPSP and two patients in each group reported their worst pain in the previous 24 hours at ≥3/10 at six months. There were no significant differences in adverse event rates, quality of recovery scores, or cumulative morphine equivalents consumption in the first 72 hours. Numeric Rating Scale pain scores (median [interquartile range, IQR]) for average pain in the previous 24 hours among those patients reporting CPSP were 17.5 [0 to 40] /100 with no difference between treatment groups. A large (n=4,000 to 5,000) adequately powered multicentre trial is feasible using this population and methodology.

Lessons from the pilot of a mobile application to map assistive technology suppliers in Africa.

PubMed

Visagie, Surona J; Matter, Rebecca; Kayange, George M; Chiwaula, Mussa; Harniss, Mark; Mji, Gubela; Scheffler, Elsje

2018-01-01

A pilot project to develop and implement a mobile smartphone application (App) that tracks and maps assistive technology (AT) availability in southern Africa was launched in Botswana in 2016. The App was developed and tested through an iterative process. The concept of the App (AT-Info-Map) was well received by most stakeholders within the pilot country, and broader networks. Several technical and logistical obstacles were encountered. These included high data costs; difficulty in accessing AT information from the public healthcare sector, the largest supplier of AT; and the high human resource demand of collecting and keeping up-to-date device-level information within a complex and fragmented supply sector that spans private, public and civil society entities. The challenges were dealt with by keeping the data burden low and eliminating product-level tracking. The App design was expanded to include disability services, contextually specific AT categories and make navigation more intuitive. Long-term sustainability strategies like generating funding through advertisements on the App or supplier usage fees must be explored. Outreach and sensitisation programmes about both the App and AT in general must be intensified. The project team must continually strengthen partnerships with private and public stakeholders to ensure ongoing project engagement. The lessons learnt might be of value to others who wish to embark on initiatives in AT and/or implement Apps in health or disability in southern Africa and in low-resourced settings around the world.

Chile rural electrification cooperation

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

Flowers, L.

1997-12-01

The author describes a joint program to use renewables for rural electrification projects in Chile. The initial focus was in a limited part of the country, involving wind mapping, pilot project planning, training, and development of methodologies for comparative evaluations of resources. To this point three wind hybrid systems have been installed in one region, as a part of the regional private utility, and three additional projects are being designed. Additional resource assessment and training is ongoing. The author points out the difficulties in working with utilities, the importance of signed documentation, and the need to look at these programsmore » as long term because of the time involved in introducing such new technologies.« less

Carbon dioxide (CO2) sequestration in deep saline aquifers and formations: Chapter 3

USGS Publications Warehouse

Rosenbauer, Robert J.; Thomas, Burt

2010-01-01

Carbon dioxide (CO2) capture and sequestration in geologic media is one among many emerging strategies to reduce atmospheric emissions of anthropogenic CO2. This chapter looks at the potential of deep saline aquifers – based on their capacity and close proximity to large point sources of CO2 – as repositories for the geologic sequestration of CO2. The petrochemical characteristics which impact on the suitability of saline aquifers for CO2 sequestration and the role of coupled geochemical transport models and numerical tools in evaluating site feasibility are also examined. The full-scale commercial CO2 sequestration project at Sleipner is described together with ongoing pilot and demonstration projects.

Achieving TASAR Operational Readiness

NASA Technical Reports Server (NTRS)

Wing, David J.

2015-01-01

NASA has been developing and testing the Traffic Aware Strategic Aircrew Requests (TASAR) concept for aircraft operations featuring a NASA-developed cockpit automation tool, the Traffic Aware Planner (TAP), which computes traffic/hazard-compatible route changes to improve flight efficiency. The TAP technology is anticipated to save fuel and flight time and thereby provide immediate and pervasive benefits to the aircraft operator, as well as improving flight schedule compliance, passenger comfort, and pilot and controller workload. Previous work has indicated the potential for significant benefits for TASAR-equipped aircraft, and a flight trial of the TAP software application in the National Airspace System has demonstrated its technical viability. This paper reviews previous and ongoing activities to prepare TASAR for operational use.

Diabetes ongoing sustainable care and treatment (DOST): A strategy for informational deliverance through visual dynamic modules sustained by near peer mentoring.

PubMed

Joshi, Ankur; Arutagi, Vishwanath; Nahar, Nitin; Tiwari, Sharad; Singh, Daneshwar; Sethia, Soumitra

2016-01-01

The informational continuity for a diabetic patient is of paramount importance. This study on a pilot basis explores the process utility of structured educational modular sessions grounded on the principle of near-peer mentoring. Visual modules were prepared for diabetic patients. These modules were instituted to 25 diabetic patients in logical sequences. In the next phase, 4 persons of these 25 patients were designated as diabetic-diabetes ongoing sustainable care and treatment (DOST). Each diabetic-DOST was clubbed with two patients for modular session and informational deliverance during the next 7 days. Process analysis was performed with "proxy-indicators," namely, monthly glycemic status, knowledge assessment scores, and quality of life. Data were analyzed by interval estimates and through nonparametric analysis. Nonparametric analysis indicated a significant improvement in glycemic status in terms with fasting blood sugar (W = 78 z = 3.04, P = 0.002), 2 h-postprandial blood sugar (W = 54, z = 2.01, P = 0.035), and in knowledge score (χ 2 = 19.53, df = 3; P = 0.0002). Quality of life score showed significant improvement in 2 out of 7 domains, namely, satisfaction with treatment ([difference in mean score = 1.40 [1.94 to 0.85]) and symptom botherness (difference in mean score = 0.98 [1.3-0.65]). Because of inherent methodological limitations and innate biases, at this juncture no conclusive statement can be drawn. Although, primitive process evidences indicate the promising role of the diabetic-DOST strategy.

Pavlovian-to-instrumental transfer in alcohol dependence: a pilot study.

PubMed

Garbusow, Maria; Schad, Daniel J; Sommer, Christian; Jünger, Elisabeth; Sebold, Miriam; Friedel, Eva; Wendt, Jean; Kathmann, Norbert; Schlagenhauf, Florian; Zimmermann, Ulrich S; Heinz, Andreas; Huys, Quentin J M; Rapp, Michael A

2014-01-01

Pavlovian processes are thought to play an important role in the development, maintenance and relapse of alcohol dependence, possibly by influencing and usurping ongoing thought and behavior. The influence of pavlovian stimuli on ongoing behavior is paradigmatically measured by pavlovian-to-instrumental transfer (PIT) tasks. These involve multiple stages and are complex. Whether increased PIT is involved in human alcohol dependence is uncertain. We therefore aimed to establish and validate a modified PIT paradigm that would be robust, consistent and tolerated by healthy controls as well as by patients suffering from alcohol dependence, and to explore whether alcohol dependence is associated with enhanced PIT. Thirty-two recently detoxified alcohol-dependent patients and 32 age- and gender-matched healthy controls performed a PIT task with instrumental go/no-go approach behaviors. The task involved both pavlovian stimuli associated with monetary rewards and losses, and images of drinks. Both patients and healthy controls showed a robust and temporally stable PIT effect. Strengths of PIT effects to drug-related and monetary conditioned stimuli were highly correlated. Patients more frequently showed a PIT effect, and the effect was stronger in response to aversively conditioned CSs (conditioned suppression), but there was no group difference in response to appetitive CSs. The implementation of PIT has favorably robust properties in chronic alcohol-dependent patients and in healthy controls. It shows internal consistency between monetary and drug-related cues. The findings support an association of alcohol dependence with an increased propensity towards PIT. © 2014 S. Karger AG, Basel.

Review of immunomodulation by photopheresis: treatment of cutaneous T-cell lymphoma, autoimmune disease, and allograft rejection.

PubMed

Wolfe, J T; Lessin, S R; Singh, A H; Rook, A H

1994-12-01

Photopheresis is an apheresis-based therapy that is currently available at approximately 70 medical centers worldwide. Recent evidence indicates that extracorporeal photopheresis can significantly prolong life as well as induce a 60-75% response rate among individuals with advanced cutaneous T-cell lymphoma (CTCL). Moreover, a 10-15% cure rate, in response to photopheresis alone, or in combination with interferon-alpha, has been obtained at our institution. These complete responses have been characterized by the complete disappearance of morphologically atypical cells from the skin and blood. Southern blot analysis of peripheral blood specimens has also confirmed the indefinite disappearance of the malignant T-cell clone from the blood of patients with complete responses. Current immunological data obtained from in vitro human studies and from animal models suggest that the basis for the responses of CTCL patients are related to activation of treated macrophages resulting in release of cytokines, including substantial levels of tumor necrosis factor alpha (TNF-alpha), and perhaps, to the induction of anticlonotypic immunity directed against pathogenic clones of T lymphocytes. In addition to the treatment of CTCL, a potential role for photopheresis in the therapy of autoimmune disease has been suggested by recent pilot studies of pemphigus vulgaris, rheumatoid arthritis, and systemic lupus erythematosus. Furthermore, a randomized, single-blinded trial involving 79 patients with early onset, aggressive systemic sclerosis suggested that photopheresis could benefically affect the course of the cutaneous thickening in this form of the disease. Lastly, two independent pilot studies of cardiac transplantation have indicated that photopheresis can reverse acute cardiac allograft rejection and potentially suppress ongoing chronic rejection. Randomized, controlled trials for these new indications for photopheresis therapy are currently in the early stages of implementation.

Science for watershed decisions on abandoned mine lands; review of preliminary results, Denver, Colorado, February 4-5, 1998

USGS Publications Warehouse

Nimick, David A.; Von Guerard, Paul

1998-01-01

From the Preface: There are thousands of abandoned or inactive mines on or adjacent to public lands administered by the U.S. Forest Service, Bureau of Land Management, and National Park Service. Mine wastes from many of these abandoned mines adversely affect resources on public lands. In 1995, an interdepartmental work group within the Federal government developed a strategy to address remediation of the many abandoned mines on public lands. This strategy is based on using a watershed approach to address the abandoned mine lands (AML) problem. The USGS, working closely with the Federal land-management agencies (FLMAs), is key for the success of this watershed approach. In support of this watershed approach, the USGS developed an AML Initiative with pilot studies in the Boulder River in Montana and the Animas River in Colorado. The goal of these studies is to design and implement a reliable strategy that will supply the scientific information to the FLMAs so that land managers can develop efficient and cost-effective remediation of AML. The symposium 'Science for Watershed Decisions on Abandoned Mine Lands: Review of Preliminary Results' held in Denver, Colorado, on February 4-5, 1998, provided the FLMAs a first look at the techniques, data, and interpretations being generated by the USGS pilot studies. This multidisciplined effort already is proving very valuable to land managers in making science-based AML cleanup decisions and will continue to be of increasing value as additional and more complete information is obtained. Ongoing interaction between scientists and land managers is essential to insure the efficient continuation and success of AML cleanup efforts.

A tutorial on pilot studies: the what, why and how

PubMed Central

2010-01-01

Pilot studies for phase III trials - which are comparative randomized trials designed to provide preliminary evidence on the clinical efficacy of a drug or intervention - are routinely performed in many clinical areas. Also commonly know as "feasibility" or "vanguard" studies, they are designed to assess the safety of treatment or interventions; to assess recruitment potential; to assess the feasibility of international collaboration or coordination for multicentre trials; to increase clinical experience with the study medication or intervention for the phase III trials. They are the best way to assess feasibility of a large, expensive full-scale study, and in fact are an almost essential pre-requisite. Conducting a pilot prior to the main study can enhance the likelihood of success of the main study and potentially help to avoid doomed main studies. The objective of this paper is to provide a detailed examination of the key aspects of pilot studies for phase III trials including: 1) the general reasons for conducting a pilot study; 2) the relationships between pilot studies, proof-of-concept studies, and adaptive designs; 3) the challenges of and misconceptions about pilot studies; 4) the criteria for evaluating the success of a pilot study; 5) frequently asked questions about pilot studies; 7) some ethical aspects related to pilot studies; and 8) some suggestions on how to report the results of pilot investigations using the CONSORT format. PMID:20053272

Artificial intelligence and its impact on combat aircraft

NASA Technical Reports Server (NTRS)

Ott, Lawrence M.; Abbot, Kathy; Kleider, Alfred; Moon, D.; Retelle, John

1987-01-01

As the threat becomes more sophisticated and weapon systems more complex to meet the threat, the need for machines to assist the pilot in the assessment of information becomes paramount. This is particularly true in real-time, high stress situations. The advent of artificial intelligence (AI) technology offers the opportunity to make quantum advances in the application of machine technology. However, if AI systems are to find their way into combat aircraft, they must meet certain criteria. The systems must be responsive, reliable, easy to use, flexible, and understandable. These criteria are compared with the current status used in a combat airborne application. Current AI systems deal with nonreal time applications and require significant user interaction. On the other hand, aircraft applications require real time, minimum human interaction systems. In order to fill the gap between where technology is now and where it must be for aircraft applications, considerable government research is ongoing in NASA, DARPA, and three services. The ongoing research is briefly summarized. Finally, recognizing that AI technology is in its embryonic stage, and the aircraft needs are very demanding, a number of issues arise. These issues are delineated and findings are provided where appropriate.

Simulation in interprofessional education for patient-centred collaborative care.

PubMed

Baker, Cynthia; Pulling, Cheryl; McGraw, Robert; Dagnone, Jeffrey Damon; Hopkins-Rosseel, Diana; Medves, Jennifer

2008-11-01

This paper is a report of preliminary evaluations of an interprofessional education through simulation project by focusing on learner and teacher reactions to the pilot modules. Approaches to interprofessional education vary widely. Studies indicate, however, that active, experiential learning facilitate it. Patient simulators require learners to incorporate knowing, being and doing in action. A theoretically based competency framework was developed to guide interprofessional education using simulation. The framework includes a typology of shared, complementary and profession-specific competencies. Each competency type is associated with an intraprofessional, multiprofessional, or interprofessional teaching modality and with the professional composition of learner groups. The project is guided by an action research approach in which ongoing evaluation generates knowledge to modify and further develop it. Preliminary evaluations of the first pilot module, cardiac resuscitation rounds, among 101 nursing students, 42 medical students and 70 junior medical residents were conducted in 2005-2007 using a questionnaire with rating scales and open-ended questions. Another 20 medical students, 7 junior residents and 45 nursing students completed a questionnaire based on the Interdisciplinary Education Perception scale. Simulation-based learning provided students with interprofessional activities they saw as relevant for their future as practitioners. They embraced both the interprofessional and simulation components enthusiastically. Attitudinal scores and responses were consistently positive among both medical and nursing students. Interprofessional education through simulation offers a promising approach to preparing future healthcare professionals for the collaborative models of healthcare delivery being developed internationally.

Integrated design and manufacturing for the high speed civil transport

NASA Technical Reports Server (NTRS)

Lee, Jae Moon; Gupta, Anurag; Mueller, Craig; Morrisette, Monica; Dec, John; Brewer, Jason; Donofrio, Kevin; Sturisky, Hilton; Smick, Doug; An, Meng Lin

1994-01-01

In June 1992, the School of Aerospace Engineering at Georgia Tech was awarded a three year NASA University Space Research Association (USRA) Advanced Design Program (ADP) grant to address issues associated with the Integrated Design and Manufacturing of High Speed Civil Transport (HSCT) configurations in its graduate Aerospace Systems Design courses. This report provides an overview of the on-going Georgia Tech initiative to address these design/manufacturing issues during the preliminary design phases of an HSCT concept. The new design methodology presented here has been incorporated in the graduate aerospace design curriculum and is based on the concept of Integrated Product and Process Development (IPPD). The selection of the HSCT as a pilot project was motivated by its potential global transportation payoffs; its technological, environmental, and economic challenges; and its impact on U.S. global competitiveness. This pilot project was the focus of each of the five design courses that form the graduate level aerospace systems design curriculum. This year's main objective was the development of a systematic approach to preliminary design and optimization and its implementation to an HSCT wing/propulsion configuration. The new methodology, based on the Taguchi Parameter Design Optimization Method (PDOM), was established and was used to carry out a parametric study where various feasible alternative configurations were evaluated. The comparison criterion selected for this evaluation was the economic impact of this aircraft, measured in terms of average yield per revenue passenger mile ($/RPM).

Beyond the cockpit: The visual world as a flight instrument

NASA Technical Reports Server (NTRS)

Johnson, W. W.; Kaiser, M. K.; Foyle, D. C.

1992-01-01

The use of cockpit instruments to guide flight control is not always an option (e.g., low level rotorcraft flight). Under such circumstances the pilot must use out-the-window information for control and navigation. Thus it is important to determine the basis of visually guided flight for several reasons: (1) to guide the design and construction of the visual displays used in training simulators; (2) to allow modeling of visibility restrictions brought about by weather, cockpit constraints, or distortions introduced by sensor systems; and (3) to aid in the development of displays that augment the cockpit window scene and are compatible with the pilot's visual extraction of information from the visual scene. The authors are actively pursuing these questions. We have on-going studies using both low-cost, lower fidelity flight simulators, and state-of-the-art helicopter simulation research facilities. Research results will be presented on: (1) the important visual scene information used in altitude and speed control; (2) the utility of monocular, stereo, and hyperstereo cues for the control of flight; (3) perceptual effects due to the differences between normal unaided daylight vision, and that made available by various night vision devices (e.g., light intensifying goggles and infra-red sensor displays); and (4) the utility of advanced contact displays in which instrument information is made part of the visual scene, as on a 'scene linked' head-up display (e.g., displaying altimeter information on a virtual billboard located on the ground).

An inverse-modelling approach for frequency response correction of capacitive humidity sensors in ABL research with small remotely piloted aircraft (RPA)

NASA Astrophysics Data System (ADS)

Wildmann, N.; Kaufmann, F.; Bange, J.

2014-09-01

The measurement of water vapour concentration in the atmosphere is an ongoing challenge in environmental research. Satisfactory solutions exist for ground-based meteorological stations and measurements of mean values. However, carrying out advanced research of thermodynamic processes aloft as well, above the surface layer and especially in the atmospheric boundary layer (ABL), requires the resolution of small-scale turbulence. Sophisticated optical instruments are used in airborne meteorology with manned aircraft to achieve the necessary fast-response measurements of the order of 10 Hz (e.g. LiCor 7500). Since these instruments are too large and heavy for the application on small remotely piloted aircraft (RPA), a method is presented in this study that enhances small capacitive humidity sensors to be able to resolve turbulent eddies of the order of 10 m. The sensor examined here is a polymer-based sensor of the type P14-Rapid, by the Swiss company Innovative Sensor Technologies (IST) AG, with a surface area of less than 10 mm2 and a negligible weight. A physical and dynamical model of this sensor is described and then inverted in order to restore original water vapour fluctuations from sensor measurements. Examples of flight measurements show how the method can be used to correct vertical profiles and resolve turbulence spectra up to about 3 Hz. At an airspeed of 25 m s-1 this corresponds to a spatial resolution of less than 10 m.

Outcomes of a community-based HIV-prevention pilot programme for township men who have sex with men in Cape Town, South Africa.

PubMed

Batist, Elizabeth; Brown, Benjamin; Scheibe, Andrew; Baral, Stefan D; Bekker, Linda-Gail

2013-12-02

Men who have sex with men (MSM) in Cape Town's townships remain in need of targeted HIV-prevention services. In 2012, a pilot community-based HIV-prevention programme was implemented that aimed to reach MSM in five Cape Town townships, disseminate HIV-prevention information and supplies, and promote the use of condoms and HIV services. Convenience sampling was used to recruit self-identified MSM who were 18 years old or older in five Cape Town townships. The six-month pilot programme trained five community leaders who, along with staff, provided HIV-prevention information and supplies to MSM through small-group meetings, community-based social activities and inter-community events. After the completion of the pilot programme, in-depth interviews and focus group discussions (FGDs) were conducted with a subset of conveniently sampled participants and with each of the community leaders. Qualitative data were then analyzed thematically. Overall, 98 mostly gay-identified black MSM consented to participate, 57 community-based activities were facilitated and 9 inter-community events were conducted. Following their enrollment, 60% (59/98) of participants attended at least one pilot activity. Of those participants, 47% (28/59) attended at least half of the scheduled activities. A total of 36 participants took part in FGDs, and five in-depth interviews were completed with community leaders. Participants reported gaining access to MSM-specific HIV-prevention information, condoms and water-based lubricant through the small-group meetings. Some participants described how their feelings of loneliness, social isolation, self-esteem and self-efficacy were improved after taking part. The social activities and group meetings were viable strategies for disseminating HIV-prevention information, condoms and water-based lubricant to MSM in this setting. Many MSM were also able to receive social support, reduce social isolation and improve their self-esteem. Further research is needed to explore factors affecting attendance and the sustainability of these activities. Perspectives of MSM who did not attend pilot activities regularly were not equally represented in the final qualitative interviews, which could bias the findings. The use of community-based activities and small-group meetings should be explored further as components to ongoing HIV-prevention interventions for MSM in this setting.

ïSCOPE: Safer care for older persons (in residential) environments: A study protocol

PubMed Central

2011-01-01

Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012) proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility) are led by healthcare aides (non-regulated caregivers) and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement initiatives in the long-term care sector. PMID:21745382

Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care

PubMed Central

2014-01-01

Background Physical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care. Methods This study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care. Discussion Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence-base, that is, the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes. The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents, to the best of our knowledge, the first of its kind in the United Kingdom. This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care. Trial registration Movement as Medicine for Type 2 Diabetes (MaMT2D) was registered with Current Controlled Trials on the 14th January 2012: ISRCTN67997502. The first primary care practice was randomised on the 5th October 2012. PMID:24491134

An earned presence: studying the effect of multi-task improvisation systems on cognitive and learning capacity

NASA Astrophysics Data System (ADS)

Hansen, Pil; Oxoby, Robert J.

2017-01-01

In this article, we articulate preliminary insights from two pilot studies. These studies contribute to an ongoing process of developing empirical, cross-disciplinary measures to understand the cognitive and learning effects of complex artistic practices - effects that we situate between theory of embodied concepts and conceptually calibrated physical attention and action. The stage of this process that we report on here was led by the cognitive performance studies scholar and dramaturge, Pil Hansen, and undertaken in collaboration with the experimental psychologist, Vina Goghari, and the behavioural economist, Robert Oxoby, assisted by four research assistants from Drama, Music, and Psychology at the University of Calgary. Our team set out to test the following hypothesis: Active participation in performance generating systems has a positive effect on advanced student performers' working memory capacity, executive functions, and learning. Our results have implications, in particular, for understandings of embodied learning in the educational sector, however a perhaps more significant contribution is a better understanding of the measures and constructs needed to arrive at a more complex, yet operational concept of embodied learning and forward the experimental study of relationships between performing arts practices, cognition, and learning.

Bacteriologic monitoring of multidrug-resistant tuberculosis patients in five DOTS-Plus pilot projects.

PubMed

Gammino, V M; Taylor, A B; Rich, M L; Bayona, J; Becerra, M C; Bonilla, C; Gelmanova, I; Hollo, V; Jaramillo, E; Keshavjee, S; Leimane, V; Mitnick, C D; Quelapio, M I D; Riektsina, V; Tupasi, T E; Wells, C D; Zignol, M; Cegielski, P J

2011-10-01

Multidrug-resistant tuberculosis programs in DOTS-Plus pilot sites in five countries. To calculate sputum conversion time and its relationship to treatment outcome, document the frequency of culture reversions and examine concordance of smear and culture to assess the potential consequences of monitoring by smear microscopy alone. Retrospective cohort analysis of 1926 patients receiving individualized, second-line therapy. Among 1385 sputum culture-positive cases at baseline, 1146 (83%) experienced at least one culture conversion during treatment. Conversion, however, was not sustained in all patients: 201 (15%) experienced initial culture conversion and at least one subsequent culture reversion to positive; 1064 (77%) achieved sustained culture conversion. Median time to culture conversion was 3 months. Among 206 patients whose nal conversion occurred 7-18 months after the initiation of therapy, 71% were cured or had completed treatment. Prolonged treatment for patients with delayed conversion may be beneficial, as 71% of late converters still achieved cure or completed treatment. This has implications for programs with de ned end points for treatment failure. The interval between rst and nal conversion among patients whose initial con- version is not sustained raises concern with respect to the ongoing debate regarding duration of treatment and the definition of cure.

Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success.

PubMed

Wray, Jane; Archibong, Uduak; Walton, Sean

2017-01-23

Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers' competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers' confidence and competence, and contributes to the understanding of research. Implications for practice Pilots can be used effectively in qualitative studies to refine the final design, and provide the researcher with practical experience to enhance confidence and competence.

The use of reflective diaries in end of life training programmes: a study exploring the impact of self-reflection on the participants in a volunteer training programme.

PubMed

Germain, Alison; Nolan, Kate; Doyle, Rita; Mason, Stephen; Gambles, Maureen; Chen, Hong; Smeding, Ruthmarijke; Ellershaw, John

2016-03-05

A training programme was developed and delivered to a cohort of volunteers who were preparing for a unique role to provide companionship to dying patients in the acute hospital setting. This comprehensive programme aimed to provide an opportunity for participants to fully understand the nature and responsibilities of the role, whilst also allowing sufficient time to assess the qualities and competencies of participants for their ongoing volunteering role. Participants completed reflective diaries throughout the training course to record their ongoing thoughts and feelings. The purpose of this paper is to present a phenomenological analysis of these entries to understand participants' experiences, perceptions and motivations. The wider study was structured into three phases. Phase 1 was the delivery of a 12 week, bespoke training programme; Phase 2 involved a 26 week pilot implementation of the Care of the Dying Volunteer Service and Phase 3 was the research evaluation of the training and implementation which would inform the further development of the training programme. Self-reflection is a common component of End of Life training programmes and volunteers in this study completed a reflective diary after participation in each of the training sessions. A thematic analysis was undertaken to explore and understand the participants' experience, perceptions and motivations in relation to their participation in the training. All 19 volunteers completed the reflective diaries. From a potential 228 diary entries over the 12 week training programme, 178 diary entries were submitted (78 %). The following key themes were identified: Dying Alone and the importance of being present, Personal loss and the reconstruction of meaning, Self-Awareness and Personal growth, Self-preservation and Coping strategies and group unity/cohesion. The participants in this study demonstrated that they were able to use the diaries as an appropriate medium for reflection. Their reflections were also instrumental in the ongoing revision and development of the training programme. Analysis of their entries illustrated that the diaries could provide the opportunity for a reappraisal of their world view and personal philosophy around death and dying. Further research is undoubtedly required, however this paper suggests that self-reflection in this way, supports preparation in honing the appropriate attitudes and qualities required to work in this role.

MELATONIN - WORKING IN COLLABERATION WITH THE CCG TO REDUCE COSTS.

PubMed

Haley, Helen

2016-09-01

To reduce the overall expenditure on melatonin for the local health economy by working collaboratively with the CCG's. To ensure that all paediatric patients prescribed melatonin have been clinically assessed by a specialist and the most appropriate formulation is dispensed. Evaluation of GP melatonin prescribing cost across CCG using ePACT data and extrapolation of equivalent cost of prescribing and dispensing within secondary care. This initial data was then refined to exclude patients 16 years and over on unlicensed formulations of melatonin and all patients on licensed formulations. This was used to estimate the net potential saving achieved by repatriating the prescribing of melatonin for children for the local CCG's. A six month pilot was initiated to establish if the predicted savings translated into reality for the local health economy. It was estimated that approximately 100 patients under 16 years were prescribed melatonin by GP's in the local CCG's, 60 of these patients were on unlicensed formulations hence eligible for the pilot. To date we have received 42 referrals from GP's to review the prescribing of melatonin unlicensed formulations. 32 patients had been initiated melatonin by the child development team or paediatric specialist 16 (50%) of whom were currently under the care of the team and being reviewed every six months. 10 of the referrals were for patients under the care of CAMHs who were happy to provide ongoing treatment to avoid duplicated appointments. From the remainder of the referrals 6 patients when contacted had advised that they were no longer using melatonin. The remaining 10 patients have an appointment to review treatment and if deemed appropriate provide ongoing prescriptions using formulations approved by pharmacy. There are still 18 patients prescribed melatonin by Gp's who have not been referred and the medicines management team are chasing. A review of ePACT data for the CCG at the end of the six month pilot compared with the recharge expenditure demonstrated that the predicted net cost of the repatriation was cost neutral for the CCG whilst delivering a predicted saving for the hospital of around £30,000 per annum. Additional savings for the CCG are anticipated once the remainder of the patients are repatriated. The initial assumption that all unlicensed melatonin prescribing within the local CCG's was for children with severe learning difficulties was unfounded with a number of GP's prescribing these formulations for adults. Consequently the initial projected savings were an overestimate as only paediatric patients would be repatriated as part of this proposal.The hospital expenditure on melatonin had also increased from the original projections due to increasing patient numbers with GP's unwilling to take on the ongoing prescribing. In addition the child development team had started to use Circadin off label for older patients ensuring cost containment for GP's when patients discharged from the child health team.Despite these barriers to success the overall impact of the repatriation process was cost neutral for the CCG. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

International developments in openEHR archetypes and templates.

PubMed

Leslie, Heather

Electronic Health Records (EHRs) are a complex knowledge domain. The ability to design EHRs to cope with the changing nature of health knowledge, and to be shareable, has been elusive. A recent pilot study1 tested the applicability of the CEN 13606 as an electronic health record standard. Using openEHR archetypes and tools2, 650 clinical content specifi cations (archetypes) were created (e.g. for blood pressure) and re-used across all clinical specialties and contexts. Groups of archetypes were aggregated in templates to support clinical information gathering or viewing (e.g. 80 separate archetypes make up the routine antenatal visit record). Over 60 templates were created for use in the emergency department, antenatal care and delivery of an infant, and paediatric hearing loss assessment. The primary goal is to define a logical clinical record architecture for the NHS but potentially, with archetypes as the keystone, shareable EHRs will also be attainable. Archetype and template development work is ongoing, with associated evaluation occurring in parallel.

Characterizing infantile hemangiomas with a near-infrared spectroscopic handheld wireless device

NASA Astrophysics Data System (ADS)

Fong, Christopher J.; Hoi, Jennifer W.; Kim, Hyun K.; Behr, Gerald; Geller, Lauren; Antonov, Nina; Flexman, Molly; Garzon, Maria; Hielscher, Andreas H.

2015-03-01

Infantile hemangiomas (IH) are common vascular growths that occur in 5-10% of neonates and have the potential to cause disfiguring and even life-threatening complications. Currently, no objective tool exist to monitor either progression or treatment of IH. To address this unmet clinical need, we have developed a handheld wireless device (HWD) that uses diffuse optical spectroscopy for the assessment of IH. The system employs 4 wavelengths (l=780nm, 805nm, 850nm, and 905nm) and 6 source-detector pairs with distances between 0.6 and 20 mm. Placed on the skin surface, backreflection data is obtained and a multispectral evolution algorithm is used to determine total hemoglobin concentration and tissue oxygen saturation. First results of an ongoing pilot study involving 13 patients (average enrollment age = 25 months) suggest that an increase in hypoxic stress over time can lead to the proliferation of IH. Involuting IH lesions showed an increase in tissue oxygen saturation as well as a decrease in total hemoglobin.

A Pilot Study to Test the Efficacy of Psychologically Based Physical Therapy Training for Treating Deployed U.S. Sailors and Marines with Musculoskeletal Injuries

DTIC Science & Technology

2015-10-01

questionnaires………………………………………………………………...8 Procedures for completing SOAP note………………………………………………………………………………………….8 Procedures for scanning consent...questionnaire and SOAP note data………………………………………….9 Procedures for collecting on-going treatment data………………………………………………………………….……9 Procedures for...accuracy of data collection; f. Completion of SOAP notes; g. Handling, storing and transferring research data; h. Reporting of adverse events; i

Tracing dynamics of relative volumetric soil moisture content using SAR data

NASA Astrophysics Data System (ADS)

Avetisyan, Daniela; Velizarova, Emiliya; Nedkov, Roumen

2017-09-01

Soil is a dominant factor of the terrestrial geosystems in the dry sub-humid zones, particularly through its effect on biomass production. Due to the climate changes and industrial development, soil resources in these zones are prone to degradation. Mitigation of the negative effects of land degradation requires in-depth knowledge of the ongoing in the geosystems processes and application of innovative end effective methods for their investigation. The recent study aims to evaluate the relative soil moisture content in various soil differences and to trace its dynamics during growing season. In order to achieve this aim, Relative Soil Moisture Index (RSMI) based on Synthetic Aperture Radar (SAR) data was calculated. The index estimates the relative variation of volumetric soil moisture content in a given time period and enables determination of its change in relative values. The generated results show very high level of correlation for the investigated pilot areas which testifies that the RSMI is applicable in different territories.

Inter-rater reliability of output measures for a posture matching assessment approach: a pilot study with food service workers.

PubMed

Cann, A P; Connolly, M; Ruuska, R; MacNeil, M; Birmingham, T B; Vandervoort, A A; Callaghan, J P

2008-04-01

Despite the ongoing health problem of repetitive strain injuries, there are few tools currently available for ergonomic applications evaluating cumulative loading that have well-documented evidence of reliability and validity. The purpose of this study was to determine the inter-rater reliability of a posture matching based analysis tool (3DMatch, University of Waterloo) for predicting cumulative and peak spinal loads. A total of 30 food service workers were each videotaped for a 1-h period while performing typical work activities and a single work task was randomly selected from each for analysis by two raters. Inter-rater reliability was determined using intraclass correlation coefficients (ICC) model 2,1 and standard errors of measurement for cumulative and peak spinal and shoulder loading variables across all subjects. Overall, 85.5% of variables had moderate to excellent inter-rater reliability, with ICCs ranging from 0.30-0.99 for all cumulative and peak loading variables. 3DMatch was found to be a reliable ergonomic tool when more than one rater is involved.

Scaling up ART adherence clubs in the public sector health system in the Western Cape, South Africa: a study of the institutionalisation of a pilot innovation.

PubMed

MacGregor, Hayley; McKenzie, Andrew; Jacobs, Tanya; Ullauri, Angelica

2018-04-25

In 2011, a decision was made to scale up a pilot innovation involving 'adherence clubs' as a form of differentiated care for HIV positive people in the public sector antiretroviral therapy programme in the Western Cape Province of South Africa. In 2016 we were involved in the qualitative aspect of an evaluation of the adherence club model, the overall objective of which was to assess the health outcomes for patients accessing clubs through epidemiological analysis, and to conduct a health systems analysis to evaluate how the model of care performed at scale. In this paper we adopt a complex adaptive systems lens to analyse planned organisational change through intervention in a state health system. We explore the challenges associated with taking to scale a pilot that began as a relatively simple innovation by a non-governmental organisation. Our analysis reveals how a programme initially representing a simple, unitary system in terms of management and clinical governance had evolved into a complex, differentiated care system. An innovation that was assessed as an excellent idea and received political backing, worked well whilst supported on a small scale. However, as scaling up progressed, challenges have emerged at the same time as support has waned. We identified a 'tipping point' at which the system was more likely to fail, as vulnerabilities magnified and the capacity for adaptation was exceeded. Yet the study also revealed the impressive capacity that a health system can have for catalysing novel approaches. We argue that innovation in largescale, complex programmes in health systems is a continuous process that requires ongoing support and attention to new innovation as challenges emerge. Rapid scaling up is also likely to require recourse to further resources, and a culture of iterative learning to address emerging challenges and mitigate complex system errors. These are necessary steps to the future success of adherence clubs as a cornerstone of differentiated care. Further research is needed to assess the equity and quality outcomes of a differentiated care model and to ensure the inclusive distribution of the benefits to all categories of people living with HIV.

The Effects of Longitudinal Control-System Dynamics on Pilot Opinion and Response Characteristics as Determined from Flight Tests and from Ground Simulator Studies

NASA Technical Reports Server (NTRS)

Sadoff, Melvin

1958-01-01

The results of a fixed-base simulator study of the effects of variable longitudinal control-system dynamics on pilot opinion are presented and compared with flight-test data. The control-system variables considered in this investigation included stick force per g, time constant, and dead-band, or stabilizer breakout force. In general, the fairly good correlation between flight and simulator results for two pilots demonstrates the validity of fixed-base simulator studies which are designed to complement and supplement flight studies and serve as a guide in control-system preliminary design. However, in the investigation of certain problem areas (e.g., sensitive control-system configurations associated with pilot- induced oscillations in flight), fixed-base simulator results did not predict the occurrence of an instability, although the pilots noted the system was extremely sensitive and unsatisfactory. If it is desired to predict pilot-induced-oscillation tendencies, tests in moving-base simulators may be required. It was found possible to represent the human pilot by a linear pilot analog for the tracking task assumed in the present study. The criterion used to adjust the pilot analog was the root-mean-square tracking error of one of the human pilots on the fixed-base simulator. Matching the tracking error of the pilot analog to that of the human pilot gave an approximation to the variation of human-pilot behavior over a range of control-system dynamics. Results of the pilot-analog study indicated that both for optimized control-system dynamics (for poor airplane dynamics) and for a region of good airplane dynamics, the pilot response characteristics are approximately the same.

76 FR 70152 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-10

...] Pilot Program for Early Feasibility Study Investigational Device Exemption Applications AGENCY: Food and... feasibility study investigational device exemption (IDE) applications. The pilot program will conform to the... Feasibility Medical Device Clinical Studies, Including Certain First in Human (FIH) Studies.'' Under the pilot...

The role of domain expertise and judgment in dealing with unexpected events

NASA Astrophysics Data System (ADS)

Kochan, Janeen Adrion

Unexpected events, particularly those creating surprise, interrupt ongoing mental and behavioral processes, creating an increased potential for unwanted outcomes to the situation. Human reactions to unexpected events vary. One can hypothesize a number of reasons for this variation, including level of domain expertise, previous experience with similar events, emotional connotation, and the contextual surround of the event. Whereas interrupting ongoing activities and focusing attention temporarily on a surprising event may be a useful evolutionary response to a threatening situation, the same process may be maladaptive in today's highly dynamic world. The purpose of this study was to investigate how different aspects of expertise affected one's ability to detect and react to an unexpected event. It was hypothesized that there were two general types of expertise, domain expertise and judgment (Hammond, 2000), which influenced one's performance on dealing with an unexpected event. The goal of the research was to parse out the relative contribution of domain expertise, so the role of judgment could be revealed. The research questions for this study were: (a) Can we identify specific knowledges and skills which enhance one's ability to deal with unexpected events? (b) Are these skills "automatically" included in domain expertise? (c) How does domain expertise improve or deter one's reaction and response to unexpected events? (d) What role does judgment play in responding to surprise? The general hypothesis was that good judgment would influence the process of surprise at different stages and in different ways than would domain expertise. The conclusions from this research indicated that good judgment had a significant positive effect in helping pilots deal with unexpected events. This was most pronounced when domain expertise was low.

Problem-oriented patient record model as a conceptual foundation for a multi-professional electronic patient record.

PubMed

De Clercq, Etienne

2008-09-01

It is widely accepted that the development of electronic patient records, or even of a common electronic patient record, is one possible way to improve cooperation and data communication between nurses and physicians. Yet, little has been done so far to develop a common conceptual model for both medical and nursing patient records, which is a first challenge that should be met to set up a common electronic patient record. In this paper, we describe a problem-oriented conceptual model and we show how it may suit both nursing and medical perspectives in a hospital setting. We started from existing nursing theory and from an initial model previously set up for primary care. In a hospital pilot site, a multi-disciplinary team refined this model using one large and complex clinical case (retrospective study) and nine ongoing cases (prospective study). An internal validation was performed through hospital-wide multi-professional interviews and through discussions around a graphical user interface prototype. To assess the consistency of the model, a computer engineer specified it. Finally, a Belgian expert working group performed an external assessment of the model. As a basis for a common patient record we propose a simple problem-oriented conceptual model with two levels of meta-information. The model is mapped with current nursing theories and it includes the following concepts: "health care element", "health approach", "health agent", "contact", "subcontact" and "service". These concepts, their interrelationships and some practical rules for using the model are illustrated in this paper. Our results are compatible with ongoing standardization work at the Belgian and European levels. Our conceptual model is potentially a foundation for a multi-professional electronic patient record that is problem-oriented and therefore patient-centred.

A case study in the use of community-based participatory research in public health nursing.

PubMed

Savage, Christine L; Xu, Yin; Lee, Rebecca; Rose, Barbara L; Kappesser, Mary; Anthony, Jean Spann

2006-01-01

There is growing demand for research using a community-based participatory (CBPR) approach. CBPR requires that the academic research team actively partner with community members and stakeholders in the entire research process. The community members are full partners with the researchers in relation to the development and implementation of the study, analysis of the data, and dissemination of the findings. The purpose of this article is to review four basic principles of CBPR and provide an example of how these CBPR principles were used in an ethnographic study related to the culture of African American infant health. In the pilot study, CBPR provided the framework for recruitment and retention of participants, ongoing data analysis, and dissemination of findings. Using CBPR provided the researchers an introduction into the selected community. Community members served as key informants about the culture of the community and provided access to potential participants. The community partners contributed to analysis of emerging themes and in the dissemination of findings to the community, stakeholders, and the scientific community. CBPR provides opportunities for community health nurse researchers to conduct research with vulnerable populations and sets the stage for implementing evidenced-based nursing interventions in the community.

A Study of the Characteristics of Human-Pilot Control Response to Simulated Aircraft Lateral Motions

NASA Technical Reports Server (NTRS)

Cheatham, Donald C

1954-01-01

Report presents the results of studies made in an attempt to provide information on the control operations of the human pilot. These studies included an investigation of the ability of pilots to control simulated unstable yawing oscillations, a study of the basic characteristics of human-pilot control response, and a study to determine whether and to what extent pilot control response can be represented in an analytical form.

Improved understanding of geologic CO{sub 2} storage processes requires risk-driven field experiments

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

Oldenburg, C.M.

2011-06-01

The need for risk-driven field experiments for CO{sub 2} geologic storage processes to complement ongoing pilot-scale demonstrations is discussed. These risk-driven field experiments would be aimed at understanding the circumstances under which things can go wrong with a CO{sub 2} capture and storage (CCS) project and cause it to fail, as distinguished from accomplishing this end using demonstration and industrial scale sites. Such risk-driven tests would complement risk-assessment efforts that have already been carried out by providing opportunities to validate risk models. In addition to experimenting with high-risk scenarios, these controlled field experiments could help validate monitoring approaches to improvemore » performance assessment and guide development of mitigation strategies.« less

The Coach2Move Approach: Development and Acceptability of an Individually Tailored Physical Therapy Strategy to Increase Activity Levels in Older Adults With Mobility Problems.

PubMed

de Vries, Nienke M; van Ravensberg, C Dorine; Hobbelen, Johannes S M; van der Wees, Philip J; Olde Rikkert, Marcel G M; Staal, J Bart; Nijhuis-van der Sanden, Maria W G

2015-01-01

Despite the positive effects of physical activity on numerous aspects of health, many older adults remain sedentary even after participating in physical activity interventions. Standardized exercise programs do not necessarily bring about the behavioral change that is necessary. Therefore, a patient-centered approach is needed. The purpose of this study was to develop and assess the acceptability and potential effectiveness of the Coach2Move strategy; a physical therapy (PT) approach aimed at improving the long-term level of physical activity in mobility-limited older adults. The Coach2Move strategy was developed on the basis of 2 systematic literature studies and expert consultations. Multiple focus group meetings and a Delphi procedure were organized to gain consensus on the Coach2Move strategy. Acceptability and potential effectiveness were studied in a pilot study with a pre-/postdesign in which 2 physical therapists and 12 patients participated. To assess acceptability, patients were interviewed, discussion were held with the involved physical therapists was held, and health records were studied. Potential effectiveness was tested measuring the level of physical activity, frailty, quality of life, and mobility before and after treatment. On the basis of the literature study and expert consultations, an algorithm based on the Hypothesis Oriented Algorithm for Clinicians Part II was developed: the Coach2Move approach. Key elements of the Coach2Move approach include an extensive intake using motivational interviewing, clinical reasoning, coaching to increase physical activity and self-management, focusing on meaningful activities, and working according to 3 patient-tailored intervention profiles with a predefined number of sessions. The pilot study showed high appraisal of the strategy by both physical therapists and patients. Moreover, a potential effect on the level of physical activity, frailty, quality of life, and mobility was observed. Because the pilot study was not randomized or controlled and included a small sample, no conclusions can be drawn about the effectiveness of the Coach2Move strategy. However, all suggestions made in this study were implemented in an ongoing, randomized controlled trial in which the Coach2Move strategy will be compared to usual care PT. In conclusion, the Coach2Move strategy can be considered acceptable in PT practice and showed potential benefits. The results on the (cost-)effectiveness of this strategy based on a large, randomized, controlled trial are expected in 2014.

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

PubMed Central

O’Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich

2018-01-01

Objectives Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Design Systematic scoping review. Data sources MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Study selection Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. Results The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). Conclusions This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. PMID:29705769

Sewer-mining: A water reuse option supporting circular economy, public service provision and entrepreneurship.

PubMed

Makropoulos, C; Rozos, E; Tsoukalas, I; Plevri, A; Karakatsanis, G; Karagiannidis, L; Makri, E; Lioumis, C; Noutsopoulos, C; Mamais, D; Rippis, C; Lytras, E

2018-06-15

Water scarcity, either due to increased urbanisation or climatic variability, has motivated societies to reduce pressure on water resources mainly by reducing water demand. However, this practice alone is not sufficient to guarantee the quality of life that high quality water services underpin, especially within a context of increased urbanisation. As such, the idea of water reuse has been gaining momentum for some time and has recently found a more general context within the idea of the Circular Economy. This paper is set within the context of an ongoing discussion between centralized and decentralized water reuse techniques and the investigation of trade-offs between efficiency and economic viability of reuse at different scales. Specifically, we argue for an intermediate scale of a water reuse option termed 'sewer-mining', which could be considered a reuse scheme at the neighbourhood scale. We suggest that sewer mining (a) provides a feasible alternative reuse option when the geography of the wastewater treatment plant is problematic, (b) relies on mature treatment technologies and (c) presents an opportunity for Small Medium Enterprises (SME) to be involved in the water market, securing environmental, social and economic benefits. To support this argument, we report on a pilot sewer-mining application in Athens, Greece. The pilot, integrates two subsystems: a packaged treatment unit and an information and communications technology (ICT) infrastructure. The paper reports on the pilot's overall performance and critically evaluates the potential of the sewer-mining idea to become a significant piece of the circular economy puzzle for water. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Cognitive Behavioral Smoking Abstinence Intervention for Adults with Chronic Pain: A Randomized Controlled Pilot Trial

PubMed Central

Hooten, W. Michael; Townsend, Cynthia O.; Hays, J. Taylor; Ebnet, Kaye L.; Gauvin, Thomas R.; Gehin, Jessica M.; Laures, Heidi J.; Patten, Christi A.; Warner, David O.

2015-01-01

Current evidence suggests it may be difficult for patients with chronic pain to quit smoking and, based on previous formative work, a 7-session individual and group-based cognitive behavioral (CB) intervention was developed. The primary aim of this randomized controlled pilot trial was to test the hypothesis that abstinence at month 6 would be greater among patients with chronic pain who received the CB intervention compared to a control condition. Upon admission to a 3-week interdisciplinary pain treatment (IPT) program, patients were randomized to receive the CB intervention (n = 30) or the control condition (n = 30). The 7-day point prevalence of self-reported smoking status was assessed at week 3 (upon completion of the 3-week IPT program) and at month 6 in an intent-to-treat analysis. At week 3, 30% (n=9) of patients in the CB condition were abstinent from smoking compared to 10% (n=3) in the control group (P=.104). At month 6, 20% (n=6) of patients who received the CB intervention were abstinent compared to none in the control group (P=.024). At week 3, a significant group by time interaction effect was found where the CB patients experienced greater improvements in self-efficacy from baseline compared to the control group (P=.002). A greater proportion of patients randomized to the CB group completed the IPT program (P=.052). The findings of this pilot trial suggest that integration of a CB-based smoking abstinence intervention into ongoing pain therapy may be an effective treatment for smokers with chronic pain. PMID:24333035

A Pilot Trial of the Combination of Vemurafenib with Adoptive Cell Therapy in Patients with Metastatic Melanoma

PubMed Central

Deniger, Drew C.; Kwong, Mei Li M.; Pasetto, Anna; Dudley, Mark E.; Wunderlich, John R.; Langhan, Michelle M.; Lee, Chyi-Chia Richard; Rosenberg, Steven A.

2016-01-01

Purpose This pilot feasibility clinical trial evaluated the co-administration of vemurafenib, a small molecule antagonist of BRAFV600 mutations, and tumor infiltrating lymphocytes (TIL) for the treatment of metastatic melanoma. Experimental Design A metastatic tumor was resected for growth of TIL and patients were treated with vemurafenib for 2 weeks followed by resection of a second lesion. Patients then received a non-myeloablative pre-conditioning regimen, infusion of autologous TIL and high-dose interleukin-2 administration. Vemurafenib was restarted at the time of TIL infusion and was continued for 2 years or until disease progression. Clinical responses were evaluated by RECIST 1.0. Metastases resected prior to and after two weeks of vemurafenib were compared using TCRB deep sequencing, immunohistochemistry, proliferation and recognition of autologous tumor. Results The treatment was well tolerated and had a safety profile similar to that of TIL or vemurafenib alone. Seven of 11 patients (64%) experienced an objective clinical response and 2 patients (18%) had a complete response for 3 years (one response is ongoing at 46 months). Proliferation and viability of infusion bag TIL and peripheral blood T cells were inhibited in vitro by vemurafenib (PLX4032) when approaching the maximum serum concentration of vemurafenib. TCRB repertoire (clonotypes numbers, clonality and frequency) did not significantly change between pre- and post-vemurafenib lesions. Recognition of autologous tumor by T cells was similar between TIL grown from pre- and post-vemurafenib metastases. Conclusions Co-administration of vemurafenib and TIL was safe, feasible and generated objective clinical responses in this small pilot clinical trial. PMID:28093487

Teaching weather and climate science in primary schools - a pilot project from the UK Met Office

NASA Astrophysics Data System (ADS)

Orrell, Richard; Liggins, Felicity; Challenger, Lesley; Lethem, Dom; Campbell, Katy

2017-04-01

Wow Schools is a pilot project from the Met Office with an aim to inspire and educate the next generation of scientists and, uniquely, use the data collected by schools to improve weather forecasts and warnings across the UK. Wow Schools was launched in late 2015 with a competition open to primary schools across the UK. 74 schools entered the draw, all hoping to be picked as one of the ten lucky schools taking part in the pilot scheme. Each winning school received a fully automatic weather station (AWS), enabling them to transmit real-time local weather observations to the Met Office's Weather Observation Website (WOW - wow.metoffice.gov.uk), an award winning web portal for uploading and sharing a range of environmental observations. They were also given a package of materials designed to get students out of the classroom to observe the weather, get hands-on with the science underpinning weather forecasting, and analyse the data they are collecting. The curriculum-relevant materials were designed with the age group 7 to 11 in mind, but could be extended to support other age groups. Each school was offered a visit by a Wow Schools Ambassador (a Met Office employee) to bring the students' learning to life, and access to a dedicated forecast for its location generated by our new supercomputer. These forecasts are improved by the school's onsite AWS reinforcing the link between observations and forecast production. The Wow Schools pilot ran throughout 2016. Here, we present the initial findings of the project, examining the potential benefits and challenges of working with schools across the UK to: enrich students' understanding of the science of weather forecasting; to source an ongoing supply of weather observations and discover how these might be used in the forecasting process; and explore what materials and business model(s) would be most useful and affordable if a wider roll-out of the initiative was undertaken.

Quality improvement training for core medical and general practice trainees: a pilot study of project participation, completion and journal publication.

PubMed

McNab, Duncan; McKay, John; Bowie, Paul

2015-11-01

Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal. A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success. Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%). This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be realised. © The Author(s) 2015.

'Out of hours' adult CT head interpretation by senior emergency department staff following an intensive teaching session: a prospective blinded pilot study of 405 patients.

PubMed

Jamal, Karim; Mandel, Laura; Jamal, Leila; Gilani, Shamim

2014-06-01

Cranial CT is the gold standard for the investigation of intracranial emergencies. The aim of this pilot study was to audit whether senior emergency physicians were able to report CT head scans accurately and reliably having attended structured teaching. Senior emergency physicians attended a 3 h teaching session. Following this, they independently reported adult CT head scans between 22:00 and 08:00 using a pro forma. CT head examinations performed in this 'out of hours' period were formally reported by a consultant radiologist on the following morning. Data were collected in a blinded fashion over an 8-month period. 405 adult CT head examinations were performed. 360 pro formas were available for analysis, and the rest were excluded either because a consultant radiologist had been rung to discuss the results (five patients) or because the pro forma was not completed (40 patients). Concordance between consultant radiologists and emergency physicians was found in 339 (94%) of the cases (κ coefficient 0.78). None of the discordant cases was managed inappropriately or had an adverse clinical outcome. All cases of extradural, subdural and subarachnoid haemorrhage were detected by emergency physicians. In conclusion, we feel that this model can be employed as a safe and long-term alternative provided that the radiology department are committed to providing ongoing teaching and that a database is maintained to highlight problem areas. Emergency physicians need to remember that the clinical status of the patient must never be ignored, irrespective of their CT head findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Impacts of Residual Surfactant on Tetrachloroethene (PCE) Degradation Following Pilot-Scale SEAR Treatment at a Chloroethene-Impacted Site

NASA Astrophysics Data System (ADS)

Ramsburg, C. A.; Abriola, L. M.; Pennell, K. D.; Löffler, F. E.; Gamache, M.; Petrovskis, E. A.

2003-04-01

A pilot-scale surfactant-enhanced aquifer remediation (SEAR) demonstration was completed during the summer of 2000 at the Bachman Road site (Oscoda, MI USA). For this test, an aqueous solution of 60 g/L Tween 80 (polyoxyethylene (20) sorbitan monooleate) was used to recover tetrachloroethene (PCE) from a suspected source zone, located underneath a former dry-cleaning facility. Tween 80 was selected for use based upon its demonstrated capacity to solubilize PCE, “food-grade” status, and biodegradative potential. Hydraulic control was maintained throughout the test, with 95% of the injected surfactant mass recovered by a single extraction well. Source-zone monitoring conducted 15 months after SEAR treatment revealed the presence of previously undetected volatile fatty acids (acetate and formate) and PCE degradation products (trichloroethene, cis-1,2-dichloroethene, trans-1,2-dichlorethene, and vinyl chloride), in conjunction with PCE concentration reductions of approximately two orders-of-magnitude. The detection of volatile fatty acids is relevant, as they are likely fermentation products of residual Tween 80. Microbial reductive dechlorination is limited by available electron donors, and microcosm studies demonstrated that both acetate and formate support reductively dechlorinating populations present at the oligotrophic Bachman Road site aquifer. Surfactant transport simulations, using a regional flow model developed for the site, were employed to determine appropriate down-gradient monitoring locations. Drive point samples taken 15 months post-treatment in the vicinity of the simulated residual surfactant plume, contained elevated concentrations of acetate and PCE daughter products. Ongoing efforts include continued site-monitoring, and microcosm studies to corroborate a causal relationship between Tween 80 fermentation and PCE dechlorination.

Pilot Certification, Age of Pilot, and Drug Use in Fatal Civil Aviation Accidents.

PubMed

Akparibo, Issaka Y; Stolfi, Adrienne

2017-10-01

This study examined the association between mean age of pilot, pilot license, pilot medical certificate and drug use trends in pilots fatally injured in aircraft accidents. The prevalence of prescription drugs, OTC drugs, controlled drugs and drugs that may be potentially impairing was also examined. This study was a descriptive observational study in which the NTSB Aviation Accident Database was searched from the period beginning January 1, 2012 to December 31, 2014. During the study period a total of 706 accidents involving 711 fatalities were investigated by the NTSB. This study included 633 of these accidents, involving 646 fatalities. Of these pilots, 42.1% had drugs in their biological samples. The prevalence of prescription drugs, controlled drugs, OTC drugs, opioids, and potentially impairing drugs in the fatally injured pilot population over the study period was 28.9%, 15.0%, 20.1%, 5.1%, and 25.5%, respectively. Pilots with any drugs in their samples were significantly older than those without drugs. Medical certificate held was associated with drug use; pilots who held third class certificates had the highest prevalence at 54.1%. Pilot license was not associated with drug use. In 3.8% of the accidents, drugs were a contributing factor in the cause. Despite current FAA medical regulations, potentially impairing drugs are frequently found in biological samples of fatally injured pilots in the U.S. More education of airmen by aviation medical examiners is needed on the safety of drug use.Akparibo IY, Stolfi A. Pilot certification, age of pilot, and drug use in fatal civil aviation accidents. Aerosp Med Hum Perform. 2017; 88(10):931-936.

Pilot-model analysis and simulation study of effect of control task desired control response

NASA Technical Reports Server (NTRS)

Adams, J. J.; Gera, J.; Jaudon, J. B.

1978-01-01

A pilot model analysis was performed that relates pilot control compensation, pilot aircraft system response, and aircraft response characteristics for longitudinal control. The results show that a higher aircraft short period frequency is required to achieve superior pilot aircraft system response in an altitude control task than is required in an attitude control task. These results were confirmed by a simulation study of target tracking. It was concluded that the pilot model analysis provides a theoretical basis for determining the effect of control task on pilot opinions.

Rationale, design and methods of the HEALTHY study physical education intervention component.

PubMed

McMurray, R G; Bassin, S; Jago, R; Bruecker, S; Moe, E L; Murray, T; Mazzuto, S L; Volpe, S L

2009-08-01

The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention integrated nutrition, physical education (PE) and behavior changes with a communications strategy of promotional and educational materials and activities. The PE intervention component was developed over a series of pilot studies to maximize student participation and the time (in minutes) spent in moderate-to-vigorous physical activity (MVPA), while meeting state-mandated PE guidelines. The goal of the PE intervention component was to achieve > or =150 min of MVPA in PE classes every 10 school days with the expectation that it would provide a direct effect on adiposity and insulin resistance, subsequently reducing the risk of type 2 diabetes in youth. The PE intervention component curriculum used standard lesson plans to provide a comprehensive approach to middle school PE. Equipment and PE teacher assistants were provided for each school. An expert in PE at each center trained the PE teachers and assistants, monitored delivery of the intervention and provided ongoing feedback and guidance.

Rationale, design and methods of the HEALTHY study physical education intervention component

PubMed Central

McMurray, RG; Bassin, S; Jago, R; Bruecker, S; Moe, EL; Murray, T; Mazzuto, SL; Volpe, SL

2009-01-01

The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention integrated nutrition, physical education (PE) and behavior changes with a communications strategy of promotional and educational materials and activities. The PE intervention component was developed over a series of pilot studies to maximize student participation and the time (in minutes) spent in moderate-to-vigorous physical activity (MVPA), while meeting state-mandated PE guidelines. The goal of the PE intervention component was to achieve ≥150 min of MVPA in PE classes every 10 school days with the expectation that it would provide a direct effect on adiposity and insulin resistance, subsequently reducing the risk of type 2 diabetes in youth. The PE intervention component curriculum used standard lesson plans to provide a comprehensive approach to middle school PE. Equipment and PE teacher assistants were provided for each school. An expert in PE at each center trained the PE teachers and assistants, monitored delivery of the intervention and provided ongoing feedback and guidance. PMID:19623187

[Assessment of a supervision grid being used in the laboratories of cutaneous leishmaniasis in Morocco].

PubMed

El Mansouri, Bouchra; Amarir, Fatima; Hajli, Yamina; Fellah, Hajiba; Sebti, Faiza; Delouane, Bouchra; Sadak, Abderrahim; Adlaoui, El Bachir; Rhajaoui, Mohammed

2017-01-01

The aim of our study was to assess a standardized supervisory grid as a new supervision tool being used in the laboratories of leishmaniasis. We conducted a pilot trial to evaluate the ongoing performances of seven provincial laboratories, in four provinces in Morocco, over a period of two years, between 2006 and 2014. This study detailed the situation in provincial laboratories before and after the implementation of the supervisory grid. A total of twenty-one grids were analyzed. In 2006, the results clearly showed a poor performance of laboratories: need for training (41.6%), staff performing skin biopsy (25%), shortage of materials and reagents (65%), non-compliant document and local management (85%). Several corrective actions were conducted by the National Reference Laboratory (LNRL) of Leishmaniasis during the study period. In 2014, the LNRL recorded a net improvement of the performances of the laboratories. The need for training, the quality of the biopsy, the supply of tools and reagents were met and an effective coordination activity was established between the LNRL and the provincial laboratories. This trial shows the effectiveness of the grid as a high quality supervisory tool and as a cornerstone of making progress on fight programs against leishmaniases.

Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial).

PubMed

Slynarski, Konrad; Walawski, Jacek; Smigielski, Robert; van der Merwe, Willem

2017-01-01

In young patients with medial knee osteoarthritis (OA), surgical intervention may not be desirable due to preferences to avoid bone cutting procedures, return to high activity levels, and prolong implant survival. The Atlas Knee System was designed to fill the gap between ineffective conservative treatments and invasive surgery. This single-arm study included 26 patients, aged 25 to 65 years, who completed 12 months of follow-up. All dimensions of the Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score significantly improved from baseline to 12 months. About 96.2% and 92.3% of patients experienced a ⩾20% improvement in their KOOS pain and WOMAC pain scores, respectively, at 12 months. This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months.

Development of the National Health Information Systems in Botswana: Pitfalls, prospects and lessons.

PubMed

Seitio-Kgokgwe, Onalenna; Gauld, Robin D C; Hill, Philip C; Barnett, Pauline

2015-01-01

Studies evaluating development of health information systems in developing countries are limited. Most of the available studies are based on pilot projects or cross-sectional studies. We took a longitudinal approach to analysing the development of Botswana's health information systems. We aimed to: (i) trace the development of the national health information systems in Botswana (ii) identify pitfalls during development and prospects that could be maximized to strengthen the system; and (iii) draw lessons for Botswana and other countries working on establishing or improving their health information systems. This article is based on data collected through document analysis and key informant interviews with policy makers, senior managers and staff of the Ministry of Health and senior officers from various stakeholder organizations. Lack of central coordination, weak leadership, weak policy and regulatory frameworks, and inadequate resources limited development of the national health information systems in Botswana. Lack of attention to issues of organizational structure is one of the major pitfalls. The ongoing reorganization of the Ministry of Health provides opportunity to reposition the health information system function. The current efforts including development of the health information management policy and plan could enhance the health information management system.

Development of the Internet-Enabled System for Exercise Telerehabilitation and Cardiovascular Training.

PubMed

Dedov, Vadim N; Dedova, Irina V

2015-07-01

Sustained exercise training could significantly improve patient rehabilitation and management of noncommunicable diseases in the community. This study aimed to develop a universal telecare system for delivery of exercise rehabilitation and cardiovascular training services at home. An innovative bilateral leg training device was equipped with an electronic system for the ongoing measurement of training activities with the device. A single-item parameter reflecting the intensity of training was monitored using several modern telecommunication technologies. According to the application protocol, eight volunteers first tried the device for 30-60 min to determine their personal training capacity. Then, they were provided with equipment to use at home for 4 weeks. Adherence to daily training was assessed by the number of training days per week, training intensity, and duration of training sessions. The system provided reliable recording of training activities with the device using (1) long-term data logging without an ongoing connection to the computer, (2) wireless monitoring and recording of training activities on a stand-alone computer, and (3) a secure cloud-based monitoring over the Internet connection using electronic devices, including smartphones. Overall analysis of recordings and phone feedbacks to participants took only approximately 5 h for the duration of study. This study, although of a pilot nature, described the comprehensive exercise telerehabilitation system integrating mobile training equipment with personalized training protocols and remote monitoring. A single-item electronic parameter of the system usage facilitated time-effective data management. Wireless connection allowed various locations of device application and several monitoring arrangements ranging from real-time monitoring to long-term recording of exercise activities. A cloud-based software platform enabled management of multiple users at distance. Implementation of this model may facilitate both accessibility and availability of personalized exercise telerehabilitation services. Further studies would validate it in the clinical and healthcare environment.

MS PHD'S Professional Development Program: A Scientific Renaissance in Cyberspace

NASA Astrophysics Data System (ADS)

Powell, J. M.; Williamson, V. A.; Griess, C. A.; Pyrtle, A. J.

2004-12-01

This study is a component of a four-year investigation of MS PHD'S Professional Development Program's virtual community through the lenses of underrepresented minority students in Earth system science and engineering fields. In this presentation, the development, assessment and projected utilization of the ongoing study will be discussed. The overall goal of this study is to examine the effectiveness of virtual team building methods and understand how the development of a communal cyberinfrastructure acts as an integral part of the emergence of a Scientific Renaissance. The exemplar, Minorities Striving and Pursuing Higher Degrees of Success in Earth System Science (MS PHD'S), provides professional development experiences to facilitate the advancement of students of color achieving outstanding Earth system careers. Undergraduate and graduate students are supported through access to scientific conferences, mentorship and virtual community building. Framed by critical theory, this ethnographic exploration uses a mixed methods research design to record, observe, and analyze both the processes and products of the website, listserv and synchronous web-based dialogue. First, key findings of the formative evaluation and annual reports of the successfully implemented 2003 MS PHD'S Pilot Project are presented. These findings inform future evaluations of the use of technological resources and illustrate how this public space provides peer support and enriched research opportunities. Quantitative methods such as statistical analysis, academic and professional tracking and evaluative tools for scientific content and competency are complimented by qualitative methods that include observations, heuristic case studies and focus group interviews. The findings of this ongoing investigation will provide insight on how national organizations, higher education practitioners, community-based support systems and underrepresented minorities in the sciences promote diversity by developing successful cyberspace programs and networks. Through the examination of the transformation, expansion and democratization of the Earth system science community, new knowledge will be obtained on how a cyber-community fuses science, diversity and technology to form dialectics between creating and analyzing a Scientific Renaissance.

Amphibious Local Seismic Observations by SFB 574 in Costa Rica

NASA Astrophysics Data System (ADS)

Gossler, J.; Arroyo, I.; Flueh, E. F.; Goltz, C.; Wagner, G.; Boschini, I.; Mora, M.

2004-12-01

The goal of the SFB 574 ''Volatiles and Fluids in Subduction Zones'' subproject A2 is to study the seismogenic zone of Costa Rica and Nicaragua as examples of an erosive margin and to better understand its local variability. In 2002/2003 we studied the seismogenic zone in two adjacent areas of Costa Rica. One of the areas is characterised by the subduction of a seamount, the other one contains a megalens structure, which had been inferred from reflection seismic data before and which is interpreted to indicate a possible mechanism for mass transfer from the upper to the lower plate. 23 ocean bottom sensors from IFM-GEOMAR and 15 landstations from the GFZ Potsdam were deployed in the coastal Pacific region of central Costa Rica near Jaco in April 2002. The network was moved south-east towards Quepos in October 2002 and operated until spring 2003. 1,968 earthquakes between April and October 2002 could be located by the Jaco network. Most of the earthquakes took place offshore beneath the continental margin close to or beneath the network. The hypocenter determination of these events using the on- and offshore parts of the network delivers very precise earthquake locations, because the network covers the source region very well. Another region of high seismic activity is located southeast of the network, where a magnitude 6.3 earthquake took place on June 16, 2002, followed by several hundred aftershocks. Ongoing studies focus especially on the updip limit of these events. From the Quepos network 1,241 earthquakes between October and December 2002 have been located, so far. In a pilot study focal mechanism of 13 earthquakes with clear polarities had been determined using the Jaco onshore network only. Except for two earthquakes these events were shallow and took place in the continental wedge. The orientations of their focal planes coincides well with the geological fault system of the Jaco area. Ongoing work focuses on slab related earthquakes.

SUPERFUND TREATABILITY CLEARINGHOUSE: SOIL STABILIZATION PILOT STUDY, UNITED CHROME NPL SITE PILOT STUDY AND HEALTH AND SAFETY PROGRAM, UNITED CHROME NPL SITE PILOT STUDY

EPA Science Inventory

This document is a project plan for a pilot study at the United Chrome NPL site, Corvallis, Oregon and includes the health and safety and quality assurance/quality control plans. The plan reports results of a bench-scale study of the treatment process as iieasured by the ...

An Introduction to the Tibet cGPS pilot project: TigiCAS

NASA Astrophysics Data System (ADS)

Zhang, Z.; Liu, J.; Galetzka, J.; Avouac, J.; Tapponnier, P.; Zeng, L.; Gan, W.; Shen, Z.; Wang, M.

2007-12-01

The convergence between India and Eurasia is the¡¡prototype of continental collision in action. Compared¡¡to geological history and fault kinematics studies, the present-day, regional pattern of strain-partitioning¡¡is still inadequately known. Among limited geodetic¡¡efforts in the past decade or two, most have been focused¡¡on refining measurements of the current crustal¡¡shortening rate across the Himalaya. The vast region¡¡immediately to the north is sparsely instrumented, with only one continuous GPS station (Lhasa) within¡¡the plateau proper. Campaign stations are few and¡¡ill-positioned, mostly along major roads, providing¡¡poor constraints on present-day slip-rates on individual¡¡active faults. The extant GPS network configuration is thus still insufficient to discriminate between block vs continuum deformation. In November 2006, the¡¡Chinese Academy of Sciences led a pilot program and¡¡installed 6 continuous GPS stations in southern Tibet, crossing the NS-trending normal fault systems and¡¡complementing the Nepal cGPS profiles. We present¡¡here the new sites, preliminary data processing results, and the spatial relationship with ongoing or planned¡¡continuous GPS sites from a couple of other projects. Together with such projects, TigiCAS will provide¡¡a substantial increase in geodetic data in the¡¡Himalayan-Tibet convergent belt in the next few¡¡years, and lead to a better understanding of¡¡contemporary deformation of the region.

Brief cognitive and behavioral screening in children with new-onset epilepsy: a pilot feasibility trial.

PubMed

Triplett, Regina L; Asato, Miya R

2015-01-01

Minimal work has used psychometrically robust measures in a systematic fashion to identify and monitor children at risk for cognitive and behavioral comorbidities in current epilepsy care. We piloted a computerized cognitive battery and behavioral questionnaire for children with newly diagnosed epilepsy to determine clinical feasibility and acceptability to parents and patients. We recruited medication-naïve children (ages 8-17 years) with recent-onset seizures and typical developmental history from an outpatient child neurology clinic. Children completed the CNS Vital Signs computerized battery, whereas parents completed the Strengths and Difficulties Questionnaire. Post-test interviews with parents and patients were completed regarding the acceptability of the assessment procedures. Forty-four families were eligible, and 39 agreed to participate (89%). All assessments were completed in less than 45 minutes. Parents rated testing in clinic as convenient and important, expressing strong interest in the cognitive and behavioral impact of epilepsy and medication. Children also rated the testing procedure as acceptable and agreed that they would recommend it to peers. Our brief battery was tolerated and well received by children and their parents. Computerized testing of children along with a parent questionnaire is a psychometrically viable approach that is acceptable to families. Our protocol is time efficient for clinical use with the potential to detect early cognitive and behavioral difficulties related to epilepsy. Ongoing longitudinal study will provide further information regarding the success of our screening methods in monitoring for disease- or treatment-related changes. Copyright © 2015 Elsevier Inc. All rights reserved.

Pilot Study of Physiologic Partograph Use Among Low-Risk, Nulliparous Women With Spontaneous Labor Onset.

PubMed

Neal, Jeremy L; Lowe, Nancy K; Nacht, Amy S; Koschoreck, Kate; Anderson, Jessica

2016-01-01

Neal and Lowe developed a physiologic partograph to give clinicians an evidence-based, uniform approach to assessing active labor progress and diagnosing dystocia in high-resource settings. The aim of this pilot study was to examine the feasibility of implementing the Neal and Lowe partograph for in-hospital labor assessment. A descriptive study of low-risk, nulliparous women with spontaneous labor onset was performed at an academic medical center. Eight certified nurse-midwives from a single practice used the Neal and Lowe partograph for the assessment of labor progress. Descriptive statistics were used to summarize characteristics, interventions, and outcomes for women with partograph-assessed labors. Labors assessed by nurse-midwives (n = 83) or obstetricians (n = 75) using their usual assessment strategies were also described for the year prior to partograph introduction to contextualize partograph-assessed labor findings. Inferential statistical tests were not performed. Thirty-one of 34 (91.2%) partographs were used correctly. Seventy-one percent (n = 22) of these women progressed to complete dilatation within expected physiologic time frames while the remaining women (n = 9) experienced labor dystocia. Similar proportions of women in the partograph and usual labor assessment groups received oxytocin during labor. The cesarean rate was lower in the partograph group than in the usual care groups. No cesareans were performed for dystocia in active labor for women whose labors were assessed via partograph. Implementation of the Neal and Lowe partograph for in-hospital labor assessment is feasible. Incorrect plotting and/or interpretation of the partograph may be further minimized by providing clinicians opportunities for ongoing partograph training after implementation or through partograph software development. The Neal and Lowe partograph may assist clinicians in safely and significantly decreasing primary cesarean births performed for active labor dystocia in high-resource settings. Larger scale, hypothesis-testing studies of partograph implementation are now warranted. © 2016 by the American College of Nurse-Midwives.

Exercise Training and Cardiovascular Health in Cancer Patients.

PubMed

Squires, Ray W; Shultz, Adam M; Herrmann, Joerg

2018-03-10

Cancer patients nearly universally experience a decline in quality of life, with fatigue and reduced exercise tolerance as cardinal reflections. A routine exercise program can improve these signs and symptoms as well as overall outcomes. The review provides an updated overview of the field and its translation to clinical practice. A wealth of clinical studies have documented the safety and benefits of exercise after and during cancer therapy, and pilot and larger-scale studies are currently ongoing to integrate exercise into the treatment program for cancer patients undergoing active therapy (EXACT pilot, OptiTrain, and TITAN study). More recently, efforts have emerged to commence exercise programs before the start of cancer therapy, so-called pre-habilitation. The concept of increasing the cardiovascular reserve beforehand is intuitively attractive. In agreement, preclinical studies support exercise as an effective preventive means before and during cardiotoxic drug exposure. Assuming that a pronounced drop in exercise tolerance will occur during cancer therapy, pre-habilitation can potentially curtail or raise the nadir level of exercise tolerance. Furthermore, such efforts might serve as pre-conditioning efforts in reducing not only the nadir, but even the magnitude of drop in cardiovascular reserve. Initiated beforehand, cancer patients are also more likely to continue these efforts during cancer therapy. Finally, an active exercise routine (≥ 150 min/week moderate intensity or ≥ 75 min/week vigorous intensity or combination) in conjunction with the other six American Heart Association's cardiovascular health metrics (BMI < 25 kg/m 2 , blood pressure < 120/80 mmHg, fasting plasma glucose < 100 mg/dL, total cholesterol < 200 mg/dL, 4-5 component healthy diet, no smoking) reduces not only the cardiovascular but also the cancer disease risk. Exercise can reduce the risks of developing cancer, the detrimental effects of its treatment on the cardiovascular system, and overall morbidity and mortality. Exercise should become an integral part of the care for every cancer patient.

CRIB--the use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial (RCT) with embedded feasibility study.

PubMed

Munro, Julie; Adams, Richard; Campbell, Anna; Campbell, Sandra; Donaldson, Cam; Godwin, Jon; Haw, Sally; Kidd, Lisa; Lane, Chrissie; Leslie, Stephen J; Mason, Helen; Mutrie, Nanette; O'Carroll, Ronan; Taylor, Cara; Treweek, Shaun; Watson, Angus; Hubbard, Gill

2014-02-18

Patients with colorectal cancer report ongoing physical and psychological impairments and a high proportion of these patients are overweight, insufficiently active and high-risk drinkers, putting them at risk of poor recovery and risk of recurrence and comorbidities. A challenge is implementing sustainable and effective rehabilitation as part of routine care for this group. A two-arm pilot randomised controlled trial (RCT) with embedded feasibility study undertaken as a phased programme of work. The intervention involves an existing cardiac rehabilitation programme for cardiac patients accepting colorectal cancer patient referrals. The intervention consists of supervised exercise sessions run by a cardiac physiotherapist and information sessions. Phase 1 will involve one research site enrolling 12 patients to assess intervention and study design processes. Semistructured interviews with patients with colorectal cancer and cardiac patients and clinicians will be used to gather data on acceptability of the intervention and study procedures. Phase 2 will involve three sites enrolling 66 patients with colorectal cancer randomised to control or intervention groups. Outcome measures will be taken preintervention and postintervention, for phases 1 and 2. The primary outcome is accelerometer measured physical activity; secondary outcomes are self-report physical activity, quality of life, anxiety, depression, symptoms including fatigue. The following variables will also be examined to determine if these factors influence adherence and outcomes: self-efficacy, risk perception and treatments. Full ethical approval was granted by NRES Committees-North of Scotland (13/NS/0004; IRAS project ID: 121757) on 22 February 2013. The proposed work is novel in that it aims to test the feasibility and acceptability of using an evidence-based and theory driven existing cardiac rehabilitation service with patients with colorectal cancer. Should this model of rehabilitation prove to be clinically and cost effective we aim to conduct a randomised controlled trial of this intervention to measure effectiveness. ISRCTN63510637; UKCRN id 14092.

Drilling into an active mofette: pilot-hole study of the impact of CO2-rich mantle-derived fluids on the geo-bio interaction in the western Eger Rift (Czech Republic)

NASA Astrophysics Data System (ADS)

Bussert, Robert; Kämpf, Horst; Flechsig, Christina; Hesse, Katja; Nickschick, Tobias; Liu, Qi; Umlauft, Josefine; Vylita, Tomáš; Wagner, Dirk; Wonik, Thomas; Estrella Flores, Hortencia; Alawi, Mashal

2017-11-01

Microbial life in the continental deep biosphere is closely linked to geodynamic processes, yet this interaction is poorly studied. The Cheb Basin in the western Eger Rift (Czech Republic) is an ideal place for such a study because it displays almost permanent seismic activity along active faults with earthquake swarms up to ML 4.5 and intense degassing of mantle-derived CO2 in conduits that show up at the surface in form of mofettes. We hypothesize that microbial life is significantly accelerated in active fault zones and in CO2 conduits, due to increased fluid and substrate flow. To test this hypothesis, pilot hole HJB-1 was drilled in spring 2016 at the major mofette of the Hartoušov mofette field, after extensive pre-drill surveys to optimize the well location. After drilling through a thin caprock-like structure at 78.5 m, a CO2 blowout occurred indicating a CO2 reservoir in the underlying sandy clay. A pumping test revealed the presence of mineral water dominated by Na+, Ca2+, HCO3-, SO42- (Na-Ca-HCO3-SO4 type) having a temperature of 18.6 °C and a conductivity of 6760 µS cm-1. The high content of sulfate (1470 mg L-1) is typical of Carlsbad Spa mineral waters. The hole penetrated about 90 m of Cenozoic sediments and reached a final depth of 108.50 m in Palaeozoic schists. Core recovery was about 85 %. The cored sediments are mudstones with minor carbonates, sandstones and lignite coals that were deposited in a lacustrine environment. Deformation structures and alteration features are abundant in the core. Ongoing studies will show if they result from the flow of CO2-rich fluids or not.

Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial.

PubMed

Srikesavan, Cynthia Swarnalatha; Shay, Barbara; Robinson, David B; Szturm, Tony

2013-03-09

Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann-Whitney U test. The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand. ClinicalTrials.gov: NCT01635582.

Does endometrial integrin expression in endometriosis patients predict enhanced in vitro fertilization cycle outcomes after prolonged GnRH agonist therapy?

PubMed

Surrey, Eric S; Lietz, Annette K; Gustofson, Robert L; Minjarez, Debra A; Schoolcraft, William B

2010-02-01

To determine whether endometrial expression of the integrin alpha(v)beta(3) vitronectin can predict which endometriosis patient subgroup will benefit from pre-IVF cycle prolonged GnRH agonist (GnRHa) therapy. Prospective randomized institutional review board approved pilot trial. Private assisted reproductive technology program. IVF candidates with regular menses, surgically confirmed endometriosis, and normal ovarian reserve. All patients underwent endometrial biopsy 9 to 11 days post-LH surge to evaluate alpha(v)beta(3) integrin expression. Patients were randomized either to receive depot leuprolide acetate 3.75 mg every 28 days for three doses before controlled ovarian hyperstimulation (COH) or to proceed directly to COH and IVF. Group 1: integrin-positive controls (N = 12); group 2: integrin-positive administered prolonged GnRHa (N = 8). Group A: integrin-negative controls (N = 7); group B: integrin-negative administered prolonged GnRHa (N = 9). COH responses, ongoing pregnancy and implantation rates. There were no significant effects of GnRH agonist treatment in either of the integrin expression strata regarding ongoing pregnancy or implantation rates, although these outcomes were more frequent in group 2 vs. 1 (62.5% vs. 41.6% and 35% vs. 20.6%, respectively). This effect may have because of limited sample size. The value of a negative integrin biopsy in predicting an ongoing pregnancy after prolonged GnRH agonist therapy was only 44.4%. Endometrial alpha(v)beta(3) integrin expression did not predict which endometriosis patients would benefit from prolonged GnRHa therapy before IVF. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

SUPERFUND TREATABILITY CLEARINGHOUSE: PILOT STUDY OF ENCLOSED THERMAL SOIL AERATION FOR REMOVAL OF VOLATILE ORGANIC CONTAMINATION AT THE MCKIN SUPERFUND SITE

EPA Science Inventory

This paper reports on the results of a pilot study that treated vadose zone soil contaminated with VOCs in an enclosed thermal aeration system. The McKin site, an NPL site in Grey, Maine, was the location of the pilot study. The pilot study was chosen to demonstrate the viabili...

Patent foramen ovale and asymptomatic brain lesions in military fighter pilots.

PubMed

Kang, Kyung Wook; Kim, Joon-Tae; Choi, Won-Ho; Park, Won-Ju; Shin, Young Ho; Choi, Kang-Ho

2014-10-01

Previous studies have reported higher incidence of white matter lesions (WMLs) in military pilots. The anti-gravity straining maneuver, which fighter military pilots perform numerously during a flight is identical to the valsalva maneuver. We sought to investigate the prevalence of right-to-left shunt (RLS) associated with WMLs in military pilots. A prospective study was performed involving military pilots who visited the Airomedical Center. The pilots underwent brain magnetic resonance imaging (MRI) scan and transcranial Doppler (TCD) with intravenous injection of agitated saline solution for the detection of RLS. Periventricular WMLs (PVWMLs) on MRI were graded using Fazeka's scale, and deep WMLs (DWMLs) were graded using Scheltens's scale. This study included 81 military pilots. RLS on TCD was observed less frequently in non-fighter pilots than in fighter pilots (35.5% vs. 64.5%, p=0.011). Fighter pilot was an independently associated factor with RLS on the TCD. DWMLs were independently associated with RLSs through a patent foramen ovale (PFO) (OR 3.507, 95% CI 1.223-10.055, p=0.02). The results suggest that DWMLs in military pilots may significantly be associated with RLS via PFO. Additional investigations are warranted. Copyright © 2014 Elsevier B.V. All rights reserved.

Expertise and responsibility effects on pilots' reactions to flight deck alerts in a simulator.

PubMed

Zheng, Yiyuan; Lu, Yanyu; Yang, Zheng; Fu, Shan

2014-11-01

Flight deck alerts provide system malfunction information designed to lead corresponding pilot reactions aimed at guaranteeing flight safety. This study examined the roles of expertise and flight responsibility and their relationship to pilots' reactions to flight deck alerts. There were 17 pilots composing 12 flight crews that were assigned into pairs according to flight hours and responsibilities. The experiment included 9 flight scenarios and was carried out in a CRJ-200 flight simulator. Pilot performance was recorded by a wide angle video camera, and four kinds of reactions to alerts were defined for analysis. Pilots tended to have immediate reactions to uninterrupted cautions, with a turning off rate as high as 75%. However, this rate decreased sharply when pilots encountered interrupted cautions and warnings; they also exhibited many wrong reactions to warnings. Pilots with more expertise had more reactions to uninterrupted cautions than those with less expertise, both as pilot flying and pilot monitoring. Meanwhile, the pilot monitoring, regardless of level of expertise, exhibited more reactions than the pilot flying. In addition, more experienced pilots were more likely to have wrong reactions to warnings while acting as the monitoring pilot. These results suggest that both expertise and flight responsibility influence pilots' reactions to alerts. Considering crew pairing strategy, when a pilot flying is a less experienced pilot, a more experience pilot is suggested to be the monitoring pilot. The results of this study have implications for understanding pilots' behaviors to flight deck alerts, calling for specialized training and design of approach alarms on the flight deck.

Human factors in aviation crashes involving older pilots.

PubMed

Li, Guohua; Baker, Susan P; Lamb, Margaret W; Grabowski, Jurek G; Rebok, George W

2002-02-01

Pilot errors are recognized as a contributing factor in as many as 80% of aviation crashes. Experimental studies using flight simulators indicate that due to decreased working memory capacity, older pilots are outperformed by their younger counterparts in communication tasks and flight summary scores. This study examines age-related differences in crash circumstances and pilot errors in a sample of pilots who flew commuter aircraft or air taxis and who were involved in airplane or helicopter crashes. A historical cohort of 3306 pilots who in 1987 flew commuter aircraft or air taxis and were 45-54 yr of age was constructed using the Federal Aviation Administration's airmen information system. Crash records of the study subjects for the years 1983-1997 were obtained from the National Transportation Safety Board (NTSB) by matching name and date of birth. NTSB's investigation reports were reviewed to identify pilot errors and other contributing factors. Comparisons of crash circumstances and human factors were made between pilots aged 40-49 yr and pilots aged 50-63 yr. A total of 165 crash records were studied, with 52% of these crashes involving pilots aged 50-63 yr. Crash circumstances, such as time and location of crash, type and phase of flight, and weather conditions, were similar between the two age groups. Pilot error was a contributing factor in 73% of the crashes involving younger pilots and in 69% of the crashes involving older pilots (p = 0.50). Age-related differences in the pattern of pilot errors were statistically insignificant. Overall, 23% of pilot errors were attributable to inattentiveness, 20% to flawed decisions, 18% to mishandled aircraft kinetics, and 18% to mishandled wind/runway conditions. Neither crash circumstances nor the prevalence and patterns of pilot errors appear to change significantly as age increases from the 40s to the 50s and early 60s.

The psychophysiological assessment method for pilot's professional reliability.

PubMed

Zhang, L M; Yu, L S; Wang, K N; Jing, B S; Fang, C

1997-05-01

Previous research has shown that a pilot's professional reliability depends on two relative factors: the pilot's functional state and the demands of task workload. The Psychophysiological Reserve Capacity (PRC) is defined as a pilot's ability to accomplish additive tasks without reducing the performance of the primary task (flight task). We hypothesized that the PRC was a mirror of the pilot's functional state. The purpose of this study was to probe the psychophysiological method for evaluating a pilot's professional reliability on a simulator. The PRC Comprehensive Evaluating System (PRCCES) which was used in the experiment included four subsystems: a) quantitative evaluation system for pilot's performance on simulator; b) secondary task display and quantitative estimating system; c) multiphysiological data monitoring and statistical system; and d) comprehensive evaluation system for pilot PRC. Two studies were performed. In study one, 63 healthy and 13 hospitalized pilots participated. Each pilot performed a double 180 degrees circuit flight program with and without secondary task (three digit operation). The operator performance, score of secondary task and cost of physiological effort were measured and compared by PRCCES in the two conditions. Then, each pilot's flight skill in training was subjectively scored by instructor pilot ratings. In study two, 7 healthy pilots volunteered to take part in the experiment on the effects of sleep deprivation on pilot's PRC. Each participant had PRC tested pre- and post-8 h sleep deprivation. The results show that the PRC values of a healthy pilot was positively correlated with abilities of flexibility, operating and correcting deviation, attention distribution, and accuracy of instrument flight in the air (r = 0.27-0.40, p < 0.05), and negatively correlated with emotional anxiety in flight (r = -0.40, p < 0.05). The values of PRC in healthy pilots (0.61 +/- 0.17) were significantly higher than that of hospitalized pilots (0.43 +/- 0.15) (p < 0.05). The PRC value after 8 h sleep loss (0.50 +/- 0.17) was significantly lower than those before sleep loss (0.70 +/- 0.15) (p < 0.05). We conclude that a pilot's PRC, which was closely related to flight ability and functional state, could partly represent the pilot's professional reliability. It is worthwhile to further research using a pilot's PRC as a predictor of mental workload in aircraft design.

Improving linear transport infrastructure efficiency by automated learning and optimised predictive maintenance techniques (INFRALERT)

NASA Astrophysics Data System (ADS)

Jiménez-Redondo, Noemi; Calle-Cordón, Alvaro; Kandler, Ute; Simroth, Axel; Morales, Francisco J.; Reyes, Antonio; Odelius, Johan; Thaduri, Aditya; Morgado, Joao; Duarte, Emmanuele

2017-09-01

The on-going H2020 project INFRALERT aims to increase rail and road infrastructure capacity in the current framework of increased transportation demand by developing and deploying solutions to optimise maintenance interventions planning. It includes two real pilots for road and railways infrastructure. INFRALERT develops an ICT platform (the expert-based Infrastructure Management System, eIMS) which follows a modular approach including several expert-based toolkits. This paper presents the methodologies and preliminary results of the toolkits for i) nowcasting and forecasting of asset condition, ii) alert generation, iii) RAMS & LCC analysis and iv) decision support. The results of these toolkits in a meshed road network in Portugal under the jurisdiction of Infraestruturas de Portugal (IP) are presented showing the capabilities of the approaches.

Arab-American adolescent tobacco use: four pilot studies.

PubMed

Rice, Virginia Hill; Templin, Thomas; Kulwicki, Anahid

2003-11-01

Four pilot studies were conducted to determine the (1) current tobacco use patterns and predictors among 14- to 18-year-old Arab-American youths; (2) psychometric properties of study measures (English and Arabic); (3) cultural appropriateness of Project Toward No Tobacco (TNT) for intervention; (4) accessible population for a longitudinal study. Three studies were descriptive and one used a pretest-posttest design. From four Pilot Focus groups (N = 28 smokers) key tobacco use themes emerged along with information on study measures and the Project TNT intervention; Pilot Intervention tested the tailored Project TNT intervention with 9 Arab-American teens; Pilot Clinic (N = 44) determined the characteristics of the accessible teen health clinic population; and Pilot School (N = 119) obtained tobacco use data only. From Pilot Focus seven themes (being cool, "nshar ma'a al shabab" [hanging out with the guys], present [time] orientation, smoking feels and tastes good, keeps your mind off trouble, easy to get, and (many) "barriers to quitting") emerged from the data. In the Pilot Intervention a 37.5% cessation rate was found. In the Pilot Clinic study, 24% males and 17% females smoked. The current smoking rate in the Pilot School (N = 119) sample was 17%; 34% admitted to having ever smoked (even a puff). Significant predictors for current tobacco use included poor grades, stress, having many family members and peers who smoke, being exposed to many hours of smoking each day, receiving offers of tobacco products, advertising and mail, and believing that tobacco can help one to make friends. The four pilots contributed unique and essential knowledge for designing a longitudinal clinical trial on tobacco use by Arab-American adolescents.

Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature.

PubMed

O'Donovan, James; O'Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich; Winters, Niall

2018-04-28

Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Systematic scoping review. MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. © 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.

WE-G-217BCD-04: Diagnostic Image Quality Evaluation of a Dedicated Extremity Cone- Beam CT Scanner: Pre-Clinical Studies and First Clinical Results.

PubMed

Muhit, A; Zbijewski, W; Stayman, J; Thawait, G; Yorkston, J; Foos, D; Packard, N; Yang, D; Senn, R; Carrino, J; Siewerdsen, J

2012-06-01

To assess the diagnostic performance of a prototype cone-beam CT (CBCT) scanner developed for musculoskeletal extremity imaging. Studies involved controlled observer studies conducted subsequent to rigorous technical assessment as well as patient images from the first clinical trial in imaging the hand and knee. Performance assessment included: 1.) rigorous technical assessment; 2.) controlled observer studies using CBCT images of cadaveric specimens; and 3.) first clinical images. Technical assessment included measurement of spatial resolution (MTF), constrast, and noise (SDNR) versus kVp and dose using standard CT phantoms. Diagnostic performance in comparison to multi- detector CT (MDCT) was assessed in controlled observer studies involving 12 cadaveric hands and knees scanned with and without abnormality (fracture). Observer studies involved five radiologists rating pertinent diagnostics tasks in 9-point preference and 10-point diagnostic satisfaction scales. Finally, the first clinical images from an ongoing pilot study were assessed in terms of diagnostic utility in disease assessment and overall workflow in patient setup. Quantitative assessment demonstrated sub-mm spatial resolution (MTF exceeding 10% out to 15-20 cm-1) and SDNR sufficient for relevant soft-tissue visualization tasks at dose <10 mGy. Observer studies confirmed optimal acquisition techniques and demonstrated superior utility of combined soft-tissue visualization and isotropic spatial resolution in diagnostic tasks. Images from the patient trial demonstrate exquisite contrast and detail and the ability to detect tissue impingement in weight-bearing exams. The prototype CBCT scanner provides isotropic spatial resolution superior to standard-protocol MDCT with soft-tissue visibility sufficient for a broad range of diagnostic tasks in musculoskeletal radiology. Dosimetry and workflow were advantageous in comparison to whole-body MDCT. Multi-mode and weight-bearing capabilities add valuable functionality. An ongoing clinical study further assesses diagnostic utility and defines the role of such technology in the diagnostic arsenal. - Research Grant, Carestream Health - Research Grant, National Institutes of Health 2R01-CA-112163. © 2012 American Association of Physicists in Medicine.

Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy: a pilot cohort study.

PubMed

Santamaria, Xavier; Cabanillas, Sergio; Cervelló, Irene; Arbona, Cristina; Raga, Francisco; Ferro, Jaime; Palmero, Julio; Remohí, Jose; Pellicer, Antonio; Simón, Carlos

2016-05-01

Could cell therapy using autologous peripheral blood CD133+ bone marrow-derived stem cells (BMDSCs) offer a safe and efficient therapeutic approach for patients with refractory Asherman's syndrome (AS) and/or endometrial atrophy (EA) and a wish to conceive? In the first 3 months, autologous cell therapy, using CD133+ BMDSCs in conjunction with hormonal replacement therapy, increased the volume and duration of menses as well as the thickness and angiogenesis processes of the endometrium while decreasing intrauterine adhesion scores. AS is characterized by the presence of intrauterine adhesions and EA prevents the endometrium from growing thicker than 5 mm, resulting in menstruation disorders and infertility. Many therapies have been attempted for these conditions, but none have proved effective. This was a prospective, experimental, non-controlled study. There were 18 patients aged 30-45 years with refractory AS or EA were recruited, and 16 of these completed the study. Medical history, physical examination, endometrial thickness, intrauterine adhesion score and neoangiogenesis were assessed before and 3 and 6 months after cell therapy. After the initial hysteroscopic diagnosis, BMDSC mobilization was performed by granulocyte-CSF injection, then CD133+ cells were isolated through peripheral blood aphaeresis to obtain a mean of 124.39 million cells (range 42-236), which were immediately delivered into the spiral arterioles by catheterization. Subsequently, endometrial treatment after stem cell therapy was assessed in terms of restoration of menses, endometrial thickness (by vaginal ultrasound), adhesion score (by hysteroscopy), neoangiogenesis and ongoing pregnancy rate. The study was conducted at Hospital Clínico Universitario of Valencia and IVI Valencia (Spain). All 11 AS patients exhibited an improved uterine cavity 2 months after stem cell therapy. Endometrial thickness increased from an average of 4.3 mm (range 2.7-5) to 6.7 mm (range 3.1-12) ( ITALIC! P = 0.004). Similarly, four of the five EA patients experienced an improved endometrial cavity, and endometrial thickness increased from 4.2 mm (range 2.7-5) to 5.7 mm (range 5-12) ( ITALIC! P = 0.03). The beneficial effects of the cell therapy increased the mature vessel density and the duration and intensity of menses in the first 3 months, with a return to the initial levels 6 months after the treatment. Three patients became pregnant spontaneously, resulting in one baby boy born, one ongoing pregnancy and a miscarriage. Furthermore, seven pregnancies were obtained after fourteen embryo transfers, resulting in three biochemical pregnancies, one miscarriage, one ectopic pregnancy, one baby born and one ongoing pregnancy. Limitations of this pilot study include the small sample size and the lack of control group. This novel autologous cell therapy is a promising therapeutic option for patients with these incurable pathologies and a wish to conceive. This study was funded by the Spanish Ministry of Science and Innovation (SAF 2012-31017, Principal Investigator C.S.), Spanish Ministry of Health (EC11-299, Principal Investigator C.S.) and Regional Valencian Ministry of Education (PROMETEOII/2013/018, Principal Investigator C.S.). Four authors (X.S., I.C., A.P. and C.S.) are co-inventors of the patent resulting from this work (Application number: 62/013,121). S.C., C.A., F.R., J.F., J.P. and J.R. have no conflict of interest in relation to this work. This study was registered with ClinicalTrials.gov (NCT02144987). © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

PubMed Central

White, Julia N; Corker, Jamaica

2016-01-01

ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

Preparing Safety Cases for Operating Outside Prescriptive Fatigue Risk Management Regulations.

PubMed

Gander, Philippa; Mangie, Jim; Wu, Lora; van den Berg, Margo; Signal, Leigh; Phillips, Adrienne

2017-07-01

Transport operators seeking to operate outside prescriptive fatigue management regulations are typically required to present a safety case justifying how they will manage the associated risk. This paper details a method for constructing a successful safety case. The method includes four elements: 1) scope (prescriptive rules and operations affected); 2) risk assessment; 3) risk mitigation strategies; and 4) monitoring ongoing risk. A successful safety case illustrates this method. It enables landing pilots in 3-pilot crews to choose the second or third in-flight rest break, rather than the regulatory requirement to take the third break. Scope was defined using a month of scheduled flights that would be covered (N = 4151). These were analyzed in the risk assessment using existing literature on factors affecting fatigue to estimate the maximum time awake at top of descent and sleep opportunities in each break. Additionally, limited data collected before the new regulations showed that pilots flying at landing chose the third break on only 6% of flights. A prospective survey comparing subjective reports (N = 280) of sleep in the second vs. third break and fatigue and sleepiness ratings at top of descent confirmed that the third break is not consistently superior. The safety case also summarized established systems for fatigue monitoring, risk assessment and hazard identification, and multiple fatigue mitigation strategies that are in place. Other successful safety cases have used this method. The evidence required depends on the expected level of risk and should evolve as experience with fatigue risk management systems builds.Gander P, Mangie J, Wu L, van den Berg M, Signal L, Phillips A. Preparing safety cases for operating outside prescriptive fatigue risk management regulations. Aerosp Med Hum Perform. 2017; 88(7):688-696.

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

PubMed

White, Julia N; Corker, Jamaica

2016-08-11

Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

Preliminary Data on a Care Coordination Program for Home Care Recipients.

PubMed

Dean, Katie M; Hatfield, Laura A; Jena, Anupam B; Cristman, David; Flair, Michael; Kator, Kylie; Nudd, Geoffrey; Grabowski, David C

2016-09-01

Home care recipients are often hospitalized for potentially avoidable reasons. A pilot program (Intervention in Home Care to Improve Health Outcomes (In-Home)) was designed to help home care providers identify acute clinical changes in condition and then manage the condition in the home and thereby avoid a costly hospitalization. Caregivers answer simple questions about the care recipient's condition during a telephone-based "clock-out" at the end of each shift. Responses are electronically captured in the agency management software that caregivers use to "clock-in," manage care, and "clock-out" on every shift. These are transmitted to the agency's care manager, who follows up on the change in condition and escalates appropriately. A description of the In-Home model is presented, and pilot data from 22 home care offices are reported. In the pilot, caregivers reported a change in condition after 2% of all shifts, representing an average of 1.9 changes per care recipient in a 6-month period. Changes in behavior and skin condition were the most frequently recorded domains. Interviews with participating caregivers and care managers suggested positive attitudes regarding the intervention; challenges included resistance to change on the part of home care staff and difficulties in applying a uniform intervention to individuals with varying needs in home care offices with varying capacities. In an ongoing randomized trial, the success of the overall program will be measured primarily according to the potential reduction in avoidable hospitalizations of home care recipients and the effect this potential reduction has on spending and healthcare outcomes. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

A Pilot Trial of the Combination of Vemurafenib with Adoptive Cell Therapy in Patients with Metastatic Melanoma.

PubMed

Deniger, Drew C; Kwong, Mei Li M; Pasetto, Anna; Dudley, Mark E; Wunderlich, John R; Langhan, Michelle M; Lee, Chyi-Chia Richard; Rosenberg, Steven A

2017-01-15

This pilot feasibility clinical trial evaluated the coadministration of vemurafenib, a small-molecule antagonist of BRAF V600 mutations, and tumor-infiltrating lymphocytes (TIL) for the treatment of metastatic melanoma. A metastatic tumor was resected for growth of TILs, and patients were treated with vemurafenib for 2 weeks, followed by resection of a second lesion. Patients then received a nonmyeloablative preconditioning regimen, infusion of autologous TILs, and high-dose interleukin-2 administration. Vemurafenib was restarted at the time of TIL infusion and was continued for 2 years or until disease progression. Clinical responses were evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) 1.0. Metastases resected prior to and after 2 weeks of vemurafenib were compared using TCRB deep sequencing, immunohistochemistry, proliferation, and recognition of autologous tumor. The treatment was well tolerated and had a safety profile similar to that of TIL or vemurafenib alone. Seven of 11 patients (64%) experienced an objective clinical response, and 2 patients (18%) had a complete response for 3 years (one response is ongoing at 46 months). Proliferation and viability of infusion bag TILs and peripheral blood T cells were inhibited in vitro by research-grade vemurafenib (PLX4032) when approaching the maximum serum concentration of vemurafenib. TCRB repertoire (clonotypes numbers, clonality, and frequency) did not significantly change between pre- and post-vemurafenib lesions. Recognition of autologous tumor by T cells was similar between TILs grown from pre- and post-vemurafenib metastases. Coadministration of vemurafenib and TILs was safe and feasible and generated objective clinical responses in this small pilot clinical trial. Clin Cancer Res; 23(2); 351-62. ©2016 AACRSee related commentary by Cogdill et al., p. 327. ©2016 American Association for Cancer Research.

78 FR 23941 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

...] Pilot Program for Early Feasibility Study Investigational Device Exemption Applications; Extending the... 13343), FDA terminated the acceptance of applications into the program and extended the pilot program for the nine accepted sponsors until May 8, 2013. The pilot program will be further extended for the...

A preliminary study on the integral relationship between critical thinking and mathematical thinking among practicing civil engineers

NASA Astrophysics Data System (ADS)

Osman, Sharifah; Mohammad, Shahrin; Abu, Mohd Salleh

2015-05-01

Mathematics and engineering are inexorably and significantly linked and essentially required in analyzing and accessing thought to make good judgment when dealing in complex and varied engineering problems. A study in the current engineering education curriculum to explore how the critical thinking and mathematical thinking relates to one another, is therefore timely crucial. Unfortunately, there is not much information available explicating about the link. This paper aims to report findings of a critical review as well as to provide brief description of an on-going research aimed to investigate the dispositions of critical thinking and the relationship and integration between critical thinking and mathematical thinking during the execution of civil engineering tasks. The first part of the paper reports an in-depth review on these matters based on rather limited resources. The review showed a considerable form of congruency between these two perspectives of thinking, with some prevalent trends of engineering workplace tasks, problems and challenges. The second part describes an on-going research to be conducted by the researcher to investigate rigorously the relationship and integration between these two types of thinking within the perspective of civil engineering tasks. A reasonably close non-participant observations and semi-structured interviews will be executed for the pilot and main stages of the study. The data will be analyzed using constant comparative analysis in which the grounded theory methodology will be adopted. The findings will serve as a useful grounding for constructing a substantive theory revealing the integral relationship between critical thinking and mathematical thinking in the real civil engineering practice context. The substantive theory, from an angle of view, is expected to contribute some additional useful information to the engineering program outcomes and engineering education instructions, aligns with the expectations of engineering program outcomes set by the Engineering Accreditation Council.

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework.

PubMed

Eldridge, Sandra M; Lancaster, Gillian A; Campbell, Michael J; Thabane, Lehana; Hopewell, Sally; Coleman, Claire L; Bond, Christine M

2016-01-01

We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms 'pilot' and 'feasibility' in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms 'feasibility' or 'pilot' as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term 'feasibility' in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention.

Study to determine the IFR operational profile and problems of the general aviation single pilot

NASA Technical Reports Server (NTRS)

Weislogel, G. S.

1983-01-01

General aviation single pilot operating under instrument flight rules (GA SPIFR) was studied. The objectives of the study were to (1) develop a GA SPIFR operational profile, (2) identify problems experienced by the GA SPIFR pilot, and (3) identify research tasks which have the potential for eliminating or reducing the severity of the problems. To obtain the information necessary to accomplish these objectives, a mail questionnaire survey of instrument rated pilots was conducted. The general aviation IFR single pilot operational profile and selected data analysis examples are presented.

Piloted studies of Enhanced or Synthetic Vision display parameters

NASA Technical Reports Server (NTRS)

Harris, Randall L., Sr.; Parrish, Russell V.

1992-01-01

This paper summarizes the results of several studies conducted at Langley Research Center over the past few years. The purposes of these studies were to investigate parameters of pictorial displays and imaging sensors that affect pilot approach and landing performance. Pictorial displays have demonstrated exceptional tracking performance and improved the pilots' spatial awareness. Stereopsis cueing improved pilot flight performance and reduced pilot stress. Sensor image parameters such as increased field-of-view. faster image update rate, and aiding symbology improved flare initiation. Finer image resolution and magnification improved attitude control performance parameters.

PILOT STUDY: THE TAMPA ASTHMATIC CHILDREN'S STUDY (TACS)

EPA Science Inventory

The Tampa Asthmatic Children's Study (TACS) was a pilot research study that focused on developing and evaluating air pollution exposure assessment methods and participant recruiting tools for children in the age range of 1-5 years old. The pilot study focused on (a) simple, cost-...

Field-Scale Evaluation of Monitored Natural Attenuation for Dissolved Chlorinated Solvent Plumes

DTIC Science & Technology

2009-04-01

biological in-situ treatment, an air sparging pilot study, and a phytoremediation study. The innovative technology studies were conducted within the source... phytoremediation (June to September 1997), reductive anaerobic biological in-situ treatment technology (RABITT; 1998), and groundwater recirculation wells...u g / L ) Measured Concentrations in 1381MWS09 Air Sparge Pilot Test (1996/1997) Phytoremediation Pilot Test (1997) RABITT Pilot Test (1998

The Necessity of ASEAN Community in Producing Pilots

ERIC Educational Resources Information Center

Saowaros, Thanoo; Puncreobutr, Vichian

2016-01-01

The main objectives of this study are to identify the reasons for the shortage of pilots; the necessity of producing Pilots and the obstacles and problems faced by ASEAN Community in producing pilots. The study is conducted by official documents, observations, in-depth interview from personnel who are working for Airports Authority of Thailand,…

SPEEDIER Project. Preliminary Report on Social Studies Pilot Projects.

ERIC Educational Resources Information Center

Myers, Charles B.; And Others

This preliminary report describes five social studies pilot programs in the counties of Dauphin, Lancaster, Lebanon, and York, Pennsylvania. It is expected that these pilot endeavors will affect educators in the counties served by SPEEDIER as follows: 1) increase understanding of the newer content, ideas, and strategies in the pilot programs; 2)…

Pilot Study: Foam Wedge Chin Support Static Tolerance Testing

DTIC Science & Technology

2017-10-24

AFRL-SA-WP-SR-2017-0026 Pilot Study : Foam Wedge Chin Support Static Tolerance Testing Austin M. Fischer, BS1; William W...COVERED (From – To) April – October 2017 4. TITLE AND SUBTITLE Pilot Study : Foam Wedge Chin Support Static Tolerance Testing 5a. CONTRACT NUMBER...prototype to mitigate the increase in helmet weight and forward center of gravity. The purpose of this pilot study was to determine the feasibility and

Oral Propranolol: A New Treatment for Infants with Retinopathy of Prematurity?

PubMed

Bührer, Christoph; Bassler, Dirk

2015-01-01

Oral propranolol has improved the treatment of infantile hemangiomas, and a pediatric oral solution of propranolol has recently been licensed in the USA and Europe. In very preterm infants, infantile hemangiomas are associated with the occurrence of retinopathy of prematurity (ROP), and both diseases share a peculiar time course, featuring a lag phase after birth followed by rapid growth and then gradual regression. To identify clinical studies evaluating the use of oral propranolol in preterm infants with ROP. Two small bicentric, pilot, randomized controlled trials found a nonsignificant reduction of ROP requiring intervention by laser treatment or bevacizumab injection of similar magnitude. Together, 6 of 35 (17%) infants who had been receiving oral propranolol underwent ROP intervention, as opposed to 14 of 36 (39%) controls (relative risk 0.42, 95% CI: 0.15-1.16). Randomized controlled trials are ongoing that investigate early preventive oral propranolol starting at 1 week of age and propranolol eye drops in preterm infants with stage 2 ROP. Further, large interventional studies are required to determine the clinical benefit-risk ratio of oral propranolol to prevent vision-threatening ROP in very preterm infants. © 2015 S. Karger AG, Basel.

Volunteer involvement in the support of self-managed computerised aphasia treatment: The volunteer perspective.

PubMed

Palmer, Rebecca; Enderby, Pam

2016-10-01

The speech-language pathology profession has explored a number of approaches to support efficient delivery of interventions for people with stroke-induced aphasia. This study aimed to explore the role of volunteers in supporting self-managed practice of computerised language exercises. A qualitative interview study of the volunteer support role was carried out alongside a pilot randomised controlled trial of computer aphasia therapy. Patients with aphasia practised computer exercises tailored for them by a speech-language pathologist at home regularly for 5 months. Eight of the volunteers who supported the intervention took part in semi-structured interviews. Interviews were audio recorded, transcribed verbatim and analysed thematically. Emergent themes included: training and support requirements; perception of the volunteer role; challenges facing the volunteer, in general and specifically related to supporting computer therapy exercises. The authors concluded that volunteers helped to motivate patients to practise their computer therapy exercises and also provided support to the carers. Training and ongoing structured support of therapy activity and conduct is required from a trained speech-language pathologist to ensure the successful involvement of volunteers supporting impairment-based computer exercises in patients' own homes.

The Worksite Heart Health Improvement Project (WHHIP): feasibility and efficacy.

PubMed

Flannery, Kelly; Resnick, Barbara; Galik, Elizabeth; Lipscomb, Jane; McPhaul, Kathleen; Shaughnessy, Marianne

2012-01-01

Test the feasibility and efficacy of the Worksite Heart Health Improvement Project (WHHIP). The WHHIP was a quasi-experimental 6-month pilot performed in 2 long-term care facilities. Thirty-nine female minority nursing assistants participated in this study with a mean age of 42.39 (SD = 12.79) years. Measures were collected at baseline, 3, and 6 months and included blood pressure, lipid panel, body mass index, physical activity levels, diet behaviors, depressive symptoms, and self-efficacy outcomes. The 3-month WHHIP intervention included 3 components: environmental and policy assessment; education; and on-going motivation. The control site received education only. Subject participation averaged 47% and 58% in exercise and diet related activities, respectively. Generalized estimating equations showed the treatment group showed significant improvements in depressive symptoms (p = .012), systolic blood pressure (p = .028), total cholesterol (p = .002) and triglycerides (p = .011) over time. The treatment group also showed trends for improvement in diet behaviors (p = .069) and diastolic blood pressure (p = .073). This study provided feasibility evidence for the WHHIP and preliminary evidence that the WHHIP can improve heart healthy behaviors and subsequent outcomes among nursing assistants in long-term care settings. © 2012 Wiley Periodicals, Inc.

"iM Ready to Learn": Undergraduate Nursing Students Knowledge, Preferences, and Practice of Mobile Technology and Social Media.

PubMed

Hay, Benjamin; Carr, Peter J; Dawe, Lydia; Clark-Burg, Karen

2017-01-01

The purpose of this study was to identify in what way social media and mobile technology assist with learning and education of the undergraduate nurse. The study involved undergraduate nursing students across three campuses from the University of Notre Dame Australia. Participants were invited to complete an online questionnaire that related to their current knowledge, preferences, and practice with mobile technology and social media within their undergraduate nursing degree. A quantitative descriptive survey design was adapted from an initial pilot survey by the authors. A total of 386 nursing students (23.47% of the total enrolment) completed the online survey. Overall, results suggested that students are more supportive of social media and mobile technology in principle than in practice. Students who frequently use mobile technologies prefer to print out, highlight, and annotate the lecture material. Findings suggest that nursing students currently use mobile technology and social media and are keen to engage in ongoing learning and collaboration using these resources. Therefore, nursing academia should encourage the appropriate use of mobile technology and social media within the undergraduate curriculum so that responsible use of such technologies positively affects the future nursing workforce.

Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases.

PubMed

Li, Bo; Gao, Hong-yang; Gao, Rui; Zhao, Ying-pan; Li, Qing-na; Zhao, Yang; Tang, Xu-dong; Shang, Hong-cai

2016-02-01

Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

A cross-sectional pilot study of compassion fatigue, burnout, and compassion satisfaction in pediatric palliative care providers in the United States.

PubMed

Kase, Samuel M; Waldman, Elisha D; Weintraub, Andrea S

2018-02-05

Compassion fatigue (CF) is secondary traumatic distress experienced by providers from contact with patients' suffering. Burnout (BO) is job-related distress resulting from uncontrollable workplace factors that manifest in career dissatisfaction. Compassion satisfaction (CS) is emotional fulfillment derived from caring for others. The literature on BO in healthcare providers is extensive, whereas CF and CS have not been comprehensively studied. Because of ongoing exposure to patient and family distress, pediatric palliative care (PPC) providers may be at particular risk for CF. We conducted a cross-sectional pilot study of CF, BO, and CS among PPC providers across the United States. The Compassion Fatigue and Satisfaction Self-Test for Helpers and a questionnaire of professional and personal characteristics were distributed electronically and anonymously to PPC physicians and nurses. Logistic and linear regression models for CF, BO, and CS as a function of potential risk factors were constructed. The survey response rate was 39%, primarily consisting of female, Caucasian providers. The prevalence of CF, BO, and CS was 18%, 12%, and 25%, respectively. Distress about a "clinical situation," physical exhaustion, and personal loss were identified as significant determinants of CF. Distress about "coworkers," emotional depletion, social isolation, and "recent involvement in a clinical situation in which life-prolonging activities were not introduced" were significant determinants of BO. Physical exhaustion, personal history of trauma, "recent involvement in a clinical situation in which life-prolonging activities were not introduced," and not discussing distressing issues were significant predictors of lower CS scores. Significance of results CF and BO directly influence the well-being and professional performance of PPC providers. To provide effective compassionate care to patients, PPC providers must be attentive to predictors of these phenomena. Further work is needed to explore additional causes of CF, BO, and CS in PPC providers as well as potential interventions.

An analytical study of aircraft lateral-directional handling qualities using pilot models

NASA Technical Reports Server (NTRS)

Adams, J. J.; Moore, F. L.

1976-01-01

A procedure for predicting lateral-directional pilot ratings on the basis of the characteristics of the pilot model and the closed-loop system characteristics is demonstrated. A correlation is shown to exist between experimentally obtained pilot ratings and the computed pilot ratings.

Study adaptation, design, and methods of a web-based PTSD intervention for women Veterans.

PubMed

Lehavot, Keren; Litz, Brett; Millard, Steven P; Hamilton, Alison B; Sadler, Anne; Simpson, Tracy

2017-02-01

Women Veterans are a rapidly growing population with high risk of exposure to potentially traumatizing events and PTSD diagnoses. Despite the dissemination of evidence-based treatments for PTSD in the VA, most women Veteran VA users underutilize these treatments. Web-based PTSD treatment has the potential to reach and engage women Veterans with PTSD who do not receive treatment in VA settings. Our objective is to modify and evaluate Delivery of Self Training and Education for Stressful Situations (DESTRESSS), a web-based cognitive-behavioral intervention for PTSD, to target PTSD symptoms among women Veterans. The specific aims are to: (1) obtain feedback about DESTRESS, particularly on its relevance and sensitivity to women, using semi-structured interviews with expert clinicians and women Veterans with PTSD, and make modifications based on this feedback; (2) conduct a pilot study to finalize study procedures and make further refinements to the intervention; and (3) conduct a randomized clinical trial (RCT) evaluating a revised, telephone-assisted DESTRESS compared to telephone monitoring only. We describe the results from the first two aims, and the study design and procedures for the ongoing RCT. This line of research has the potential to result in a gender-sensitive, empirically-based, online treatment option for women Veterans with PTSD. Published by Elsevier Inc.

Perspectives of adolescents on decision making about participation in a biobank study: a pilot study.

PubMed

Grootens-Wiegers, Petronella; Visser, Eline G; van Rossum, Annemarie M C; van Waardhuizen, Claudia N; de Wildt, Saskia N; Sweep, Boudewijn; van den Broek, Jos M; de Vries, Martine C

2017-01-01

To be able to truly involve adolescents in decision making about clinical research participation, we need more insight in the perspective of adolescents themselves. To this end, adolescents in an ongoing biobank study were consulted to test a tentative decision assessment tool. The perspectives of adolescents (n=8) concerning participation in decision making for research participation were explored in interviews with a tentative tool, which covered six topics: information material usage, understanding, disease perceptions, anxiety, decision-making process and role sharing. All adolescents unequivocally expressed the desire to be involved in decision making, but also wanted advice from their parents. The extent of the preferred role of adolescent versus parents varied between individuals. In decision making, adolescents relied on parents for information. More than half hardly used the information material. Adolescents in our study preferred a shared decision-making process. The extent of sharing varied between individuals. The decision assessment tool was a fruitful starting point to discuss adolescents' perspectives and may aid in tailoring the situation to the individual to achieve optimal participation practices. Consulting adolescents about their preferences concerning decision making using the tool will facilitate tailoring of the shared decision-making process and optimising the developing autonomy of minors.

National Assessment of Historical Shoreline Change: A Pilot Study of Historical Coastal Bluff Retreat in the Great Lakes, Erie, Pennsylvania

USGS Publications Warehouse

Hapke, Cheryl J.; Malone, Shamus; Kratzmann, Meredith G.

2009-01-01

Coastal bluff retreat is a chronic problem along many high-relief coastlines in the United States. As coastal populations continue to grow and community infrastructures are threatened by erosion, there is increased demand for accurate information regard-ing trends and rates of bluff retreat. There is also a need for a comprehensive analysis that is consistent from one coastal region to another. To address these national needs, the U.S. Geological Survey (USGS), as part of the National Assessment of Coastal Change Hazards Project, conducted a pilot study of bluff retreat along the Lake Erie, Pa., coastline to assess the feasibility of undertaking a larger, multi-state analysis in the Great Lakes region. This report provides an overview of the pilot-study location and bluff geomorphology, the data sources and methodology, results of the analysis, and a discussion of the feasibility of undertaking a similar analysis along eroding bluffs in other Great Lakes states. This pilot study is part of an ongoing effort by the USGS to provide a comprehensive analysis of historical shoreline change and cliff and bluff retreat along open-ocean coastlines of the conterminous United States and parts of Hawaii, Alaska, and the Great Lakes. One purpose of the work is to develop standard, repeatable methods for mapping and analyzing coastal change so that systematic and consistent periodic updates of coastal erosion can be made nationally. Bluff-retreat evaluations are conducted by comparing the location of a historical bluff edge digitized from aerial photographs with those of recent bluff edges interpreted from both aerial photographs and lidar topographic surveys. The historical bluff edge is from 1938, whereas the more recent bluff edges are from 1998 and 2006 lidar data. Long-term (68-year) rates of retreat are calculated using the available bluff-edge data. The rates of retreat presented in this report represent conditions from the 1930s to 1998/2006, and are not intended for predicting future bluff-edge positions or rates of retreat. The report presents bluff-retreat rates for 32 km of a 60-km stretch along the Lake Erie, Pa., coastline. Data are discontinuous due to gaps in source data and lack of continuous bluffs. The average rate of coastal bluff retreat for the Lake Erie, Pa., bluffs was -0.3 +- 0.1 m/yr (retreat rates are presented as negative numbers in this report), based on rates averaged from 1,595 individual transects. Retreat rates generally were lowest where bedrock outcrops are exposed as the basal unit in the bluff. The highest rates are associated with anthropogenic activities, including jetties that trap littoral sediment, depleting a source of material for the natural replenishment of protective beaches downcoast, and extensive irrigation of farmlands on the tops of the bluffs, which can destabilize bluffs by enhancing ground-water outflow.

Dynamic Tunnel Usability Study: Format Recommendations for Synthetic Vision System Primary Flight Displays

NASA Technical Reports Server (NTRS)

Arthur, Jarvis J., III; Prinzel, Lawrence J., III; Kramer, Lynda J.; Bailey, Randall E.

2006-01-01

A usability study evaluating dynamic tunnel concepts has been completed under the Aviation Safety and Security Program, Synthetic Vision Systems Project. The usability study was conducted in the Visual Imaging Simulator for Transport Aircraft Systems (VISTAS) III simulator in the form of questionnaires and pilot-in-the-loop simulation sessions. Twelve commercial pilots participated in the study to determine their preferences via paired comparisons and subjective rankings regarding the color, line thickness and sensitivity of the dynamic tunnel. The results of the study showed that color was not significant in pilot preference paired comparisons or in pilot rankings. Line thickness was significant for both pilot preference paired comparisons and in pilot rankings. The preferred line/halo thickness combination was a line width of 3 pixels and a halo of 4 pixels. Finally, pilots were asked their preference for the current dynamic tunnel compared to a less sensitive dynamic tunnel. The current dynamic tunnel constantly gives feedback to the pilot with regard to path error while the less sensitive tunnel only changes as the path error approaches the edges of the tunnel. The tunnel sensitivity comparison results were not statistically significant.

Effects of alcohol on pilot performance in simulated flight

NASA Technical Reports Server (NTRS)

Billings, C. E.; Demosthenes, T.; White, T. R.; O'Hara, D. B.

1991-01-01

Ethyl alcohol's known ability to produce reliable decrements in pilot performance was used in a study designed to evaluate objective methods for assessing pilot performance. Four air carrier pilot volunteers were studied during eight simulated flights in a B727 simulator. Total errors increased linearly and significantly with increasing blood alcohol. Planning and performance errors, procedural errors and failures of vigilance each increased significantly in one or more pilots and in the group as a whole.

Social networks of HIV-positive women and their association with social support and depression symptoms.

PubMed

Cederbaum, Julie A; Rice, Eric; Craddock, Jaih; Pimentel, Veronica; Beaver, Patty

2017-02-01

Social support is important to the mental health and well-being of HIV-positive women. Limited information exists about the specific structure and composition of HIV-positive women's support networks or associations of these network properties with mental health outcomes. In this pilot study, the authors examine whether support network characteristics were associated with depressive symptoms. Survey and network data were collected from HIV-positive women (N = 46) via a web-based survey and an iPad application in August 2012. Data were analyzed using multivariate linear regression models in SAS. Depressive symptoms were positively associated with a greater number of doctors in a woman's network; having more HIV-positive network members was associated with less symptom reporting. Women who reported more individuals who could care for them had more family support. Those who reported feeling loved were less likely to report disclosure stigma. This work highlighted that detailed social network data can increase our understanding of social support so as to identify interventions to support the mental health of HIV-positive women. Most significant is the ongoing need for support from peers.

Community-based Early Warning and Adaptive Response System (EWARS) for mosquito borne diseases: An open source/open community approach

NASA Astrophysics Data System (ADS)

Babu, A. N.; Soman, B.; Niehaus, E.; Shah, J.; Sarda, N. L.; Ramkumar, P. S.; Unnithan, C.

2014-11-01

A variety of studies around the world have evaluated the use of remote sensing with and without GIS in communicable diseases. The ongoing Ebola epidemic has highlighted the risks that can arise for the global community from rapidly spreading diseases which may outpace attempts at control and eradication. This paper presents an approach to the development, deployment, validation and wide-spread adoption of a GIS-based temporo-spatial decision support system which is being collaboratively developed in open source/open community mode by an international group that came together under UN auspices. The group believes in an open source/open community approach to make the fruits of knowledge as widely accessible as possible. A core initiative of the groups is the EWARS project. It proposes to strengthen existing public health systems by the development and validation a model for a community based surveillance and response system which will initially address mosquito borne diseases in the developing world. At present mathematical modeling to support EWARS is at an advanced state, and it planned to embark on a pilot project

Applications of laser in ischemic heart disease in China

NASA Astrophysics Data System (ADS)

Chen, Mingzhe; Zhang, Yongzhen

1999-09-01

Current data demonstrate that laser coronary angioplasty is most useful in complex lesions not well suited for percutaneous transluminal coronary angioplasty (PTCA). It is not `stand-alone' procedure, and should be considered an adjunct to PTCA or stenting. To date, there are not data supporting reduction of restenosis. Direct myocardial revascularization (DMR), either transmyocardial revascularization (TMR) or percutaneous (catheter-based) myocardial revascularization (PMR), uses laser to create channels between ischemic myocardium and left ventricular cavity. Candidates include patients with chronic, severe, refractory angina and those unable to undergo angioplasty or bypass surgery because conduits or acceptable target vessels are lacking. Although the mechanisms of action of DMR have not yet been clearly elucidated, but several theories have been proposed, including channel patency, angiogenesis, and denervation. TMR, typically requiring open thoracotomy, is effective for improving myocardial perfusion and reducing angina. Pilot studies demonstrate that clinical application of PMR is feasible and safe and effective for decreasing angina. Late sequelae also remain to be determined. An ongoing randomized clinical trial is comparing PMR with conventional medical therapy in patients with severe, refractory angina and disease unamenable to angioplasty or bypass surgery.

The pragmatic language, communication skills, parent-child relationships, and symptoms of children with ADHD and their playmates 18-months after a parent-delivered play-based intervention.

PubMed

Wilkes-Gillan, Sarah; Cantrill, Alycia; Parsons, Lauren; Smith, Cally; Cordier, Reinie

2017-07-01

This study examined the communication skills, pragmatic language, parent-child relationships, and attention deficit hyperactivity disorder (ADHD) symptoms of children with ADHD and their playmates 18-months after a pilot parent-delivered intervention for improving social play skills and pragmatic language. Participants were five children with ADHD, their parents, and five typically-developing playmates. Outcomes were measured immediately post and 18-months following the intervention. Parent-rated norm-based assessments and an observational measure were used. Differences within and between the ADHD and playmate groups were examined. Children maintained all skills gained 18-months following the intervention. Compared to a normative sample, children with ADHD remained below the average range on aspects of communication skills, parent-child relationships, and ADHD symptom levels 18-months following intervention. After intervention, children with ADHD still experienced pragmatic language skills below those of their peers on norm-based assessments that measure their skills across contexts. School-based interventions are needed to facilitate ongoing skill development and generalization.

The Large Sky Area Multi-object Fiber Spectroscopic Telescope Quasar Survey: Quasar Properties from the First Data Release

NASA Astrophysics Data System (ADS)

Ai, Y. L.; Wu, Xue-Bing; Yang, Jinyi; Yang, Qian; Wang, Feige; Guo, Rui; Zuo, Wenwen; Dong, Xiaoyi; Zhang, Y.-X.; Yuan, H.-L.; Song, Y.-H.; Wang, Jianguo; Dong, Xiaobo; Yang, M.; -Wu, H.; Shen, S.-Y.; Shi, J.-R.; He, B.-L.; Lei, Y.-J.; Li, Y.-B.; Luo, A.-L.; Zhao, Y.-H.; Zhang, H.-T.

2016-02-01

We present preliminary results of the quasar survey in the Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) first data release (DR1), which includes the pilot survey and the first year of the regular survey. There are 3921 quasars reliably identified, among which 1180 are new quasars discovered in the survey. These quasars are at low to median redshifts, with a highest z of 4.83. We compile emission line measurements around the Hα, Hβ, Mg II, and C IV regions for the new quasars. The continuum luminosities are inferred from SDSS photometric data with model fitting, as the spectra in DR1 are non-flux-calibrated. We also compile the virial black hole mass estimates, with flags indicating the selection methods, and broad absorption line quasars. The catalog and spectra for these quasars are also available. Of the 3921 quasars, 28% are independently selected with optical-infrared colors, indicating that the method is quite promising for the completeness of the quasar survey. LAMOST DR1 and the ongoing quasar survey will provide valuable data for studies of quasars.

Salovum egg yolk containing antisecretory factor as an adjunct therapy in severe cholera in adult males: a pilot study.

PubMed

Alam, Nur H; Ashraf, Hasan; Olesen, Maryam; Salam, Mohammed A; Gyr, Niklaus; Meier, Remy

2011-08-01

Cholera involves stimulation of intestinal secretory process in response to cholera toxin leading to profuse watery diarrhoea that might cause death due to dehydration unless timely rehydration therapy is initiated. Efforts to identify and test potential antisecretory agents are ongoing. Antisecretory factor (AF) is a naturally-occurring protein produced in the human secretory organs, including the intestine, with antisectory properties demonstrated in animal and human models of secretory diarrhoea. Salovum egg yolk powder contains antisecretory proteins in a much higher (500 times) concentration than that of normal hen eggs. This is achieved by feeding hens with specially-processed cereals, capable of inducing antisecretory proteins in the yolk. The aim of the study was to examine the effect of Salovum egg yolk powder containing AF in the treatment of adult cholera patients. In an open, randomized controlled trial (pilot study), 40 adult male patients with severe cholera were studied: 20 received standard treatment (oral rehydration solution, antibiotic, and usual hospital diet) plus Salovum egg yolk powder (study group) and 20 received standard treatment alone (control group). All the patients received tablet doxycycline (300 mg) once immediately after randomization. Written informed consent was obtained from each subject before enrollment. The main outcome measures were stool weight and duration of diarrhoea. The demographic and baseline clinical characteristics of the study patients were comparable between the groups. No significant differences were found in the mean stool weight, g/kg of body-weight during the first 24 hours [study vs control group, mean +/- standard deviation (SD), 218 +/- 119 vs 195 +/- 136], second 24 hours (mean +/- SD, 23 +/- 39 vs 22 +/- 34), and cumulative up to 72 hours (mean +/- SD, 245 +/- 152 vs 218 +/- 169). The duration (hours) of diarrhoea after admission in the hospital was also similar in both the groups (mean +/- SD, 33 +/- 14 vs 32 +/- 10). No adverse effect was observed. Salovum egg powder containing AF as an adjunct therapy in the treatment of severe cholera could not demonstrate any beneficial effect. Further studies with higher doses of Salovum egg yolk powder might be considered in future to establish its antisecretory effect.

An Intervention Using Gamification to Increase Human Immunodeficiency Virus and Sexually Transmitted Infection Screening Among Young Men Who Have Sex With Men in California: Rationale and Design of Stick To It

PubMed Central

Mejia, Christopher M; Acland, Daniel; Buzdugan, Raluca; Grimball, Reva; Natoli, Lauren; McGrath, Mark R; Klausner, Jeffrey D

2017-01-01

Background In the United States, young men who have sex with men (YMSM) remain disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Although routine HIV/STI screening is pivotal to the timely diagnosis of HIV and STIs, initiation of appropriate treatment, and reduced onward disease transmission, repeat screening is underused. Novel interventions that incorporate elements of games, an approach known as gamification, have the potential to increase routinization of HIV/STI screening among YMSM. Objective The study aims to test the hypothesis that an incentive-based intervention that incorporates elements of gamification can increase routine HIV/STI screening among YMSM in California. Methods The study consists of a formative research phase to develop the intervention and an implementation phase where the intervention is piloted in a controlled research setting. In the formative research phase, we use an iterative development process to design the intervention, including gathering information about the feasibility, acceptability, and expected effectiveness of potential game elements (eg, points, leaderboards, rewards). These activities include staff interviews, focus group discussions with members of the target population, and team meetings to strategize and develop the intervention. The final intervention is called Stick To It and consists of 3 components: (1) online enrollment, (2) Web-based activities consisting primarily of quizzes and a countdown “timer” to facilitate screening reminders, and (3) in-person activities that occur at 2 sexual health clinics. Participants earn points through the Web-based activities that are then redeemed for chances to win various prizes during clinic visits. The pilot study is a quasi-experimental study with a minimum of 60 intervention group participants recruited at the clinics, at community-based events, and online. We will compare outcomes in the intervention group with a historical control group consisting of individuals meeting the inclusion criteria who attended study clinics in the 12 months prior to intervention implementation. Eligible participants in the pilot study (1) are 18 to 26 years old, (2) were born or identify as male, 3) report male sexual partners, and 4) have a zip code of residence within defined areas in the vicinity of 1 of the 2 implementation sites. The primary outcome is repeat HIV/STI screening within 6 months. Results This is an ongoing research study with initial results expected in the fourth quarter of 2017. Conclusions We will develop and pilot test a gamification intervention to encourage YMSM to be regularly screened for HIV/STIs. The results from this research will provide preliminary evidence about the potential effectiveness of using gamification to amplify health-related behavioral change interventions. Further, the research aims to determine the processes that are essential to developing and implementing future health-related gamification interventions. Trial Registration Clinicaltrials.gov NCT02946164; https://clinicaltrials.gov/ct2/show/NCT02946164 (Archived by WebCite at http://www.webcitation.org/6ri3G4HwD) PMID:28716771

An experimental study of the effect of a pilot flame on technically pre-mixed, self-excited combustion instabilities

NASA Astrophysics Data System (ADS)

O'Meara, Bridget C.

Combustion instabilities are a problem facing the gas turbine industry in the operation of lean, pre-mixed combustors. Secondary flames known as "pilot flames" are a common passive control strategy for eliminating combustion instabilities in industrial gas turbines, but the underlying mechanisms responsible for the pilot flame's stabilizing effect are not well understood. This dissertation presents an experimental study of a pilot flame in a single-nozzle, swirl-stabilized, variable length atmospheric combustion test facility and the effect of the pilot on combustion instabilities. A variable length combustor tuned the acoustics of the system to excite instabilities over a range of operating conditions without a pilot flame. The inlet velocity was varied from 25 -- 50 m/s and the equivalence ratio was varied from 0.525 -- 0.65. This range of operating conditions was determined by the operating range of the combustion test facility. Stability at each operating condition and combustor length was characterized by measurements of pressure oscillations in the combustor. The effect of the pilot flame on the magnitude and frequency of combustor stability was then investigated. The mechanisms responsible for the pilot flame effect were studied using chemiluminescence flame images of both stable and unstable flames. Stable flame structure was investigated using stable flame images of CH* chemiluminescence emission. The effect of the pilot on stable flame metrics such as flame length, flame angle, and flame width was investigated. In addition, a new flame metric, flame base distance, was defined to characterize the effect of the pilot flame on stable flame anchoring of the flame base to the centerbody. The effect of the pilot flame on flame base anchoring was investigated because the improved stability with a pilot flame is usually attributed to improved flame anchoring through the recirculation of hot products from the pilot to the main flame base. Chemiluminescence images of unstable flames were used to identify several instability mechanisms and infer how these mechanisms are affected by the pilot flame. Flame images of cases in which the pilot flame did not eliminate the instability were investigated to understand why the pilot flame is not effective in certain cases. The phase of unstable pilot flame oscillations was investigated to determine how the phase of pilot flame oscillations may affect its ability to interfere with instability mechanisms in the main flame. A forced flame response study was conducted to determine the effect of inlet velocity oscillation amplitude on the pilot flame. The flame response was characterized by measurements of velocity oscillations in the injector and chemiluminescence intensity oscillations determined from flame images. As the forcing amplitude increases, the pilot flame's effect on the flame transfer function magnitude becomes weaker. Flame images show that as the forcing amplitude increases, the pilot flame oscillations increase, leading to an ineffective pilot. The results of the flame response portion of this study highlight the effect of instability amplitude on the ability of a pilot flame to eliminate a combustion instability.

Controlling road rage : a literature review and pilot study

DOT National Transportation Integrated Search

1999-06-01

This report discusses results of a literature review and pilot study on how to prevent aggressive driving and road rage. The study "Controlling Road Rage: A Literature Review and Pilot Study" defines road rage as "an incident in which an angry or imp...

Physiological studies on air tanker pilots flying forest fire retardant missions.

DOT National Transportation Integrated Search

1968-10-01

Pre-flight and post-flight studies were carried out on five air tanker pilots; in-flight studies were carried out on four of these five pilots. Pre- and post-flight studies consisted of a questionnaire and determinations of blood pressure, psychomoto...

Lessons from a One-to-One Laptop Pilot

ERIC Educational Resources Information Center

Peterson, Lana; Scharber, Cassandra

2017-01-01

The purpose of this study was to document the process one district used to design, develop, and implement a one-to-one pilot at its high school as part of its broader commitment to contemporary learning. Specifically, this qualitative case study (a) outlines the process of the laptop pilot, (b) describes the pilot implementation experience for…

Narrative medicine in surgical education.

PubMed

Pearson, A Scott; McTigue, Michael P; Tarpley, John L

2008-01-01

Narrative medicine is a patient-centered approach to the practice of medicine that rescues the patients' stories and integrates what is important to them into decisions regarding their health care. Our hypothesis is that narrative understanding enhances the patient-provider relationship and contributes to optimizing patient care. We propose to use written narrative reflection to capture and measure the general competencies of systems-based practice, practice-based learning, communication skills, and professionalism. DEVELOPMENT/METHODS: The development of this narrative-based project is based on a pilot study that we conducted at our institution with third-year surgical clerkship students. In the pilot, students produced in-depth narrative write-ups on a patient they had had the opportunity to "know." We plan a similar approach for surgical resident education. After a brief discussion of narrative medicine during our scheduled didactic conference, the residents are asked to initiate a written narrative reflection on a patient of their choosing. The narratives will be collected 1 week later. Our plan is to repeat this assessment quarterly so that 4 narratives will be generated annually from internship through the chief resident year. The narratives will be analyzed for content and recurring themes that capture the resident's communication skills, professionalism, as well as self-critique (practice-based learning) and value attributed to health-care teams (systems-based practice). After completion of the narratives, a 5-point Likert response survey will be given to the residents to assess their experience and the perceived value of written reflection. The written narratives will become part of the resident's ongoing portfolio. IMPLEMENTATION/EXPERIENCE TO DATE: Feedback from the medical student pilot study was favorable. When asked in a follow-up questionnaire, most students reported the experience to be valuable and recommended the use of narrative reflection in medical education. To assess the feasibility of this approach in surgical residency, we introduced the concept of narrative reflection to our residents during surgery grand rounds. Thirty-three narratives were collected 1 week later. CONCLUSION/NEXT STEPS: This preliminary experience suggests that acquisition of resident-authored narrative reflection is feasible during surgical residency. Use of this narrative-based approach in surgical resident education has the potential to capture and measure the general competencies of systems-based practice, practice-based learning, communication skills, and professionalism.

Development of an Interactive, Web-Delivered System to Increase Provider–Patient Engagement in Smoking Cessation

PubMed Central

Delaughter, Kathryn; Crenshaw, Katie; Sobko, Heather J; Williams, Jessica H; Coley, Heather L; Ray, Midge N; Ford, Daniel E; Allison, Jeroan J; Houston, Thomas K

2011-01-01

Background Patient self-management interventions for smoking cessation are effective but underused. Health care providers do not routinely refer smokers to these interventions. Objective The objective of our study was to uncover barriers and facilitators to the use of an e-referral system that will be evaluated in a community-based randomized trial. The e-referral system will allow providers to refer smokers to an online smoking intervention during routine clinical care. Methods We devised a four-step development and pilot testing process: (1) system conceptualization using Delphi to identify key functionalities that would overcome barriers in provider referrals for smoking cessation, (2) Web system programming using agile software development and best programming practices with usability refinement using think-aloud testing, (3) implementation planning using the nominal group technique for the effective integration of the system into the workflow of practices, and (4) pilot testing to identify practice recruitment and system-use barriers in real-world settings. Results Our Delphi process (step 1) conceptualized three key e-referral functions: (1) Refer Your Smokers, allowing providers to e-refer patients at the point of care by entering their emails directly into the system, (2) practice reports, providing feedback regarding referrals and impact of smoking-cessation counseling, and (3) secure messaging, facilitating provider–patient communication. Usability testing (step 2) suggested the system was easy to use, but implementation planning (step 3) suggested several important approaches to encourage use (eg, proactive email cues to encourage practices to participate). Pilot testing (step 4) in 5 practices had limited success, with only 2 patients referred; we uncovered important recruitment and system-use barriers (eg, lack of study champion, training, and motivation, registration difficulties, and forgetting to refer). Conclusions Implementing a system to be used in a clinical setting is complex, as several issues can affect system use. In our ongoing large randomized trial, preliminary analysis with the first 50 practices using the system for 3 months demonstrated that our rigorous preimplementation evaluation helped us successfully identify and overcome these barriers before the main trial. Trial Clinicaltrials.gov NCT00797628; http://clinicaltrials.gov/ct2/show/NCT00797628 (Archived by WebCite at http://www.webcitation.org/61feCfjCy) PMID:22011394

Pilot Non-Conformance to Alerting System Commands

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1997-01-01

Instances of pilot non-conformance to alerting system commands have been identified in previous studies. Pilot non-conformance changes the final behavior of the system, and therefore may reduce actual performance from that anticipated. A simulator study has examined pilot non-conformance, using the task of collision avoidance during closely spaced parallel approaches as a case study. Consonance between the display and the alerting system was found to significantly improve subject agreement with automatic alerts. Based on these results, a more general discussion of the factors involved in pilot conformance is given, and design guidelines for alerting systems are given.

Pilot error in air carrier accidents: does age matter?

PubMed

Li, Guohua; Grabowski, Jurek G; Baker, Susan P; Rebok, George W

2006-07-01

The relationship between pilot age and safety performance has been the subject of research and controversy since the "Age 60 Rule" became effective in 1960. This study aimed to examine age-related differences in the prevalence and patterns of pilot error in air carrier accidents. Investigation reports from the National Transportation Safety Board for accidents involving Part 121 operations in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Accident circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. Of the 558 air carrier accidents studied, 25% resulted from turbulence, 21% from mechanical failure, 16% from taxiing events, 13% from loss of control at landing or takeoff, and 25% from other causes. Accidents involving older pilots were more likely to be caused by turbulence, whereas accidents involving younger pilots were more likely to be taxiing events. Pilot error was a contributing factor in 34%, 38%, 35%, and 34% of the accidents involving pilots ages 25-34 yr, 35-44 yr, 45-54 yr, and 55-59 yr, respectively (p = 0.87). The patterns of pilot error were similar across age groups. Overall, 26% of the pilot errors identified were inattentiveness, 22% flawed decisions, 22% mishandled aircraft kinetics, and 11% poor crew interactions. The prevalence and patterns of pilot error in air carrier accidents do not seem to change with pilot age. The lack of association between pilot age and error may be due to the "safe worker effect" resulting from the rigorous selection processes and certification standards for professional pilots.

77 FR 13343 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

...] Pilot Program for Early Feasibility Study Investigational Device Exemption Applications; Termination of... acceptance of nominations for the Early Feasibility Study Investigational Device Exemption (IDE) Applications... technologies to participate in a pilot program for early feasibility study IDE applications. FDA is also...

Integrated trimodal SSEP experimental setup for visual, auditory and tactile stimulation

NASA Astrophysics Data System (ADS)

Kuś, Rafał; Spustek, Tomasz; Zieleniewska, Magdalena; Duszyk, Anna; Rogowski, Piotr; Suffczyński, Piotr

2017-12-01

Objective. Steady-state evoked potentials (SSEPs), the brain responses to repetitive stimulation, are commonly used in both clinical practice and scientific research. Particular brain mechanisms underlying SSEPs in different modalities (i.e. visual, auditory and tactile) are very complex and still not completely understood. Each response has distinct resonant frequencies and exhibits a particular brain topography. Moreover, the topography can be frequency-dependent, as in case of auditory potentials. However, to study each modality separately and also to investigate multisensory interactions through multimodal experiments, a proper experimental setup appears to be of critical importance. The aim of this study was to design and evaluate a novel SSEP experimental setup providing a repetitive stimulation in three different modalities (visual, tactile and auditory) with a precise control of stimuli parameters. Results from a pilot study with a stimulation in a particular modality and in two modalities simultaneously prove the feasibility of the device to study SSEP phenomenon. Approach. We developed a setup of three separate stimulators that allows for a precise generation of repetitive stimuli. Besides sequential stimulation in a particular modality, parallel stimulation in up to three different modalities can be delivered. Stimulus in each modality is characterized by a stimulation frequency and a waveform (sine or square wave). We also present a novel methodology for the analysis of SSEPs. Main results. Apart from constructing the experimental setup, we conducted a pilot study with both sequential and simultaneous stimulation paradigms. EEG signals recorded during this study were analyzed with advanced methodology based on spatial filtering and adaptive approximation, followed by statistical evaluation. Significance. We developed a novel experimental setup for performing SSEP experiments. In this sense our study continues the ongoing research in this field. On the other hand, the described setup along with the presented methodology is a considerable improvement and an extension of methods constituting the state-of-the-art in the related field. Device flexibility both with developed analysis methodology can lead to further development of diagnostic methods and provide deeper insight into information processing in the human brain.

Utilization of Unmanned Aerial Vehicles for Rangeland Resources Monitoring in a Changing Regulatory Environment (Invited)

NASA Astrophysics Data System (ADS)

Rango, A.; Vivoni, E. R.; Browning, D. M.; Anderson, C.; Laliberte, A. S.

2013-12-01

It is taking longer than expected to realize the immense potential of Unmanned Aerial Vehicles (UAVs)for civil applications due to the complexity of regulations being developed by the Federal Aviation Authority (FAA) that can be applied to both manned and unmanned flight in the National Airspace System (NAS). As a result, FAA has required that for all UAV flights in the NAS, an external pilot must maintain line-of-sight contact with the UAV. Properly trained observers must also be present to assist the external pilot in collision avoidance. Additionally, in order to fly in the NAS, formal approval must be requested from FAA through application for a Certificate of Authorization (COA for government applicants or a Special Airworthiness Certificate (SAC) in the experimental category for non-government applicants. Flight crews of UAVs must pass exams also required for manned airplane pilots. Although flight crews for UAVs are not required to become manned airplane pilots, UAV flight missions are much more efficient if one or two of the UAV flight crew are also manned aircraft pilots so they can serve as the UAV mission commander. Our group has performed numerous UAV flights within the Jornada Experimental Range in southern New Mexico. Two developments with Jornada UAVs can be recommended to other UAV operators that would increase flight time experience and study areas covered by UAV images. First, do not overlook the possibility of obtaining permission to fly in Restricted Military Airspace (RMA). At the Jornada, our airspace is approximately 50% NAS and 50% RMA. With experiments ongoing in both types of airspace, we can fly in both areas and continue to increase UAV flights. Second, we have developed an air- and-ground vehicle approach for long distance, continuous pilot transport that always maintains line-of-sight requirements. This allows flying several target areas on a single mission and increasing the number of acquired UAV images - over 90,000 UAV images have now been acquired at Jornada. Most of our UAV flights have taken place over rangelands or watersheds in the western U.S. These flights have been successful used for classification of vegetation cover and type, measuring gaps between vegetation patches, identifing locations of potentially erosive soil, deriving digital elevation models, and monitoring plant phenology.. These measurements can be directly compared to more costly and time-intensive traditional techniques used in rangeland health determinations. New UAVs are becoming available with increased sensor payload capacity. At Jornada we have concentrated on flying at low altitudes (~215 m) to acquire hyperspatial resolutions with digital cameras of about 5-6 cm. We also fly a six band multispectral camera with spatial resolution of ~ 13 cm. We have recently acquired a larger Bat-4 UAV to go with the Bat-3 UAV. The major improvement associated with this upgrade is an increase in sensor payload from 1.4 kg to 14 kg. We are surveying the type of sensors that we could add to best increase our information content.

Autogenic Feedback Training Exercise and pilot performance: enhanced functioning under search-and-rescue flying conditions.

PubMed

Cowings, P S; Kellar, M A; Folen, R A; Toscano, W B; Burge, J D

2001-01-01

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group contained 4 pilots from HC-130 Hercules aircraft and 4 HH-65 Dolphin helicopter pilots; the control group contained 3 pilots of HC-130s and 6 helicopter pilots. During an initial flight, physiological data were recorded on each crewmember and an instructor pilot rated individual crew performance. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training Exercise (AFTE). The remaining participants received no training. During a second flight, treatment participants showed significant improvement in performance (rated by the same instructor pilot as in pretests) while controls did not improve. The results indicate that AFTE management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

Autogenic Feedback Training Exercise and pilot performance: enhanced functioning under search-and-rescue flying conditions

NASA Technical Reports Server (NTRS)

Cowings, P. S.; Kellar, M. A.; Folen, R. A.; Toscano, W. B.; Burge, J. D.

2001-01-01

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group contained 4 pilots from HC-130 Hercules aircraft and 4 HH-65 Dolphin helicopter pilots; the control group contained 3 pilots of HC-130s and 6 helicopter pilots. During an initial flight, physiological data were recorded on each crewmember and an instructor pilot rated individual crew performance. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training Exercise (AFTE). The remaining participants received no training. During a second flight, treatment participants showed significant improvement in performance (rated by the same instructor pilot as in pretests) while controls did not improve. The results indicate that AFTE management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

EXPOSURE ASSESSMENT METHODS DEVELOPMENT PILOTS FOR THE NATIONAL CHILDREN'S STUDY

EPA Science Inventory

Accurate exposure classification tools are needed to link exposure with health effects. EPA began methods development pilot studies in 2000 to address general questions about exposures and outcome measures. Selected pilot studies are highlighted in this poster. The “Literature Re...

Considerations in the rationale, design and methods of the Strategic Timing of AntiRetroviral Treatment (START) study

PubMed Central

Babiker, Abdel G; Emery, Sean; Fätkenheuer, Gerd; Gordin, Fred M; Grund, Birgit; Lundgren, Jens D; Neaton, James D; Pett, Sarah L; Phillips, Andrew; Touloumi, Giota; Vjecha, Michael J

2012-01-01

Background Untreated human immunodeficiency virus (HIV) infection is characterized by progressive depletion of CD4+ T lymphocyte (CD4) count leading to the development of opportunistic diseases (acquired immunodeficiency syndrome (AIDS)), and more recent data suggest that HIV is also associated with an increased risk of serious non-AIDS (SNA) diseases including cardiovascular, renal, and liver diseases and non-AIDS-defining cancers. Although combination antiretroviral treatment (ART) has resulted in a substantial decrease in morbidity and mortality in persons with HIV infection, viral eradication is not feasible with currently available drugs. The optimal time to start ART for asymptomatic HIV infection is controversial and remains one of the key unanswered questions in the clinical management of HIV-infected individuals. Purpose In this article, we outline the rationale and methods of the Strategic Timing of AntiRetroviral Treatment (START) study, an ongoing multicenter international trial designed to assess the risks and benefits of initiating ART earlier than is currently practiced. We also describe some of the challenges encountered in the design and implementation of the study and how these challenges were addressed. Methods A total of 4000 study participants who are HIV type 1 (HIV-1) infected, ART naïve with CD4 count > 500 cells/μL are to be randomly allocated in a 1:1 ratio to start ART immediately (early ART) or defer treatment until CD4 count is <350 cells/ μL (deferred ART) and followed for a minimum of 3 years. The primary outcome is time to AIDS, SNA, or death. The study had a pilot phase to establish feasibility of accrual, which was set as the enrollment of at least 900 participants in the first year. Results Challenges encountered in the design and implementation of the study included the limited amount of data on the risk of a major component of the primary endpoint (SNA) in the study population, changes in treatment guidelines when the pilot phase was well underway, and the complexities of conducting the trial in a geographically wide population with diverse regulatory requirements. With the successful completion of the pilot phase, more than 1000 participants from 100 sites in 23 countries have been enrolled. The study will expand to include 237 sites in 36 countries to reach the target accrual of 4000 participants. Conclusions START is addressing one of the most important questions in the clinical management of ART. The randomization provided a platform for the conduct of several substudies aimed at increasing our understanding of HIV disease and the effects of antiretroviral therapy beyond the primary question of the trial. The lessons learned from its design and implementation will hopefully be of use to future publicly funded international trials. PMID:22547421

Can monaural temporal masking explain the ongoing precedence effect?

PubMed

Freyman, Richard L; Morse-Fortier, Charlotte; Griffin, Amanda M; Zurek, Patrick M

2018-02-01

The precedence effect for transient sounds has been proposed to be based primarily on monaural processes, manifested by asymmetric temporal masking. This study explored the potential for monaural explanations with longer ("ongoing") sounds exhibiting the precedence effect. Transient stimuli were single lead-lag noise burst pairs; ongoing stimuli were trains of 63 burst pairs. Unlike with transients, monaural masking data for ongoing sounds showed no advantage for the lead, and are inconsistent with asymmetric audibility as an explanation for ongoing precedence. This result, along with supplementary measurements of interaural time discrimination, suggests different explanations for transient and ongoing precedence.

Prevalence of fatigue in a group of airline pilots.

PubMed

Reis, Cátia; Mestre, Catarina; Canhão, Helena

2013-08-01

Fatigue is a common phenomenon in airline pilots that can impair alertness and ability of crewmembers to safely operate an aircraft and perform safety related tasks. Fatigue can increase the risk of an incident or even an accident. This study provides the first prevalence values for clinically significant fatigue in Portuguese airline pilots. The hypothesis that medium/short-haul pilots may currently present different levels of fatigue than long-haul pilots was also tested. A survey was conducted by requesting Portuguese airline pilots to complete questionnaires placed in the pilots' personal lockers from 1 April until 15 May 2012. The questionnaire included the self-response Fatigue Severity Scale (FSS) to measure subjective fatigue and some additional questions concerning perception of fatigue by pilots. The prevalence values for total and mental fatigue achieved in the Portuguese airline pilots were: 89.3% (FSS > or = 4) and 94.1% (FSS > or = 4) when splitting the sample in two subsamples, long- and medium/short-haul pilots. Levels of total and mental fatigue were higher for medium/short-haul pilots. The analysis of fatigue levels in each type of aviator showed that medium/short-haul pilots presented the highest levels of total and mental fatigue. This study produced the first prevalence values of total and mental fatigue among Portuguese airline pilots, which represents a great step to understanding and addressing this critical phenomenon.

76 FR 12367 - Proposed Information Collection; Visibility Valuation Survey Pilot Study

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

... Survey Pilot Study AGENCY: National Park Service, U.S. Department of the Interior. ACTION: Notice... Code of Federal Regulations). Updated estimates of visibility benefits are required because the studies... a pilot study to test the survey instrument and implementation procedures prior to the full survey...

Pre-Study Walkthrough with a Commercial Pilot for a Preliminary Single Pilot Operations Experiment

NASA Technical Reports Server (NTRS)

O'Connor-Dreher, Ryan; Roberts, Z.; Ziccardi, J.; Vu, K-P. L.; Strybel, T.; Koteskey, Robert William; Lachter, Joel B.; Vi Dao, Quang; Johnson, Walter W.; Battiste, V.

2013-01-01

The number of crew members in commercial flights has decreased to two members, down from the five-member crew required 50 years ago. One question of interest is whether the crew should be reduced to one pilot. In order to determine the critical factors involved in safely transitioning to a single pilot, research must examine whether any performance deficits arise with the loss of a crew member. With a concrete understanding of the cognitive and behavioral role of a co-pilot, aeronautical technologies and procedures can be developed that make up for the removal of the second aircrew member. The current project describes a pre-study walkthrough process that can be used to help in the development of scenarios for testing future concepts and technologies for single pilot operations. Qualitative information regarding the tasks performed by the pilots can be extracted with this technique and adapted for future investigations of single pilot operations.

International Translation of Project EX: A Teen Tobacco Use Cessation Program.

PubMed

Sussman, Steve

2012-10-01

There are relatively few documented teen tobacco use cessation efforts outside the United States (U.S.). Project EX is an evidence-based program that consists of eight sessions, as a school-based clinic tobacco cessation-only version and a classroom-based prevention and cessation version. This paper provides a 'snapshot' of progress on international translation of ProjectEXpilot study work in eight countries that have been approached thus far. The program was implemented in Wuhan, China; Israel and partners; Bashkortostan, Russia; and Elche, Spain. Implementation is planned for Vienna, Austria; Mumbai, India; and Bangkok, Thailand. This work will lead eventually to a greater understanding regarding preference for type of programming (e.g., clinic versus classroom modality), challenges in recruitment and retention, program receptivity, and short-term (approximately 3-month post-program) quit rates. Convenience samples are being recruited based on previous contacts with each location. A protocol was sent to each location, proposing a controlled design, in which subjects enter cessation groups or become a wait-list control, with an immediate pretest, posttest, and 3-month follow-up. Language translation of program materials was completed in seven of the eight locations. Several variations in design and implementation were demanded though. For example, youth fear of reporting tobacco publicly mandated to researchers that the prevention/cessation classroom version be implemented in some locations (Israel and partners, and India). Program effects are suggested across countries. Ongoing partnerships with parties actively involved in tobacco control facilitate pilot testing of teen tobacco use cessation programming. The Project EX curriculum appears quite translatable, though having flexibility in implementation modality eased being able to pilot test the program. Research on this cognitive-behavioral, motivation enhancement approach continues.

A Pilot Feasibility Intervention to Increase Advance Care Planning among African Americans in the Deep South.

PubMed

Huang, Chao-Hui Sylvia; Crowther, Martha; Allen, Rebecca S; DeCoster, Jamie; Kim, Giyeon; Azuero, Casey; Ang, Xinying; Kvale, Elizabeth

2016-02-01

Despite growing efforts to facilitate advance care planning (ACP) to decrease health disparities in palliative care, low completion rates of advance directives (AD) have been consistently found among African Americans. The objective was to examine the feasibility of a multicomponent ACP intervention program that integrates motivational interviewing, evidence-based ACP facilitation program (Respecting Choices(®)), and health-literacy adjusted AD. This pilot study aims to address the unique barriers to ACP engagement among African Americans in the Deep South. The design was a mixed-method randomized controlled trial design. Analysis of covariance (ANCOVA) and thematic content analysis (TCA) were conducted to identify barriers and facilitators for ACP engagement and to assess feasibility, knowledge, and intention to complete an AD. Thirty community-dwelling African Americans (mean age M = 55.43, SD = 6.71, range = 47-73) were recruited from the Deep South and randomly assigned to receive intervention (n = 15) or educational material (n = 15) at a local university medical center. All participants (n = 30) reported high satisfaction (M = 4.81, SD = 0.44, max score = 5) and increased intent to complete an AD at postintervention. A significant increase in knowledge on AD from baseline to postintervention was observed in the intervention group-t(14) = -3.06, p = 0.01, d = 1.67); no significant change was found for control. Lack of information, mistrust of doctors, and avoidance of discussing death were primary barriers to ACP discussions. Facilitators include ACP education, decreased mistrust, and proactive initiation of ongoing ACP discussions. Feasibility data revealed successful implementation of a brief intervention to increase ACP engagement and willingness to complete an AD among southern African Americans.

Cancer and the family: assessment, communication and brief interventions-the development of an educational programme for healthcare professionals when a parent has cancer.

PubMed

Grant, Lucy; Sangha, Amrit; Lister, Sara; Wiseman, Theresa

2016-12-01

This study developed and piloted an educational intervention to support healthcare professionals (HCPs) to provide supportive care for families when a parent has cancer. Programme development followed the Medical Research Council (MRC) framework, beginning with examination of theory and research, and consultation with experts. The programme content incorporated attachment theory, child development and family systems theory. It was piloted thrice with HCPs from a cancer centre. The evaluation involved a questionnaire, comprising open-ended questions, completed before and after the programme. Data from the questionnaire were analysed using framework analysis. 31 HCPs from varying disciplines participated. The programme was evaluated positively by participants. Before the programme, participants had significant concerns about their professional competence, which included: managing their own emotions; a perceived sensitivity around raising child and family matters with patients and a lack of specialist experience, skills and knowledge. After completing the programme, participants reported greater understanding and knowledge, increased confidence to approach patients about family matters, greater skill to initiate conversations and explore family concerns and guiding parent-child communication according to the child's level of understanding, and an increased engagement and resilience for caring for parents with cancer. Supporting HCPs to provide family-centred care is likely to reduce psychological difficulties in families where a parent has cancer. Further work is planned to disseminate the programme, evaluate the transfer of skills into practice, assess how HCPs manage the emotional demands of providing supportive care over time, and consider on-going professional support for HCPs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessment of Military Cultural Competence: A Pilot Study.

PubMed

Meyer, Eric G; Hall-Clark, Brittany N; Hamaoka, Derrick; Peterson, Alan L

2015-08-01

Cultural competence is widely considered a cornerstone of patient care. Efforts to improve military cultural competency have recently gained national attention. Assessment of cultural competence is a critical component to this effort, but no assessment of military cultural competence currently exists. An assessment of military cultural competence (AMCC) was created through broad input and consensus. Careful review of previous cultural competency assessment designs and analysis techniques was considered. The AMCC was organized into three sections: skills, attitudes, and knowledge. In addition to gathering data to determine absolute responses from groups with different exposure levels to the military (direct, indirect, and none), paired questions were utilized to assess relative competencies between military culture and culture in general. Piloting of the AMCC revealed significant differences between military exposure groups. Specifically, those with personal military exposure were more likely to be in absolute agreement that the military is a culture, were more likely to screen for military culture, and had increased knowledge of military culture compared to those with no military exposure. Relative differences were more informative. For example, all groups were less likely to agree that their personal culture could be at odds with military culture as compared to other cultures. Such perceptions could hinder asking difficult questions and thus undermine care. The AMCC is a model for the measurement of the skills, attitudes, and knowledge related to military cultural competence. With further validity testing, the AMCC will be helpful in the critical task of measuring outcomes in ongoing efforts to improve military cultural competence. The novel approach of assessing variance appears to reduce bias and may also be helpful in the design of other cultural competency assessments.

International Translation of Project EX: A Teen Tobacco Use Cessation Program

PubMed Central

Sussman, Steve

2013-01-01

Aims There are relatively few documented teen tobacco use cessation efforts outside the United States (U.S.). Project EX is an evidence-based program that consists of eight sessions, as a school-based clinic tobacco cessation-only version and a classroom-based prevention and cessation version. This paper provides a ‘snapshot’ of progress on international translation of ProjectEXpilot study work in eight countries that have been approached thus far. The program was implemented in Wuhan, China; Israel and partners; Bashkortostan, Russia; and Elche, Spain. Implementation is planned for Vienna, Austria; Mumbai, India; and Bangkok, Thailand. This work will lead eventually to a greater understanding regarding preference for type of programming (e.g., clinic versus classroom modality), challenges in recruitment and retention, program receptivity, and short-term (approximately 3-month post-program) quit rates. Protocol and Interim Results of International Translation of Project EX Convenience samples are being recruited based on previous contacts with each location. A protocol was sent to each location, proposing a controlled design, in which subjects enter cessation groups or become a wait-list control, with an immediate pretest, posttest, and 3-month follow-up. Language translation of program materials was completed in seven of the eight locations. Several variations in design and implementation were demanded though. For example, youth fear of reporting tobacco publicly mandated to researchers that the prevention/cessation classroom version be implemented in some locations (Israel and partners, and India). Program effects are suggested across countries. Conclusions Ongoing partnerships with parties actively involved in tobacco control facilitate pilot testing of teen tobacco use cessation programming. The Project EX curriculum appears quite translatable, though having flexibility in implementation modality eased being able to pilot test the program. Research on this cognitive-behavioral, motivation enhancement approach continues. PMID:23885135

Reconsolidated Salt as a Geotechnical Barrier

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

Hansen, Francis D.; Gadbury, Casey

Salt as a geologic medium has several attributes favorable to long-term isolation of waste placed in mined openings. Salt formations are largely impermeable and induced fractures heal as stress returns to equilibrium. Permanent isolation also depends upon the ability to construct geotechnical barriers that achieve nearly the same high-performance characteristics attributed to the native salt formation. Salt repository seal concepts often include elements of reconstituted granular salt. As a specific case in point, the Waste Isolation Pilot Plant recently received regulatory approval to change the disposal panel closure design from an engineered barrier constructed of a salt-based concrete to onemore » that employs simple run-of-mine salt and temporary bulkheads for isolation from ventilation. The Waste Isolation Pilot Plant is a radioactive waste disposal repository for defense-related transuranic elements mined from the Permian evaporite salt beds in southeast New Mexico. Its approved shaft seal design incorporates barrier components comprising salt-based concrete, bentonite, and substantial depths of crushed salt compacted to enhance reconsolidation. This paper will focus on crushed salt behavior when applied as drift closures to isolate disposal rooms during operations. Scientific aspects of salt reconsolidation have been studied extensively. The technical basis for geotechnical barrier performance has been strengthened by recent experimental findings and analogue comparisons. The panel closure change was accompanied by recognition that granular salt will return to a physical state similar to the halite surrounding it. Use of run-of-mine salt ensures physical and chemical compatibility with the repository environment and simplifies ongoing disposal operations. Our current knowledge and expected outcome of research can be assimilated with lessons learned to put forward designs and operational concepts for the next generation of salt repositories. Mined salt repositories have the potential to isolate permanently vast inventories of radioactive and hazardous wastes.« less

Improving dementia health literacy using the FLOW mnemonic: pilot findings from the Old SCHOOL hip-hop program.

PubMed

Noble, James M; Hedmann, Monique G; Williams, Olajide

2015-02-01

Dementia health literacy is low among the public and likely poses a significant barrier to Alzheimer's disease (AD) symptom recognition and treatment, particularly among minority populations already facing higher AD burden. We evaluated the pilot phase of a novel AD health education program, Old SCHOOL (Seniors Can Have Optimal Aging and Ongoing Longevity) Hip-Hop (OSHH), which is designed to enable children to be AD health educational conduits in the home ("child-mediated health communication"). OSHH applied our stroke-validated model of engaging, dynamic, and age- and culturally appropriate curriculum delivered to elementary school-age children (fourth/fifth grades, ages 9-11 years). We assessed AD knowledge among the children at baseline, immediately following the intervention (1-hour program delivered daily over 3 consecutive days), and 3 months later. For key AD symptoms, we developed the FLOW mnemonic (forget, lose, overlook, write/wander); students were additionally taught action plans for recognized symptoms. Seventy-five students completed baseline assessments, and 68 completed posttesting. AD symptoms in FLOW were not well known at baseline (individually ranging from 16% to 71% correct) but were highly learned after 3 days (89% to 98% correct) and retained well after 3 months (80% to 95% correct, p ≤ .01 for all comparisons vs. baseline). AD localization, including its effect on memory and the hippocampus, was also highly learned and retained (p < .001). Eighteen students (24%) reported having a close friend/family member with AD. This study suggests our hip-hop health education model may be an effective method to improve AD health literacy. © 2014 Society for Public Health Education.

Improving FHWA's Ability to Assess Highway Infrastructure Health : Pilot Study Report

DOT National Transportation Integrated Search

2012-07-01

This report documents the results of a pilot study conducted as part of a project on improving FHWAs ability to assess highway infrastructure health. As part of the pilot study, a section of Interstate 90 through South Dakota, Minnesota, and Wisco...

Recommendations for Planning Pilot Studies in Clinical and Translational Research

PubMed Central

Moore, Charity G.; Carter, Rickey E.; Nietert, Paul J.; Stewart, Paul W.

2011-01-01

Abstract  Advances in clinical and translation science are facilitated by building on prior knowledge gained through experimentation and observation. In the context of drug development, preclinical studies are followed by a progression of phase I through phase IV clinical trials. At each step, the study design and statistical strategies are framed around research questions that are prerequisites for the next phase. In other types of biomedical research, pilot studies are used for gathering preliminary support for the next research step. However, the phrase “pilot study” is liberally applied to projects with little or no funding, characteristic of studies with poorly developed research proposals, and usually conducted with no detailed thought of the subsequent study. In this article, we present a rigorous definition of a pilot study, offer recommendations for the design, analysis and sample size justification of pilot studies in clinical and translational research, and emphasize the important role that well‐designed pilot studies play in the advancement of science and scientific careers. Clin Trans Sci 2011; Volume 4: 332–337 PMID:22029804

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

Hansen, Francis D.; Leigh, Christi; Stein, Walter

The 5th US/German Workshop on Salt Repository Research, Design, and Operation was held in Santa Fe New Mexico September 8-10, 2014. The forty seven registered participants were equally divided between the United States (US) and Germany, with one participant from The Netherlands. The agenda for the 2014 workshop was under development immediately upon finishing the 4th Workshop. Ongoing, fundamental topics such as thermomechanical behavior of salt, plugging and sealing, the safety case, and performance assessment continue to advance the basis for disposal of heat-generating nuclear waste in salt formations. The utility of a salt underground research laboratory (URL) remains anmore » intriguing concept engendering discussion of testing protocol. By far the most interest in this years’ workshop pertained to operational safety. Given events at the Waste Isolation Pilot Plant (WIPP), this discussion took on a new sense of relevance and urgency.« less

Piloted simulation study of an ILS approach of a twin-pusher business/commuter turboprop aircraft configuration

NASA Technical Reports Server (NTRS)

Riley, Donald R.; Brandon, Jay M.; Glaab, Louis J.

1994-01-01

A six-degree-of-freedom nonlinear simulation of a twin-pusher, turboprop business/commuter aircraft configuration representative of the Cessna ATPTB (Advanced turboprop test bed) was developed for use in piloted studies with the Langley General Aviation Simulator. The math models developed are provided, simulation predictions are compared with with Cessna flight-test data for validation purposes, and results of a handling quality study during simulated ILS (instrument landing system) approaches and missed approaches are presented. Simulated flight trajectories, task performance measures, and pilot evaluations are presented for the ILS approach and missed-approach tasks conducted with the vehicle in the presence of moderate turbulence, varying horizontal winds and engine-out conditions. Six test subjects consisting of two research pilots, a Cessna test pilot, and three general aviation pilots participated in the study. This effort was undertaken in cooperation with the Cessna Aircraft Company.

Study to determine the IFR operational profile and problems to the general aviation pilot

NASA Technical Reports Server (NTRS)

Weislogel, S.

1983-01-01

A study of the general aviation single pilot operating under instrument flight rules (GA SPIFR) has been conducted for NASA Langley Research Center. The objectives of the study were to (1) develop a GA SPIFR operational profile, (2) identify problems experienced by the GA SPIFR pilot, and (3) identify research tasks which have the potential for eliminating or reducing the severity of the problems. To obtain the information necessary to accomplish these objectives, a mail questionnaire survey of instrument rated pilots was conducted. Complete questionnaire data is reported in NASA CR-165805, "Statistical Summary: Study to Determine the IFR Operational Profile and Problems of the General Aviation Single Pilot'-Based upon the results of the GA SPIFR survey, this final report presents the general aviation IFR single pilot operational profile, illustrates selected data analysis, examples, identifies the problems which he is experiencing, and recommends further research.

Bilateral comparison of 100 pF capacitance standards (ongoing BIPM key comparison BIPM.EM-K14.b) between the BIM, Bulgaria, and the BIPM, April 2012 to September 2012

NASA Astrophysics Data System (ADS)

Sapunova, I.; Fletcher, N.; Goebel, R.; Stock, M.

2015-01-01

This report gives the result of a bilateral comparison of capacitance between the BIM (Bulgaria) and the BIPM carried out in 2012. Two 100 pF travelling standards belonging to the BIPM were used. The comparison was carried out with an 'A-B-A' pattern of measurements; the standards were measured first at the BIPM for a period of about one month, then for a similar period at the BIM, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of 1000 Hz and for a measuring voltage of 15 V. The BIPM was the pilot laboratory, and the comparison forms part of the ongoing BIPM key comparison BIPM.EM-K14.a. The results from the BIM and the BIPM were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95% confidence, k = 2) of 1.1 × 10-6. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral comparison of 10 pF capacitance standards (ongoing BIPM key comparison BIPM.EM-K14.a) between the BIM, Bulgaria, and the BIPM, April 2012 to September 2012

NASA Astrophysics Data System (ADS)

Sapunova, I.; Fletcher, N.; Goebel, R.; Stock, M.

2015-01-01

This report gives the result of a bilateral comparison of capacitance between the BIM (Bulgaria) and the BIPM carried out in 2012. Two 10 pF travelling standards belonging to the BIPM were used. The comparison was carried out with an 'A-B-A' pattern of measurements; the standards were measured first at the BIPM for a period of about one month, then for a similar period at the BIM, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of 1000 Hz and for a measuring voltage of 15 V. The BIPM was the pilot laboratory, and the comparison forms part of the ongoing BIPM key comparison BIPM.EM-K14.a. The results from the BIM and the BIPM were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95% confidence, k = 2) of 1.1 × 10-6. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral comparison of 100 pF capacitance standards (ongoing BIPM key comparison BIPM.EM-K14.b) between the NSAI-NML, Ireland, and the BIPM, March-August 2011

NASA Astrophysics Data System (ADS)

Power, O.; Moran, A.; Fletcher, N.; Goebel, R.; Stock, M.

2015-01-01

This report gives the result of a bilateral comparison of capacitance between the NSAI-NML (Ireland) and the BIPM carried out in 2011. Two 100 pF travelling standards belonging to the BIPM were used. The comparison was carried out with an 'A-B-A' pattern of measurements; the standards were measured first at the BIPM for a period of about one month, then for a similar period at the NSAI-NML, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of 1000 Hz, for a measuring voltage of 15 V. The BIPM was the pilot laboratory, and the comparison forms part of the ongoing BIPM key comparison BIPM.EM-K14.b. The results from the NSAI-NML and the BIPM were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of 0.66 × 10-6. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral comparison of 10 pF capacitance standards (ongoing BIPM key comparison BIPM.EM-K14.a) between the NSAI-NML, Ireland, and the BIPM, March-August 2011

NASA Astrophysics Data System (ADS)

Power, O.; Moran, A.; Fletcher, N.; Goebel, R.; Stock, M.

2015-01-01

This report gives the result of a bilateral comparison of capacitance between the NSAI-NML (Ireland) and the BIPM carried out in 2011. Two 10 pF travelling standards belonging to the BIPM were used. The comparison was carried out with an 'A—B—A' pattern of measurements; the standards were measured first at the BIPM for a period of about one month, then for a similar period at the NSAI-NML, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of 1000 Hz for a measuring voltage of 15 V. The BIPM was the pilot laboratory, and the comparison forms part of the ongoing BIPM key comparison BIPM.EM-K14.a. The results from the NSAI-NML and the BIPM were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of 2.5 × 10-6. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral comparison of 100 pF standards (ongoing BIPM key comparison BIPM.EM-K14.b) between the NSAI-NML (Ireland) and the BIPM

NASA Astrophysics Data System (ADS)

Gournay, Pierre; Power, Oliver

2017-01-01

This report presents the results of a bilateral comparison of capacitance at 100 pF between the NSAI-NML (Ireland) and the BIPM carried out in 2016. This comparison forms part of the ongoing BIPM key comparison BIPM.EM-K14.b in which the BIPM is the pilot laboratory. Two 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NSAI-NML, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of 1000 Hz, for a measuring rms voltage of 15 V. The results from the NSAI-NML and the BIPM were found to be in relatively good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of 0.85 × 10-6. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Transcranial Direct Current Stimulation in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder (ADHD): A Pilot Study.

PubMed

Bandeira, Igor Dórea; Guimarães, Rachel Silvany Quadros; Jagersbacher, João Gabriel; Barretto, Thiago Lima; de Jesus-Silva, Jéssica Regina; Santos, Samantha Nunes; Argollo, Nayara; Lucena, Rita

2016-06-01

Studies investigating the possible benefits of transcranial direct current stimulation on left dorsolateral prefrontal cortex in children and adolescents with attention-deficit hyperactivity disorder (ADHD) have not been performed. This study assesses the effect of transcranial direct current stimulation in children and adolescents with ADHD on neuropsychological tests of visual attention, visual and verbal working memory, and inhibitory control. An auto-matched clinical trial was performed involving transcranial direct current stimulation in children and adolescents with ADHD, using SNAP-IV and subtests Vocabulary and Cubes of the Wechsler Intelligence Scale for Children III (WISC-III). Subjects were assessed before and after transcranial direct current stimulation sessions with the Digit Span subtest of the WISC-III, inhibitory control subtest of the NEPSY-II, Corsi cubes, and the Visual Attention Test (TAVIS-3). There were 9 individuals with ADHD according to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria. There was statistically significant difference in some aspects of TAVIS-3 tests and the inhibitory control subtest of NEPSY-II. Transcranial direct current stimulation can be related to a more efficient processing speed, improved detection of stimuli, and improved ability to switch between an ongoing activity and a new one. © The Author(s) 2016.

Reflecting on the Germanwings Disaster: A Systematic Review of Depression and Suicide in Commercial Airline Pilots.

PubMed

Pasha, Terouz; Stokes, Paul R A

2018-01-01

The 2015 Germanwings Flight 9525 disaster, in which 150 people were killed after the co-pilot may have intentionally crashed the plane in a suicide attempt, highlights the importance of better understanding the mental health of commercial airline pilots. However, there have been few systematic reviews investigating the topic of mental health in commercial aviation. This systematic review aims to identify the types and prevalence of mental health disorders that commercial airline pilots experience with a focus on mood disorders and suicide risk. A systematic literature search was performed using PubMed, EMBASE, and PsycINFO databases. Eligible studies were assessed and data was extracted and analyzed. 20 studies were identified. The prevalence of depression experienced by commercial airline pilots in this review ranged from 1.9% to 12.6%. Factors that negatively impacted the mental health of pilots included substance abuse, experiencing verbal or sexual abuse, disruption in sleep circadian rhythms and fatigue. This systematic review identifies that commercial airline pilots may experience depression at least as frequently as the general population. Commercial airline pilots experience occupational stressors, such as disrupted circadian rhythms and fatigue which may increase risks of developing mood disorders. Most studies identified in this review were cross-sectional in nature with substantial limitations. There is a clear need for further higher quality longitudinal studies to better understand the mental health of commercial airline pilots.

A study on aircraft map display location and orientation. [effects of map display location on manual piloting performance

NASA Technical Reports Server (NTRS)

Baty, D. L.; Wempe, T. E.; Huff, E. M.

1973-01-01

Six airline pilots participated in a fixed-base simulator study to determine the effects of two Horizontal Situation Display (HSD/map) panel locations relative to the Vertical Situation Display (VSD), and of three map orientations on manual piloting performance. Pilot comments and opinions were formally obtained. Significant performance differences were found between wind conditions, and among pilots, but not between map locations and orientations. The results also illustrate the potential tracking accuracy of such a display. Recommendations concerning display location and map orientation are made.

78 FR 48715 - Proposed Information Collection; Comment Request: NPS Study of Value of Natural Sounds: A Pilot...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

....NS0000] Proposed Information Collection; Comment Request: NPS Study of Value of Natural Sounds: A Pilot Study AGENCY: National Park Service, Interior. ACTION: Notice; request for comments. SUMMARY: We.... This is a new collection. Title: NPS Study of Value of Natural Sounds: A Pilot Study. Type of Request...

Prediction of aircraft handling qualities using analytical models of the human pilot

NASA Technical Reports Server (NTRS)

Hess, R. A.

1982-01-01

The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot-induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

Prediction of aircraft handling qualities using analytical models of the human pilot

NASA Technical Reports Server (NTRS)

Hess, R. A.

1982-01-01

The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot induced oscillations is formulated. Finally, a model based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

An analytical approach for predicting pilot induced oscillations

NASA Technical Reports Server (NTRS)

Hess, R. A.

1981-01-01

The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion or determining the susceptability of an aircraft to pilot induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

Numerical and flight simulator test of the flight deterioration concept

NASA Technical Reports Server (NTRS)

Mccarthy, J.; Norviel, V.

1982-01-01

Manned flight simulator response to theoretical wind shear profiles was studied in an effort to calibrate fixed-stick and pilot-in-the-loop numerical models of jet transport aircraft on approach to landing. Results of the study indicate that both fixed-stick and pilot-in-the-loop models overpredict the deleterious effects of aircraft approaches when compared to pilot performance in the manned simulator. Although the pilot-in-the-loop model does a better job than does the fixed-stick model, the study suggests that the pilot-in-the-loop model is suitable for use in meteorological predictions of adverse low-level wind shear along approach and departure courses to identify situations in which pilots may find difficulty. The model should not be used to predict the success or failure of a specific aircraft. It is suggested that the pilot model be used as part of a ground-based Doppler radar low-level wind shear detection and warning system.

Mandibular position influence on pilots' postural balance analyzed under dynamic conditions.

PubMed

Baldini, Alberto; Nota, Alessandro; Cioffi, Clementina; Ballanti, Fabiana; Tecco, Simona

2017-11-01

The aim of this study is to evaluate the influence of the mandibular position on the postural stability in a sample of civilian and military pilots. Twenty military pilots (males, mean age 35.15 ± 3.14 years) and 17 civilian pilots (males, mean 34.91 ± 2.15 years) were enrolled in this study and underwent a Sensory Organization Test (SOT) using the EquiTest® (NeuroCom International Inc., Clackamas, OR, USA) computerized dynamic posturography. The composite parameter was recorded and analyzed. The equilibrium score (ES) recorded in centric occlusion is slightly higher than the ES recorded in mandibular rest position; civilian pilots showed ESs slightly higher than military pilots. The two-way ANOVA analysis shows these differences are not statistically significant. The findings of this study seem to suggest that the composite parameter of the SOT is not sensitive in analyzing the influence of the stomatognathic system on the postural balance of civilian and military pilots.

Pilot age and error in air taxi crashes.

PubMed

Rebok, George W; Qiang, Yandong; Baker, Susan P; Li, Guohua

2009-07-01

The associations of pilot error with the type of flight operations and basic weather conditions are well documented. The correlation between pilot characteristics and error is less clear. This study aims to examine whether pilot age is associated with the prevalence and patterns of pilot error in air taxi crashes. Investigation reports from the National Transportation Safety Board for crashes involving non-scheduled Part 135 operations (i.e., air taxis) in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Crash circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. Of the 1751 air taxi crashes studied, 28% resulted from mechanical failure, 25% from loss of control at landing or takeoff, 7% from visual flight rule conditions into instrument meteorological conditions, 7% from fuel starvation, 5% from taxiing, and 28% from other causes. Crashes among older pilots were more likely to occur during the daytime rather than at night and off airport than on airport. The patterns of pilot error in air taxi crashes were similar across age groups. Of the errors identified, 27% were flawed decisions, 26% were inattentiveness, 23% mishandled aircraft kinetics, 15% mishandled wind and/or runway conditions, and 11% were others. Pilot age is associated with crash circumstances but not with the prevalence and patterns of pilot error in air taxi crashes. Lack of age-related differences in pilot error may be attributable to the "safe worker effect."

75 FR 80827 - Compliance Policy Guide; Radiofrequency Identification Feasibility Studies and Pilot Programs for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... Identification (RFID) Feasibility Studies and Pilot Programs for Drugs'' to December 31, 2012. FOR FURTHER... Sec. 400.210 entitled ``Radiofrequency Identification (RFID) Feasibility Studies and Pilot Programs... FR 65750, November 23, 2007; 73 FR 78371, December 22, 2008). FDA has identified RFID as a promising...

Autogenic-feedback training improves pilot performance during emergency flying conditions

NASA Technical Reports Server (NTRS)

Kellar, Michael A.; Folen, Raymond A.; Cowings, Patricia S.; Toscano, William B.; Hisert, Glen L.

1994-01-01

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group comprised three pilots of HC-130 Hercules aircraft and four HH-65 Dolphin helicopter pilots; the control group comprised three pilots of HC-130's and six Dolphin helicopter pilots. During an initial flight, physiological data were recorded for each crew member and individual crew performance was rated by an instructor pilot. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training (AFT). The remaining subjects received no training. During a second flight, treatment subjects showed significant improvement in performance, while controls did not improve. The results indicate that AFT management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

Using Motivational Enhancement Among OIF / OEF Veterans Returning to the Community

DTIC Science & Technology

2014-10-01

than veterans who receive treatment as usual. During this year the pilot study for the project was completed. The purpose of the pilot study group was...pilot group members could not be used. The veterans in the pilot study were notified of the lapse and were re-consented. During the year the team...Veterans must not be currently in counseling to participate in the project. To combat this, one idea proposed is to allow veterans who live outside of

A roadmap for improving healthcare service quality.

PubMed

Kennedy, Denise M; Caselli, Richard J; Berry, Leonard L

2011-01-01

A data-driven, comprehensive model for improving service and creating long-term value was developed and implemented at Mayo Clinic Arizona (MCA). Healthcare organizations can use this model to prepare for value-based purchasing, a payment system in which quality and patient experience measures will influence reimbursement. Surviving and thriving in such a system will require a comprehensive approach to sustaining excellent service performance from physicians and allied health staff (e.g., nurses, technicians, nonclinical staff). The seven prongs in MCA's service quality improvement model are (1) multiple data sources to drive improvement, (2) accountability for service quality, (3) service consultation and improvement tools, (4) service values and behaviors, (5) education and training, (6) ongoing monitoring and control, and (7) recognition and reward. The model was fully implemented and tested in five departments in which patient perception of provider-specific service attributes and/or overall quality of care were below the 90th percentile for patient satisfaction in the vendor's database. Extent of the implementation was at the discretion of department leadership. Perception data rating various service attributes were collected from randomly selected patients and monitored over a 24-month period. The largest increases in patient perception of excellence over the pilot period were realized when all seven prongs of the model were implemented as a comprehensive improvement approach. The results of this pilot may help other healthcare organizations prepare for value-based purchasing.

Advanced piloted aircraft flight control system design methodology. Volume 2: The FCX flight control design expert system

NASA Technical Reports Server (NTRS)

Myers, Thomas T.; Mcruer, Duane T.

1988-01-01

The development of a comprehensive and electric methodology for conceptual and preliminary design of flight control systems is presented and illustrated. The methodology is focused on the design states starting with the layout of system requirements and ending when some viable competing system architectures (feedback control structures) are defined. The approach is centered on the human pilot and the aircraft as both the sources of, and the keys to the solution of, many flight control problems. The methodology relies heavily on computational procedures which are highly interactive with the design engineer. To maximize effectiveness, these techniques, as selected and modified to be used together in the methodology, form a cadre of computational tools specifically tailored for integrated flight control system preliminary design purposes. The FCX expert system as presently developed is only a limited prototype capable of supporting basic lateral-directional FCS design activities related to the design example used. FCX presently supports design of only one FCS architecture (yaw damper plus roll damper) and the rules are largely focused on Class IV (highly maneuverable) aircraft. Despite this limited scope, the major elements which appear necessary for application of knowledge-based software concepts to flight control design were assembled and thus FCX represents a prototype which can be tested, critiqued and evolved in an ongoing process of development.

PILOT-SCALE TEST RESULTS OF A THIN FILM EVAPORATOR SYSTEM FOR MANAGEMENT OF LIQUID HIGH-LEVEL WASTES AT THE HANFORD SITE WASHINGTON USA -11364

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

CORBETT JE; TEDESCH AR; WILSON RA

2011-02-14

A modular, transportable evaporator system, using thin film evaporative technology, is planned for deployment at the Hanford radioactive waste storage tank complex. This technology, herein referred to as a wiped film evaporator (WFE), will be located at grade level above an underground storage tank to receive pumped liquids, concentrate the liquid stream from 1.1 specific gravity to approximately 1.4 and then return the concentrated solution back into the tank. Water is removed by evaporation at an internal heated drum surface exposed to high vacuum. The condensed water stream will be shipped to the site effluent treatment facility for final disposal.more » This operation provides significant risk mitigation to failure of the aging 242-A Evaporator facility; the only operating evaporative system at Hanford maximizing waste storage. This technology is being implemented through a development and deployment project by the tank farm operating contractor, Washington River Protection Solutions (WRPS), for the Office of River Protection/Department of Energy (ORPIDOE), through Columbia Energy and Environmental Services, Inc. (Columbia Energy). The project will finalize technology maturity and install a system at one of the double-shell tank farms. This paper summarizes results of a pilot-scale test program conducted during calendar year 2010 as part of the ongoing technology maturation development scope for the WFE.« less

Compensation for time delay in flight simulator visual-display systems

NASA Technical Reports Server (NTRS)

Crane, D. F.

1983-01-01

A piloted aircraft can be viewed as a closed-loop, man-machine control system. When a simulator pilot is performing a precision maneuver, a delay in the visual display of aircraft response to pilot-control input decreases the stability of the pilot-aircraft system. The less stable system is more difficult to control precisely. Pilot dynamic response and performance change as the pilot attempts to compensate for the decrease in system stability, and these changes bias the simulation results by influencing the pilot's rating of the handling qualities of the simulated aircraft. Delay compensation, designed to restore pilot-aircraft system stability, was evaluated in several studies which are reported here. The studies range from single-axis, tracking-task experiments (with sufficient subjects and trials to establish statistical significance of the results) to a brief evaluation of compensation of a computer-generated-imagery (CGI) visual display system in a full six-degree-of-freedom simulation. The compensation was effective - improvements in pilot performance and workload or aircraft handling-qualities rating (HQR) were observed. Results from recent aircraft handling-qualities research literature which support the compensation design approach are also reviewed.

NORTHWEST ORGEON PILOT STUDY AREA (USA): THE USE OF LANDSCAPE SCIENCE FOR ENVIRONMENTAL ASSESSMENT PILOT STUDY

EPA Science Inventory

The Northwest Oregon Pilot Study Area encompasses approximately 59,167 km2 and varies in elevation from sea level to 3,200 m. Annual precipitation varies with elevation and meridian and ranges from 25 - 460cm. The study area comprises a mixture of federal, state, and privately ow...

Pilot Comments From the Boeing High Speed Research Aircraft, Cycle 3, Simulation Study of the Effects of Aeroservoelasticity (LaRC.3)

NASA Technical Reports Server (NTRS)

Bailey, Melvin L. (Editor)

2000-01-01

This is a compilation of pilot comments from the Boeing High Speed Research Aircraft, Cycle 3, simulation study (LaRC.3) of the effects of aeroservoelasticity, conducted from October to December 1997 at NASA Langley Research Center. This simulation study was conducted using the Visual Motion Simulator. The comments are from direct tape transcriptions and have been edited for spelling only. These comments were made on tape following the completion of each flight card, immediately after the pilot was satisfied with his practice and data recording runs. Six pilots were used in the evaluation and they are identified as pilots A through F.

The use of total simulator training in transitioning air-carrier pilots: A field evaluation

NASA Technical Reports Server (NTRS)

Randle, R. J., Jr.; Tanner, T. A.; Hamerman, J. A.; Showalter, T. H.

1981-01-01

A field study was conducted in which the performance of air carrier transitioning pilots who had landing training in a landing maneuver approved simulator was compared with the performance of pilots who had landing training in the aircraft. Forty-eight trainees transitioning to the B-727 aircraft and eighty-seven trainees transitioning to the DC-10 were included in the study. The study results in terms of both objectively measured performance indicants and observer and check-pilot ratings did not demonstrate a clear distinction between the two training groups. The results suggest that, for these highly skilled transitioning pilots, a separate training module in the aircraft may be of dubious value.

Oregon department of transportation small business group twice-monthly payments pilot project : summary report.

DOT National Transportation Integrated Search

2008-07-01

Oregon Department of Transportation (ODOT) recently completed a pilot study on small business payment practices. In the study, three pilot projects were tested where payments to small business contractors were changed from a monthly payment to twice-...

Modeling human pilot cue utilization with applications to simulator fidelity assessment.

PubMed

Zeyada, Y; Hess, R A

2000-01-01

An analytical investigation to model the manner in which pilots perceive and utilize visual, proprioceptive, and vestibular cues in a ground-based flight simulator was undertaken. Data from a NASA Ames Research Center vertical motion simulator study of a simple, single-degree-of-freedom rotorcraft bob-up/down maneuver were employed in the investigation. The study was part of a larger research effort that has the creation of a methodology for determining flight simulator fidelity requirements as its ultimate goal. The study utilized a closed-loop feedback structure of the pilot/simulator system that included the pilot, the cockpit inceptor, the dynamics of the simulated vehicle, and the motion system. With the exception of time delays that accrued in visual scene production in the simulator, visual scene effects were not included in this study. Pilot/vehicle analysis and fuzzy-inference identification were employed to study the changes in fidelity that occurred as the characteristics of the motion system were varied over five configurations. The data from three of the five pilots who participated in the experimental study were analyzed in the fuzzy-inference identification. Results indicate that both the analytical pilot/vehicle analysis and the fuzzy-inference identification can be used to identify changes in simulator fidelity for the task examined.

A queueing model of pilot decision making in a multi-task flight management situation

NASA Technical Reports Server (NTRS)

Walden, R. S.; Rouse, W. B.

1977-01-01

Allocation of decision making responsibility between pilot and computer is considered and a flight management task, designed for the study of pilot-computer interaction, is discussed. A queueing theory model of pilot decision making in this multi-task, control and monitoring situation is presented. An experimental investigation of pilot decision making and the resulting model parameters are discussed.

Integration of molecular typing results into tuberculosis surveillance in Germany—A pilot study

PubMed Central

Fiebig, Lena; Priwitzer, Martin; Richter, Elvira; Rüsch-Gerdes, Sabine; Haas, Walter; Niemann, Stefan; Brodhun, Bonita

2017-01-01

An integrated molecular surveillance for tuberculosis (TB) improves the understanding of ongoing TB transmission by combining molecular typing and epidemiological data. However, the implementation of an integrated molecular surveillance for TB is complex and requires thoughtful consideration of feasibility, demand, public health benefits and legal issues. We aimed to pilot the integration of molecular typing results between 2008 and 2010 in the German Federal State of Baden-Württemberg (population 10.88 Million) as preparation for a nationwide implementation. Culture positive TB cases were typed by IS6110 DNA fingerprinting and results were integrated into routine notification data. Demographic and clinical characteristics of cases and clusters were described and new epidemiological links detected after integrating typing data were calculated. Furthermore, a cross-sectional survey was performed among local public health offices to evaluate their perception and experiences. Overall, typing results were available for 83% of notified culture positive TB cases, out of which 25% were clustered. Age <15 years (OR = 4.96, 95% CI: 1.69–14.55) and being born in Germany (OR = 2.01, 95% CI: 1.44–2.80) were associated with clustering. At cluster level, molecular typing information allowed the identification of previously unknown epidemiological links in 11% of the clusters. In 59% of the clusters it was not possible to identify any epidemiological link. Clusters extending over different counties were less likely to have epidemiological links identified among their cases (OR = 11.53, 95% CI: 3.48–98.23). The majority of local public health offices found molecular typing useful for their work. Our study illustrates the feasibility of integrating typing data into the German TB notification system and depicts its added public health value as complementary strategy in TB surveillance, especially to uncover transmission events among geographically separated TB patients. It also emphasizes that special efforts are required to strengthen the communication between local public health offices in different counties to enhance TB control. PMID:29166403

SU-E-T-197: Helical Cranial-Spinal Treatments with a Linear Accelerator

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

Anderson, J; Bernard, D; Liao, Y

2014-06-01

Purpose: Craniospinal irradiation (CSI) of systemic disease requires a high level of beam intensity modulation to reduce dose to bone marrow and other critical structures. Current helical delivery machines can take 30 minutes or more of beam-on time to complete these treatments. This pilot study aims to test the feasibility of performing helical treatments with a conventional linear accelerator using longitudinal couch travel during multiple gantry revolutions. Methods: The VMAT optimization package of the Eclipse 10.0 treatment planning system was used to optimize pseudo-helical CSI plans of 5 clinical patient scans. Each gantry revolution was divided into three 120° arcsmore » with each isocenter shifted longitudinally. Treatments requiring more than the maximum 10 arcs used multiple plans with each plan after the first being optimized including the dose of the others (Figure 1). The beam pitch was varied between 0.2 and 0.9 (couch speed 5- 20cm/revolution and field width of 22cm) and dose-volume histograms of critical organs were compared to tomotherapy plans. Results: Viable pseudo-helical plans were achieved using Eclipse. Decreasing the pitch from 0.9 to 0.2 lowered the maximum lens dose by 40%, the mean bone marrow dose by 2.1% and the maximum esophagus dose by 17.5%. (Figure 2). Linac-based helical plans showed dose results comparable to tomotherapy delivery for both target coverage and critical organ sparing, with the D50 of bone marrow and esophagus respectively 12% and 31% lower in the helical linear accelerator plan (Figure 3). Total mean beam-on time for the linear accelerator plan was 8.3 minutes, 54% faster than the tomotherapy average for the same plans. Conclusions: This pilot study has demonstrated the feasibility of planning pseudo-helical treatments for CSI targets using a conventional linac and dynamic couch movement, and supports the ongoing development of true helical optimization and delivery.« less

Gastroenteritis Aggressive Versus Slow Treatment For Rehydration (GASTRO). A pilot rehydration study for severe dehydration: WHO plan C versus slower rehydration

PubMed Central

Houston, Kirsty A.; Gibb, Jack G.; Mpoya, Ayub; Obonyo, Nchafatso; Olupot-Olupot, Peter; Nakuya, Margeret; Evans, Jennifer A; George, Elizabeth C; Gibb, Diana M; Maitland, Kathryn

2017-01-01

Background: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy. Those findings warrant a detailed physiological study of children’s responses to rehydration therapy incorporating quantification of myocardial performance and haemodynamic changes.  Methods: GASTRO is a multi-centre, unblinded Phase II randomised controlled trial of 120 children aged 2 months to 12 years admitted to hospital with severe dehydration secondary to AGE. Children with severe malnutrition, chronic diarrhoea and congenital/rheumatic heart disease are excluded. Children will be enrolled over 18 months in 3 centres in Kenya and Uganda and followed until 7 days post-discharge. The trial will randomise children 1:1 to standard rapid rehydration using Ringers Lactate  (WHO plan ‘C’ – 100mls/kg over 3-6 hours according to age, plus additional 0.9% saline boluses for children presenting in shock) or to a slower rehydration regimen (100mls/kg given over 8 hours and without the addition of fluid boluses). Enrolment started in November 2016 and is on-going. Primary outcome is frequency of adverse events, particularly related to cardiovascular compromise and neurological sequelae.  Secondary outcomes focus on clinical, biochemical, and physiological measures related to assessment of severity of dehydration, and response to treatment by intravenous rehydration. Discussion: Results from this pilot will contribute to generating robust definitions of outcomes (in particular for non-mortality endpoints) for a larger Phase III trial. PMID:28905004

Integration of molecular typing results into tuberculosis surveillance in Germany-A pilot study.

PubMed

Andrés, Marta; Göhring-Zwacka, Elke; Fiebig, Lena; Priwitzer, Martin; Richter, Elvira; Rüsch-Gerdes, Sabine; Haas, Walter; Niemann, Stefan; Brodhun, Bonita

2017-01-01

An integrated molecular surveillance for tuberculosis (TB) improves the understanding of ongoing TB transmission by combining molecular typing and epidemiological data. However, the implementation of an integrated molecular surveillance for TB is complex and requires thoughtful consideration of feasibility, demand, public health benefits and legal issues. We aimed to pilot the integration of molecular typing results between 2008 and 2010 in the German Federal State of Baden-Württemberg (population 10.88 Million) as preparation for a nationwide implementation. Culture positive TB cases were typed by IS6110 DNA fingerprinting and results were integrated into routine notification data. Demographic and clinical characteristics of cases and clusters were described and new epidemiological links detected after integrating typing data were calculated. Furthermore, a cross-sectional survey was performed among local public health offices to evaluate their perception and experiences. Overall, typing results were available for 83% of notified culture positive TB cases, out of which 25% were clustered. Age <15 years (OR = 4.96, 95% CI: 1.69-14.55) and being born in Germany (OR = 2.01, 95% CI: 1.44-2.80) were associated with clustering. At cluster level, molecular typing information allowed the identification of previously unknown epidemiological links in 11% of the clusters. In 59% of the clusters it was not possible to identify any epidemiological link. Clusters extending over different counties were less likely to have epidemiological links identified among their cases (OR = 11.53, 95% CI: 3.48-98.23). The majority of local public health offices found molecular typing useful for their work. Our study illustrates the feasibility of integrating typing data into the German TB notification system and depicts its added public health value as complementary strategy in TB surveillance, especially to uncover transmission events among geographically separated TB patients. It also emphasizes that special efforts are required to strengthen the communication between local public health offices in different counties to enhance TB control.

Feasibility of an Assessment Tool for Children's Competence to Consent to Predictive Genetic Testing: a Pilot Study.

PubMed

Hein, Irma M; Troost, Pieter W; Lindeboom, Robert; Christiaans, Imke; Grisso, Thomas; van Goudoever, Johannes B; Lindauer, Ramón J L

2015-12-01

Knowledge on children's capacities to consent to medical treatment is limited. Also, age limits for asking children's consent vary considerably between countries. Decision-making on predictive genetic testing (PGT) is especially complicated, considering the ongoing ethical debate. In order to examine just age limits for alleged competence to consent in children, we evaluated feasibility of a standardized assessment tool, and investigated cutoff ages for children's competence to consent to PGT. We performed a pilot study, including 17 pediatric outpatients between 6 and 18 years at risk for an autosomal dominantly inherited cardiac disease, eligible for predictive genetic testing. The reference standard for competence was established by experts trained in the relevant criteria for competent decision-making. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) served as index test. Data analysis included raw agreement between competence classifications, difference in mean ages between children judged competent and judged incompetent, and estimation of cutoff ages for judgments of competence. Twelve (71 %) children were considered competent by the reference standard, and 16 (94 %) by the MacCAT-T, with an overall agreement of 76 %. The expert judgments disagreed in most cases, while the MacCAT-T judgments agreed in 65 %. Mean age of children judged incompetent was 9.3 years and of children judged competent 12.1 years (p = .035). With 90 % sensitivity, children younger than 10.0 years were judged incompetent, with 90 % specificity children older than 11.8 years were judged competent. Feasibility of the MacCAT-T in children is confirmed. Initial findings on age cutoffs are indicative for children between the age of 12 and 18 to be judged competent for involvement in the informed consent process. Future research on appropriate age-limits for children's alleged competence to consent is needed.

Lunar Analog

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.

2009-01-01

In this viewgraph presentation, a ground-based lunar analog is developed for the return of manned space flight to the Moon. The contents include: 1) Digital Astronaut; 2) Bed Design; 3) Lunar Analog Feasibility Study; 4) Preliminary Data; 5) Pre-pilot Study; 6) Selection of Stockings; 7) Lunar Analog Pilot Study; 8) Bed Design for Lunar Analog Pilot.

Study of occupational stress among railway engine pilots

PubMed Central

Kumar, Devesh; Singh, Jai Vir; Kharwar, Poonam S.

2011-01-01

Background: Traffic volume and speed is going to be increased in Indian Railways successively, leading to higher stress in staff connected with train operations. The jobs of railway engine pilots come under the category of high-strain jobs, necessitating a need to conduct multicentric study to unfold the factors associated with occupational stress and organizational strategies. Materials and Methods: Present study covered 185 railway engine pilots and office clerks working in various railway zones by incidental method. Occupational Stress Index (OSI) test developed by Srivastva and Singh, questionnaire of specific stressors constructed by authors and laboratory test battery for psychological screening of high-speed train pilots were used as tools. Results: Means of OSI and all the 12 occupational stressors of railway engine pilots were found significantly higher to that of office clerks. Means of OSI and occupational stressors of goods train pilots were significantly higher in comparison to high-speed train pilots and passenger train pilots. Study revealed positive correlation of speed perception and complex reaction time tests and negative correlation of other constituent tests of laboratory test battery to OSI test. Highest subgroup of stressor observedwas role overload followed by role conflict. Conclusions: These findings provide a prima facie evidence of higher occupational stress among railway engine pilots because of identified specific stressors prevalent in their job and explore the possible intervention strategies for its reduction. Significant correlation is noticed between OSI and laboratory test results, indicating its relevant utility in preliminary psychological screening. PMID:21808497

A simulator evaluation of an automatic terminal approach system

NASA Technical Reports Server (NTRS)

Hinton, D. A.

1983-01-01

The automatic terminal approach system (ATAS) is a concept for improving the pilot/machine interface with cockpit automation. The ATAS can automatically fly a published instrument approach by using stored instrument approach data to automatically tune airplane avionics, control the airplane's autopilot, and display status information to the pilot. A piloted simulation study was conducted to determine the feasibility of an ATAS, determine pilot acceptance, and examine pilot/ATAS interaction. Seven instrument-rated pilots each flew four instrument approaches with a base-line heading select autopilot mode. The ATAS runs resulted in lower flight technical error, lower pilot workload, and fewer blunders than with the baseline autopilot. The ATAS status display enabled the pilots to maintain situational awareness during the automatic approaches. The system was well accepted by the pilots.

Revised NEO Personality Inventory profiles of male and female U.S. Air Force pilots.

PubMed

Callister, J D; King, R E; Retzlaff, P D; Marsh, R W

1999-12-01

The study of pilot personality characteristics has a long and controversial history. Personality characteristics seem to be fairly poor predictors of training outcome; however, valid personality assessment is essential to clinical psychological evaluations. Therefore, the personality characteristics of pilots must be studied to ensure valid clinical assessment. This paper describes normative personality characteristics of U.S. Air Force pilots based on the Revised NEO Personality Inventory profiles of 1,301 U.S. Air Force student pilots. Compared with male adult norms, male student pilots had higher levels of extraversion and lower levels of agreeableness. Compared with female adult norms, female student pilots had higher levels of extraversion and openness and lower levels of agreeableness. Descriptive statistics and percentile tables for the five domain scores and 30 facet scores are provided for clinical use, and a case vignette is provided as an example of the clinical utility of these U.S. Air Force norms.

Head positioning for high +Gz loads: an analysis of the techniques used by F/A-18 pilots.

PubMed

Newman, D G

1997-08-01

A study was undertaken among Royal Australian Air Force fighter pilots to determine whether, as an occupational group, they had developed any particular protective head positioning strategies in order to minimize their risk of sustaining a +Gz-induced neck injury during air combat maneuvering. There were 42 F/A-18 Hornet pilots who responded to an anonymous questionnaire which asked about head positioning strategies. Of these, 29 pilots reported using a protective strategy. Several pilots reported using several different techniques. The most popular strategy reported was positioning the head prior to the application of +Gz (13 respondents). Eleven pilots reported using aircraft structures to wedge or brace their heads against. The results of this study show that fighter pilots who are regularly exposed to high +Gz forces develop an individualized approach to protecting their cervical spines from +Gz-induced injury.

Effects of hydration on cognitive function of pilots.

PubMed

Lindseth, Paul D; Lindseth, Glenda N; Petros, Thomas V; Jensen, Warren C; Caspers, Julie

2013-07-01

The objective of this study was to examine the effect of fluid intake and possible dehydration on cognitive flight performance of pilots. A repeated-measures, counterbalanced, mixed study design was used to examine differences in working memory, spatial orientation, and cognitive flight performance of 40 randomly selected healthy pilots after having high and low fluid intakes. Serial weights were also analyzed to determine differences in cognitive flight performance of the dehydrated (1-3% weight loss) and hydrated study participants. Results showed flight performance and spatial cognition test scores were significantly (p < 0.05) poorer for pilots who had low fluid intakes and experienced dehydration in comparison to the hydrated pilots. These findings indicate fluid intake differences resulting in dehydration may have safety implications because peak cognitive performance among pilots is critical for flight safety. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Pilot Age and Error in Air-Taxi Crashes

PubMed Central

Rebok, George W.; Qiang, Yandong; Baker, Susan P.; Li, Guohua

2010-01-01

Introduction The associations of pilot error with the type of flight operations and basic weather conditions are well documented. The correlation between pilot characteristics and error is less clear. This study aims to examine whether pilot age is associated with the prevalence and patterns of pilot error in air-taxi crashes. Methods Investigation reports from the National Transportation Safety Board for crashes involving non-scheduled Part 135 operations (i.e., air taxis) in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Crash circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. Results Of the 1751 air-taxi crashes studied, 28% resulted from mechanical failure, 25% from loss of control at landing or takeoff, 7% from visual flight rule conditions into instrument meteorological conditions, 7% from fuel starvation, 5% from taxiing, and 28% from other causes. Crashes among older pilots were more likely to occur during the daytime rather than at night and off airport than on airport. The patterns of pilot error in air-taxi crashes were similar across age groups. Of the errors identified, 27% were flawed decisions, 26% were inattentiveness, 23% mishandled aircraft kinetics, 15% mishandled wind and/or runway conditions, and 11% were others. Conclusions Pilot age is associated with crash circumstances but not with the prevalence and patterns of pilot error in air-taxi crashes. Lack of age-related differences in pilot error may be attributable to the “safe worker effect.” PMID:19601508

Human risk factors associated with pilots in runway excursions.

PubMed

Chang, Yu-Hern; Yang, Hui-Hua; Hsiao, Yu-Jung

2016-09-01

A breakdown analysis of civil aviation accidents worldwide indicates that the occurrence of runway excursions represents the largest portion among all aviation occurrence categories. This study examines the human risk factors associated with pilots in runway excursions, by applying a SHELLO model to categorize the human risk factors and to evaluate the importance based on the opinions of 145 airline pilots. This study integrates aviation management level expert opinions on relative weighting and improvement-achievability in order to develop four kinds of priority risk management strategies for airline pilots to reduce runway excursions. The empirical study based on experts' evaluation suggests that the most important dimension is the liveware/pilot's core ability. From the perspective of front-line pilots, the most important risk factors are the environment, wet/containment runways, and weather issues like rain/thunderstorms. Finally, this study develops practical strategies for helping management authorities to improve major operational and managerial weaknesses so as to reduce the human risks related to runway excursions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Study of the use of a nonlinear, rate limited, filter on pilot control signals

NASA Technical Reports Server (NTRS)

Adams, J. J.

1977-01-01

The use of a filter on the pilot's control output could improve the performance of the pilot-aircraft system. What is needed is a filter with a sharp high frequency cut-off, no resonance peak, and a minimum of lag at low frequencies. The present investigation studies the usefulness of a nonlinear, rate limited, filter in performing the needed function. The nonlinear filter is compared with a linear, first order filter, and no filter. An analytical study using pilot models and a simulation study using experienced test pilots was performed. The results showed that the nonlinear filter does promote quick, steady maneuvering. It is shown that the nonlinear filter attenuates the high frequency remnant and adds less phase lag to the low frequency signal than does the linear filter. It is also shown that the rate limit in the nonlinear filter can be set to be too restrictive, causing an unstable pilot-aircraft system response.

Airplane pilot mental health and suicidal thoughts: a cross-sectional descriptive study via anonymous web-based survey.

PubMed

Wu, Alexander C; Donnelly-McLay, Deborah; Weisskopf, Marc G; McNeely, Eileen; Betancourt, Theresa S; Allen, Joseph G

2016-12-15

The Germanwings Flight 9525 crash has brought the sensitive subject of airline pilot mental health to the forefront in aviation. Globally, 350 million people suffer from depression-a common mental disorder. This study provides further information on this important topic regarding mental health especially among female airline pilots. This is the first study to describe airline pilot mental health-with a focus on depression and suicidal thoughts-outside of the information derived from aircraft accident investigations, regulated health examinations, or identifiable self-reports, which are records protected by civil aviation authorities and airline companies. This is a descriptive cross-sectional study via an anonymous web-based survey administered between April and December 2015. Pilots were recruited from unions, airline companies, and airports via convenience sampling. Data analysis included calculating absolute number and prevalence of health characteristics and depression scores. One thousand eight hundred thirty seven (52.7%) of the 3485 surveyed pilots completed the survey, with 1866 (53.5%) completing at least half of the survey. 233 (12.6%) of 1848 airline pilots responding to the Patient Health Questionnaire 9 (PHQ-9), and 193 (13.5%) of 1430 pilots who reported working as an airline pilot in the last seven days at time of survey, met depression threshold-PHQ-9 total score ≥ 10. Seventy-five participants (4.1%) reported having suicidal thoughts within the past two weeks. We found a significant trend in proportions of depression at higher levels of use of sleep-aid medication (trend test z = 6.74, p < 0.001) and among those experiencing sexual harassment (z = 3.18, p = 0.001) or verbal harassment (z = 6.13, p < 0.001). Hundreds of pilots currently flying are managing depressive symptoms perhaps without the possibility of treatment due to the fear of negative career impacts. This study found 233 (12.6%) airline pilots meeting depression threshold and 75 (4.1%) pilots reporting having suicidal thoughts. Although results have limited generalizability, there are a significant number of active pilots suffering from depressive symptoms. We recommend airline organizations increase support for preventative mental health treatment. Future research will evaluate additional risk factors of depression such as sleep and circadian rhythm disturbances.

Pilot Convective Weather Decision Making in En Route Airspace

NASA Technical Reports Server (NTRS)

Wu, Shu-Chieh; Gooding, Cary L.; Shelley, Alexandra E.; Duong, Constance G.; Johnson, Walter W.

2012-01-01

The present research investigates characteristics exhibited in pilot convective weather decision making in en route airspace. In a part-task study, pilots performed weather avoidance under various encounter scenarios. Results showed that the margins of safety that pilots maintain from storms are as fluid as deviation decisions themselves.

Pilot age and expertise predict flight simulator performance: a 3-year longitudinal study.

PubMed

Taylor, Joy L; Kennedy, Quinn; Noda, Art; Yesavage, Jerome A

2007-02-27

Expert knowledge may compensate for age-related declines in basic cognitive and sensory-motor abilities in some skill domains. We investigated the influence of age and aviation expertise (indexed by Federal Aviation Administration pilot ratings) on longitudinal flight simulator performance. Over a 3-year period, 118 general aviation pilots aged 40 to 69 years were tested annually, in which their flight performance was scored in terms of 1) executing air-traffic controller communications; 2) traffic avoidance; 3) scanning cockpit instruments; 4) executing an approach to landing; and 5) a flight summary score. More expert pilots had better flight summary scores at baseline and showed less decline over time. Secondary analyses revealed that expertise effects were most evident in the accuracy of executing aviation communications, the measure on which performance declined most sharply over time. Regarding age, even though older pilots initially performed worse than younger pilots, over time older pilots showed less decline in flight summary scores than younger pilots. Secondary analyses revealed that the oldest pilots did well over time because their traffic avoidance performance improved more vs younger pilots. These longitudinal findings support previous cross-sectional studies in aviation as well as non-aviation domains, which demonstrated the advantageous effect of prior experience and specialized expertise on older adults' skilled cognitive performances.

Feasibility and Pilot Studies in Palliative Care Research: A Systematic Review.

PubMed

Jones, Terry A; Olds, Timothy S; Currow, David C; Williams, Marie T

2017-07-01

Feasibility and pilot study designs are common in palliative care research. Finding standard guidelines on the structure and reporting of these study types is difficult. In feasibility and pilot studies in palliative care research, to determine 1) how commonly a priori feasibility are criteria reported and whether results are subsequently reported against these criteria? and 2) how commonly are participants' views on acceptability of burden of the study protocol assessed? Four databases (OVID Medline, EMBASE, CINAHL, and PubMed via caresearch.com.au.) were searched. Search terms included palliative care, terminal care, advance care planning, hospice, pilot, feasibility, with a publication date between January 1, 2012 and December 31, 2013. Articles were selected and appraised by two independent reviewers. Fifty-six feasibility and/or pilot studies were included in this review. Only three studies had clear a priori criteria to measure success. Sixteen studies reported participant acceptability or burden with measures. Forty-eight studies concluded feasibility. The terms "feasibility" and "pilot" are used synonymously in palliative care research when describing studies that test for feasibility. Few studies in palliative care research outline clear criteria for success. The assessment of participant acceptability and burden is uncommon. A gold standard for feasibility study design in palliative care research that includes both clear criteria for success and testing of the study protocol for participant acceptability and burden is needed. Such a standard would assist with consistency in the design, conduct and reporting of feasibility and pilot studies. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Intelligent Pilot Aids for Flight Re-Planning in Emergencies

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Ockerman, Jennifer

2005-01-01

Effective and safe control of an aircraft may be difficult or nearly impossible for a pilot following an unexpected system failure. Without prior training, the pilot must ascertain on the fly those changes in both manual control technique and procedures that will lead to a safe landing of the aircraft. Sophisticated techniques for determining the required control techniques are now available. Likewise, a body of literature on pilot decision making provides formalisms for examining how pilots approach discrete decisions framed as the selection between options. However, other aspects of behavior, such as the task of route planning and guidance, are not as well studied. Not only is the pilot faced with possible performance changes to the aircraft dynamics, but he or she is also tasked to create a plan of actions that will effectively take the aircraft down to a safe landing. In this plan, the many actions that the pilot can perform are closely intertwined with the trajectory of the aircraft, making it difficult to accurately predict the final outcome. Coupled with the vast number of potential actions to be taken, this problem may seem intractable. This is reflected in the lack of a pre-specified procedure capable of giving pilots the ability to find a resolution for this task. This report summarizes a multi-year effort to examine methods to aid pilots in planning an approach and arrival to an airport following an aircraft systems failure. Ultimately, we hypothesize that automatic assistance to pilots can be provided in real-time in the form of improving pilot control of a damaged aircraft and providing pilots with procedural directives suitable for critical flight conditions; such systems may also benefit pilot training and procedure design. To achieve this result, a systematic, comprehensive research program was followed, building on prior research. This approach included a pencil-and-paper study with airline pilots examining methods of representing a flight route in an immediately understandable manner, and in a manner that would allow the pilot to modify an automatically-generated route and/or detect any inappropriate elements in an automatically-generated route. Likewise, a flight simulator study examined different cockpit systems for the relative merits of providing pilots with any of a variety of automated functions for emergency flight planning. The results provide specific guidance for the design of such systems.

Airline Pilot Cosmic Radiation and Circadian Disruption Exposure Assessment from Logbooks and Company Records

PubMed Central

Grajewski, Barbara; Waters, Martha A.; Yong, Lee C.; Tseng, Chih-Yu; Zivkovich, Zachary; Cassinelli II, Rick T.

2011-01-01

Objectives: US commercial airline pilots, like all flight crew, are at increased risk for specific cancers, but the relation of these outcomes to specific air cabin exposures is unclear. Flight time or block (airborne plus taxi) time often substitutes for assessment of exposure to cosmic radiation. Our objectives were to develop methods to estimate exposures to cosmic radiation and circadian disruption for a study of chromosome aberrations in pilots and to describe workplace exposures for these pilots. Methods: Exposures were estimated for cosmic ionizing radiation and circadian disruption between August 1963 and March 2003 for 83 male pilots from a major US airline. Estimates were based on 523 387 individual flight segments in company records and pilot logbooks as well as summary records of hours flown from other sources. Exposure was estimated by calculation or imputation for all but 0.02% of the individual flight segments’ block time. Exposures were estimated from questionnaire data for a comparison group of 51 male university faculty. Results: Pilots flew a median of 7126 flight segments and 14 959 block hours for 27.8 years. In the final study year, a hypothetical pilot incurred an estimated median effective dose of 1.92 mSv (absorbed dose, 0.85 mGy) from cosmic radiation and crossed 362 time zones. This study pilot was possibly exposed to a moderate or large solar particle event a median of 6 times or once every 3.7 years of work. Work at the study airline and military flying were the two highest sources of pilot exposure for all metrics. An index of work during the standard sleep interval (SSI travel) also suggested potential chronic sleep disturbance in some pilots. For study airline flights, median segment radiation doses, time zones crossed, and SSI travel increased markedly from the 1990s to 2003 (Ptrend < 0.0001). Dose metrics were moderately correlated with records-based duration metrics (Spearman’s r = 0.61–0.69). Conclusions: The methods developed provided an exposure profile of this group of US airline pilots, many of whom have been exposed to increasing cosmic radiation and circadian disruption from the 1990s through 2003. This assessment is likely to decrease exposure misclassification in health studies. PMID:21610083

Airline pilot cosmic radiation and circadian disruption exposure assessment from logbooks and company records.

PubMed

Grajewski, Barbara; Waters, Martha A; Yong, Lee C; Tseng, Chih-Yu; Zivkovich, Zachary; Cassinelli, Rick T

2011-06-01

US commercial airline pilots, like all flight crew, are at increased risk for specific cancers, but the relation of these outcomes to specific air cabin exposures is unclear. Flight time or block (airborne plus taxi) time often substitutes for assessment of exposure to cosmic radiation. Our objectives were to develop methods to estimate exposures to cosmic radiation and circadian disruption for a study of chromosome aberrations in pilots and to describe workplace exposures for these pilots. Exposures were estimated for cosmic ionizing radiation and circadian disruption between August 1963 and March 2003 for 83 male pilots from a major US airline. Estimates were based on 523 387 individual flight segments in company records and pilot logbooks as well as summary records of hours flown from other sources. Exposure was estimated by calculation or imputation for all but 0.02% of the individual flight segments' block time. Exposures were estimated from questionnaire data for a comparison group of 51 male university faculty. Pilots flew a median of 7126 flight segments and 14 959 block hours for 27.8 years. In the final study year, a hypothetical pilot incurred an estimated median effective dose of 1.92 mSv (absorbed dose, 0.85 mGy) from cosmic radiation and crossed 362 time zones. This study pilot was possibly exposed to a moderate or large solar particle event a median of 6 times or once every 3.7 years of work. Work at the study airline and military flying were the two highest sources of pilot exposure for all metrics. An index of work during the standard sleep interval (SSI travel) also suggested potential chronic sleep disturbance in some pilots. For study airline flights, median segment radiation doses, time zones crossed, and SSI travel increased markedly from the 1990s to 2003 (P(trend) < 0.0001). Dose metrics were moderately correlated with records-based duration metrics (Spearman's r = 0.61-0.69). The methods developed provided an exposure profile of this group of US airline pilots, many of whom have been exposed to increasing cosmic radiation and circadian disruption from the 1990s through 2003. This assessment is likely to decrease exposure misclassification in health studies.

Early Maladaptive Schemas in a Sample of Airline Pilots seeking Residential Substance Use Treatment: An Initial Investigation

PubMed Central

Shorey, Ryan C.; Brasfield, Hope; Anderson, Scott; Stuart, Gregory L.

2014-01-01

Background Recent research has begun to examine the early maladaptive schemas of substance abusers, as it is believed that targeting these core beliefs in treatment may result in improved substance use outcomes. One special population that has received scant attention in the research literature, despite high levels of substance use, is airline pilots. Aims The current study examined the early maladaptive schemas of a sample of airline pilots (n = 64) who were seeking residential treatment for alcohol dependence and whether they differed in early maladaptive schemas from non-pilot substance abusers who were also seeking residential treatment for alcohol dependence (n = 45). Method Pre-existing medical records from patients of a residential substance abuse treatment facility were reviewed for the current study. Results Of the 18 early maladaptive schemas, results demonstrated that pilots scored higher than non-pilots on the early maladaptive schema of unrelenting standards (high internalized standards of behavior), whereas non-pilots scored higher on insufficient self-control (low frustration tolerance and self-control). Conclusions Early maladaptive schemas may be a relevant treatment target for substance abuse treatment seeking pilots and non-pilots. PMID:24701252

Report of ejections in the Spanish Air Force, 1979-1995: an epidemiological and comparative study.

PubMed

Moreno Vázquez, J M; Durán Tejeda, M R; García Alcón, J L

1999-07-01

Ejection seats have saved many lives with more than 80% of pilots having survived an ejection. Nevertheless, ejection injuries are seen in all modern air forces. An epidemiological study has been carried out on the 48 ejections made by the Spanish Air Force (SpAF) from 1979-1995. From data facilitated by the Flight Safety Section of the SpAF Staff, by the Flight Safety Section of Squadrons, and from personal reports of pilots who survived ejections a form was created. Relationships between data concerning aeronautical parameters, pilot data and injuries have been found, and a comparative study was made between these results and data shown by air forces of other countries. Of 48 pilots who ejected, 7 died, 25 had severe injuries, 11 had minor injuries and 5 had no injuries. The reason for the ejections included 35 cases of technical failure, and 13 cases of human error. Of 43 surviving pilots, 23 were injured only at the egress phase, 1 1 only at landing, and 9 cases at both moments. None of the five pilots who ejected outside the ejection envelope were able to adopt the correct position. However, of 43 pilots who ejected within the envelope, 19 were seated in good position. Of 13 pilots who maintained control of the airplane, 9 were able to adopt a correct position. Of 35 pilots who effected the ejection without control of the aircraft, 25 were not able to achieve a correct seated position. The pilot position in the ejection seat, plane control, ejection inside the envelope, the pilot's training in how to assume the necessary body position at both egress and landing phases are determining factors for successful ejections.

Cardiac responses to long duration and high magnitude +Gz exposure in pilots: an observational study.

PubMed

Öztürk, Cengiz; İlbasmış, M Savaş; Akın, Ahmet

2012-12-01

In military aviation, high performance aircraft pilots are exposed to +Gz acceleration at longer durations and higher magnitude than transport/helicopter pilots. The purpose of this study was to reveal the negative or positive cardiac responses to this occupational high +Gz exposure. Our study design was cross-sectional and observational. We have evaluated 21 echocardiographic parameters of 63 pilots who applied for aircrew periodic medical examination. Of 63 pilots, 33 were grouped as high performance aircraft pilots group (Group A) and 30 were grouped as control group (Group B) whose aircraft type was transport or helicopter. Means of demographic and echocardiography parameters between two groups were compared statistically with Student's t-test, Mann- Whitney U or Chi-square test as appropriate. Among all echocardiographic parameters, mean TV A (tricuspid valve peak velocity during late diastolic filling) was significantly higher and TV E (peak velocity during early diastolic filling)/ A ratio was significantly lower for Group A pilots (p<0.05). In Group A pilots, mean TV A and TV E/A ratio were (52.12 ± 13.85) and (1.36 ± 0.30) respectively. In Group B pilots, mean TV A and TV E/A ratio were (42.61 ± 6.42) and (1.53 ± 0.20) respectively (p=0.001 for TVA and p=0.005 for TV E/A). Mean pulmonary artery pressure (PAP) of Group A pilots (32.04 ± 9.09) was higher than Group B pilots (28.76 ± 7.9) but it was not statistically significant (p>0.05). We conclude that according to the results of our study, long term +Gz exposure has no effects on cardiac morphologic and systolic functions but has effects on right ventricular diastolic functions. We have considered that these effects may be a result of chronic +Gz adaptation or high PAP levels.

Efficacy, safety and tolerability of ongoing statin plus ezetimibe versus doubling the ongoing statin dose in hypercholesterolemic Taiwanese patients: an open-label, randomized clinical trial

PubMed Central

2012-01-01

Background Reducing low-density lipoprotein cholesterol (LDL-C) is associated with reduced risk for major coronary events. Despite statin efficacy, a considerable proportion of statin-treated hypercholesterolemic patients fail to reach therapeutic LDL-C targets as defined by guidelines. This study compared the efficacy of ezetimibe added to ongoing statins with doubling the dose of ongoing statin in a population of Taiwanese patients with hypercholesterolemia. Methods This was a randomized, open-label, parallel-group comparison study of ezetimibe 10 mg added to ongoing statin compared with doubling the dose of ongoing statin. Adult Taiwanese hypercholesterolemic patients not at optimal LDL-C levels with previous statin treatment were randomized (N = 83) to ongoing statin + ezetimibe (simvastatin, atorvastatin or pravastatin + ezetimibe at doses of 20/10, 10/10 or 20/10 mg) or doubling the dose of ongoing statin (simvastatin 40 mg, atorvastatin 20 mg or pravastatin 40 mg) for 8 weeks. Percent change in total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C) and triglycerides, and specified safety parameters were assessed at 4 and 8 weeks. Results At 8 weeks, patients treated with statin + ezetimibe experienced significantly greater reductions compared with doubling the statin dose in LDL-C (26.2% vs 17.9%, p = 0.0026) and total cholesterol (20.8% vs 12.2%, p = 0.0003). Percentage of patients achieving treatment goal was greater for statin + ezetimibe (58.6%) vs doubling statin (41.2%), but the difference was not statistically significant (p = 0.1675). The safety and tolerability profiles were similar between treatments. Conclusion Ezetimibe added to ongoing statin therapy resulted in significantly greater lipid-lowering compared with doubling the dose of statin in Taiwanese patients with hypercholesterolemia. Studies to assess clinical outcome benefit are ongoing. Trial registration Registered at ClinicalTrials.gov: NCT00652327 PMID:22621316

Universities Reaching Outwards: Science Education Partnerships with Urban School Systems

NASA Astrophysics Data System (ADS)

Sandifer, Cody

2013-03-01

The goals of this talk are to: (1) describe how universities, physics departments, and individual faculty can partner with urban school systems to benefit K-16 students, teacher education programs, and university instructors, (2) summarize research on effective university-school system education partnerships, and (3) offer advice and share lessons learned so that university partners can avoid common pitfalls and maximize the potential for collaborative success. Possible areas of university-school collaboration include resident teachers, curricular review, early teaching experiences, demo sharing sessions, ongoing professional development, on- and off-campus science outreach, RET programs, science education resource centers, and others. University-school educational partnerships offer numerous benefits but can be challenging to implement and maintain. Research shows that most successful partnerships possess the following characteristics: mutual self-interest, participant commitment, mutual trust and respect, shared decision-making, information sharing, and ongoing evaluation. K-16 course and curriculum redesign is a specific issue that has its own unique set of contextual factors that impact the project's chance at success, including available materials, administrative support, formative assessments, pilot-testing and instructor feedback, and ongoing professional development. I have learned a number of lessons in own science education collaborations with the Baltimore City Public School System, which is an urban school system with 200 schools, 84,000 students, and 10,700 teachers and administrators. These lessons pertain to: communication, administrative power, and the structure of the school system; relevant contextual factors in the university and K-12 schools; and good old-fashioned common sense.Specific advice on K-16 science education partnerships will be provided to help universities increase student and instructor satisfaction with their physics and teacher education programs, maintain a positive and mutually beneficial relationship with local schools, and improve science education at all levels of instruction. Common sense is encouraged, but not required, to attend the invited talk.

Bilateral comparison of 10 pF and 100 pF standards (ongoing BIPM key comparisons BIPM.EM-K14.a and 14.b) between the NIS (Egypt) and the BIPM

NASA Astrophysics Data System (ADS)

Gournay, Pierre; Helmy, M.; Raouf, A.; Hamed, Heba A. M.; Eliwa Gad, A.

2017-01-01

This report presents the results of a bilateral comparison of 10 pF and 100 pF capacitance standards between the NIS (Egypt) and the BIPM carried out in 2016. The comparison at 10 pF forms part of the ongoing BIPM key comparison BIPM.EM-K14.a and that at 100 pF of the ongoing BIPM key comparison BIPM.EM-K14.b. The BIPM is the pilot laboratory for both of these comparisons. Two 10 pF and 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NIS, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of either 1000 Hz or 1592 Hz, for a measuring rms voltage of 15 V at 10 pF and 10 V at 100 pF. One of the 10 pF travelling standards had to be eliminated from the comparison due to a bistable behaviour, possibly due to transportation. The results from the NIS and the BIPM at both 1000 Hz and 1592 Hz were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of about 0.72 × 10-6 at 10 pF and about 0.65 × 10-6 at 100 pF. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Dietary Effects on Cognition and Pilots' Flight Performance.

PubMed

Lindseth, Glenda N; Lindseth, Paul D; Jensen, Warren C; Petros, Thomas V; Helland, Brian D; Fossum, Debra L

2011-01-01

The purpose of this study was to investigate the effects of diet on cognition and flight performance of 45 pilots. Based on a theory of self-care, this clinical study used a repeated-measure, counterbalanced crossover design. Pilots were randomly rotated through 4-day high-carbohydrate, high-protein, high-fat, and control diets. Cognitive flight performance was evaluated using a GAT-2 full-motion flight simulator. The Sternberg short-term memory test and Vandenberg's mental rotation test were used to validate cognitive flight test results. Pilots consuming a high-protein diet had significantly poorer ( p < .05) overall flight performance scores than pilots consuming high-fat and high-carbohydrate diets.

Where have all the pilot studies gone? A follow-up on 30 years of pilot studies in Clinical Rehabilitation

PubMed Central

Kaur, Navaldeep; Figueiredo, Sabrina; Bouchard, Vanessa; Moriello, Carolina; Mayo, Nancy

2017-01-01

Introduction: Pilot studies are meritorious for determining the feasibility of a definitive clinical trial in terms of conduct and potential for efficacy, but their possible applications for planning a future trial are not always fully realized. The purpose of this review was to estimate the extent to which pilot/feasibility studies: (i) addressed needed objectives; (ii) led to definitive trials; and (iii) whether the subsequent undertaking of a definitive trial was influenced by the strength of the evidence of outcome improvement. Methods: Trials published in the journal Clinical Rehabilitation, since its inception, were eligible if the word ‘pilot’ or ‘feasibility’ was specified somewhere in the article. A total of 191 studies were reviewed, results were summarized descriptively, and between-group effect sizes were computed. Results: The specific purposes of piloting were stated in only 58% (n = 110) of the studies. The most frequent purpose was to estimate the potential for efficacy (85%), followed by testing the feasibility of the intervention (60%). Only 12% of the studies were followed by a definitive trial; <4% of studies had a main study underway or a published study protocol. There was no relationship between observed effect size and follow-up of pilot studies, although the confidence intervals were very wide owing to small number of trials that followed on. Discussion: Labelling and reporting of pilot studies needs to be improved to be concordant with the recently issued CONSORT guidelines. Feasibility needs to be fully tested and demonstrated prior to committing considerable human and monetary resources. PMID:28786333

Embryo selection using time-lapse analysis (Early Embryo Viability Assessment) in conjunction with standard morphology: a prospective two-center pilot study.

PubMed

Kieslinger, Dorit C; De Gheselle, Stefanie; Lambalk, Cornelis B; De Sutter, Petra; Kostelijk, E Hanna; Twisk, Jos W R; van Rijswijk, Joukje; Van den Abbeel, Etienne; Vergouw, Carlijn G

2016-11-01

Does prospective embryo selection using the results from the Eava Test (Early Embryo Viability Assessment) in combination with standard morphology increase the pregnancy rate of IVF and ICSI patients compared to embryo selection based on morphology only? Embryo selection using the Eeva Test plus standard morphology on Day 3 results in comparable pregnancy rates as conventional morphological embryo selection. Time-lapse monitoring of embryo development may represent a superior way to culture and select embryos in vitro. The Eeva Test records the development of each embryo with a cell-tracking system and predicts the likelihood (High, Medium or Low) that an embryo will form a blastocyst based on an automated analysis of early cell division timings. This trial was designed as a prospective, observational, two-center pilot study with a propensity matched control group. The analysis involved 280 of 302 enrolled patients who were included in the Eeva Test group in 2013 and 560 control patients who were treated in the years 2011-2013. The majority of transfers (98%) were single embryo transfers. Two academic hospitals (VUmc Amsterdam and UZ Gent) enrolled patients <41 years old, with <3 previous attempts and ≥5 normally fertilized eggs. Propensity matching was used to identify a propensity matched control group from a cohort of 1777 patients based on age, cycle number, oocyte number and number of fertilized oocytes. There was no difference in patient baseline characteristics between the two groups. The ongoing pregnancy rate (OPR) of patients enrolled in the Eeva Test group (34.3%; 96/280) did not differ significantly from the OPR in the propensity matched control group (34.6%, 194/560; P = 0.92). However, significantly less top quality embryos (eight-cell embryos with ≤25% fragmentation) were transferred in the Eeva Test group compared to the propensity matched control group (70.4% vs. 82.3%; P < 0.001). The transfer of Eeva High and Medium embryos resulted in a significantly higher OPR of 36.8% (89/242) compared to 18.4% (7/38) for Eeva Low embryos (P = 0.02). This pilot study is limited by its nonrandomized design with a concurrent and historical control. Our pilot data did not reveal significant differences between time-lapse based and conventional embryo selection. Interestingly, the pregnancy rates were comparable in both groups even though the morphological quality of the transferred embryos was significantly lower in the Eeva Test group compared to the propensity matched control group. A sufficiently powered three-armed randomized controlled trial (RCT) with a solid design should be performed to generate decisive evidence in the future. Progyny Inc., formerly Auxogyn provided the Eeva scopes, software and technical support for this study. The funding sources did neither influence data collection, management, analysis and interpretation of the data, nor the preparation of the manuscript. ClinicalTrials.gov: NCT01671644. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Intervention Using Gamification to Increase Human Immunodeficiency Virus and Sexually Transmitted Infection Screening Among Young Men Who Have Sex With Men in California: Rationale and Design of Stick To It.

PubMed

Mejia, Christopher M; Acland, Daniel; Buzdugan, Raluca; Grimball, Reva; Natoli, Lauren; McGrath, Mark R; Klausner, Jeffrey D; McCoy, Sandra I

2017-07-17

In the United States, young men who have sex with men (YMSM) remain disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Although routine HIV/STI screening is pivotal to the timely diagnosis of HIV and STIs, initiation of appropriate treatment, and reduced onward disease transmission, repeat screening is underused. Novel interventions that incorporate elements of games, an approach known as gamification, have the potential to increase routinization of HIV/STI screening among YMSM. The study aims to test the hypothesis that an incentive-based intervention that incorporates elements of gamification can increase routine HIV/STI screening among YMSM in California. The study consists of a formative research phase to develop the intervention and an implementation phase where the intervention is piloted in a controlled research setting. In the formative research phase, we use an iterative development process to design the intervention, including gathering information about the feasibility, acceptability, and expected effectiveness of potential game elements (eg, points, leaderboards, rewards). These activities include staff interviews, focus group discussions with members of the target population, and team meetings to strategize and develop the intervention. The final intervention is called Stick To It and consists of 3 components: (1) online enrollment, (2) Web-based activities consisting primarily of quizzes and a countdown "timer" to facilitate screening reminders, and (3) in-person activities that occur at 2 sexual health clinics. Participants earn points through the Web-based activities that are then redeemed for chances to win various prizes during clinic visits. The pilot study is a quasi-experimental study with a minimum of 60 intervention group participants recruited at the clinics, at community-based events, and online. We will compare outcomes in the intervention group with a historical control group consisting of individuals meeting the inclusion criteria who attended study clinics in the 12 months prior to intervention implementation. Eligible participants in the pilot study (1) are 18 to 26 years old, (2) were born or identify as male, 3) report male sexual partners, and 4) have a zip code of residence within defined areas in the vicinity of 1 of the 2 implementation sites. The primary outcome is repeat HIV/STI screening within 6 months. This is an ongoing research study with initial results expected in the fourth quarter of 2017. We will develop and pilot test a gamification intervention to encourage YMSM to be regularly screened for HIV/STIs. The results from this research will provide preliminary evidence about the potential effectiveness of using gamification to amplify health-related behavioral change interventions. Further, the research aims to determine the processes that are essential to developing and implementing future health-related gamification interventions. Clinicaltrials.gov NCT02946164; https://clinicaltrials.gov/ct2/show/NCT02946164 (Archived by WebCite at http://www.webcitation.org/6ri3G4HwD). ©Christopher M Mejia, Daniel Acland, Raluca Buzdugan, Reva Grimball, Lauren Natoli, Mark R McGrath, Jeffrey D Klausner, Sandra I McCoy. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 17.07.2017.

Pilot Decision-Making in Irreversible Emergencies

ERIC Educational Resources Information Center

Winter, Scott R.

2013-01-01

The purpose of this study was to determine if a reflexive learning treatment utilizing select case studies could enhance the decision-making of pilots who encounter an irreversible emergency. Participants, who consisted of members of the subject university's professional pilot program, were divided into either a control or experimental group and…

77 FR 69658 - Agency Information Collection Activities; Proposed Collection; Comment Request: Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... Activities; Proposed Collection; Comment Request: Generic Clearance for Cognitive, Pilot and Field Studies...) Title of the Form/Collection: BJS Generic Clearance for Cognitive, Pilot, and Field Test Studies. (3... respondents will be involved in exploratory, field test, pilot, cognitive, and focus group work conducted...

A Study of Longitudinal Control Problems at Low and Negative Damping and Stability with Emphasis on Effects of Motion Cues

NASA Technical Reports Server (NTRS)

Sadoff, Melvin; McFadden, Norman M.; Heinle, Donovan R.

1961-01-01

As part of a general investigation to determine the effects of simulator motions on pilot opinion and task performance over a wide range of vehicle longitudinal dynamics, a cooperative NASA-AMAL program was conducted on the centrifuge at Johnsville, Pennsylvania. The test parameters and measurements for this program duplicated those of earlier studies made at Ames Research Center with a variable-stability airplane and with a pitch-roll chair flight simulator. Particular emphasis was placed on the minimum basic damping and stability the pilots would accept and on the minimum dynamics they considered controllable in the event of stability-augmentation system failure. Results of the centrifuge-simulator program indicated that small positive damping was required by the pilots over most of the frequency range covered for configurations rated acceptable for emergency conditions only (e.g., failure of a pitch damper). It was shown that the pilot's tolerance for unstable dynamics was dependent primarily on the value of damping. For configurations rated acceptable for emergency operation only, the allowable instability and damping corresponded to a divergence time to double amplitude of about 1 second. Comparisons were made of centrifuge, pitch-chair and fixed-cockpit simulator tests with flight tests. Pilot ratings indicated that the effects of incomplete or spurious motion cues provided by these three modes of simulation were important only for high-frequency, lightly damped dynamics or unstable, moderately damped dynamics. The pitch- chair simulation, which provided accurate angular-acceleration cues to the pilot, compared most favorably with flight. For the centrifuge simulation, which furnished accurate normal accelerations but spurious pitching and longitudinal accelerations, there was a deterioration of pilots' opinion relative to flight results. Results of simulator studies with an analog pilot replacing the human pilot illustrated the adaptive capability of human pilots in coping with the wide range of vehicle dynamics and the control problems covered in this study. It was shown that pilot-response characteristics, deduced by the analog-pilot method, could be related to pilot opinion. Possible application of these results for predicting flight-control problems was illustrated by means of an example control-problem analysis. The results of a brief evaluation of a pencil-type side-arm controller in the centrifuge showed a considerable improvement in the pilots' ability to cope with high-frequency, low-damping dynamics, compared to results obtained with the center stick. This improvement with the pencil controller was attributed primarily to a marked reduction in the adverse effects of large and exaggerated pitching and longitudinal accelerations on pilot control precision.

Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial

PubMed Central

2013-01-01

Background Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. Methods/Design The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann–Whitney U test. Discussion The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand. Trial registration ClinicalTrials.gov: NCT01635582 PMID:23497529

Field Collection Methods for an EPA Pilot Study Evaluating Personal, Housing, and Community Factors Influencing Children’s Potential Exposures to Indoor Contaminants at Various Lifestages (EPA Pilot Study Add-On to the GreenHousing Study)

EPA Science Inventory

This compilation of field collection standard operating procedures (SOPs) was assembled for the U.S. Environmental Protection Agency’s (EPA) Pilot Study add-on to the Green Housing Study (GHS). A detailed description of this add-on study can be found in the peer reviewed research...

Effects of malicious ocular laser exposure in commercial airline pilots.

PubMed

Palakkamanil, Mathew M; Fielden, Michael P

2015-12-01

Intentional malicious laser strikes on commercial pilots are committed by individuals who target a laser into airplane cockpits during takeoff and landing. Because laser exposure to pilots is a relatively new but growing occurrence, our study investigates the ocular effect of this laser exposure in pilots. Retrospective chart review by a single ophthalmologist. All commercial airline pilots (58 male, 3 female) who experienced a laser strike while flying between April 2012 and November 2014 who presented to our clinic were included. A retrospective chart review was performed in a retinal specialist's practice. Ocular assessment was performed within 3 days of laser exposure. A complete ophthalmic evaluation was conducted, including Early Treatment Diabetic Retinopathy Study visual acuity, colour vision, visual fields, intraocular pressure, slit-lamp examination, dilated fundus examination, colour fundus photographs, and ocular coherence tomography. Sixty-four laser strike incidents involving commercial pilots were included. All pilots in the study experienced some degree of immediate ocular irritation or light sensitivity. No definite cases of ocular damage were attributed to laser strikes. No pilot had any functional ocular deficits. Our study revealed that laser strikes on aircraft did not result in permanent visual functional or structural deficits. However, laser strikes cause immediate visual effects, including glare, flash blindness, and ocular irritation that can interfere with a pilot's visual function. Given the widespread accessibility of high-power lasers and the rapid increase in incidents, laser strikes threaten to jeopardize aviation safety unless effective preventative measures are put in place. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Neo-Institutional Analysis on Response Patterns of Pilot Schools

ERIC Educational Resources Information Center

Shin, Chol-Kyun

2016-01-01

This study examines response patterns of pilot schools in the neo-institutional perspective to make improvements on the pilot school systematic framework. In order to achieve this goal, in-depth interviews were conducted to obtain qualitative data. The results show that pilot schools either (a) actively adopt or (b) ceremonially adopt an education…

Pilot-Reported Beta-Blockers Identified by Forensic Toxicology Analysis of Postmortem Specimens.

PubMed

Canfield, Dennis V; Dubowski, Kurt M; Whinnery, James M; Forster, Estrella M

2018-01-01

This study compared beta-blockers reported by pilots with the medications found by postmortem toxicology analysis of specimens received from fatal aviation accidents between 1999 and 2015. Several studies have compared drugs using the standard approach: Compare the drug found by toxicology analysis with the drug reported by the pilot. This study uniquely examined first the pilot-reported medication and then compared it to that detected by toxicology analysis. This study will serve two purposes: (i) to determine the capability of a toxicology laboratory to detect reported medications, and (ii) to identify pilots with medications below detectable limits. All information required for this study was extracted from the Toxicology Data Base system and was searched using ToxFlo or SQL Server Management Studio. The following information was collected and analyzed: pilot-reported trade and/or generic drug, date specimens received, time of accident, type of aviation operations (CFR), state, pilot level, age, class of medical, specimen type, specimen concentration, dose reported, frequency reported associated with the accident, quantity reported, National Transportation Safety Board (NTSB) accident event number, and all NTSB reports. There were 319 pilots that either reported taking a beta-blocker or were found to be taking a beta-blocker by postmortem toxicology analysis. Time of death, therapeutic concentration and specimen type were found to be factors in the ability of the laboratory to detect beta-blockers. Beta-blockers taken by pilots will, in most cases, be found by a competent postmortem forensic toxicology laboratory at therapeutic concentrations. The dose taken by the pilot was not found to be a factor in the ability of the laboratory to identify beta-blockers. Time of dose, route of administration, specimen tested and therapeutic concentration of the drug were found to be factors in the ability of the laboratory to identify beta-blockers in postmortem specimens. Published by Oxford University Press 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The Pixhawk Open-Source Computer Vision Framework for Mavs

NASA Astrophysics Data System (ADS)

Meier, L.; Tanskanen, P.; Fraundorfer, F.; Pollefeys, M.

2011-09-01

Unmanned aerial vehicles (UAV) and micro air vehicles (MAV) are already intensively used in geodetic applications. State of the art autonomous systems are however geared towards the application area in safe and obstacle-free altitudes greater than 30 meters. Applications at lower altitudes still require a human pilot. A new application field will be the reconstruction of structures and buildings, including the facades and roofs, with semi-autonomous MAVs. Ongoing research in the MAV robotics field is focusing on enabling this system class to operate at lower altitudes in proximity to nearby obstacles and humans. PIXHAWK is an open source and open hardware toolkit for this purpose. The quadrotor design is optimized for onboard computer vision and can connect up to four cameras to its onboard computer. The validity of the system design is shown with a fully autonomous capture flight along a building.

A critical care helicopter system in trauma.

PubMed Central

Jacobs, L. M.; Bennett, B.

1989-01-01

Civilian helicopters and emergency medical services in the United States have been in existence for approximately 15 years. The rapid growth of this type of health care delivery coupled with an increasing number of accidents has prompted professional and lay scrutiny of these programs. Although they have a demonstrated history of benefit to patients, the type and severity of injuries to patients who are eligible for helicopter transportation need further definition. The composition of the medical crews and the benefits that particular crew members bring to the patients require ongoing evaluation. Significant questions regarding the number of pilots in a helicopter and in a program remain to be answered. This article reviews the role of emergency medical air transport services in providing care to trauma patients, staff training and evaluation, and safety criteria and offers recommendations to minimize risks to patients and crews. PMID:2695653

Combined monitoring, decision and control model for the human operator in a command and control desk

NASA Technical Reports Server (NTRS)

Muralidharan, R.; Baron, S.

1978-01-01

A report is given on the ongoing efforts to mode the human operator in the context of the task during the enroute/return phases in the ground based control of multiple flights of remotely piloted vehicles (RPV). The approach employed here uses models that have their analytical bases in control theory and in statistical estimation and decision theory. In particular, it draws heavily on the modes and the concepts of the optimal control model (OCM) of the human operator. The OCM is being extended into a combined monitoring, decision, and control model (DEMON) of the human operator by infusing decision theoretic notions that make it suitable for application to problems in which human control actions are infrequent and in which monitoring and decision-making are the operator's main activities. Some results obtained with a specialized version of DEMON for the RPV control problem are included.

Teleconsultation in school settings: linking classroom teachers and behavior analysts through web-based technology.

PubMed

Frieder, Jessica E; Peterson, Stephanie M; Woodward, Judy; Crane, Jaelee; Garner, Marlane

2009-01-01

This paper describes a technically driven, collaborative approach to assessing the function of problem behavior using web-based technology. A case example is provided to illustrate the process used in this pilot project. A school team conducted a functional analysis with a child who demonstrated challenging behaviors in a preschool setting. Behavior analysts at a university setting provided the school team with initial workshop trainings, on-site visits, e-mail and phone communication, as well as live web-based feedback on functional analysis sessions. The school personnel implemented the functional analysis with high fidelity and scored the data reliably. Outcomes of the project suggest that there is great potential for collaboration via the use of web-based technologies for ongoing assessment and development of effective interventions. However, an empirical evaluation of this model should be conducted before wide-scale adoption is recommended.

THE SPACE PUBLIC OUTREACH TEAM (SPOT)

NASA Astrophysics Data System (ADS)

Williamson, Kathryn; National Radio Astronomy Observatory; Montana Space Grant Consortium; West Virginia Space Grant Consortium; NASA Independent Verification and Validation Center

2014-01-01

The Space Public Outreach Team (SPOT) has shown over 17 years of success in bringing astronomy and space science-themed presentations to approximately 10,000 students per year in Montana, and the program is now being piloted in West Virginia through a joint partnership between the National Radio Astronomy Observatory (NRAO), the West Virginia Space Grant Consortium, and NASA Independent Verification and Validation Center. SPOT recruits and trains undergraduate presenters from all over the state to learn interactive slide shows that highlight the state’s on-going and world-class space science research. Presenters then travel to K-12 schools to deliver these presentations and provide teachers additional supplemental information for when the SPOT team leaves. As a large-scale, low-cost, and sustainable program being implemented in both Montana and West Virginia, SPOT has the potential to become a nation-wide effort that institutions in other states can model to increase their education and public outreach presence.

Productivity improvement in engineering at Rocketdyne

NASA Technical Reports Server (NTRS)

Nordlund, R. M.; Vogt, S. T.; Woo, A. K.

1985-01-01

The Rocketdyne Division of Rockwell International has embarked on a productivity improvement program in engineering. This effort included participation in the White Collar Productivity Improvement (WCPI) project sponsored by the American Productivity Center. A number of things have been learned through this project. It seems that any productivity improvement project should be employee driven. The Rocketdyne project was essentially started as a result of a grassroots effort to remove some particular hindrances, and employee enthusiasm was a prime factor in the continuing progress of the effort. A significant result was that awareness of problems at all levels increased. Many issues surfaced in the diagnostic phase, and were then noted and discussed. This process added legitimacy to issues that had previously been merely unspoken concerns. The initial feelings of many members of the pilot group was that significant changes would occur relatively quickly. It is now recognized that this will have to be an ongoing, long-term effort.

Successful integration efforts in water quality from the integrated Ocean Observing System Regional Associations and the National Water Quality Monitoring Network

USGS Publications Warehouse

Ragsdale, R.; Vowinkel, E.; Porter, D.; Hamilton, P.; Morrison, R.; Kohut, J.; Connell, B.; Kelsey, H.; Trowbridge, P.

2011-01-01

The Integrated Ocean Observing System (IOOS??) Regional Associations and Interagency Partners hosted a water quality workshop in January 2010 to discuss issues of nutrient enrichment and dissolved oxygen depletion (hypoxia), harmful algal blooms (HABs), and beach water quality. In 2007, the National Water Quality Monitoring Council piloted demonstration projects as part of the National Water Quality Monitoring Network (Network) for U.S. Coastal Waters and their Tributaries in three IOOS Regional Associations, and these projects are ongoing. Examples of integrated science-based solutions to water quality issues of major concern from the IOOS regions and Network demonstration projects are explored in this article. These examples illustrate instances where management decisions have benefited from decision-support tools that make use of interoperable data. Gaps, challenges, and outcomes are identified, and a proposal is made for future work toward a multiregional water quality project for beach water quality.

Limited English proficiency workers. Health and safety education.

PubMed

Hong, O S

2001-01-01

1. As the population of adults with limited English proficiency plays an increasingly important role in the United States workplaces, there has been a growing recognition that literacy and limited English skills affect health and safety training programs. 2. Several important principles can be used as the underlying framework to guide teaching workers with limited English proficiency: clear and vivid way of teaching; contextual curriculum based on work; using various teaching methods; and staff development. 3. Two feasible strategies were proposed to improve current situation in teaching health and safety to workers with limited English proficiency in one company: integrating safety and health education with ongoing in-house ESL instruction and developing a multilingual video program. 4. Successful development and implementation of proposed programs requires upper management support, workers' awareness and active participation, collaborative teamwork, a well structured action plan, testing of pilot program, and evaluation.

Video Guidance Sensor for Surface Mobility Operations

NASA Technical Reports Server (NTRS)

Fernandez, Kenneth R.; Fischer, Richard; Bryan, Thomas; Howell, Joe; Howard, Ricky; Peters, Bruce

2008-01-01

Robotic systems and surface mobility will play an increased role in future exploration missions. Unlike the LRV during Apollo era which was an astronaut piloted vehicle future systems will include teleoperated and semi-autonomous operations. The tasks given to these vehicles will run the range from infrastructure maintenance, ISRU, and construction to name a few. A common task that may be performed would be the retrieval and deployment of trailer mounted equipment. Operational scenarios may require these operations to be performed remotely via a teleoperated mode,or semi-autonomously. This presentation describes the on-going project to adapt the Automated Rendezvous and Capture (AR&C) sensor developed at the Marshall Space Flight Center for use in an automated trailer pick-up and deployment operation. The sensor which has been successfully demonstrated on-orbit has been mounted on an iRobot/John Deere RGATOR autonomous vehicle for this demonstration which will be completed in the March 2008 time-frame.

Water quality success stories: Integrated assessments from the IOOS regional associations and national water quality monitoring network

USGS Publications Warehouse

Ragsdale, Rob; Vowinkel, Eric; Porter, Dwayne; Hamilton, Pixie; Morrison, Ru; Kohut, Josh; Connell, Bob; Kelsey, Heath; Trowbridge, Phil

2011-01-01

The Integrated Ocean Observing System (IOOS®) Regional Associations and Interagency Partners hosted a water quality workshop in January 2010 to discuss issues of nutrient enrichment and dissolved oxygen depletion (hypoxia), harmful algal blooms (HABs), and beach water quality. In 2007, the National Water Quality Monitoring Council piloted demonstration projects as part of the National Water Quality Monitoring Network (Network) for U.S. Coastal Waters and their Tributaries in three IOOS Regional Associations, and these projects are ongoing. Examples of integrated science-based solutions to water quality issues of major concern from the IOOS regions and Network demonstration projects are explored in this article. These examples illustrate instances where management decisions have benefited from decision-support tools that make use of interoperable data. Gaps, challenges, and outcomes are identified, and a proposal is made for future work toward a multiregional water quality project for beach water quality.

Cosmic Radiation and Cataracts in Airline Pilots

NASA Astrophysics Data System (ADS)

Rafnsson, V.; Olafsdottir, E.; Hrafnkelsson, J.; de Angelis, G.; Sasaki, H.; Arnarson, A.; Jonasson, F.

Nuclear cataracts have been associated with ionising radiation exposure in previous studies. A population based case-control study on airline pilots has been performed to investigate whether employment as a commercial pilot and consequent exposure to cosmic radiation were associated to lens opacification, when adjusted for known risk factors for cataracts. Cases of opacification of the ocular lens were found in surveys among pilots and a random sample of the Icelandic population. Altogether 445 male subjects underwent a detailed eye examination and answered a questionnaire. Information from the airline company on the 79 pilots employment time, annual hours flown per aircraft type, the timetables and the flight profiles made calculation of individual cumulated radiation dose (mSv) possible. Lens opacification were classified and graded according to WHO simplified cataracts grading system using slit lamp. The odds ratio from logistic regression of nuclear cataracts risk among cases and controls was 3.02 (95% CI 1.44 to 6.35) for pilots compared with non-pilots, adjusted for age, smoking and sunbathing habits, whereas that of cortical cataracts risk among cases and controls was lower than unity (non significant) for pilots compared with non-pilots in a logistic regression analysis adjusted for same factors. Length of employment as a pilot and cumulated radiation dose (mSv) were significantly related to the risk of nuclear cataracts. So the association between radiation exposure of pilots and the risk of nuclear cataracts, adjusted for age, smoking and sunbathing habits, indicates that cosmic radiation may be cause of nuclear cataract among commercial pilots.

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework

PubMed Central

Eldridge, Sandra M.; Lancaster, Gillian A.; Campbell, Michael J.; Thabane, Lehana; Hopewell, Sally; Coleman, Claire L.; Bond, Christine M.

2016-01-01

We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms ‘pilot’ and ‘feasibility’ in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms ‘feasibility’ or ‘pilot’ as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term ‘feasibility’ in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention. PMID:26978655

A study on aircraft map display location and orientation

NASA Technical Reports Server (NTRS)

Baty, D. L.; Wempe, T.; Huff, E.

1973-01-01

Six airline pilots participated in a fixed-based simulator study to determine the effects of two horizontal situation display (HSD/map) panel locations relative to the vertical situation display (VSD), and of three map orientations on manual piloting performance. Pilot comments and opinions were formally obtained. Significant performance differences were found between wind conditions and among pilots but not between map locations and orientations. The results also illustrate the potential tracking accuracy of such a display. Recommendations concerning display location and map orientation are made.

Visual cues to geographical orientation during low-level flight

NASA Technical Reports Server (NTRS)

Battiste, Vernol; Delzell, Suzanne

1991-01-01

A field study of an operational Emergency Medical Service (EMS) unit was conducted to investigate the relationships among geographical orientation, pilot decision making, and workload in EMS flights. The map data collected during this study were compared to protocols gathered in the laboratory, where pilots viewed a simulated flight over different types of unfamiliar terrain and verbally identified the features utilized to maintain geographical orientation. The EMS pilot's questionnaire data were compared with data from non-EMS helicopter pilots with comparable flight experience.

A study on aircraft map display location and orientation

NASA Technical Reports Server (NTRS)

Baty, D. L.; Wempe, T. E.; Huff, E. M.

1974-01-01

Six airline pilots participated in a fixed-base simulator study to determine the effects of two horizontal situation display (HSD/map) panel locations relative to the vertical situation display (VSD), and of three map orientations on manual piloting performance. Pilot comments and opinions were formally obtained. Significant performance differences were found between wind conditions and among pilots, but not between map locations and orientations. The results also illustrate the potential tracking accuracy of such a display. Recommendations concerning display location and map orientation are made.

The Internet and Some International Regulatory Issues Relating to Content: A Pilot Comparative Study.

ERIC Educational Resources Information Center

Australian Broadcasting Authority.

In December 1996 UNESCO commissioned the Australian Broadcasting Authority to conduct a pilot study which considered a range of online issues; this report outlines the findings of the pilot study, based on data collected between February and May 1997 and updated in July 1997. The objective is to identify the main types of Internet content which…

Employee performance in the knowledge economy: Capturing the keys to success

PubMed Central

Fauth, Rebecca; Bevan, Stephen; Mills, Peter

2009-01-01

The present study examines the key determinants of employee performance in a knowledge-intensive service firm located in the UK. Using data from a pilot study, we mapped eight performance-related behaviors to two measures of global performance to isolate the strongest predictors of the latter. We also examined the degree to which these associations varied depending on whether employees or their managers reported on performance as well as according to the degree of complexity (eg, ongoing learning, multitasking, problem solving, etc.) present in workers’ jobs. Findings revealed that more traditional employee performance-related behaviors (eg, dependability) as well as behaviors that have likely increased in importance in the knowledge economy (eg, sharing ideas and information) accounted for the most variance in reported global performance. Sharing ideas and information was a particularly important predictor for workers in complex jobs. When the performance-related behaviors were regressed on the organization’s annual employee appraisal ratings, only dependability and time management behaviors were significantly associated with the outcome. As organizational success increasingly is dependent on intangible inputs stemming from the ideas, innovations and creativity of its workforce, organizations need to ensure that they are capturing the full range of behaviors that help to define their success. Further research with a diverse range of organizations will help define this further. PMID:22110316

Promoting advance directives among African Americans: a faith-based model.

PubMed

Bullock, Karen

2006-02-01

Studies show that African Americans are less likely than other ethnic groups to complete advance directives. However, what influences African Americans' decisions to complete or not complete advance directives is unclear. Using a faith-based promotion model, 102 African Americans aged 55 years or older were recruited from local churches and community-based agencies to participate in a pilot study to promote advance care planning. Focus groups were used to collect data on participants' preferences for care, desire to make personal choices, values and attitudes, beliefs about death and dying, and advance directives. A standardized interview was used in the focus groups, and the data were organized and analyzed using NUDIST 4 software (QRS Software, Victoria, Australia). Three fourths of the participants refused to complete advance directives. The following factors influenced the participants' decisions about end-of-life care and completion of an advance directive: spirituality; view of suffering, death, and dying; social support networks; barriers to utilization; and mistrust of the health care system. The dissemination of information apprises individuals of their right to self-determine about their care, but educational efforts may not produce a significant change in behavior toward completion of advance care planning. Thus, ongoing efforts are needed to improve the trust that African Americans have in medical and health care providers.

Role of genetic testing in patients undergoing percutaneous coronary intervention.

PubMed

Moon, Jae Youn; Franchi, Francesco; Rollini, Fabiana; Rivas Rios, Jose R; Kureti, Megha; Cavallari, Larisa H; Angiolillo, Dominick J

2018-02-01

Variability in individual response profiles to antiplatelet therapy, in particular clopidogrel, is a well-established phenomenon. Genetic variations of the cytochrome P450 (CYP) 2C19 enzyme, a key determinant in clopidogrel metabolism, have been associated with clopidogrel response profiles. Moreover, the presence of a CYP2C19 loss-of-function allele is associated with an increased risk of atherothrombotic events among clopidogrel-treated patients undergoing percutaneous coronary interventions (PCI), prompting studies evaluating the use of genetic tests to identify patients who may be potential candidates for alternative platelet P2Y 12 receptor inhibiting therapies (prasugrel or ticagrelor). Areas covered: The present manuscript provides an overview of genetic factors associated with response profiles to platelet P2Y 12 receptor inhibitors and their clinical implications, as well as the most recent developments and future considerations on the role of genetic testing in patients undergoing PCI. Expert commentary: The availability of more user-friendly genetic tests has contributed towards the development of many ongoing clinical trials and personalized medicine programs for patients undergoing PCI. Results of pilot investigations have shown promising results, which however need to be confirmed in larger-scale studies to support the routine use of genetic testing as a strategy to personalize antiplatelet therapy and improve clinical outcomes.

Simultaneous, multi-wavelength flare observations of nearby low-mass stars

NASA Astrophysics Data System (ADS)

Thackeray, Beverly; Barclay, Thomas; Quintana, Elisa; Villadsen, Jacqueline; Wofford, Alia; Schlieder, Joshua; Boyd, Patricia

2018-01-01

Low-mass stars are the most common stars in the Galaxy and have been targeted in the tens-of-thousands by K2, the re-purposed Kepler mission, as they are prime targets to search for and characterize small, Earth-like planets. Understanding how these fully convective stars drive magnetic activity that manifests as stochastic, short-term brightenings, or flares, provides insight into the prospects of planetary habitability. High energy radiation and energetic particle emission associated with these stars can erode atmospheres, and impact habitability. An innovative campaign to study low mass stars through simultaneous multi-wavelength observations is currently underway with observations ongoing in the X-ray, UV, optical, and radio. I will present early results of our pilot study of the nearby M-Dwarf star Wolf 359 (CN Leo) using K2, SWIFT, and ground based radio observatories, forming a comprehensive picture of flare activity from an M-Dwarf, and discuss the potential impact of these results on exoplanets. "This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. DGE1322106. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation."

Improving computer usage for students with physical disabilities through a collaborative approach: a pilot study.

PubMed

Borgestig, Maria; Falkmer, Torbjörn; Hemmingsson, Helena

2013-11-01

The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers' opinions of goal setting were collected at follow-up. The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students' computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

Production of Caproic Acid from Mixed Organic Waste: An Environmental Life Cycle Perspective

PubMed Central

2017-01-01

Caproic acid is an emerging platform chemical with diverse applications. Recently, a novel biorefinery process, that is, chain elongation, was developed to convert mixed organic waste and ethanol into renewable caproic acids. In the coming years, this process may become commercialized, and continuing to improve on the basis of numerous ongoing technological and microbiological studies. This study aims to analyze the environmental performance of caproic acid production from mixed organic waste via chain elongation at this current, early stage of technological development. To this end, a life cycle assessment (LCA) was performed to evaluate the environmental impact of producing 1 kg caproic acid from organic waste via chain elongation, in both a lab-scale and a pilot-scale system. Two mixed organic waste were used as substrates: the organic fraction of municipal solid waste (OFMSW) and supermarket food waste (SFW). Ethanol use was found to be the dominant cause of environmental impact over the life cycle. Extraction solvent recovery was found to be a crucial uncertainty that may have a substantial influence on the life-cycle impacts. We recommend that future research and industrial producers focus on the reduction of ethanol use in chain elongation and improve the recovery efficiency of the extraction solvent. PMID:28513150

Role of Genetic Testing in Patients undergoing Percutaneous Coronary Intervention

PubMed Central

Moon, Jae Youn; Franchi, Francesco; Rollini, Fabiana; Rios, Jose R. Rivas; Kureti, Megha; Cavallari, Larisa H.; Angiolillo, Dominick J.

2017-01-01

Introduction Variability in individual response profiles to antiplatelet therapy, in particular clopidogrel, is a well-established phenomenon. Genetic variations of the cytochrome P450 (CYP) 2C19 enzyme, a key determinant in clopidogrel metabolism, have been associated with clopidogrel response profiles. Moreover, the presence of a CYP2C19 loss-of-function allele is associated with an increased risk of atherothrombotic events among clopidogrel-treated patients undergoing percutaneous coronary interventions (PCI), prompting studies evaluating the use of genetic tests to identify patients who may be potential candidates for alternative platelet P2Y12 receptor inhibiting therapies (prasugrel or ticagrelor). Areas covered The present manuscript provides an overview of genetic factors associated with response profiles to platelet P2Y12 receptor inhibitors and their clinical implications, as well as the most recent developments and future considerations on the role of genetic testing in patients undergoing PCI. Expert Commentary The availability of more user-friendly genetic tests has contributed towards the development of many ongoing clinical trials and personalized medicine programs for patients undergoing PCI. Results of pilot investigations have shown promising results, which however need to be confirmed in larger-scale studies to support the routine use of genetic testing as a strategy to personalize antiplatelet therapy and improve clinical outcomes. PMID:28689434

Perspectives for immunotherapy in glioblastoma treatment.

PubMed

Finocchiaro, Gaetano; Pellegatta, Serena

2014-11-01

Avoiding immune destruction is one emerging hallmark of cancer, including glioblastoma. The number of immunotherapy approaches to fight glioblastoma is growing. Here, we review the recent progress in four main areas: dendritic cell immunotherapy, peptide vaccination, chimeric antigen receptors and immune checkpoints. We and others are using dendritic cells to present glioblastoma antigens (whole tumor lysate) to the immune system; our initial data indicate that clinical benefit is associated to increased presence of natural killer cells in the periphery. A pilot study loading dendritic cells with glioblastoma stem-like cells will start soon. Peptide vaccination targeting the epidermal growth factor receptor variant III (EGFRvIII) epitope, present in 25% of glioblastomas, is ongoing. Intriguing results have been obtained by vaccination with three other peptides in pediatric gliomas. Another clinical trial is targeting EGFRvIII by adoptive cell transfer of chimeric antigen receptor. This exciting technology could be suited for a number of other potential epitopes discovered through next-generation sequencing. Finally, antibodies against the immune checkpoints cytotoxic T lymphocyte antigen-4 and programmed cell death-1, which demonstrated efficacy in advanced melanomas, will be used in novel trials for recurrent glioblastoma. In all these studies attention to novel side-effects and to MRI as immunological follow-up to distinguish progression or pseudoprogression will be of critical relevance.

What do surgical oncology staff nurses know about colorectal cancer ostomy care?

PubMed

Gemmill, Robin; Kravits, Kathy; Ortiz, Mildred; Anderson, Casandra; Lai, Lily; Grant, Marcia

2011-02-01

For most patients diagnosed with colorectal cancer, dealing with the adjustment and rehabilitation after treatment can be overwhelming. There is a significant need for expert educational and counseling support, especially for the patient with a new ostomy. This pilot study describes acute care oncology staff nurses' knowledge about and attitudes toward providing direct ostomy care support and education. This study is part of a larger project assessing gaps in education and services in support of patients with colorectal cancer. The Survey on Ostomy Care questionnaire designed to assess nurses' knowledge about and attitudes toward ostomy care was administered to oncology staff nurses at a comprehensive cancer center. Only 30% of staff nurses surveyed strongly agreed or agreed with the statement, "I care for ostomy patients often enough to keep up my skills in ostomy care." Maintaining staff nurses' ability to teach and demonstrate to patients complex care such as ostomy care depends on the ability to practice both education and hands-on skills. Staff nurses identify that lack of opportunity to care for the new ostomy patient influences their ability to maintain skill expertise. The results show the need to explore the provision of ongoing staff education for low-volume patient populations using creative teaching strategies, such as clinical simulation and short videos. Copyright 2011, SLACK Incorporated.

Assessing five pilot carbon trading programs in China from a perspective of efficiency analysis

NASA Astrophysics Data System (ADS)

Yu, Xianyu; Shi, Guo; Wang, Jinghan

2018-02-01

In order to overcome the challenge of growing carbon emissions in China, the pilot carbon emissions trading systems (ETSs) serve as precursors of the national carbon ETS. Five province-level pilot ETSs in Beijing, Tianjin, Shanghai, Guangdong and Hubei are assessed from the view of carbon emission efficiency analysis in this study. Firstly, both the environmental production technology and the Malmquist index are adopted to evaluate the carbon emission efficiency of 28 provinces in China. Then, the regression significance analysis of carbon emission efficiency and the operational information evaluation for pilot ETSs are combined to develop an integrated approach for assessing five considered pilot ETSs. The Efficiency analysis of carbon emissions indicate that the effect of ETS in Beijing is significant, the effect of ETS in Tianjin is weak significant, and those of the other three pilot ETSs are not significant. Based on the operational information for pilot ETSs, the evaluating results of pilot ETSs in Beijing and Hubei are better than those of other pilot ETSs. This study highlights two main findings. First, the pilot ETS in Beijing has better performance than the other considered pilot ETSs, and its operational experience should be promoted throughout the country to improve the construction of national carbon ETS. Second, the successful cooperation between the ETSs in Beijing and Tianjin implies that the regional cooperation among neighbouring ETSs should be encouraged and further implemented to enhance the overall performance of the regional ETSs.

Flight Simulator Visual-Display Delay Compensation

NASA Technical Reports Server (NTRS)

Crane, D. Francis

1981-01-01

A piloted aircraft can be viewed as a closed-loop man-machine control system. When a simulator pilot is performing a precision maneuver, a delay in the visual display of aircraft response to pilot-control input decreases the stability of the pilot-aircraft system. The less stable system is more difficult to control precisely. Pilot dynamic response and performance change as the pilot attempts to compensate for the decrease in system stability. The changes in pilot dynamic response and performance bias the simulation results by influencing the pilot's rating of the handling qualities of the simulated aircraft. The study reported here evaluated an approach to visual-display delay compensation. The objective of the compensation was to minimize delay-induced change in pilot performance and workload, The compensation was effective. Because the compensation design approach is based on well-established control-system design principles, prospects are favorable for successful application of the approach in other simulations.

A pilot study of simple interventions to improve informed consent in clinical research: feasibility, approach, and results.

PubMed

Kass, Nancy E; Taylor, Holly A; Ali, Joseph; Hallez, Kristina; Chaisson, Lelia

2015-02-01

Research suggests that participants do not always adequately understand studies. While some consent interventions increase understanding, methodologic challenges have been raised in studying consent outside of actual trial settings. This study examined the feasibility of testing two consent interventions in actual studies and measured effectiveness of interventions in improving understanding. Participants enrolling in any of eight ongoing clinical trials were sequentially assigned to one of three different informed consent strategies for enrollment in their clinical trial. Control participants received standard consent procedures for their trial. Participants in the first intervention arm received a bulleted fact sheet summarizing key study information. Participants in the second intervention arm received the bulleted fact sheet and also engaged in a feedback Q&A session. Later, patients answered closed- and open-ended questions to assess patient understanding and literacy. Descriptive statistics, Wilcoxon -Mann -Whitney and Kruskal-Wallis tests were generated to assess correlations; regression analysis determined predictors of understanding. 144 participants enrolled. Using regression analysis, participants receiving the second intervention scored 7.6 percentage points higher (p = .02) on open-ended questions about understanding than participants in the control, although unadjusted comparisons did not reach statistical significance. Our study supports the hypothesis that patients receiving both bulleted fact sheets and a Q&A session had higher understanding compared to standard consent. Fact sheets and short structured dialog are quick to administer and easy to replicate across studies and should be tested in larger samples. © The Author(s) 2014.

The size of a pilot study for a clinical trial should be calculated in relation to considerations of precision and efficiency.

PubMed

Sim, Julius; Lewis, Martyn

2012-03-01

To investigate methods to determine the size of a pilot study to inform a power calculation for a randomized controlled trial (RCT) using an interval/ratio outcome measure. Calculations based on confidence intervals (CIs) for the sample standard deviation (SD). Based on CIs for the sample SD, methods are demonstrated whereby (1) the observed SD can be adjusted to secure the desired level of statistical power in the main study with a specified level of confidence; (2) the sample for the main study, if calculated using the observed SD, can be adjusted, again to obtain the desired level of statistical power in the main study; (3) the power of the main study can be calculated for the situation in which the SD in the pilot study proves to be an underestimate of the true SD; and (4) an "efficient" pilot size can be determined to minimize the combined size of the pilot and main RCT. Trialists should calculate the appropriate size of a pilot study, just as they should the size of the main RCT, taking into account the twin needs to demonstrate efficiency in terms of recruitment and to produce precise estimates of treatment effect. Copyright © 2012 Elsevier Inc. All rights reserved.

The Ongoing and Open-Ended Simulation

ERIC Educational Resources Information Center

Cohen, Alexander

2016-01-01

This case study explores a novel form of classroom simulation that differs from published examples in two important respects. First, it is ongoing. While most simulations represent a single learning episode embedded within a course, the ongoing simulation is a continuous set of interrelated events and decisions that accompany learning throughout…

Pilots' monitoring strategies and performance on automated flight decks: an empirical study combining behavioral and eye-tracking data.

PubMed

Sarter, Nadine B; Mumaw, Randall J; Wickens, Christopher D

2007-06-01

The objective of the study was to examine pilots' automation monitoring strategies and performance on highly automated commercial flight decks. A considerable body of research and operational experience has documented breakdowns in pilot-automation coordination on modern flight decks. These breakdowns are often considered symptoms of monitoring failures even though, to date, only limited and mostly anecdotal data exist concerning pilots' monitoring strategies and performance. Twenty experienced B-747-400 airline pilots flew a 1-hr scenario involving challenging automation-related events on a full-mission simulator. Behavioral, mental model, and eye-tracking data were collected. The findings from this study confirm that pilots monitor basic flight parameters to a much greater extent than visual indications of the automation configuration. More specifically, they frequently fail to verify manual mode selections or notice automatic mode changes. In other cases, they do not process mode annunciations in sufficient depth to understand their implications for aircraft behavior. Low system observability and gaps in pilots' understanding of complex automation modes were shown to contribute to these problems. Our findings describe and explain shortcomings in pilot's automation monitoring strategies and performance based on converging behavioral, eye-tracking, and mental model data. They confirm that monitoring failures are one major contributor to breakdowns in pilot-automation interaction. The findings from this research can inform the design of improved training programs and automation interfaces that support more effective system monitoring.

Prospective memory in context: Moving through a familiar space.

PubMed

Smith, Rebekah E; Hunt, R Reed; Murray, Amy E

2017-02-01

Successful completion of delayed intentions is a common but important aspect of daily behavior. Such behavior requires not only memory for the intended action but also recognition of the opportunity to perform that action, known collectively as prospective memory. The fact that prospective memory tasks occur in the midst of other activities is captured in laboratory tasks by embedding the prospective memory task in an ongoing activity. In many cases the requirement to perform the prospective memory task results in a reduction in ongoing performance relative to when the ongoing task is performed alone. This is referred to as the cost to the ongoing task and reflects the allocation of attentional resources to the prospective memory task. The current study examined the pattern of cost across the ongoing task when the ongoing task provided contextual information that in turn allowed participants to anticipate when target events would occur within the ongoing task. The availability of contextual information reduced ongoing task response times overall, with an increase in response times closer to the target locations (Experiments 1-3). The fourth study, drawing on the Event Segmentation Theory, provided support for the proposal made by the Preparatory Attentional and Memory Processes theory of prospective memory that decisions about the allocation of attention to the prospective memory task are more likely to be made at points of transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

An investigation into pilot and system response to critical in-flight events. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Rockwell, T. H.; Griffin, W. C.

1981-01-01

Critical in-flight events (CIFE) that threaten the aircraft were studied. The scope of the CIFE was described and defined with emphasis on characterizing event development, detection and assessment; pilot information requirements, sources, acquisition, and interpretation, pilot response options, decision processed, and decision implementation and event outcome. Detailed scenarios were developed for use in simulators and paper and pencil testing for developing relationships between pilot performance and background information as well as for an analysis of pilot reaction decision and feedback processes. Statistical relationships among pilot characteristics and observed responses to CIFE's were developed.

Operational problems experienced by single pilots in instrument meteorological conditions

NASA Technical Reports Server (NTRS)

Weislogel, S.

1981-01-01

The development and implementation of a search strategy to extract pertinent reports from the Aviation Safety Reporting System-2 (ASRS-2) database are described. For any particular occurence to be pertinent to the study, it must have satisfied the following conditions: the aircraft must be of the type usually flown by a single pilot; operation on an IFR flight plan in instrument meteorological conditions; pilot experienced an operational problem. The occurances consist of reports by the pilot about his own performance, by the pilot about the system performance, or by an air traffic controller about a pilot's performance.

75 FR 75725 - Financial Management Service; Proposed Collection of Information: Tax Time Card Account Pilot...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

... Information: Tax Time Card Account Pilot, Screening, Focus Groups, and Study AGENCY: Financial Management... general public and other Federal agencies to take this opportunity to comment on a continuing information... Account Pilot Screening, Focus Groups, and Study.'' DATES: Written comments should be received on or...

PILOT-SCALE STUDIES ON THE EFFECT OF BROMINE ADDITION ON THE EMISSIONS OF CHLORINATED ORGANIC COMBUSTION BY-PRODUCTS

EPA Science Inventory

The paper reports on a study to evaluate organic combustion by-product emissions while feeding varying amounts of bromine (Br) and chlorine (Cl) into a pilot-scale incinerator burning surrogate waste materials. (NOTE: Adding brominated organic compounds to a pilot-scale incinerat...

Final Report of NATO/SPS Pilot Study on Clean Products and Processes (Phase I and II)

EPA Science Inventory

Early in 1998 the NATO Committee for Challenges to Modern Society (SPS) (Science for Peace and Security) approved the Pilot Study on Clean Products and Processes for an initial period of five years. The pilot was to provide a forum for member country representatives to discuss t...

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.

Manpower Projections, Recruitment Needs and Training Requirements for Commercial Airline Pilots in the United States 1968-1979.

ERIC Educational Resources Information Center

Simons, Robert Marchand

This study evaluated the reported airline pilot shortage in relation to certified air carriers; recruitment needs for qualified applicants; training requirements as recommended by air carriers, airline captains, and flight officers; and airline pilot supply and demand during 1968-79. A literature review on foreign and domestic pilot shortages was…

THE EFFECTIVENESS OF PILOT PROGRAMS COMPARED TO OTHER PROGRAMS OF VOCATIONAL AGRICULTURE IN TENNESSEE.

ERIC Educational Resources Information Center

LEGG, OTTO

THE OBJECTIVE OF THIS COMPARATIVE STUDY WAS TO EVALUATE THE RELATIVE EFFECTIVENESS OF TENNESSEE VOCATIONAL AGRICULTURE PROGRAMS IN FOUR CATEGORIES -- (1) PILOT SCHOOLS, (2) LIKE-PILOT SCHOOLS OR SCHOOLS RESEMBLING PILOT SCHOOLS, (3) STUDENT TEACHING CENTERS, AND (4) NEGRO SCHOOLS. THE RANDOM SAMPLE INCLUDED 800 STUDENTS FROM 20 SCHOOLS DIVIDED…

Investigating the impact of the properties of pilot points on calibration of groundwater models: case study of a karst catchment in Rote Island, Indonesia

NASA Astrophysics Data System (ADS)

Klaas, Dua K. S. Y.; Imteaz, Monzur Alam

2017-09-01

A robust configuration of pilot points in the parameterisation step of a model is crucial to accurately obtain a satisfactory model performance. However, the recommendations provided by the majority of recent researchers on pilot-point use are considered somewhat impractical. In this study, a practical approach is proposed for using pilot-point properties (i.e. number, distance and distribution method) in the calibration step of a groundwater model. For the first time, the relative distance-area ratio ( d/ A) and head-zonation-based (HZB) method are introduced, to assign pilot points into the model domain by incorporating a user-friendly zone ratio. This study provides some insights into the trade-off between maximising and restricting the number of pilot points, and offers a relative basis for selecting the pilot-point properties and distribution method in the development of a physically based groundwater model. The grid-based (GB) method is found to perform comparably better than the HZB method in terms of model performance and computational time. When using the GB method, this study recommends a distance-area ratio of 0.05, a distance-x-grid length ratio ( d/ X grid) of 0.10, and a distance-y-grid length ratio ( d/ Y grid) of 0.20.

The impact of transition training on adapting to Technically Advanced Aircraft at regional airlines: Perceptions of pilots and instructor pilots

NASA Astrophysics Data System (ADS)

di Renzo, John Carl, Jr.

Scope and method of study. The purpose of this study was to test a hypothesis about pilot and instructor pilot perceptions of how effectively pilots learn and use new technology, found in Technically Advanced Aircraft (TAA), given initial type of instrumentation training. New aviation technologies such as Glass Cockpits in technically advanced aircraft are complex and can be difficult to learn and use. The research questions focused on the type of initial instrumentation training to determine the differences among pilots trained using various types of instrumentation ranging from aircraft equipped with traditional analog instrumentation to aircraft equipped with glass cockpits. A convenience sample of Pilots in Training (PT) and Instructor Pilots (IP) was selected from a regional airline. The research design used a mixed methodology. Pilots in training completed a thirty-two question quantitative questionnaire and instructor pilots completed a five question qualitative questionnaire. Findings and conclusions. This investigation failed to disprove the null hypothesis. The type of instrumentation training has no significant effect on newly trained regional airline pilot perceived ability to adapt to advanced technology cockpits. Therefore, no evidence exists from this investigation to support the early introduction and training of TAA. While the results of this investigation were surprising, they are nonetheless, instructive. Even though it would seem that there would be a relationship between exposure to and use of technically advanced instrumentation, apparently there was no perceived relationship for this group of airline transport pilots. However, a point of interest is that these pilots were almost evenly divided in their opinion of whether or not their previous training had prepared them for transition to TAA. The majority also believed that the type of initial instrumentation training received does make a difference when transitioning to TAA. Pilots believed that TAA made them safer pilots, but were not convinced it made them better pilots. The results of this investigation raise many new questions and provide a number of ideas for future research projects.

A mixed method pilot study: the researchers' experiences.

PubMed

Secomb, Jacinta M; Smith, Colleen

2011-08-01

This paper reports on the outcomes of a small well designed pilot study. Pilot studies often disseminate limited or statistically meaningless results without adding to the body knowledge on the comparative research benefits. The design a pre-test post-test group parallel randomised control trial and inductive content analysis of focus group transcripts was tested specifically to increase outcomes in a proposed larger study. Strategies are now in place to overcome operational barriers and recruitment difficulties. Links between the qualitative and quantitative arms of the proposed larger study have been made; it is anticipated that this will add depth to the final report. More extensive reporting on the outcomes of pilot studies would assist researchers and increase the body of knowledge in this area.

Successful implementation of clinical practice guidelines for pressure risk management in a home nursing setting.

PubMed

Kapp, Suzanne

2013-10-01

This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines for the Prediction and Prevention of Pressure Ulcers. In 2007 a pilot study was conducted. Nurse perspectives (n=21) were obtained via survey and a client profile (n=218) was generated. Audit of the uptake and continued use of the pressure risk screening tool, during the pilot study and later once implemented as standard practice organizational wide, was conducted. Nurses at the pilot site successfully implemented the practice guidelines, pressure risk screening was adopted and supporting resources were well received. Most clients were at low risk of pressure ulcer development. The pilot site maintained and extended their pilot study success, ensuring more than 90% of clients were screened for pressure risk over the 18 months which followed. All other sites performed less well initially, however subsequently improved, meeting the pilot sites success after 18 months. Two years later, the organization continues to screen more than 90% of all clients for pressure risk. Implementation of clinical practice guidelines was successful in the pilot project and pressure risk screening became a well-adopted practice. Success continued following organizational wide implementation. Pilot study findings suggest it may be prudent to monitor the pressure ulcer risk status of low risk clients so as to prevent increasing risk and pressure ulcer development among this group. © 2012 John Wiley & Sons Ltd.

Structural Differences in Gray Matter between Glider Pilots and Non-Pilots. A Voxel-Based Morphometry Study

PubMed Central

Ahamed, Tosif; Kawanabe, Motoaki; Ishii, Shin; Callan, Daniel E.

2014-01-01

Glider flying is a unique skill that requires pilots to control an aircraft at high speeds in three dimensions and amidst frequent full-body rotations. In the present study, we investigated the neural correlates of flying a glider using voxel-based morphometry. The comparison between gray matter densities of 15 glider pilots and a control group of 15 non-pilots exhibited significant gray matter density increases in left ventral premotor cortex, anterior cingulate cortex, and the supplementary eye field. We posit that the identified regions might be associated with cognitive and motor processes related to flying, such as joystick control, visuo-vestibular interaction, and oculomotor control. PMID:25506339

Analysis of aircraft longitudinal handling qualities

NASA Technical Reports Server (NTRS)

Hess, R. A.

1981-01-01

The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

[Adaptive process in Vietnamese military pilots during the flights on modern Russian aircraft].

PubMed

Ushakov, I V; Pham Xuan, Nihn; Bukhtiaiarov, I V; Ushakov, B N

2013-04-01

Study on health status of 156 Vietnamese military pilots on Russian modern jet planes (Su-22, Su-27, Su-30, MiG-21B). The results showed that unprofitable factors in working environment (acceleration, radiation, high temperature, humidity, noise) have an impact on the health of pilots during the flight, leading to deterioration of professional health and physiological functions (cardiovascular, respiratory and nervous system) and obesity of pilots after 35 years old. Basing on the studies, we suggested some measures for health protecting, safety of flight and prolonging flight-activity of pilots (training in decompression chamber, vestibular training) and balance in food ration for prevention of professional diseases.