District heating and cooling systems for communities through power plant retrofit distribution network, Phase 2. Final report, 1 March 1980-31 January 1984. Volume II

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

Not Available

1984-01-31

This volume begins with an Introduction summarizing the history, methodology and scope of the study, the project team members and the private and public groups consulted in the course of the study. The Load and Service Area Assessment follows, including: a compilation and analysis of existing statistical thermal load data from census data, industrial directories, PSE and G records and other sources; an analysis of responses to a detailed, 4-page thermal load questionnaire; data on public buildings and fuel and energy use provided by the New Jersey Dept. of Energy; and results of other customer surveys conducted by PSE andmore » G. A discussion of institutional questions follows. The general topic of rates is then discussed, including a draft hypothetical Tariff for Thermal Services. Financial considerations are discussed including a report identifying alternative ownership/financing options for district heating systems and the tax implications of these options. Four of these options were then selected by PSE and G and a financial (cash-flow) analysis done (by the PSE and G System Planning Dept.) in comparison with a conventional heating alternative. Year-by-year cost of heat ($/10/sup 6/ Btu) was calculated and tabulated, and the various options compared.« less

ARSENIC TREATMENT OPTIONS

EPA Science Inventory

The PPT presentation will provide information on the drinking water treatment options for small utilities to remove arsenic from ground water. The discussion will include information on the EPA BAT listed processes and on some of the newer technologies, such as the iron based ad...

Analysis of Shroud Options in Support of the Human Exploration of Mars

NASA Technical Reports Server (NTRS)

Feldman, Stuart; Borowski, Stanley; Engelund, Walter; Hundley, Jason; Monk, Timothy; Munk, Michelle

2010-01-01

In support of the Mars Design Reference Architecture (DRA) 5.0, the NASA study team analyzed several shroud options for use on the Ares V launch vehicle.1,2 These shroud options included conventional "large encapsulation" shrouds with outer diameters ranging from 8.4 to 12.9 meters (m) and overall lengths of 22.0 to 54.3 meters, along with a "nosecone-only" shroud option used for Mars transfer vehicle component delivery. Also examined was a "multi-use" aerodynamic encapsulation shroud used for launch, Mars aerocapture, and entry, descent, and landing of the cargo and habitat landers. All conventional shroud options assessed for use on the Mars launch vehicles were the standard biconic design derived from the reference shroud utilized in the Constellation Program s lunar campaign. It is the purpose of this paper to discuss the technical details of each of these shroud options including material properties, structural mass, etc., while also discussing both the volume and mass of the various space transportation and surface system payload elements required to support a "minimum launch" Mars mission strategy, as well as the synergy, potential differences and upgrade paths that may be required between the Lunar and Mars mission shrouds.

Some unconventional approaches to the exploration of Mars

NASA Astrophysics Data System (ADS)

French, J. R.

1991-02-01

The topics of space transport to Mars, and surface transport and surface operations on Mars are discussed in detail and new options for accomplishing these activities are presented. The question of maximizing the return on the investment in a Mars mission is addressed. One way to accomplish this is through reduction of propellant requirements by increasing the performance of the rocket engine, while another option is to make use of nuclear fuel. A technique discussed in detail would provide a means to manufacture fuel from Martian resources for both the return trip and for Mars surface exploration. Options for Mars surface transport include battery and nuclear powered rovers, solar powered automobiles, and either battery, nuclear or Mars-generated-propellant-powered aircraft specially designed to explore the Martian surface. The advantages and disadvantages of each of these options are considered, and the usefulness of a manned aircraft for both exploration and surface operational functions is discussed.

Options Counseling for the Pregnant Adolescent Patient.

PubMed

Hornberger, Laurie L

2017-09-01

Each year, more than 500 000 girls and young women younger than 20 years become pregnant. It is important for pediatricians to have the ability and the resources in their offices to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental pregnancy options counseling. Counseling includes an unbiased discussion of the adolescent's legal options to either continue or terminate her pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue. Copyright © 2017 by the American Academy of Pediatrics.

Schema Versioning for Multitemporal Relational Databases.

ERIC Educational Resources Information Center

De Castro, Cristina; Grandi, Fabio; Scalas, Maria Rita

1997-01-01

Investigates new design options for extended schema versioning support for multitemporal relational databases. Discusses the improved functionalities they may provide. Outlines options and basic motivations for the new design solutions, as well as techniques for the management of proposed schema versioning solutions, includes algorithms and…

Internet Access and Pricing: Sorting Out the Options.

ERIC Educational Resources Information Center

Fowler, Thomas B.

1997-01-01

Discusses Internet access and pricing options. Highlights include restructuring of the telecommunications industry; current methods of access; economics of high-speed access; the impact of cheap Internet access; long-term possibilities; and a table that provides a comparison of Internet access methods. (LRW)

If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients' medical records.

PubMed

Quinn, Gwendolyn P; Block, Rebecca G; Clayman, Marla L; Kelvin, Joanne; Arvey, Sarah R; Lee, Ji-Hyun; Reinecke, Joyce; Sehovic, Ivana; Jacobsen, Paul B; Reed, Damon; Gonzalez, Luis; Vadaparampil, Susan T; Laronga, Christine; Lee, M Catherine; Pow-Sang, Julio; Eggly, Susan; Franklin, Anna; Shah, Bijal; Fulp, William J; Hayes-Lattin, Brandon

2015-03-01

The adolescent and young adult (AYA) population is underserved because of unique late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers. All centers reviewed randomized records within the top four AYA disease sites (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible records included those of patients: diagnosed in 2011, with no prior receipt of gonadotoxic therapy; age 18 to 45 years; with no multiple primary cancers; and for whom record was not second opinion. Quality Oncology Practice Initiative methods were used to evaluate documentation of discussion of risk of infertility, discussion of FP options, and referral to a fertility specialist. Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P = .030 and .004, respectively) and those with breast cancer (P = .021 and < .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P = .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P < .001, < .001, and .002, respectively) and those who already had children (all P < .001). The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation. Copyright © 2014 by American Society of Clinical Oncology.

Management of complications of Dupuytren contracture.

PubMed

Cheung, Kevin; Walley, Kempland C; Rozental, Tamara D

2015-05-01

This evidence-based article discusses the current management options of Dupuytren disease and strategies to avoid and manage any potential complications. Treatment options include fasciectomy, needle fasciotomy/aponeurotomy, and collagenase injection. Complications include digital nerve and artery injury, flexor tendon injury, skin fissures and wound healing complications, hematoma, infection, flare reaction/complex regional pain syndrome, and recurrence. Complication rates, prevention, and management differ with each treatment modality. A detailed understanding of each of these options allows hand surgeons to select the most appropriate treatment for each patient. Copyright © 2015 Elsevier Inc. All rights reserved.

Choices and Motivations of Infertile Couples.

ERIC Educational Resources Information Center

van Balen, Frank; Verdurmen, Jacqueline; Ketting, Evert

1997-01-01

Infertile couples' (N=131) consideration of options for dealing with infertility (medical help, adoption, fostering, alternative medicine, and focusing on other life goals) is studied. Options were related to specific motivations including altruistic motives for adoption or foster care. Results, timing of choices, and motivations are discussed.…

Treatment options for Primary CNS Lymphoma.

PubMed

Laghari, Altaf Ali; Ahmed, Syed Ijlal; Jabbar, Adnan; Shamim, Muhammad Shahzad

2018-03-01

Primary CNS lymphoma (PCNSL) is a rare and aggressive brain tumour that is uniformly fatal. The rarity of the disease and the poor response to treatment makes it difficult to reach a consensus with regards to treatment options. In this review, the authors have discussed different treatment modalities used in the management of PCNSL including chemotherapy, surgery and radiation, as well as the results of recent clinical trials on treatment options for PCNSL.

The Traveler's Guide to E-mail Access.

ERIC Educational Resources Information Center

Clyde, Anne

1999-01-01

Presents options that travelers can use to keep in e-mail contact. Discusses equipment/access issues related to traveling with a laptop; Internet cafes; free e-mail services; accessing home mail via a Web page; and new options e-mail access for travelers. Includes Internet resources on Internet access providers. (AEF)

Effluent treatment for nuclear thermal propulsion ground testing

NASA Technical Reports Server (NTRS)

Shipers, Larry R.

1993-01-01

The objectives are to define treatment functions, review concept options, discuss PIPET effluent treatment system (ETS), and outline future activities. The topics covered include the following: reactor exhaust; effluent treatment functions; effluent treatment categories; effluent treatment options; concept evaluation; PIPETS ETS envelope; PIPET effluent treatment concept; and future activities.

Repaying Your Student Loans, 2003-2004. [Braille Version].

ERIC Educational Resources Information Center

Office of Federal Student Aid (ED), Washington, DC.

This Braille publication explores available options on federal student loans so that borrowers can avoid repayment problems and manage and repay their debts. The guide contains information on repayment plans for Perkins loans, Direct Loans, and Federal Family Education Loans. The repayment options discussed include consolidation, deferment, and…

Integrating Research and Practice: Distractions, Controversies, and Options for Moving Forward

ERIC Educational Resources Information Center

Gambrill, Eileen

2015-01-01

Integrating practice and research is vital in all helping professions in order to offer the most ethical, evidence-informed interventions to clients. This article describes some avoidable distractions that hinder integration, discusses controversies related to integration, and describes options for moving forward, including making wasted resources…

Multi-attribute criteria applied to electric generation energy system analysis LDRD.

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

Kuswa, Glenn W.; Tsao, Jeffrey Yeenien; Drennen, Thomas E.

2005-10-01

This report began with a Laboratory-Directed Research and Development (LDRD) project to improve Sandia National Laboratories multidisciplinary capabilities in energy systems analysis. The aim is to understand how various electricity generating options can best serve needs in the United States. The initial product is documented in a series of white papers that span a broad range of topics, including the successes and failures of past modeling studies, sustainability, oil dependence, energy security, and nuclear power. Summaries of these projects are included here. These projects have provided a background and discussion framework for the Energy Systems Analysis LDRD team to carrymore » out an inter-comparison of many of the commonly available electric power sources in present use, comparisons of those options, and efforts needed to realize progress towards those options. A computer aid has been developed to compare various options based on cost and other attributes such as technological, social, and policy constraints. The Energy Systems Analysis team has developed a multi-criteria framework that will allow comparison of energy options with a set of metrics that can be used across all technologies. This report discusses several evaluation techniques and introduces the set of criteria developed for this LDRD.« less

Magnetism in Chemistry

ERIC Educational Resources Information Center

Brookes, R. W.; McFadyen, W. D.

1975-01-01

Discusses the technical aspects of paramagnetism and an electrostatic model called Crystal Field Theory (CFT), very often used in the case of transition metal compounds. Suggests that this discussion be included as an option for college chemistry courses. (MLH)

Prostate Cancer: A Contemporary Approach to Treatment and Outcomes.

PubMed

Weiner, Adam B; Kundu, Shilajit D

2018-03-01

Given the high incidence of prostate cancer and the need for shared decision-making before screening, it is imperative that primary care providers understand treatment options and treatment adverse effects. In this review article, the treatment options for the localized and metastatic prostate cancer are discussed, including the different modalities and their indications, adverse effects, oncologic outcomes, posttreatment monitoring, and potential treatment options following cancer recurrence. Copyright © 2017 Elsevier Inc. All rights reserved.

Curbing International Piracy of Intellectual Property. Policy Options for a Major Exporting Country.

ERIC Educational Resources Information Center

Hoffman, Gary M.; Marcou, George T.

This report of the International Piracy Project addresses three major topics: (1) The Costs and Complications of Piracy; (2) Rights Enforcement Today; and (3) Policy Options for Curbing Piracy. The first section discusses piracy of copyrights, patents, and other intellectual property, including economic losses and damage to the finances and…

Toward a National Ocean Policy, 1976 and Beyond.

ERIC Educational Resources Information Center

Osgood, Robert E.; And Others

Each chapter in this publication takes up a specific issue, analyzes its importance to the United States, discusses its evolution in the international negotiating process, and considers the various policy options in the context of the treaty making exercise. The criteria for evaluating policy options are included. The eight chapters are: (1) The…

Policy Options for Education Reform: A Policy Analysis Paper. Discussion Draft.

ERIC Educational Resources Information Center

Hansen, Kenneth H.

This document examines approaches to educational reform currently under consideration in the Pacific Northwest and discusses policy issues involved with these reform efforts. The introduction discusses broad-scale policy issues, including the setting of priorities amid the diversity of reforms, the clarifying of beliefs and selection of changes…

Como reembolsar sus prestamos para estudiantes (Repaying Your Student Loans).

ERIC Educational Resources Information Center

Office of Federal Student Aid (ED), Washington, DC.

This guide, written in Spanish, discusses how to repay student loans. Following a general introduction, the guide discusses the grace period before repayment and repayment requirements. Repayment plans are described for Perkins Loans, Direct Loans, and Federal Family Education Loans. Repayment options are discussed, including consolidation,…

Automobiles and global warming: Alternative fuels and other options for carbon dioxide emissions reduction

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

Sagar, A.D.

Automobiles are a source of considerable pollution at the global level, including a significant fraction of the total greenhouse gas emissions. Alternative fuels have received some attention as potential options to curtail the carbon dioxide emissions from motor vehicles. This article discusses the feasibility and desirability (from a technical as well as a broader environmental perspective) of the large-scale production and use of alternative fuels as a strategy to mitigate automotive carbon dioxide emissions. Other options such as improving vehicle efficiency and switching to more efficient modes of passenger transportation are also discussed. These latter options offer an effective andmore » immediate way to tackle the greenhouse and other pollutant emission from automobiles, especially as the limitations of currently available alternative fuels and the technological and other constraints for potential future alternatives are revealed.« less

Micros for the 1990's: An Update.

ERIC Educational Resources Information Center

Grosch, Audrey N.

1991-01-01

Discusses new hardware and software developments for microcomputers and considers strategies for future library microcomputing. Topics discussed include developments with Macintosh computers; the importance of local area networks (LANs); upgrading options for hardware; operating system upgrades; dynamic data exchange (DDE); microcomputer…

Neurogenic detrusor overactivity in patients with spinal cord injury: evaluation and management.

PubMed

Sahai, Arun; Cortes, Eduardo; Seth, Jai; Khan, Muhammad Shamim; Panicker, Jalesh; Kelleher, Cornelius; Kessler, Thomas M; Fowler, Clare J; Dasgupta, Prokar

2011-12-01

Lower urinary tract dysfunction can have a significant impact on patients with spinal cord injury. Over the years, many treatment options have become available. This article reviews the assessment and management of neurogenic detrusor overactivity, with a particular focus on articles from the recent literature. Recent guidelines on the subject will be discussed. Management options include antimuscarinics and bladder emptying measures, botulinum toxin A, and neuromodulation in refractory cases and surgery for intractable cases. Recent and relevant publications in these areas will be summarized and discussed.

Research planning criteria for regenerative life-support systems applicable to space habitats

NASA Technical Reports Server (NTRS)

Spurlock, J.; Cooper, W.; Deal, P.; Harlan, A.; Karel, M.; Modell, M.; Moe, P.; Phillips, J.; Putnam, D.; Quattrone, P.

1979-01-01

The second phase of analyses that were conducted by the Life Support Systems Group of the 1977 NASA Ames Summer Study is described. This phase of analyses included a preliminary review of relevant areas of technology that can contribute to the development of closed life-support systems for space habitats, the identification of research options in these areas of technology, and the development of guidelines for an effective research program. The areas of technology that were studied included: (1) nutrition, diet, and food processing; (2) higher plant agriculture; (3) animal agriculture; (4) waste conversion and resource recovery; and (5) system stability and safety. Results of these analyses, including recommended research options and criteria for establishing research priorities among these many options, are discussed.

Photovoltaic solar array technology required for three wide scale generating systems for terrestrial applications: rooftop, solar farm, and satellite

NASA Technical Reports Server (NTRS)

Berman, P. A.

1972-01-01

Three major options for wide-scale generation of photovoltaic energy for terrestrial use are considered: (1) rooftop array, (2) solar farm, and (3) satellite station. The rooftop array would use solar cell arrays on the roofs of residential or commercial buildings; the solar farm would consist of large ground-based arrays, probably in arid areas with high insolation; and the satellite station would consist of an orbiting solar array, many square kilometers in area. The technology advancement requirements necessary for each option are discussed, including cost reduction of solar cells and arrays, weight reduction, resistance to environmental factors, reliability, and fabrication capability, including the availability of raw materials. The majority of the technology advancement requirements are applicable to all three options, making possible a flexible basic approach regardless of the options that may eventually be chosen. No conclusions are drawn as to which option is most advantageous, since the feasibility of each option depends on the success achieved in the technology advancement requirements specified.

Battling Budget Woes.

ERIC Educational Resources Information Center

Agron, Joe, Ed.

1999-01-01

Discusses how various school districts are addressing school quality on tight budgets. Options discussed include use of portable classrooms, streamlining non-educational services, leasing and performance contracting, and energy improvements and working with power utilities to cut costs. Argues for adopting and enforcing ISO 9000 standards to…

Lessons Learned From Option B+ in the Evolution Toward "Test and Start" From Malawi, Cameroon, and the United Republic of Tanzania.

PubMed

Kalua, Thokozani; Tippett Barr, Beth A; van Oosterhout, Joep J; Mbori-Ngacha, Dorothy; Schouten, Erik J; Gupta, Sundeep; Sande, Amakobe; Zomba, Gerald; Tweya, Hannock; Lungu, Edgar; Kajoka, Deborah; Tih, Pius; Jahn, Andreas

2017-05-01

The acceleration of prevention of mother-to-child transmission (PMTCT) activities, coupled with the rollout of 2010 World Health Organization (WHO) guidelines, led to important discussions and innovations at global and country levels. One paradigm-shifting innovation was Option B+ in Malawi. It was later included in WHO guidelines and eventually adopted by all 22 Global Plan priority countries. This article presents Malawi's experience with designing and implementing Option B+ and provides complementary narratives from Cameroon and Tanzania. Malawi's HIV program started in 2002, but by 2009, the PMTCT program was lagging far behind the antiretroviral therapy (ART) program because of numerous health system challenges. When WHO recommended Option A and Option B for PMTCT in 2010, it was clear that Malawi's HIV program would not be able to successfully implement either option without increasing existing barriers to PMTCT services and potentially decreasing women's access to care. Subsequent stakeholder discussions led to the development of Option B+. Operationalizing Option B+ required several critical considerations, including the complete integration of ART and PMTCT programs, systematic reduction of barriers to facilitate doubling the number of ART sites in less than a year, building consensus with stakeholders, and securing additional resources for the new program. During the planning and implementation process, several lessons were learned which are considerations for countries transitioning to "treat-all": Comprehensive change requires effective government leadership and coordination; national clinical guidelines must accommodate health system limitations; ART services and commodities should be decentralized within facilities; the general public should be well informed about major changes in the national HIV program; and patients should be educated on clinic processes to improve program monitoring.

Options for Affordable Fission Surface Power Systems

NASA Technical Reports Server (NTRS)

Houts, Mike; Gaddis, Steve; Porter, Ron; VanDyke, Melissa; Martin Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise

2006-01-01

Fission surface power systems could provide abundant power anywhere on free surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized; however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems.

Oncologists' experiences of discussing complementary and alternative treatment options with their cancer patients. A qualitative analysis.

PubMed

Corina, Güthlin; Christine, Holmberg; Klein, Gudrun

2016-09-01

The rising use of complementary and alternative medicine (CAM) means oncologists are increasingly asked by patients to discuss CAM treatment options. However, no formal training or established standards are available on the subject. The aim of this paper was to investigate real-world discussions of CAM treatments. In particular, we wanted to learn about the values, norms and defining features that characterise oncologist-patient discussions on CAM. Semi-standardised interviews with 17 oncologists were analysed using interpretation pattern analysis combined with thematic analysis. Advice on CAM is seen by oncologists as an important service they provide to their patients, even though their knowledge of the subject is often limited. Many interviewees mentioned an apparent lack of scientific proof, especially when their aim was to warn patients against the use of CAM. Discussions on CAM tend to reflect the idea that CAM belongs 'to another world', and judging by the interviews with oncologists, this notion appears to be shared by patients and oncologists alike. Oncologists require reliable information on CAM and would profit from training in the communication of CAM treatment options to patients. Knowing scientific data on CAM would also lower barriers stemming from the view that CAM belongs 'to another world'. Under- and postgraduate education programmes should include training on how to respond to requests addressing possible CAM options.

Computer Calculation of First-Order Rate Constants

ERIC Educational Resources Information Center

Williams, Robert C.; Taylor, James W.

1970-01-01

Discusses the computer program used to calculate first-order rate constants. Discussion includes data preparation, weighting options, comparison techniques, infinity point adjustment, least-square fit, Guggenheim calculation, and printed outputs. Exemplifies the utility of the computer program by two experiments: (1) the thermal decomposition of…

State Bioenergy Primer: Information and Resources for States on Issues, Opportunities, and Options for Advancing Bioenergy

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

Byrnett, D. S.; Mulholland, D.; Zinsmeister, E.

One renewable energy option that states frequently consider to meet their clean energy goals is the use of biomass resources to develop bioenergy. Bioenergy includes bioheat, biopower, biofuels, and bioproducts. This document provides an overview of biomass feedstocks, basic information about biomass conversion technologies, and a discussion of benefits and challenges of bioenergy options. The Primer includes a step-wise framework, resources, and tools for determining the availability of feedstocks, assessing potential markets for biomass, and identifying opportunities for action at the state level. Each chapter contains a list of selected resources and tools that states can use to explore topicsmore » in further detail.« less

Application of the Health Belief Model to bariatric surgery.

PubMed

Armstrong, Shelley N; Anderson, Mindi; Le, Emily Tran; Nguyen, Lynda H

2009-01-01

This article discusses the challenging issues faced by women who are diagnosed as being medically obese (i.e., body mass index > or = 30 kg/m). Recently cited as the new national epidemic by some healthcare professionals, obesity can lead to other medical comorbidities, including chronic heart problems, joint deterioration, sleep apnea, depression, and lower self-esteem. On the basis of medical records released by Methodist Hospital in Houston, TX, most patients who seek medical or surgical health options to control obesity are women between 25 and 40 years of age. This article discusses bariatric surgery as a weight loss option and applies the Health Belief Model to explain why patients are choosing this option to help them change eating behaviors. Interventions for nurses and other healthcare professionals are addressed.

Public Access Workstations in the Library: New Trends.

ERIC Educational Resources Information Center

Beecher, Henry

1991-01-01

Discusses the use of microcomputer-based workstations that are provided for public access in libraries. Criteria for workstations are discussed, including standard hardware, open-design software, scalable interface, and connectivity options for networking; systems that provide full-text access are described; and the need for standards is…

The origins of options.

PubMed

Smaldino, Paul E; Richerson, Peter J

2012-01-01

Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one's current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options.

The Origins of Options

PubMed Central

Smaldino, Paul E.; Richerson, Peter J.

2012-01-01

Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one’s current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options. PMID:22514515

Current and emerging treatments for the management of myasthenia gravis

PubMed Central

Sathasivam, Sivakumar

2011-01-01

Myasthenia gravis is an autoimmune neuromuscular disorder. There are several treatment options, including symptomatic treatment (acetylcholinesterase inhibitors), short-term immunosuppression (corticosteroids), long-term immunosuppression (azathioprine, cyclosporine, cyclophosphamide, methotrexate, mycophenolate mofetil, rituximab, tacrolimus), rapid acting short-term immunomodulation (intravenous immunoglobulin, plasma exchange), and long-term immunomodulation (thymectomy). This review explores in detail these different treatment options. Potential future treatments are also discussed. PMID:21845054

Up and running. Choosing the right equipment service option.

PubMed

2011-08-01

If you're trying to decide between servicing your equipment in-house or using an outside party, you know that finding the best option can be complicated. To help manage the decision process, this article includes a matrix to organize and assess all relevant factors. We also discuss equipment maintenance insurance, which allows you to cap your service costs for some or all of your equipment.

The afterlife for retiring deans and other senior medical administrators.

PubMed

Tannen, Richard L

2008-11-01

Career options for individuals leaving the administrative role as dean of a school of medicine or other senior administrative positions are considered. Options discussed include retirement and a variety of other positions both within schools of medicines and in other venues. Many opportunities exist for a challenging and fulfilling career path after leaving the role as a senior administrator in an academic medical center.

Downsizing: Fat Reduction or Fool's Gold?

ERIC Educational Resources Information Center

Teece, Phil

1999-01-01

Discussion of downsizing in organizations focuses on Australian libraries. Topics include rationales behind downsizing; negative results in terms of equity and efficiency; guidelines and other options for responsible restructuring, including skills training, continuous learning programs, information sharing, and employee participation; jobs for…

A Study of Phased Array Antennas for NASA's Deep Space Network

NASA Technical Reports Server (NTRS)

Jamnejad, Vahraz; Huang, John; Cesarone, Robert J.

2001-01-01

In this paper we briefly discuss various options but focus on the feasibility of the phased arrays as a viable option for this application. Of particular concern and consideration will be the cost, reliability, and performance compared to the present 70-meter antenna system, particularly the gain/noise temperature levels in the receive mode. Many alternative phased arrays including planar horizontal arrays, hybrid mechanically/electronically steered arrays, phased array of mechanically steered reflectors, multi-faceted planar arrays, phased array-fed lens antennas, and planar reflect-arrays are compared and their viability is assessed. Although they have many advantages including higher reliability, near-instantaneous beam switching or steering capability, the cost of such arrays is presently prohibitive and it is concluded that the only viable array options at the present are the arrays of a few or many small reflectors. The active planar phased arrays, however, may become feasible options in the next decade and can be considered for deployment in smaller configurations as supplementary options.

Aquaculture: A Component of Low Cost Sanitation Technology

NASA Technical Reports Server (NTRS)

Edwards, P.

1985-01-01

The paper discusses all phases of aquaculture, including commercial viability, sanitary and biological considerations, public health, financial/economic and sociological aspects. Current studies are detailed and options are discussed for their potential applicability to developing countries, considering requirements for capital and labor skills as well as physical needs such as land.

LGBT people's knowledge of and preparedness to discuss end-of-life care planning options.

PubMed

Hughes, Mark; Cartwright, Colleen

2014-09-01

Despite the devastating impact of HIV/AIDS, end-of-life care planning among lesbian, gay, bisexual and transgender (LGBT) communities is relatively under-researched, especially in Australia. This paper reports findings of a survey of 305 LGBT people living in New South Wales, which examined their knowledge of and attitudes towards end-of-life care. The focus of this paper is their preparedness to discuss with healthcare providers any end-of-life care plans. The results highlight that while the majority of respondents were aware of three of the four key end-of-life care planning options available in New South Wales--enduring powers of attorney, enduring guardians and person responsible (only a minority had heard of advance healthcare directives)--a much smaller number of people had actually taken up these options. Only a minority of respondents were able to identify correctly who had the legal right to make treatment decisions for a person who is unconscious following a car accident. A small proportion of people had discussed end-of-life care options with general practitioners or another main healthcare provider, and only in very few cases were these issues raised by the practitioners themselves. Those most likely to not feel comfortable discussing these issues with practitioners included younger people, those not fully open about their sexuality to family members, and transgender people and others who do not define their gender as male or female. The paper highlights the importance of education strategies to raise awareness of the end-of-life care planning options among LGBT people, as well as strategies for increasing health providers' preparedness to discuss these issues with LGBT patients. © 2014 John Wiley & Sons Ltd.

Emerging growth factor receptor antagonists for the treatment of renal cell carcinoma.

PubMed

Zahoor, Haris; Rini, Brian I

2016-12-01

The landscape of systemic treatment for metastatic renal cell carcinoma (RCC) has dramatically changed with the introduction of targeted agents including vascular endothelial growth factor (VEGF) inhibitors. Recently, multiple new agents including growth factor receptor antagonists and a checkpoint inhibitor were approved for the treatment of refractory metastatic RCC based on encouraging benefit shown in clinical trials. Areas covered: The background and biological rationale of existing treatment options including a brief discussion of clinical trials which led to their approval, is presented. This is followed by reviewing the limitations of these therapeutic options, medical need to develop new treatments and major goals of ongoing research. We then discuss two recently approved growth factor receptor antagonists i.e. cabozantinib and lenvatinib, and a recently approved checkpoint inhibitor, nivolumab, and issues pertaining to drug development, and future directions in treatment of metastatic RCC. Expert opinion: Recently approved growth factor receptor antagonists have shown encouraging survival benefit but associated drug toxicity is a major issue. Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, has similarly shown survival benefit and is well tolerated. With multiple options now available in this patient population, the right sequence of these agents remains to be determined.

Low acid producing solid propellants

NASA Technical Reports Server (NTRS)

Bennett, Robert R.

1995-01-01

The potential environmental effects of the exhaust products of conventional rocket propellants have been assessed by various groups. Areas of concern have included stratospheric ozone, acid rain, toxicity, air quality and global warming. Some of the studies which have been performed on this subject have concluded that while the impacts of rocket use are extremely small, there are propellant development options which have the potential to reduce those impacts even further. This paper discusses the various solid propellant options which have been proposed as being more environmentally benign than current systems by reducing HCI emissions. These options include acid neutralized, acid scavenged, and nonchlorine propellants. An assessment of the acid reducing potential and the viability of each of these options is made, based on current information. Such an assessment is needed in order to judge whether the potential improvements justify the expenditures of developing the new propellant systems.

Medical management of heavy menstrual bleeding

PubMed Central

Maybin, Jacqueline A; Critchley, Hilary OD

2016-01-01

Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations. PMID:26695687

Employer Supported Child Care: An Idea Whose Time Has Come. A Conference on Child Care as an Employee Benefit (Costs and Benefits, Successful Programs, Company Options, Current Issues). Conference Proceedings.

ERIC Educational Resources Information Center

Haiman, Peter, Ed.; Sud, Gian, Ed.

Many aspects of employer-sponsored child care programs--including key issues, costs and benefits, programmatic options, and implementation strategies--are discussed in these conference proceedings. Public policy issues, legal aspects of child care as an employee benefit, tax incentives for corporate child care, and funding sources for child care…

Hair camouflage: A comprehensive review.

PubMed

Saed, Stephanie; Ibrahim, Omer; Bergfeld, Wilma F

2016-12-01

Hair is venerated, cherished, and desired in societies throughout the world. Both women and men express their individual identities through their hairstyles. Healthy hair contributes to successful social assimilation, employment, and overall quality of life. Therefore, hair loss can have detrimental effects on almost every aspect of a person's life. In this review, we discuss the myriad of options that aid in concealing and camouflaging hair loss to facilitate a healthier-appearing scalp. Camouflage options for patients who suffer from hair loss include full or partial wigs, hair extensions, concealing powders and sprays, surgical tattoos, and hair transplants. We describe these modalities in detail and discuss their respective advantages and disadvantages.

Hair camouflage: A comprehensive review.

PubMed

Saed, Stephanie; Ibrahim, Omer; Bergfeld, Wilma F

2017-03-01

Hair is venerated, cherished, and desired in societies throughout the world. Both women and men express their individual identities through their hairstyles. Healthy hair contributes to successful social assimilation, employment, and overall quality of life. Therefore, hair loss can have detrimental effects on almost every aspect of a person's life. In this review, we discuss the myriad of options that aid in concealing and camouflaging hair loss to facilitate a healthier-appearing scalp. Camouflage options for patients who suffer from hair loss include full or partial wigs, hair extensions, concealing powders and sprays, surgical tattoos, and hair transplants. We describe these modalities in detail and discuss their respective advantages and disadvantages.

Satellite services system analysis study. Volume 4: Service equipment concepts

NASA Technical Reports Server (NTRS)

1981-01-01

Payload deployment equipment is discussed, including payload separation, retention structures, the remote manipulator system, tilt tables, the payload installation and deployment aid, the handling and positioning aid, and spin tables. Close proximity retrieval, and on-orbit servicing equipment is discussed. Backup and contingency equipment is also discussed. Delivery and retrieval of high-energy payloads are considered. Earth return equipment, the aft flight deck, optional, and advanced equipment are also discussed.

The GUI OPAC: Approach with Caution.

ERIC Educational Resources Information Center

Hildreth, Charles R.

1995-01-01

Discusses the graphical user interface (GUI) online public access catalog (OPAC), a user interface that uses images to represent options. Topics include user interface design for information retrieval; designing effective bibliographic displays, including subject headings; two design principles; and what GUIs can bring to OPACs. (LRW)

10 CFR 51.103 - Record of decision-general.

Code of Federal Regulations, 2011 CFR

2011-01-01

... were included in the range of alternatives discussed in the environmental impact statement, and specify... preferences among alternatives based on relevant factors, including economic and technical considerations... impacts of license renewal are so great that preserving the option of license renewal for energy planning...

Treatment of early Parkinson's disease.

PubMed

Pahwa, Rajesh; Lyons, Kelly E

2014-08-01

This review summarizes currently available treatment options and treatment strategies, investigational treatments, and the importance of exercise for early Parkinson's disease. The available treatment options for early Parkinson's disease have changed little in the past decade and include carbidopa/levodopa, dopamine agonists, and monoamine oxidase type B (MAO-B) inhibitors. However, we discuss changes in treatment strategies, including dosing and the use of combination therapy used in an attempt to reduce or delay the appearance of motor complications and other adverse events. We will also review several investigational treatments that have shown promise for the treatment of early Parkinson's disease, including a new extended release formulation of carbidopa/levodopa (IPX066), safinamide which inhibits MAO-B, dopamine uptake and glutamate and pardoprunox which is a 5HT-1A agonist and a partial dopamine agonist. Finally, we discuss recent studies focusing on exercise as an important component in the management of early Parkinson's disease. Advances in the management of early Parkinson's disease include evolving treatment strategies, new investigational treatments, and earlier implementation of various forms of exercise.

New Policy Options Through Technology.

ERIC Educational Resources Information Center

Schmitt, Harrison

1981-01-01

The author discusses past contributions technology has made to society and ways it will contribute to society's future. Included in these areas are basic biological research, laser technology, information systems, and space technologies. (CT)

Hiring and Training Lifeguards.

ERIC Educational Resources Information Center

Hunsucker, John

1993-01-01

Discusses options for the hiring, testing, training, and supervision of lifeguards. Stresses the responsibility of camp directors in hiring properly trained lifeguards to ensure camper safety. Includes a precamp screening test of lifeguard knowledge and skills. (LP)

The Many Victims of Substance Abuse

PubMed Central

2007-01-01

Substance abuse is a complicated disorder and has far reaching consequences. The victims of substance abuse extend beyond the unfortunate ones suffering from this disorder and often include family and friends. Treatment options for substance abuse are many; however, positive outcomes are not always guaranteed. Many factors play into the potential for successful treatment. Some of these include the adherence and motivation of the substance abusing patients as well as patients' surrounding environments and support systems. In this article, we present a clinical case of opioid dependence and discuss various treatment options and modalities. We will discuss different variables that may maximize positive treatment outcomes. Also a review of the current literature regarding substance abuse treatment, psychotherapy with the drug abuser, and grief therapy should the substance abusing patient die for the surviving family members will be presented. PMID:20532120

Electronic Reference Service: A Teen's Eye View.

ERIC Educational Resources Information Center

Farmer, Lesley S.

2003-01-01

Discusses electronic reference service from a teen's point of view and from the school library media specialist's view. Considers traits that attract teens, including anonymity, speed, and convenience; and explains concerns of media specialists, including quality of electronic resources, how to provide access, library instruction options, and…

PCI-based WILDFIRE reconfigurable computing engines

NASA Astrophysics Data System (ADS)

Fross, Bradley K.; Donaldson, Robert L.; Palmer, Douglas J.

1996-10-01

WILDFORCE is the first PCI-based custom reconfigurable computer that is based on the Splash 2 technology transferred from the National Security Agency and the Institute for Defense Analyses, Supercomputing Research Center (SRC). The WILDFORCE architecture has many of the features of the WILDFIRE computer, such as field- programmable gate array (FPGA) based processing elements, linear array and crossbar interconnection, and high- performance memory and I/O subsystems. New features introduced in the PCI-based WILDFIRE systems include memory/processor options that can be added to any processing element. These options include static and dynamic memory, digital signal processors (DSPs), FPGAs, and microprocessors. In addition to memory/processor options, many different application specific connectors can be used to extend the I/O capabilities of the system, including systolic I/O, camera input and video display output. This paper also discusses how this new PCI-based reconfigurable computing engine is used for rapid-prototyping, real-time video processing and other DSP applications.

Puzzling out the new Medicare. How plan sponsors can understand and use Medicare+Choice to benefit their members and themselves.

PubMed

Parahus, S

1999-01-01

This article will discuss issues confronting plan sponsors in light of new Medicare+Choice options, and ways of responding to those issues. It will include a section with highlights of the "new" Medicare, including a brief description of new terminology and general descriptions of the different types of "coordinated care plans" and other options, e.g., POS, PPO, HMO, FFS, PSO and MSA. Its principal focus, however, will be on ways that plan sponsors can respond to--and capitalize on--the changes in Medicare and offer retirees a broader array of benefits while at the same time increasing their control over plan costs. The article will introduce the idea of plan sponsors constructing a retiree "flexible benefits" program comprising Medicare+Choice options.

Engineering Options Assessment Report. Nitrate Salt Waste Stream Processing

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

Anast, Kurt Roy

2015-11-13

This report examines and assesses the available systems and facilities considered for carrying out remediation activities on remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The assessment includes a review of the waste streams consisting of 60 RNS, 29 above-ground UNS, and 79 candidate below-ground UNS containers that may need remediation. The waste stream characteristics were examined along with the proposed treatment options identified in the Options Assessment Report . Two primary approaches were identified in the five candidate treatment options discussed in the Options Assessment Report: zeolite blending and cementation.more » Systems that could be used at LANL were examined for housing processing operations to remediate the RNS and UNS containers and for their viability to provide repackaging support for remaining LANL legacy waste.« less

Engineering Options Assessment Report: Nitrate Salt Waste Stream Processing

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

Anast, Kurt Roy

2015-11-18

This report examines and assesses the available systems and facilities considered for carrying out remediation activities on remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The assessment includes a review of the waste streams consisting of 60 RNS, 29 aboveground UNS, and 79 candidate belowground UNS containers that may need remediation. The waste stream characteristics were examined along with the proposed treatment options identified in the Options Assessment Report . Two primary approaches were identified in the five candidate treatment options discussed in the Options Assessment Report: zeolite blending and cementation.more » Systems that could be used at LANL were examined for housing processing operations to remediate the RNS and UNS containers and for their viability to provide repackaging support for remaining LANL legacy waste.« less

Energy Conversion and Storage Requirements for Hybrid Electric Aircraft

NASA Technical Reports Server (NTRS)

Misra, Ajay

2016-01-01

Among various options for reducing greenhouse gases in future large commercial aircraft, hybrid electric option holds significant promise. In the hybrid electric aircraft concept, gas turbine engine is used in combination with an energy storage system to drive the fan that propels the aircraft, with gas turbine engine being used for certain segments of the flight cycle and energy storage system being used for other segments. The paper will provide an overview of various energy conversion and storage options for hybrid electric aircraft. Such options may include fuel cells, batteries, super capacitors, multifunctional structures with energy storage capability, thermoelectric, thermionic or a combination of any of these options. The energy conversion and storage requirements for hybrid electric aircraft will be presented. The role of materials in energy conversion and storage systems for hybrid electric aircraft will be discussed.

Dialogue for Change. Options for Re-Structuring K-12 Education. 3rd Edition, 1988.

ERIC Educational Resources Information Center

Metropolitan Affairs Corp., Detroit, MI.

This Third Edition of the 1985 report, "Dialogue for Change," discusses options and examples of educational choice and teacher empowerment and summarizes developments between 1985 and 1987. The following key options are discussed in Chapter 1, "Proposed Options for Change": (1) magnet schools; (2) open enrollment; (3) purchase…

Pricing and Fee Management.

ERIC Educational Resources Information Center

Fischer, Richard B.

1986-01-01

Defines key terms and discusses things to consider when setting fees for a continuing education program. These include (1) the organization's philosophy and mission, (2) certain key variables, (3) pricing strategy options, and (4) the test of reasonableness. (CH)

Educating Information Brokers.

ERIC Educational Resources Information Center

Kehoe, Cynthia A.

1997-01-01

Discusses the education and training needed for information brokers. Topics include information broker as a career option; how library and information science programs can prepare students; research skills versus reference skills; small business management; and alternative and continuing education. (LRW)

The Seven Deadly Sins of Online Microcomputing.

ERIC Educational Resources Information Center

King, Alan

1989-01-01

Offers suggestions for avoiding common errors in online microcomputer use. Areas discussed include learning the basics; hardware protection; backup options; hard disk organization; software selection; file security; and the use of dedicated communications lines. (CLB)

Birthplace choices: what are the information needs of women when choosing where to give birth in England? A qualitative study using online and face to face focus groups.

PubMed

Hinton, Lisa; Dumelow, Carol; Rowe, Rachel; Hollowell, Jennifer

2018-01-08

Current clinical guidelines and national policy in England support offering 'low risk' women a choice of birth setting. Options include: home, free-standing midwifery unit (FMU), alongside midwifery unit (AMU) or obstetric unit (OU). This study, which is part of a broader project designed to inform policy on 'choice' in relation to childbirth, aimed to provide evidence on UK women's experiences of choice and decision-making in the period since the publication of the Birthplace findings (2011) and new NICE guidelines (2014). This paper reports on findings relating to women's information needs when making decisions about where to give birth. A qualitative focus group study including 69 women in the last trimester of pregnancy in England in 2015-16. Seven focus groups were conducted online via a bespoke web portal, and one was face-to-face. To explore different aspects of women's experience, each group included women with specific characteristics or options; planning a home birth, living in areas with lots of choice, living in areas with limited choice, first time mothers, living close to a FMU, living in opt-out AMU areas, living in socioeconomically disadvantaged areas and planning to give birth in an OU. Focus group transcripts were analysed thematically. Women drew on multiple sources when making choices about where to give birth. Sources included; the Internet, friends' recommendations and experiences, antenatal classes and their own personal experiences. Their midwife was not the main source of information. Women wanted the option to discuss and consider their birth preferences throughout their pregnancy, not at a fixed point. Birthplace choice is informed by many factors. Women may encounter fewer overt obstacles to exercising choice than in the past, but women do not consistently receive information about birthplace options from their midwife at a time and in a manner that they find helpful. Introducing options early in pregnancy, but deferring decision-making about birthplace until a woman has had time to consider and explore options and discuss these with her midwife, might facilitate choice.

Study to define an approach for developing a computer-based system capable of automatic, unattended assembly/disassembly of spacecraft, phase 1

NASA Technical Reports Server (NTRS)

Nevins, J. L.; Defazio, T. L.; Seltzer, D. S.; Whitney, D. E.

1981-01-01

The initial set of requirements for additional studies necessary to implement a space-borne, computer-based work system capable of achieving assembly, disassembly, repair, or maintenance in space were developed. The specific functions required of a work system to perform repair and maintenance were discussed. Tasks and relevant technologies were identified and delineated. The interaction of spacecraft design and technology options, including a consideration of the strategic issues of repair versus retrieval-replacement or destruction by removal were considered along with the design tradeoffs for accomplishing each of the options. A concept system design and its accompanying experiment or test plan were discussed.

Industry-Related Day Care: Trends and Options.

ERIC Educational Resources Information Center

Verzaro-Lawrence, Marce; And Others

1982-01-01

Examines current needs and trends of child care options in the United States, and discusses industrial responses to providing day care services. The advantages and disadvantages of industry-related day care and options available are also discussed. (Author/DB)

Dialysis-associated steal syndrome (DASS).

PubMed

Mohamed, Ahmed S; Peden, Eric K

2017-03-06

In this article, we will review the clinical symptoms of dialysis access steal syndrome (DASS), evaluation, treatment options, and our approach and treatment algorithm. We reviewed the literature discussing different aspects of DASS including its epidemiology, pathogenesis, clinical presentation, evaluation and management options. DASS is the most dreaded complication of access surgery. Although the incidence is low, all providers caring for dialysis patients should be aware of this problem. Symptoms can range from mild to limb threatening. Although various tests are available, the diagnosis of DASS remains a clinical one and requires thoughtful management to have the best outcomes. Multiple treatment options exist for steal. We present diagnostic evaluation and management algorithm.

Nuclear Engine System Simulation (NESS). Version 2.0: Program user's guide

NASA Technical Reports Server (NTRS)

Pelaccio, Dennis G.; Scheil, Christine M.; Petrosky, Lyman

1993-01-01

This Program User's Guide discusses the Nuclear Thermal Propulsion (NTP) engine system design features and capabilities modeled in the Nuclear Engine System Simulation (NESS): Version 2.0 program (referred to as NESS throughout the remainder of this document), as well as its operation. NESS was upgraded to include many new modeling capabilities not available in the original version delivered to NASA LeRC in Dec. 1991, NESS's new features include the following: (1) an improved input format; (2) an advanced solid-core NERVA-type reactor system model (ENABLER 2); (3) a bleed-cycle engine system option; (4) an axial-turbopump design option; (5) an automated pump-out turbopump assembly sizing option; (6) an off-design gas generator engine cycle design option; (7) updated hydrogen properties; (8) an improved output format; and (9) personal computer operation capability. Sample design cases are presented in the user's guide that demonstrate many of the new features associated with this upgraded version of NESS, as well as design modeling features associated with the original version of NESS.

Project HELP: a study protocol to pilot test a shared decision-making tool about treatment options for patients with hepatitis C and chronic kidney disease.

PubMed

Politi, M C; George, N; Li, T; Korenblat, K M; Fowler, K J; Ho, C; Liapakis, A; Roth, D; Yee, J

2018-01-01

Recent advances in treatment have given patients with chronic kidney disease (CKD) access to safer and more effective medications to treat comorbid hepatitis C virus (HCV) infection. Given the variety and complexity of treatment options that depend on patients' clinical characteristics and personal preferences, education and decision support are needed to prepare patients better to discuss treatment options with their clinicians. Drawing on International Patient Decision Aids Standards guidelines, literature reviews, and guidance from a diverse expert advisory group of nephrologists, hepatologists, and patients, we will develop and test a HCV and CKD decision support tool. Named Project HELP ( Helping Empower Liver and kidney Patients ), this tool will support patients with HCV and CKD during decisions about whether, when, and how to treat each illness. The tool will (1) explain information using plain language and graphics; (2) provide a step-by-step process for thinking about treating HCV and CKD; (3) tailor relevant information to each user by asking about the individual's stage of CKD, stage of fibrosis, prior treatment, and comorbidities; (4) assess user knowledge and values for treatment choices; and (5) help individuals use and consider information appropriate to their values and needs to discuss with a clinician. A pilot study including 70 individuals will evaluate the tool's efficacy, usability, and likelihood of using it in clinical practice. Eligibility criteria will include individuals who understand and read English, who are at least 18 years old, have a diagnosis of HCV (any genotype) and CKD (any stage), and are considering treatment options. This study can identify particular characteristics of individuals or groups that might experience challenges initiating treatment for HCV in the CKD population. This tool could provide a resource to facilitate patient-clinician discussions regarding HCV and CKD treatment options.

Evaluating the Australian Traineeship System.

ERIC Educational Resources Information Center

Ryan, R. J.

1987-01-01

Describes the Australian Traineeship System (ATS), a program integrating formal education and employment designed to increase options for dropouts. Discusses problems involving the centrality of ATS's educational component and implementation of a program evaluation strategy. Includes two references. (MLH)

Quality and Equality in Education.

ERIC Educational Resources Information Center

Hanford, George H.

1984-01-01

College Board programs and publications aimed at increasing access to higher education while helping maintain and enhance educational quality are discussed, including the Educational Equality Project on college preparation, Advanced Placement, College-Level Exaination Program, and Options for Excellence. (MSE)

Psychotherapy for Suicidal Clients.

ERIC Educational Resources Information Center

Lester, David

1994-01-01

Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

Heating and Cooling from the Ground Up.

ERIC Educational Resources Information Center

Jackson, Lisa M.

1998-01-01

Explains why converting to geothermal heating and cooling is a good option when constructing or retrofitting schools. Reasons discussed include competitive installation costs, lower operating and maintenance costs, greater building-design flexibility, and greater user satisfaction. (GR)

FERRET adjustment code: status/use

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

Schmittroth, F.A.

1982-03-01

The least-squares data analysis code FERRET is reviewed. Recent enhancements are discussed along with illustrative applications. Particular features noted include the use of differential as well as integral data, and additional user options for assigning and storing covariance matrices.

Space Station needs, attributes and architectural options, volume 2, book 3: Cost and programmatics

NASA Technical Reports Server (NTRS)

1983-01-01

The cost and programmatic considerations which integrate mission requirements and architectural options into a cohesive system for exploitation of space opportunities within affordable limits are discussed. The mission requirements, baseline architecture, a top level baseline schedule, and acquisition costs are summarized. The work breakdown structure (WBS) used to structure the program, and the WBS dictionary are included. The costing approach used, including the operation of the primary costing tool, the SPACE cost model are described. The rationale for the choice of cost estimating relationships is given and costs at the module level are shown. Detailed costs at the subsystem level are shown. The baseline schedule and annual funding profiles are provided. Alternate schedules are developed to provide different funding profiles. Alternate funding sources are discussed and foreign and contractor participation is outlined. The results of the benefit analysis are given and the accrued benefits deriving from an implemented space station program are outlined.

Summary of Propagation Cases of the Second AIAA Sonic Boom Prediction Workshop

NASA Technical Reports Server (NTRS)

Rallabhandi, Sriram; Loubeau, Alexandra

2017-01-01

A summary is provided for the propagation portion of the second AIAA Sonic Boom Workshop held January 8, 2017 in conjunction with the AIAA SciTech 2017 conference. Near-field pressure waveforms for two cases were supplied and ground signatures at multiple azimuthal angles as well as their corresponding loudness metrics were requested from 10 participants, representing 3 countries. Each case had some required runs, as well as some optional runs. The required cases included atmospheric profiles with measured data including winds, using Radiosonde balloon data at multiple geographically spread locations, while the optional cases included temperature and pressure profiles from the US Standard atmosphere. The humidity profiles provided for the optional cases were taken from ANSI guidance, as the authors were unaware of an accepted standard at the time the cases were released to the participants. Participants provided ground signatures along with the requested data, including some loudness metrics using their best practices, which included lossy as well as lossless schemes. All the participants' submissions, for each case, are compared and discussed. Noise or loudness measures are calculated and detailed comparisons and statistical analyses are performed and presented. It has been observed that the variation in the loudness measures and spread between participants' submissions increased as the computation proceeded from under-track locations towards the lateral cut-off. Lessons learned during this workshop are discussed and recommendations are made for potential improvements and possible subsequent workshops as we collectively attempt to refine our analysis methods.

Palliative Care Options for a Young Adult Patient with a Diffuse Intrinsic Pontine Glioma.

PubMed

Sison, Julian; Tran, Hung; Margol, Ashley; Tiwari, Nishant; Garcia, Karla M; Cotter, Jennifer; Kiehna, Erin; Olch, Arthur J; Wong, Kenneth

2017-08-18

Diffuse intrinsic pontine gliomas (DIPGs) are rare but devastating brain tumors that occur primarily in children. These gliomas have poor prognoses and present options focus on palliation of symptoms and prolongation of life. Here, we present a case of a 16-year-old female diagnosed with a DIPG whose age group has been mostly left out of discussions regarding psychosocial support options. This report is meant to start a conversation about the different support options available at our institution that have shown promising results in the literature for palliative care applications. These options can include camps for patients with brain tumors, psychological counseling, the Ronald McDonald House, and other psychosocial programs. Many of these programs can be tailored to meet the specific needs of adolescent and young adult (AYA) patients and will hopefully be integrated into a comprehensive palliative care regimen in future studies.

How PV system ownership can impact the market value of residential homes

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

Klise, Geoffrey Taylor; Johnson, Jamie L.

2014-01-01

There are multiple ways for a homeowner to obtain the electricity generating and savings benefits offered by a photovoltaic (PV) system. These include purchasing a PV system through various financing mechanisms, or by leasing the PV system from a third party with multiple options that may include purchase, lease renewal or PV system removal. The different ownership options available to homeowners presents a challenge to appraisal and real estate professionals during a home sale or refinance in terms of how to develop a value that is reflective of the PV systems operational characteristics, local market conditions, and lender and underwritermore » requirements. This paper presents these many PV system ownership options with a discussion of what considerations an appraiser must make when developing the contributory value of a PV system to a residential property.« less

Working with interpreters: The challenges of introducing Option Grid patient decision aids.

PubMed

Wood, Fiona; Phillips, Katie; Edwards, Adrian; Elwyn, Glyn

2017-03-01

We aimed to observe how an Option Grid™ decision aid for clinical encounters might be used where an interpreter is present, and to assess the impact of its use on shared decision making. Data were available from three clinical consultations between patient, clinician (a physiotherapist), and interpreter about knee osteoarthritis. Clinicians were trained in the use of an Option Grid decision aid and the tool was used. Consultations were audio-recorded, transcribed, and translated by independent translators into English. Analysis revealed the difficulties with introducing a written decision aid into an interpreted consultation. The extra discussion needed between the clinician and interpreter around the principles and purpose of shared decision making and instructions regarding the Option Grid decision aid proved challenging and difficult to manage. Discussion of treatment options while using an Option Grid decision aid was predominantly done between clinician and interpreter. The patient appeared to have little involvement in discussion of treatment options. Patients were not active participants within the discussion. Further work needs to be done on how shared decision making can be achieved within interpreted consultations. Option Grid decision aids are not being used as intended in interpreted consultations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Discussing options between patients and health care professionals in genetic diagnosis: ethical and legal criteria

PubMed Central

Nicolás, Pilar

2007-01-01

The specific characteristics of genetic data lead to ethical-legal conflicts in the framework of genetic diagnosis. Several international organisations, including UNESCO and the Council of Europe, have enacted rules referring to the use of genetic information. This paper discusses possible legal and ethical criteria that could be used in genetic testing. PMID:19725990

Potential impacts of advanced aerodynamic technology on air transportation system productivity

NASA Technical Reports Server (NTRS)

Bushnell, Dennis M. (Editor)

1994-01-01

Summaries of a workshop held at NASA Langley Research Center in 1993 to explore the application of advanced aerodynamics to airport productivity improvement are discussed. Sessions included discussions of terminal area productivity problems and advanced aerodynamic technologies for enhanced high lift and reduced noise, emissions, and wake vortex hazard with emphasis upon advanced aircraft configurations and multidisciplinary solution options.

Space disposal of nuclear wastes

NASA Technical Reports Server (NTRS)

Priest, C. C.; Nixon, R. F.; Rice, E. E.

1980-01-01

The DOE has been studying several options for nuclear waste disposal, among them space disposal, which NASA has been assessing. Attention is given to space disposal destinations noting that a circular heliocentric orbit about halfway between Earth and Venus is the reference option in space disposal studies. Discussion also covers the waste form, showing that parameters to be considered include high waste loading, high thermal conductivity, thermochemical stability, resistance to leaching, fabrication, resistance to oxidation and to thermal shock. Finally, the Space Shuttle nuclear waste disposal mission profile is presented.

A serial digital data communications device. [for real time flight simulation

NASA Technical Reports Server (NTRS)

Fetter, J. L.

1977-01-01

A general purpose computer peripheral device which is used to provide a full-duplex, serial, digital data transmission link between a Xerox Sigma computer and a wide variety of external equipment, including computers, terminals, and special purpose devices is reported. The interface has an extensive set of user defined options to assist the user in establishing the necessary data links. This report describes those options and other features of the serial communications interface and its performance by discussing its application to a particular problem.

The Easy Way to Create Computer Slide Shows.

ERIC Educational Resources Information Center

Anderson, Mary Alice

1995-01-01

Discusses techniques for creating computer slide shows. Topics include memory; format; color use; HyperCard and CD-ROM; font styles and sizes; graphs and graphics; the slide show option; special effects; and tips for effective presentation. (Author/AEF)

#KidsAnxiety and Social Media: A Review.

PubMed

Glover, Jenna; Fritsch, Sandra L

2018-04-01

This article reviews the available literature regarding the interaction between child and adolescent anxiety and electronic media. It reviews current research contributing to understanding of the correlation of youth anxiety with engagement in social media and other online platforms, including risk and protective factors. mHealth and eHealth prevention and treatment options, available via various digital resources, are discussed. Suggestions for mental health clinicians' assessment of client's online behaviors and a review of novel treatment options are provided. The article concludes with proposing healthy online technology interventions, including popups for overuse and identification of digitally enhanced posts. Copyright © 2017 Elsevier Inc. All rights reserved.

Recent advances and product enhancements in reflective cholesteric displays

NASA Astrophysics Data System (ADS)

Khan, Asad; Schneider, Tod; Miller, Nick; Marhefka, Duane; Ernst, Todd; Nicholson, Forrest; Doane, Joseph W.

2005-04-01

Bistable reflective cholesteric displays are a liquid crystal display technology developed to fill a market need for very low power displays on a low-cost, high resolution passive matrix. Their unique look, high reflectivity, bistability, and simple structure make them an ideal flat panel display choice for handheld or other portable devices where small lightweight batteries with long lifetimes are important. We discuss recent advances in cholesteric display technology at Kent Displays such as progress towards single layer black and white displays, standard products, lower cost display modules, and various interface options for cholesteric display applications. It will be shown that inclusion of radio frequency (rf) control options and serial peripheral interface (spi) can greatly enhance the cholesteric display module market penetration by enabling quick integration into end devices. Finally, some discussion will be on the progress of the development of flexible reflective cholesteric displays. These flexible displays can dramatically change industrial design methods by enabling curved surfaces with displays integrated in them. Additional discussion in the paper will include applications of various display modes including signs, hand held instrumentation, and the electronic book and reader.

Current treatment for vitreous floaters.

PubMed

Sendrowski, David P; Bronstein, Mark A

2010-03-01

Vitreous floaters are a common complaint in the ophthalmic care setting. Patients seek explanation and advice regarding possible treatment options. Because the condition is considered benign, ophthalmic care practitioners have little to offer regarding treatment options. The majority of cases encountered are managed with patient education and reassurance. Although almost all patients accept the conservative management option, there is a small subset of patients who may desire a more aggressive treatment intervention for resolution of their visual symptoms. Information with regard to treatment options is readily available to patients through Internet searches and non-peer reviewed educational Web sites. The risks and benefits for these treatment options are not fully covered. Management of floaters should include education regarding "off-label" procedures as well as discussion about benefits and risks associated with such treatment options. It is vital that eye care practitioners advise and counsel patients with symptomatic floaters for optimum ocular health care. This article reviews the current conventional and "off-label" treatment options for symptomatic patients with vitreous floaters. Copyright (c) 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

Chronic orchialgia: Review of treatments old and new

PubMed Central

Tojuola, Bayo; Layman, Jeffrey; Kartal, Ibrahim; Gudelogul, Ahmet; Brahmbhatt, Jamin; Parekattil, Sijo

2016-01-01

Introduction: Chronic orchialgia is historically and currently a challenging disease to treat. It is a diagnostic and therapeutic challenge for physicians. Conservative therapy has served as the first line of treatment. For those who fail conservative therapy, surgical intervention may be required. We aim to provide a review of currently available surgical options and novel surgical treatment options. Methods: A review of current literature was performed using PubMed. Literature discussing treatment options for chronic orchialgia were identified. The following search terms were used to identify literature that was relevant to this review: Chronic orchialgia, testicular pain, scrotal content pain, and microsurgical denervation of the spermatic cord (MDSC). Results: The incidence of chronic orchialgia has been increasing over time. In the USA, it affects up to 100,000 men per year due to varying etiologies. The etiology of chronic orchialgia can be a confounding problem. Conservative therapy should be viewed as the first line therapy. Studies have reported poor success rates. Current surgical options for those who fail conservative options include varicocelectomy, MDSC, epididymectomy, and orchiectomy. Novel treatment options include microcryoablation of the peri-spermatic cord, botox injection, and amniofix injection. Conclusion: Chronic orchialgia has been and will continue to be a challenging disease to treat due to its multiple etiologies and variable treatment outcomes. Further studies are needed to better understand the problem. Treatment options for patients with chronic orchialgia are improving. Additional studies are warranted to better understand the long-term durability of this treatment options. PMID:26941490

Energy Options for Wireless Sensor Nodes.

PubMed

Knight, Chris; Davidson, Joshua; Behrens, Sam

2008-12-08

Reduction in size and power consumption of consumer electronics has opened up many opportunities for low power wireless sensor networks. One of the major challenges is in supporting battery operated devices as the number of nodes in a network grows. The two main alternatives are to utilize higher energy density sources of stored energy, or to generate power at the node from local forms of energy. This paper reviews the state-of-the art technology in the field of both energy storage and energy harvesting for sensor nodes. The options discussed for energy storage include batteries, capacitors, fuel cells, heat engines and betavoltaic systems. The field of energy harvesting is discussed with reference to photovoltaics, temperature gradients, fluid flow, pressure variations and vibration harvesting.

Energy Options for Wireless Sensor Nodes

PubMed Central

Knight, Chris; Davidson, Joshua; Behrens, Sam

2008-01-01

Reduction in size and power consumption of consumer electronics has opened up many opportunities for low power wireless sensor networks. One of the major challenges is in supporting battery operated devices as the number of nodes in a network grows. The two main alternatives are to utilize higher energy density sources of stored energy, or to generate power at the node from local forms of energy. This paper reviews the state-of-the art technology in the field of both energy storage and energy harvesting for sensor nodes. The options discussed for energy storage include batteries, capacitors, fuel cells, heat engines and betavoltaic systems. The field of energy harvesting is discussed with reference to photovoltaics, temperature gradients, fluid flow, pressure variations and vibration harvesting. PMID:27873975

Evidence-based drug treatment practice and the child welfare system: the example of methadone.

PubMed

Lundgren, Lena M; Schilling, Robert F; Peloquin, Susan D

2005-01-01

This article examined the extent to which methadone maintenance (MM) is considered a treatment alternative for drug-dependent parents, as reflected in the social work and child welfare literature and in child welfare policies. Findings were derived from a review of 15 social work journals published from 1996 through 2002 and from a review of child welfare policies in 27 states in regard to treatment recommendations for substance-abusing parents. These reviews found that 23 articles focused on child welfare-substance abuse issues; no article specifically discussed MM as a treatment option for heroin-using parents; and of the 27 states, only three included methadone as a treatment option in their child welfare policy recommendations. Practice and policy recommendations are discussed.

Surgical options in benign parotid tumors: a proposal for classification.

PubMed

Quer, Miquel; Vander Poorten, Vincent; Takes, Robert P; Silver, Carl E; Boedeker, Carsten C; de Bree, Remco; Rinaldo, Alessandra; Sanabria, Alvaro; Shaha, Ashok R; Pujol, Albert; Zbären, Peter; Ferlito, Alfio

2017-11-01

Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.

Solid rocket booster performance evaluation model. Volume 1: Engineering description

NASA Technical Reports Server (NTRS)

1974-01-01

The space shuttle solid rocket booster performance evaluation model (SRB-II) is made up of analytical and functional simulation techniques linked together so that a single pass through the model will predict the performance of the propulsion elements of a space shuttle solid rocket booster. The available options allow the user to predict static test performance, predict nominal and off nominal flight performance, and reconstruct actual flight and static test performance. Options selected by the user are dependent on the data available. These can include data derived from theoretical analysis, small scale motor test data, large motor test data and motor configuration data. The user has several options for output format that include print, cards, tape and plots. Output includes all major performance parameters (Isp, thrust, flowrate, mass accounting and operating pressures) as a function of time as well as calculated single point performance data. The engineering description of SRB-II discusses the engineering and programming fundamentals used, the function of each module, and the limitations of each module.

Features and selection of vascular access devices.

PubMed

Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

The MHOST finite element program: 3-D inelastic analysis methods for hot section components. Volume 2: User's manual

NASA Technical Reports Server (NTRS)

Nakazawa, Shohei

1989-01-01

The user options available for running the MHOST finite element analysis package is described. MHOST is a solid and structural analysis program based on the mixed finite element technology, and is specifically designed for 3-D inelastic analysis. A family of 2- and 3-D continuum elements along with beam and shell structural elements can be utilized, many options are available in the constitutive equation library, the solution algorithms and the analysis capabilities. The outline of solution algorithms is discussed along with the data input and output, analysis options including the user subroutines and the definition of the finite elements implemented in the program package.

TYPES OF ARSENIC AND TREATMENT OPTIONS

EPA Science Inventory

Presentation will discuss the state-of-the-art technology for removal of arsenic from drinking water. Presentation includes results of several EPA field studies on removal of arsenic from existing arsenic removal plants and key results from several EPA sponsored research studies...

Enhancing Motivation for Learning and Work.

ERIC Educational Resources Information Center

Kirkhorn, Judith

1988-01-01

Discusses motivation based on adult learning conditions, and suggests appropriate motivation plans for leaders and trainers that will enhance performance. The steps to develop motivation plans include assessing current thinking on motivation and reinforcement options; objectively describing expected behaviors; and developing motivational…

The Driving Range. A Different Story about CD-ROM Storage.

ERIC Educational Resources Information Center

Benford, Tom

1995-01-01

Discusses design options for CD-ROM storage. Highlights include a marketing strategy resulting in the creation of the jewel box; replacement and duplex jewel boxes; caddies; business furniture companies for large collections; flip-racks; and lazy-susans. (AEF)

Getting to the Bottom of L2 Listening Instruction: Making a Case for Bottom-Up Activities

ERIC Educational Resources Information Center

Siegel, Joseph; Siegel, Aki

2015-01-01

This paper argues for the incorporation of bottom-up activities for English as a foreign language (EFL) listening. It discusses theoretical concepts and pedagogic options for addressing bottom-up aural processing in the EFL classroom as well as how and why teachers may wish to include such activities in lessons. This discussion is augmented by a…

Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

NASA Astrophysics Data System (ADS)

Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

2017-08-01

This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

From Earth to Orbit: An assessment of transportation options

NASA Technical Reports Server (NTRS)

Gavin, Joseph G., Jr.; Blond, Edmund; Brill, Yvonne C.; Budiansky, Bernard; Cooper, Robert S.; Demisch, Wolfgang H.; Hawk, Clark W.; Kerrebrock, Jack L.; Lichtenberg, Byron K.; Mager, Artur

1992-01-01

The report assesses the requirements, benefits, technological feasibility, and roles of Earth-to-Orbit transportation systems and options that could be developed in support of future national space programs. Transportation requirements, including those for Mission-to-Planet Earth, Space Station Freedom assembly and operation, human exploration of space, space science missions, and other major civil space missions are examined. These requirements are compared with existing, planned, and potential launch capabilities, including expendable launch vehicles (ELV's), the Space Shuttle, the National Launch System (NLS), and new launch options. In addition, the report examines propulsion systems in the context of various launch vehicles. These include the Advanced Solid Rocket Motor (ASRM), the Redesigned Solid Rocket Motor (RSRM), the Solid Rocket Motor Upgrade (SRMU), the Space Shuttle Main Engine (SSME), the Space Transportation Main Engine (STME), existing expendable launch vehicle engines, and liquid-oxygen/hydrocarbon engines. Consideration is given to systems that have been proposed to accomplish the national interests in relatively cost effective ways, with the recognition that safety and reliability contribute to cost-effectiveness. Related resources, including technology, propulsion test facilities, and manufacturing capabilities are also discussed.

Patient and Clinician Openness to Including a Broader Range of Healing Options in Primary Care

PubMed Central

Hsu, Clarissa; Cherkin, Daniel C.; Hoffmeyer, Sylvia; Sherman, Karen J.; Phillips, William R.

2011-01-01

PURPOSE We studied the openness of patients and clinicians to introducing a broader range of healing options into primary care. METHODS Focus groups were conducted with primary care patients (4 groups) and clinicians (3 groups) from an integrated medical care system in 2008. Transcripts of discussions were analyzed using an immersion/crystallization approach. RESULTS Both patients (n = 44) and clinicians (n = 32) were open to including a wider variety of healing options in primary care. Patients desired some evidence of effectiveness, although there was wide variation in the type of evidence required. Many patients believed that the clinician’s personal and practice experience was an important form of evidence. Patients wanted to share in the decision to refer and the choice of options. Clinicians were most concerned with safety of specific treatments, including some of the herbs and dietary supplements. They also believed they lacked adequate information about the nature, benefits, and risks of many alternatives, and they were not aware of local practitioners and resources to whom they could confidently refer their patients. Both patients and clinicians were concerned that services recommended be covered by insurance or be affordable to patients. CONCLUSIONS Integrating additional healing options into primary care may be feasible and desirable, as well as help meet the needs of patients with conditions that have not been responsive to standard medical treatments. PMID:21911764

Library-Specific Microcomputer Software.

ERIC Educational Resources Information Center

Levert, Virginia M.

1985-01-01

Discusses number and type of microcomputer software programs useful to libraries and types of hardware on which they run, as identified by Nolan Information Management Services. Highlights include general application programs, applications designed to support library technical processes, producers of library software, and choosing among options.…

Design study of arresting gear system for recovery of space shuttle orbiters

NASA Technical Reports Server (NTRS)

1972-01-01

A plan is reported for the design, manufacture, development, test, and production of an emergency arrestment system for the recovery of shuttle orbiters. Time and cost estimates are included. System testing and several optional test programs are discussed.

Photovoltaic options for solar electric propulsion

NASA Technical Reports Server (NTRS)

Stella, Paul M.; Flood, Dennis J.

1990-01-01

This paper discusses both state-of-the-art and advanced development cell and array technology. Present technology includes rigid, roll-out, and foldout flexible substrate designs, with silicon and GaAs solar cells. The use of concentrator array systems is discussed based on both DOD efforts and NASA work. The benefits of advanced lightweight array technology, for both near term and far term utilization, and of advanced high efficiency thin radiation resistant cells is examined. This includes gallium arsenide/germanium, indium phosphide, and thin film devices such as copper indium disclenide.

Principles of Burn Pain Management.

PubMed

James, Dominika Lipowska; Jowza, Maryam

2017-10-01

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

Emile Durkheim and altruistic suicide.

PubMed

Stack, Steven

2004-01-01

Altruistic suicides are marked by cultural approval and benefit the social order. They occur in social groups where there is a low value placed on the individual. The principle loci of altruistic suicide are primitive societies and the modern military. Subtypes of altruistic suicide (obligatory, optional, acute) are delineated and evaluated. Military suicide rates are seen as being inversely related to civilian suicide rates. Key limitations of Durkheim's model are discussed including his exaggerating the prevalence of obligatory suicide. Suggested points of departure for future research on altruistic suicide include comparative analyses of suicide in the modern military, and application of the concept of optional altruistic suicide to the impact of suicide acceptability on national suicide rates.

What weight loss treatment options do geriatric patients with overweight and obesity want to consider?

PubMed

MacMillan, M; Cummins, K; Fujioka, K

2016-12-01

Since the 1990s, a number of weight loss medications have been removed from the USA and or European market because of adverse events associated with these medications. These medications include fenfluramine (heart valve thickening), sibutramine (cardiovascular risk) and rimonabant (depression). This history may affect a patient's desire to consider weight loss medications as an option for weight management. This descriptive study was designed to observe what treatment options the geriatric patient (age 65 or higher) seeking weight loss would like to consider, as well as the reasons they felt they struggled with overweight or obesity. A questionnaire was given to 102 geriatric patients with overweight or obesity before starting a weight loss programme at a weight management centre. The questionnaire asked the patient why they felt they were overweight or obese and what treatment options they wished to consider. The geriatric patients were matched with younger patients in body mass index and sex. The three most common perceptions that geriatric patients felt were causes of their increased weight were 'lack of exercise' (76.2%), 'poor food choices' (59.4%) and 'cravings' (47.5%). When geriatric patients were asked what treatment options they would like to discuss, the four most common options requested were 'diet and healthy eating' (67.3%), weight loss medications (57.4%), a request for a 'metabolic work up' (55.4%) and 'exercise' (53.5%). These responses were no different from their younger cohorts. When geriatric patients with a body mass index of 35 or higher were given bariatric surgery as a treatment option, 21.9% marked it as a treatment option they would like to consider. Over half of geriatric patients desired to discuss weight loss medications as a treatment option. Diet and exercise were also of strong interest, which is in line with current weight management guidelines.

Energy conservation policy evaluation. Study module IA. Volume II. Technical appendix. Final report

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

Bergstresser, K.; Berney, R.E.; Carter, L.F.

1978-01-01

This volume contains detailed technical analyses of the 19 energy conservation measures which were discussed as regional policy options in the report proper (PB-274 337). For each measure there is a description of how the measure works to reduce consumption; an assessment of potential savings, costs, and returns to adopters; probable 'normal' adoption rates under present policies; and potential adoption rates if some additional conservation policy options are implemented. Report includes chapters on environmental residuals from energy end uses, and policy preferences of households and energy marketers.

Should a colon cancer screening decision aid include the option of no testing? A comparative trial of two decision aids

PubMed Central

Griffith, Jennifer M; Fichter, Marlie; Fowler, Floyd J; Lewis, Carmen; Pignone, Michael P

2008-01-01

Background An important question in the development of decision aids about colon cancer (CRC) screening is whether to include an explicit discussion of the option of not being screened. We examined the effect of including or not including an explicit discussion of the option of deciding not to be screened in a CRC screening decision aid on subjective measures of decision aid content; interest in screening; and knowledge. Methods Adults ages 50–85 were assigned to view one of two versions of the decision aid. The two versions differed only in the inclusion of video segments of two men, one of whom decided against being screened. Participants completed questionnaires before and after viewing the decision aid to compare subjective measures of content, screening interest and intent, and knowledge between groups. Likert response categories (5-point) were used for subjective measures of content (eg. clarity, balance in favor/against screening, and overall rating), and screening interest. Knowledge was measured with a three item index and individual questions. Higher scores indicated favorable responses for subjective measures, greater interest, and better knowledge. For the subjective balance, lower numbers were associated with the impression of the decision aid favoring CRC screening. Results 57 viewed the "with" version which included the two segments and 49 viewed the "without" version. After viewing, participants found the "without" version to have better subjective clarity about benefits of screening ("with" 3.4, "without" 4.1, p < 0.01), and to have greater clarity about downsides of screening ("with" 3.2, "without" 3.6, p = 0.03). The "with" version was considered to be less strongly balanced in favor of screening. ("with" 1.8, "without" 1.6, p = 0.05); but the "without" version received a better overall rating ("with" 3.5, "without" 3.8, p = 0.03). Groups did not differ in screening interest after viewing a decision aid or knowledge. Conclusion A decision aid with the explicit discussion of the option of deciding not to be screened appears to increase the impression that the program was not as strongly in favor of screening, but decreases the impression of clarity and resulted in a lower overall rating. We did not observe clinically important or statistically significant differences in interest in screening or knowledge. PMID:18321377

The neuropsychiatry of tinnitus: a circuit-based approach to the causes and treatments available.

PubMed

Minen, Mia T; Camprodon, Joan; Nehme, Romy; Chemali, Zeina

2014-10-01

Patients presenting with tinnitus commonly have neuropsychiatric symptoms with which physicians need to be familiar. We provide an overview of tinnitus, including its types and pathophysiology. We discuss how recent methods such as transcranial magnetic stimulation, positron emission tomography, MRI, magnetoencephalography and quantitative EEG improve our understanding of the pathophysiology of tinnitus and connect tinnitus to the neuropsychiatric symptoms. We then explain why treatment of the tinnitus patient falls within the purview of neuropsychiatry. Psychiatric problems such as depression, anxiety and personality disorders are discussed. We also discuss how stress, headache, cognitive processing speed and sleep disturbance are associated with tinnitus. Finally, we provide a brief overview of treatment options and discuss the efficacy of various medications, including benzodiazepines, antidepressants, antipsychotics and mood-stabilising agents, and various non-pharmacological treatment options, such as cognitive behavioural therapy, habituation therapy and acupuncture. We also discuss how brain stimulation therapies are being developed for the treatment of tinnitus. In conclusion, a review of the literature demonstrates the varied neuropsychiatric manifestations of tinnitus. Imaging studies help to explain the mechanism of the association. However, more research is needed to elucidate the neurocircuitry underlying the association. 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.

Parental Preference Assessment for Vesicoureteral Reflux Management in Children.

PubMed

Tran, Geraldine N; Bodapati, Anand V; Routh, Jonathan C; Saigal, Christopher S; Copp, Hillary L

2017-03-01

Parents of children with vesicoureteral reflux are presented with a variety of management options, which in many cases offer a similar risk-benefit ratio. To facilitate shared decision making, parental preferences regarding vesicoureteral reflux treatment options need to be acknowledged. We aimed to characterize the clinical experience of parents and elicit core themes affecting decision making in regard to managing vesicoureteral reflux in their child. A semistructured, qualitative interview script was developed and vetted by 25 pediatric urologists to discuss treatment options for vesicoureteral reflux. Additional patient interviews were conducted until new themes failed to arise. Content analysis was performed to extract all statements that described treatment options. Similar statements were combined until a final list of unique themes emerged. A total of 26 interviews were performed, yielding 689 statements about overall parent experiences with managing vesicoureteral reflux in the child and 450 statements (65%) pertaining to treatment options. Of the 13 themes that emerged, those most commonly considered were the prevention of future urinary tract infections by 85% of parents, the efficacy rate of treatment options by 85%, the burden of daily maintenance or compliance by 77%, antibiotic resistance by 69%, chronic kidney damage by 62% and invasiveness by 58%. Our study emphasizes that when choosing a treatment option for vesicoureteral reflux in their child, parent preferences regarding risks and benefits are variable. However, their chief concerns include whether a method decreases the risk of urinary tract infections, has an acceptable efficacy rate and aligns itself with the capabilities of the family. These themes help frame discussions between families and clinicians regarding vesicoureteral reflux management, and they can facilitate shared decision making. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A study of industrial hydrogen and syngas supply systems

NASA Technical Reports Server (NTRS)

Amos, W. J.; Solomon, J.; Eliezer, K. F.

1979-01-01

The potential and incentives required for supplying hydrogen and syngas feedstocks to the U.S. chemical industry from coal gasification systems were evaluated. Future hydrogen and syngas demand for chemical manufacture was estimated by geographic area and projected economics for hydrogen and syngas manufacture was estimated with geographic area of manufacture and plant size as parameters. Natural gas, oil and coal feedstocks were considered. Problem areas presently affecting the commercial feasibility of coal gasification discussed include the impact of potential process improvements, factors involved in financing coal gasification plants, regulatory barriers affecting coal gasification, coal mining/transportation, air quality regulations, and competitive feedstock pricing barriers. The potential for making coal gasification the least costly H2 and syngas supply option. Options to stimulate coal gasification system development are discussed.

Cybersquatting and Your Legal Options.

ERIC Educational Resources Information Center

Steinbach, Sheldon; Salomon, Kenneth

2000-01-01

Discusses the increasing problem of cybersquatting, the practice of registering an Internet domain name that is confusingly similar to a well-known name or institution (including colleges and universities). Explains two remedies: (1) the recent Anticybersquatting Consumer Protection Act and the Uniform Dispute Resolution Policy of the Internet…

Evaluation of School Library Media Centers: Demonstrating Quality.

ERIC Educational Resources Information Center

Everhart, Nancy

2003-01-01

Discusses ways to evaluate school library media programs and how to demonstrate quality. Topics include how principals evaluate programs; sources of evaluative data; national, state, and local instruments; surveys and interviews; Colorado benchmarks; evaluating the use of electronic resources; and computer reporting options. (LRW)

Parenting.

ERIC Educational Resources Information Center

Spock, Benjamin; And Others

Various aspects of child-rearing are covered in this transcript of a program broadcast in the National Public Radio weekly series, "Options in Education." Authors of current popular books on parenting are interviewed. Benjamin Spock discusses changes (including sex role revisions) in his "Baby and Child Care" since the 1946…

Technology Options for Libraries. ERIC Digest.

ERIC Educational Resources Information Center

Schamber, Linda

This two-page digest briefly outlines some of the technological trends in updating a library, and briefly discusses the administrative issues and strategies involved. It begins by describing the wholly integrated information environment, which would include: (1) public-access personal and professional communications networks; (2) information…

Virtual Events: A Cyberspace Resource for Educators.

ERIC Educational Resources Information Center

McLellan, Hilary

1998-01-01

Discusses how virtual events can be used to enhance education. Topics include balancing virtual and real encounters; finding the best mix of communication options; and finding patterns of interaction that support reflective cognition, knowledge amplification, community-building, learning, and global understanding. GLOBENET 1997, an international…

Pricing Models and Payment Schemes for Library Collections.

ERIC Educational Resources Information Center

Stern, David

2002-01-01

Discusses new pricing and payment options for libraries in light of online products. Topics include alternative cost models rather than traditional subscriptions; use-based pricing; changes in scholarly communication due to information technology; methods to determine appropriate charges for different organizations; consortial plans; funding; and…

Kodak Optical Disk and Microfilm Technologies Carve Niches in Specific Applications.

ERIC Educational Resources Information Center

Gallenberger, John; Batterton, John

1989-01-01

Describes the Eastman Kodak Company's microfilm and optical disk technologies and their applications. Topics discussed include WORM technology; retrieval needs and cost effective archival storage needs; engineering applications; jukeboxes; optical storage options; systems for use with mainframes and microcomputers; and possible future…

Space station systems analysis study. Part 2, volume 3: Appendixes, Book 2: Supporting data (7 through 18)

NASA Technical Reports Server (NTRS)

1977-01-01

Topics discussed include: (1) design considerations for a MARS sample return laboratory module for space station investigations; (2) crew productivity as a function of work shift arrangement; (3) preliminary analysis of the local logistics problem on the space construction base; (4) mission hardware construction operational flows and timelines; (5) orbit transfer vehicle concept definition; (6) summary of results and findings of space processing working review; (7) crew and habitability subsystem (option L); (8) habitability subsystem considerations for shuttle tended option L; (9) orbiter utilization in manned sortie missions; (10) considerations in definition of space construction base standard module configuration (option L); (11) guidance, control, and navigation subsystems; and (12) system and design tradeoffs.

Student Loan Debt: Problems & Prospects. Proceedings from a National Symposium (Washington, DC, December 10, 1997).

ERIC Educational Resources Information Center

Education Resources Inst., Boston, MA.

These proceedings include five papers presented at a symposium on issues related to the increasing amounts of student borrowing and resulting student debt. Also included is a synopsis of a roundtable discussion addressing core questions framed by the symposium, as well as several public policy options for addressing student loan debt burden. The…

Current Options and Emerging Biomaterials for Periprosthetic Joint Infection.

PubMed

Levack, Ashley E; Cyphert, Erika L; Bostrom, Mathias P; Hernandez, Christopher J; von Recum, Horst A; Carli, Alberto V

2018-04-30

Infection in the setting of total joint arthroplasty, referred to as periprosthetic joint infection (PJI), is a devastating complication requiring prolonged and costly treatment. The unique environment around an artificial joint and ability of surrounding tissues to sequester bacteria collectively make prevention, diagnosis, and treatment of this condition challenging. In light of the unique pathogenesis of PJI, this review explores the limitations of contemporary treatments and discusses novel treatment options. Recent advancements in local antibiotic delivery platforms for preventing and treating PJI include titanium nanotube arrays, synthetic polymers, resorbable hydrogels, and cyclodextrin-based drug delivery options. In particular, cyclodextrins have facilitated great advancements in other clinical disorders and have demonstrated early promise as a future option in the arena of PJI. Novel treatment modalities for PJI optimize the implant surfaces to prevent bacterial biofilm formation or provide prolonged intra-articular antibiotic dosing to eradicate bacteria.

Pharmacological management of narcolepsy with and without cataplexy.

PubMed

Kallweit, Ulf; Bassetti, Claudio L

2017-06-01

Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy has a major impact on workableness and quality of life. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. First- and second-line options are discussed as well as combination therapies. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Finally, this review considers potential future management strategies. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies.

Scaling up IT: Weighing the Options, Maintaining the Balance.

ERIC Educational Resources Information Center

Griffiths, Jose-Marie

1999-01-01

Discusses the integration of information technology into an institution of higher education, based on experiences at the University of Tennessee at Knoxville and the University of Michigan. Topics include changes in user populations; leadership; infrastructure; teamwork; organizational priorities; attitudes and expectations; and the constancy of…

Choosing a CD-ROM Encyclopedia: How to Critically Evaluate the Product.

ERIC Educational Resources Information Center

Dickinson, Gail

1990-01-01

Offers criteria for the critical evaluation of CD-ROM encyclopedias. Differences between CD-ROM and print encyclopedias are discussed; search strategies are explained; evaluation criteria are suggested, including help messages, screen format, indexing method, and graphics and print options; future considerations are suggested, including…

Physics of Materials.

ERIC Educational Resources Information Center

Archenhold, W. F.; And Others

1987-01-01

Describes a new high school physics option in Great Britain which uses the model of a technological approach to the study of materials. Discusses the components of the program, including the development of a student book for independent learning and six case studies. Provides a case study about turbine blades. (TW)

Telecommuters.

ERIC Educational Resources Information Center

Mariani, Matthew

2000-01-01

Describes telecommuting, which occurs whenever an employee is paid for work done at an alternate worksite and total commuting time is thereby reduced. Discusses the pros and cons and examines the characteristics that make jobs and people suitable for telecommuting. Includes a self-assessment to determine whether telecommuting is a good option.…

Alcohol Policy Considerations for Indian Reservations and Bordertown Communities.

ERIC Educational Resources Information Center

May, Philip A.

1992-01-01

Alcohol abuse and alcoholism are the leading health problems among American Indian communities. Public policy options that address these problems include controlling the supply of alcoholic beverages; shaping drinking practices directly; or reducing physical and social environmental risks. Discusses alcohol-related death rates and community…

The Use of Teleconferencing to Conduct Interim Business.

ERIC Educational Resources Information Center

Frampton, Robert; and Others

This report discusses telecommunications as a possible medium for conducting certain types of Pacific Circle Consortium (PCC) business. Under the general heading of teleconferencing, the paper examines a number of telecommunications options including two-way video, electronic mail, slow-scan video, facsimile equipment, electronic blackboards,…

Aspiration, Performance, Reward: The Advanced Placement Program at 40.

ERIC Educational Resources Information Center

Rothschild, Eric

1995-01-01

The history of the College Entrance Examination Board's Advanced Placement Program is chronicled from its conception in 1951 through early developmental stages and 40 years of implementation. Issues discussed include test development, funding, administration at the institutional level, expansion of curriculum areas and testing options, teacher…

Teachers for Children with Emotional/Behavioral Disorders: Education's Greatest Challenge?

ERIC Educational Resources Information Center

Lauritzen, Paul; Friedman, Stephen J.

1991-01-01

This article describes children having emotional/behavioral disorders, presents data demonstrating the critical shortage of teachers for this population, discusses factors that contribute to this problem, and offers recommendations including giving teachers of these children an additional salary stipend and providing them the option of…

Cerebral venous thrombosis: state of the art diagnosis and management.

PubMed

Dmytriw, Adam A; Song, Jin Soo A; Yu, Eugene; Poon, Colin S

2018-05-11

This review article aims to discuss the pathophysiology, clinical presentation, and neuroimaging of cerebral venous thrombosis (CVT). Different approaches for diagnosis of CVT, including CT/CTV, MRI/MRV, and US will be discussed and the reader will become acquainted with imaging findings as well as limitations of each modality. Lastly, this exhibit will review the standard of care for CVT treatment and emerging endovascular options. A literature search using PubMed and the MEDLINE subengine was completed using the terms "cerebral venous thrombosis," "stroke," and "imaging." Studies reporting on the workup, imaging characteristics, clinical history, and management of patients with CVT were included. The presentation of CVT is often non-specific and requires a high index of clinical suspicion. Signs of CVT on NECT can be divided into indirect signs (edema, parenchymal hemorrhage, subarachnoid hemorrhage, and rarely subdural hematomas) and less commonly direct signs (visualization of dense thrombus within a vein or within the cerebral venous sinuses). Confirmation is performed with CTV, directly demonstrating the thrombus as a filling defect, or MRI/MRV, which also provides superior characterization of parenchymal abnormalities. General pitfalls and anatomic variants will also be discussed. Lastly, endovascular management options including thrombolysis and mechanical thrombectomy are discussed. CVT is a relatively uncommon phenomenon and frequently overlooked at initial presentation. Familiarity with imaging features and diagnostic work-up of CVT will help in providing timely diagnosis and therapy which can significantly improve outcome and diminish the risk of acute and long-term complications, optimizing patient care.

Managing the side effects of multiple sclerosis therapy: pharmacotherapy options for patients.

PubMed

Rommer, Paulus S; Zettl, Uwe K

2018-04-01

Multiple sclerosis (MS) is an immune-mediated and neurodegenerative disease with an unpredictable outcome. Immune-modulatory treatment aims at decreasing long-term disability. With the increasing number of treatment options, it is essential to fully digest the possible side effects of the available therapeutics and to monitor patients is essential. Areas covered: All approved disease-modifying drugs (DMD) for MS are discussed in this review. Mode of action, adverse effects, reported risks for infections and malignancies, and pregnancy related issues are discussed in the review. The authors also provide suggestions for monitoring therapy. For all approved DMDs the pivotal studies have been included for possible side effects, as well as reports by health authorities. For this manuscript, PubMed was checked for reports on side effects for various drugs. Expert opinion: Treatment options in MS are manifold, each carrying different risks. The safety-risk profile for approved agents is favorable. Knowing and monitoring these possible side effects is essential to minimize risks associated with treatment. Presently, the long-term experience for some of these therapies is missing and this must be addressed.

Sociolinguistics: Current Trends and Prospects; Report of the 23rd Annual Round Table Meeting on Linguistics and Language Studies. Monograph Series on Language and Linguistics No. 25.

ERIC Educational Resources Information Center

Shuy, Roger W., Ed.

The papers included in this volume discuss the relationship of sociolinguistics to social interaction, sociolinguistic surveys, the intersection of sociolinguistics with education, and the influence of linguistics and sociology on sociolinguistics. The papers include: "Optional Rules in Grammar" (Fraser); "The Structure of Polylectal Grammars"…

NASTRAN thermal analyzer: Theory and application including a guide to modeling engineering problems, volume 2. [sample problem library guide

NASA Technical Reports Server (NTRS)

Jackson, C. E., Jr.

1977-01-01

A sample problem library containing 20 problems covering most facets of Nastran Thermal Analyzer modeling is presented. Areas discussed include radiative interchange, arbitrary nonlinear loads, transient temperature and steady-state structural plots, temperature-dependent conductivities, simulated multi-layer insulation, and constraint techniques. The use of the major control options and important DMAP alters is demonstrated.

Options for organization and operation of space applications transfer centers

NASA Technical Reports Server (NTRS)

Robinson, A. C.; Madigan, J. A.

1976-01-01

The benefits of developing regional facilities for transfer of NASA developed technology are discussed. These centers are designed to inform, persuade, and serve users. Included will be equipment for applications and demonstrations of the processes, a library, training facilities, and meeting rooms. The staff will include experts in the various techniques, as well as personnel involved in finding and persuading potential users.

Anticipatory nausea and vomiting due to chemotherapy.

PubMed

Kamen, Charles; Tejani, Mohamedtaki A; Chandwani, Kavita; Janelsins, Michelle; Peoples, Anita R; Roscoe, Joseph A; Morrow, Gary R

2014-01-05

As a specific variation of chemotherapy-induced nausea and vomiting, anticipatory nausea and vomiting (ANV) appears particularly linked to psychological processes. The three predominant factors related to ANV are classical conditioning; demographic and treatment-related factors; and anxiety or negative expectancies. Laboratory models have provided some support for these underlying mechanisms for ANV. ANV may be treated with medical or pharmacological interventions, including benzodiazepines and other psychotropic medications. However, behavioral treatments, including systematic desensitization, remain first line options for addressing ANV. Some complementary treatment approaches have shown promise in reducing ANV symptoms. Additional research into these approaches is needed. This review will address the underlying models of ANV and provide a discussion of these various treatment options. © 2013 Published by Elsevier B.V.

Prescription Drugs: Abuse and Addiction. National Institute on Drug Abuse Research Report Series.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

This publication answers questions about the consequences of abusing commonly prescribed medications including opioids, central nervous system depressants, and stimulants. In addition to offering information on what research says about how certain medications affect the brain and body, this publication also discusses treatment options. It examines…

Fast Track to College Success. State-Federal Partnerships in Postsecondary Education

ERIC Educational Resources Information Center

Barry, Mary Nguyen

2016-01-01

This brief focuses on 12th grade students who are ready for postsecondary work, but are spending unnecessary time in high school. The brief discusses options for paying for the transition, including K-12 funds reimbursing families for tuition or 12th graders being eligible for Pell.

What About Waste? 4-H Leader's/Teacher's Guide.

ERIC Educational Resources Information Center

Bonhotal, Jean F.; And Others

This guide is designed for adult volunteer leaders, camp counselors, and teachers who want to explore the subject of waste disposal and management with youth. An introduction provides background on waste disposal problems and disposal options including reducing, reusing, recycling, and composting. Seven discussion questions are intended to…

The Distribution of Family Oriented Benefits.

ERIC Educational Resources Information Center

EBRI Issue Brief, 1992

1992-01-01

This issue of a monthly newsletter is devoted to an overview of employee benefits that assist families, including child care, extended unpaid personal leave, and flexible work options. Findings are discussed from a recent study analyzing the distribution of two of those family benefits (child care assistance and flexible work practices) among…

Young Investigators: Concerns, Options, and Opportunities. AIR Forum 1979 Paper.

ERIC Educational Resources Information Center

Trumble, Robert R.

Declining opportunities for young researchers at universities and proposals to improve the situation are discussed. Concerns related to opportunities for young researchers include: (1) the leveling-off of student enrollments at universities; (2) the fact that tenure limits faculty turnover; (3) possible effects on research if the age distribution…

Participatory Action Research as a Model for Conducting Family Research.

ERIC Educational Resources Information Center

Turnbull, Ann P.; Friesen, Barbara J.; Ramirez, Carmen

1998-01-01

This article discusses a participatory action research (PAR) approach to conducting family research. It proposes a model of PAR implementation level including the options of family members as research leaders and researchers as ongoing advisors, researchers and family members as coresearchers, and researches as leaders, and family members as…

Circuit Riding: A Method for Providing Reference Services.

ERIC Educational Resources Information Center

Plunket, Linda; And Others

1983-01-01

Discussion of the design and implementation of the Circuit Rider Librarian Program, a shared services project for delivering reference services to eight hospitals in Maine, includes a cost analysis of services and description of user evaluation survey. Five references, composite results of the survey, and postgrant options proposal are appended.…

Student Perceptions of Web-Based Supplemental Instruction

ERIC Educational Resources Information Center

Freeman, Steven A.; Field, Dennis W.

2004-01-01

The Internet is changing the way in which education is delivered, and in fact, some predict that the Internet will become the dominant distribution system for distance education and training. Many faculty members are expanding their traditional delivery methods (lecture, laboratory, face-to-face discussion) to include educational options ranging…

Furniture Faces the Future.

ERIC Educational Resources Information Center

Rittner-Heir, Robbin M.

2000-01-01

Discusses how changes in the educational tools used and the way children are taught have made classroom furniture of the past nearly obsolete. Furniture options for flexibility and buying decisions in tight budgets are addressed, including buying over the Internet. Questions to ask for buying the right furniture for school districts are…

Phase-change composites TES for nickel-hydrogen batteries

NASA Technical Reports Server (NTRS)

Knowles, Timothy R.; Meyer, Richard A.

1993-01-01

Viewgraphs of a discussion on phase-change composites thermal energy storage (TES) for nickel-hydrogen batteries are presented. Topics covered include Ni-H2 thermal control problems; passive thermal control with TES; phase-change composites (PCC); candidate materials; design options; fabrication and freeze-melt cycling; thermal modeling; system benefits; and applications.

Policy considerations for improving influenza vaccination rates among pregnant women.

PubMed

Mollard, Elizabeth K; Guenzel, Nicholas; Brown, Peggy A; Keeler, Heidi J; Cramer, Mary E

2014-01-01

Influenza exposure during pregnancy can cause severe health problems for both the mother and her offspring, including an increased risk of mortality. Influenza vaccination during all trimesters of pregnancy is safe and effective, and recommended by professional organizations such as the American College of Obstetrics and Gynecology. Despite these recommendations, the U.S. vaccination rates remain low in this high-risk population. A policy analysis based on the five-part method identified by Teitelbaum and Wilensky () addresses factors to consider in identifying the best voluntary policy options to improve the vaccination rates. The authors provide discussion of the background, landscape, and stakeholder interests and the pros and cons of two voluntary policy options to increase vaccination. The policy options include: (a) financial incentives for providers and (b) an education emphasis for providers and staff. The authors conclude that based on considerations of cost, provider preference, and practicality of implementation, a continuing educational intervention is the preferred policy venue to increase vaccination rates. © 2014 Wiley Periodicals, Inc.

Neuroimaging in aphasia treatment research: Standards for establishing the effects of treatment

PubMed Central

Kiran, Swathi; Ansaldo, Ana; Bastiaanse, Roelien; Cherney, Leora R.; Howard, David; Faroqi-Shah, Yasmeen; Meinzer, Marcus; Thompson, Cynthia K

2012-01-01

The goal of this paper is to discuss experimental design options available for establishing the effects of treatment in studies that aim to examine the neural mechanisms associated with treatment-induced language recovery in aphasia, using functional magnetic resonance imaging (fMRI). We present both group and single-subject experimental or case-series design options for doing this and address advantages and disadvantages of each. We also discuss general components of and requirements for treatment research studies, including operational definitions of variables, criteria for defining behavioral change and treatment efficacy, and reliability of measurement. Important considerations that are unique to neuroimaging-based treatment research are addressed, pertaining to the relation between the selected treatment approach and anticipated changes in language processes/functions and how such changes are hypothesized to map onto the brain. PMID:23063559

Evaluation and treatment of failed shoulder instability procedures.

PubMed

Ho, Anthony G; Gowda, Ashok L; Michael Wiater, J

2016-09-01

Management of the unstable shoulder after a failed stabilization procedure can be difficult and challenging. Detailed understanding of the native shoulder anatomy, including its static and dynamic restraints, is necessary for determining the patient's primary pathology. In addition, evaluation of the patient's history, physical exam, and imaging is important for identifying the cause for failure after the initial procedure. Common mistakes include under-appreciation of bony defects, failure to recognize capsular laxity, technical errors, and missed associated pathology. Many potential treatment options exist for revision surgery, including open or arthroscopic Bankart repair, bony augmentation procedures, and management of Hill Sachs defects. The aim of this narrative review is to discuss in-depth the common risk factors for post-surgical failure, components for appropriate evaluation, and the different surgical options available for revision stabilization. Level of evidence Level V.

All Roads Lead to Rome: Update on Rome III Criteria and New Treatment Options

PubMed Central

Shih, David Q.; Kwan, Lola Y.

2010-01-01

The recently published Rome III criteria reflect current understanding of functional gastrointestinal disorders. These criteria include definitions of these conditions and their pathophysiologic subtypes and offer guidelines for their management. At the 2006 Annual Scientific Meeting of the American College of Gastroenterology, a panel of experts discussed these criteria as they pertain to irritable bowel syndrome, functional dyspepsia, and chronic constipation. This article reviews the panel’s findings, highlights the differences between the Rome II and III criteria, and summarizes best treatment options currently available to practitioners and their patients. PMID:21544252

Chronic Testicular and Groin Pain: Pathway to Relief.

PubMed

Calixte, Nahomy; Brahmbhatt, Jamin; Parekattil, Sijo

2017-09-02

The management of patients suffering with chronic testicular and groin pain is very challenging. With increased awareness of men's health, more patients and clinicians are open to talk about this complex problem that affects over 100,000 men/year. The pathogenesis of chronic orchialgia is still not clear, but there are several postulated theories. Treatment options include conservative medical therapy with NSAIDs, antidepressants, anticonvulsants, and narcotics. Surgical options such as targeted microsurgical denervation and microcryoablation can provide permanent durable pain relief. The goal of this article is to review and discuss the management of patients with chronic orchialgia using currently available literature.

Functional Interface Considerations within an Exploration Life Support System Architecture

NASA Technical Reports Server (NTRS)

Perry, Jay L.; Sargusingh, Miriam J.; Toomarian, Nikzad

2016-01-01

As notional life support system (LSS) architectures are developed and evaluated, myriad options must be considered pertaining to process technologies, components, and equipment assemblies. Each option must be evaluated relative to its impact on key functional interfaces within the LSS architecture. A leading notional architecture has been developed to guide the path toward realizing future crewed space exploration goals. This architecture includes atmosphere revitalization, water recovery and management, and environmental monitoring subsystems. Guiding requirements for developing this architecture are summarized and important interfaces within the architecture are discussed. The role of environmental monitoring within the architecture is described.

Predictors of affect following treatment decision-making for prostate cancer: conversations, cognitive processing, and coping.

PubMed

Christie, Kysa M; Meyerowitz, Beth E; Giedzinska-Simons, Antoinette; Gross, Mitchell; Agus, David B

2009-05-01

Research suggests that cancer patients who are more involved in treatment decision-making (TDM) report better quality of life following treatment. This study examines the association and possible mechanisms between prostate cancer patient's discussions about TDM and affect following treatment. We predicted that the length of time patients spent discussing treatment options with social networks and physicians prior to treatment would predict emotional adjustment after treatment. We further predicted that cognitive processing, coping, and patient understanding of treatment options would mediate this association. Fifty-seven patients completed questionnaires prior to treatment and at 1 and 6 months following treatment completion. Findings from the present study suggest that discussing treatment options with others, prior to beginning treatment for prostate cancer, significantly contributed to improvements in affect 1 and 6 months following treatment. Residualized regression analyses indicated that discussing treatment options with patient's social networks predicted a decrease in negative affect 1 and 6 months following treatment, while discussions with physicians predicted an increase in positive affect 1 month following treatment. Patients who spent more time discussing treatment options with family and friends also reported greater pre-treatment social support and emotional expression. Mediation analyses indicated that these coping strategies facilitated cognitive processing (as measured by a decrease in intrusive thoughts) and that cognitive processing predicted improvement in affect. Greater time spent talking with family and friends about treatment options may provide opportunities for patients to cope with their cancer diagnosis and facilitate cognitive processing, which may improve patient distress over time. Copyright (c) 2008 John Wiley & Sons Ltd.

Recent advances in the treatment of rheumatoid arthritis.

PubMed

Mahajan, Tina D; Mikuls, Ted R

2018-05-01

Therapies for rheumatoid arthritis (RA) continue to expand rapidly. The purpose of this review is to discuss novel treatment options, including biosimilars, that are available, as well as to highlight promising agents in development. The purpose is also to discuss new emerging safety signals associated with these drugs and to discuss strategies in tapering therapy. There are several novel RA therapies. These include the interleukin-6 (IL-6) receptor blocker sarilumab, which was approved in 2017. In aggregate, the sarilumab studies show that it is effective in RA, including patients with incomplete responses to methotrexate and anti-tumor necrosis factor inhibitor, and showing superior efficacy when used in higher dose (200 mg every 2 weeks) to standard-dose adalilumab. Other drugs that are currently being studied include the IL-6 cytokine blocker sarikumab, the small targeted molecule filgotinib, and many new biosimilars. Baracitinib failed to achieve approval by the Food and Drug Administration primarily over perceived safety concerns. The two biosimilar drugs currently approved are CT-P13 and SB2, which are based on the reference product infliximab. Although this review summarizes trials examining biologic tapering, additional data are needed to guide clinicians in regards to treatment de-escalation in RA. With the greatly expanded armamentarium of RA treatment options available, it is important for clinicians to understand the data regarding drug efficacy and safety. With remission increasingly attainable, effective drug tapering strategies are needed. Although tapering trials do exist, more studies will be needed to help guide clinical practice.

An Option in Applied Microbiology.

ERIC Educational Resources Information Center

Lee, William E., III

1988-01-01

Describes a program option for undergraduate chemical engineering students interested in biotechnology. Discusses how this program is deployed at the University of Southern Florida. Lists courses which apply to this program. Discusses the goals of teaching applied microbiology to engineering majors. (CW)

Conservative care as a treatment option for patients aged 75 years and older with CKD stage V: a National survey in the Netherlands.

PubMed

Susanto, Christopher; Kooman, J; Courtens, A M; Konings, C J A M

2018-01-01

Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Twenty-one medical managers (35%) completed the survey. The term "conservative care" is frequently used and well known. The estimated number of patients in whom the decision for maximal conservative care was made in 2015 was 310 of 2249 patients with CKD stage 5 age 75 years and older (range 5-50 patients per department). 164 patients became symptomatic and received no dialysis. There is no official registration for this treatment option and patient category. The practice patterns vary widely. Only one of 21 respondents reported a conservative care outpatient clinic. Formal training or education regarding conservative care is not available in most of departments. 95% of respondents discussed this treatment option with their patients. General practitioners are always being informed about their patient's decision. Their main role is providing or organizing palliative care support at the end of life and discussing advance care planning. Most respondents (86%) considered to include their patients in a prospective multicentre observational study, conservative care versus dialysis. Conservative care as a treatment option for patients with CKD stage 5 aged 75 years and older is well established. The practice patterns are varied in the Netherlands. Follow-up studies are needed to see whether the new multidisciplinary guideline facilitates harmonization of practice pattern. Funding is needed to optimize the implementation of conservative care.

path integral approach to closed form pricing formulas in the Heston framework.

NASA Astrophysics Data System (ADS)

Lemmens, Damiaan; Wouters, Michiel; Tempere, Jacques; Foulon, Sven

2008-03-01

We present a path integral approach for finding closed form formulas for option prices in the framework of the Heston model. The first model for determining option prices was the Black-Scholes model, which assumed that the logreturn followed a Wiener process with a given drift and constant volatility. To provide a realistic description of the market, the Black-Scholes results must be extended to include stochastic volatility. This is achieved by the Heston model, which assumes that the volatility follows a mean reverting square root process. Current applications of the Heston model are hampered by the unavailability of fast numerical methods, due to a lack of closed-form formulae. Therefore the search for closed form solutions is an essential step before the qualitatively better stochastic volatility models will be used in practice. To attain this goal we outline a simplified path integral approach yielding straightforward results for vanilla Heston options with correlation. Extensions to barrier options and other path-dependent option are discussed, and the new derivation is compared to existing results obtained from alternative path-integral approaches (Dragulescu, Kleinert).

Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.

PubMed

Bell, Cynthia J; Zimet, Gregory D; Hinds, Pamela S; Broome, Marion E; McDaniel, Anna M; Mays, Rose M; Champion, Victoria L

Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions. The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited. We explored 2 in-depth cases across time using case-study methodology. An à priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness. Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions. Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.

Survey of Advanced Booster Options for Potential Shuttle Derivative Vehicles

NASA Technical Reports Server (NTRS)

Sackheim, Robert L.; Ryan, Richard; Threet, Ed; Kennedy, James W. (Technical Monitor)

2001-01-01

A never-ending major goal for the Space Shuttle program is to continually improve flight safety, as long as this launch system remains in operational service. One of the options to improve system safety and to enhance vehicle performance as well, that has been seriously studied over the past several decades, is to replace the existing strap-on four segment solid rocket boosters (SRB's) with more capable units. A number of booster upgrade options have been studied in some detail, ranging from five segment solids through hybrids and a wide variety of liquid strap-ons (both pressure and pump fed with various propellants); all the way to a completely reusable liquid fly back booster (complete with air breathing engines for controlled landing and return). All of these possibilities appear to offer improvements in varying degrees; and each has their strengths and weaknesses from both programmatic and technical points of view. The most beneficial booster upgrade/design, if the shuttle program were to continue long enough to justify the required investment, would be an approach that greatly increased both vehicle and crew safety. This would be accomplished by increasing the minimum range/minimum altitude envelope that would readily allow abort to orbit (ATO), possibly even to zero/zero, and possibly reduce or eliminate the Return to Launch Site (RTLS) and even the Trans Atlantic Landing (TAL) abort mode requirements. This paper will briefly survey and discuss all of the various booster'upgrade options studied previously, and compare their relative attributes. The survey will explicitly discuss, in summary comparative form, options that include: five segment solids; several hybrid possibilities; pressure and/or pump-fed liquids using either LO2/kerosene, H2O/kerosene and LO2/J2, any of which could be either fully expendable, partly or fully reusable; and finally a fully reusable liquid fly back booster system, with a number of propellant and propulsion system options. Performance and configuration comparison illustrations and tables will be included to provide a comprehensive survey for the paper.

Improvements to the FATOLA computer program including nosewheel steering: Supplemental instruction manual

NASA Technical Reports Server (NTRS)

Carden, H. D.; Mcgehee, J. R.

1978-01-01

Modifications to a multidegree of freedom flexible aircraft take-off and landing analysis (FATOLA) computer program, which improved its simulation capabilities, are discussed, and supplemental instructions for use of the program are included. Sample analytical results which illustrate the capabilities of an added nosewheel steering option indicate consistent behavior of the airplane tracking, attitude, motions, and loads for the landing cases and steering situations which were investigated.

Comparison and evaluation of power plant options for geosynchronous power stations. Part 1: Synchronous solar power

NASA Technical Reports Server (NTRS)

Williams, J. R.

1973-01-01

The present state-of-the-art is described for the development of solar power generators in far out synchronous orbit for power generation. Concepts of geosynchronous solar power satellites are discussed including photovoltaic arrays for power satellites, solar-thermal power satellites, and power transmission to earth.

Transforming the Doctorate from Residential to Online: A Distributed PhD Learning Technologies

ERIC Educational Resources Information Center

Jones, Greg; Warren, Scott J.; Ennis-Cole, Demetria; Knezek, Gerald; Lin, Lin; Norris, Cathie

2014-01-01

This article discusses a systemic change that expanded the doctorate in Learning Technologies at the University of North Texas to include a distributed option, delivered primarily online. It provides an overview of the development process from concept to initial implementation. The article examines the specific differences that make the online…

Physical Education, Part I. Options in Education, Program No. 99.

ERIC Educational Resources Information Center

George Washington Univ., Washington, DC. Inst. for Educational Leadership.

This transcript of a National Public Radio broadcast discusses the impact of Title IX on elementary and secondary physical education. Topics covered include competition, difficulties involved in the sex integration of sports, statements on Title IX by five chief state school officers, the experience of Massachusetts in implementing Title IX, and…

Chapter 8: Simulating mortality from forest insects and diseases

Treesearch

Alan A. Ager; Jane L. Hayes; Craig L. Schmitt

2004-01-01

We describe methods for incorporating the effects of insects and diseases on coniferous forests into forest simulation models and discuss options for including this capability in the modeling work of the Interior Northwest Landscape Analysis System (INLAS) project. Insects and diseases are major disturbance agents in forested ecosystems in the Western United States,...

The NTF as a national facility. [project planning

NASA Technical Reports Server (NTRS)

Nicks, O. W.

1977-01-01

Activities which led to the definition of the National Transonic Facility and the general agreements reached regarding its use and operations are reviewed. Topics discussed include: redefinition of test requirements, development of low cost options, consideration of a single transonic facility using existing hardware if feasible, facility concept recommendations, and acquisition schedule proposals.

Security Implications of Electronic Commerce: A Survey of Consumers and Businesses.

ERIC Educational Resources Information Center

Furnell, S. M.; Karweni, T.

1999-01-01

Examines general requirement for security technologies that provide a basis for trust in the electronic commerce environment. Discusses the results of two surveys that included general Internet users who are potential customers as well as commercial businesses, that considered attitudes to electronic commerce in general and options relating to…

Peripheral nerve injuries secondary to missiles.

PubMed

Katzman, B M; Bozentka, D J

1999-05-01

Peripheral nerve injuries secondary to missiles can present some of the most challenging problems faced by hand surgeons. This article reviews the pertinent neural anatomy, injury classifications, and repair techniques. Options in the management of nerve gaps are presented including the use of vascularized nerve grafts. The results are discussed and a treatment algorithm is presented.

Window Insulation: How to Sort Through the Options.

ERIC Educational Resources Information Center

Miller, Barbara

This two-part report explores the efforts of businesses and individuals to improve the thermal performance of windows. Part I discusses the basics of what makes a window product insulate or save energy. Topic areas addressed include saving energy lost through windows, key components of window insulation, three basic types of window insulation,…

Matching Educational Opportunities with the Able Elderly.

ERIC Educational Resources Information Center

Bass, Scott A.

1986-01-01

This article provides a framework, or typology, from which to examine the range of educational options that is available to the older person and provides an analysis of the potential size of the older learner student market. It includes a discussion of a demonstration program that has been well received by the able older learner. (CT)

Climate-Change Science and Policy: What Do We Know? What Should We Do

DTIC Science & Technology

2010-09-06

These briefing charts discuss climate change science and policy including: the essence of the challenge, five myths and their refutations, climate ... change risks and impact going forward, available options, how much mitigation, how soon?, mitigation supply curve and its implications, and the Obama Administration’s strategy.

Serving Up Vegetarian: A Matter of Understanding.

ERIC Educational Resources Information Center

France, Cindy

1997-01-01

A food service manager at a resident camp discusses how she changed her attitude about vegetarianism and the strategies she used to create a vegetarian menu for staff and campers. She experimented with vegetarian recipes and allowed campers and staff their choice of menu options for each camp session. Includes information sources. (LP)

Working with Students Who Are Late-Deafened. NETAC Teacher Tipsheet.

ERIC Educational Resources Information Center

Clark, Mary

This tipsheet provides suggestions to help teachers work more effectively with students who are late-deafened. Suggestions include: (1) allow time for the student to introduce himself and discuss possible needs; (2) learn the basics of CART (Computer-Aided Realtime Translation) and other communication options; (3) learn the basics of using…

Space Station needs, attributes and architectural options study. Volume 7-4A: Data book, architecture, technology and programmatics, part A

NASA Technical Reports Server (NTRS)

1983-01-01

Various parameters of the orbital space station are discussed. The space station environment, data management system, communication and tracking, environmental control, and life support system are considered. Specific topics reviewed include crew work stations, restraint systems, stowage, computer hardware, and expert systems.

Pay Now, Learn Later.

ERIC Educational Resources Information Center

Schwartz, John

1986-01-01

Duquesne University's pay-now, learn-later plan is one device that could transform college-fee payment almost as much as the GI Bill did. The further away from college age the child, the more the school earns and the deeper the discount. Some other options are discussed including installment plans and special sales on tuition. (MLW)

Reconstruction of the midface and maxilla.

PubMed

Dalgorf, Dustin; Higgins, Kevin

2008-08-01

To review the current classification systems and reconstructive options available for restoration of maxillectomy defects. Defects involving the midface can have a great functional and aesthetic impact on the patient. Adequate restoration of the complex three-dimensional maxillary structure is required to replace form and function of the native tissue. An in-depth discussion of appropriate recipient vessel selection and reconstructive options are included in this article. The superficial temporal vessel system is presented as a reliable anastomosis site for restoration of midfacial defects. In addition, the complications of vein grafting, arteriovenous fistula loops and alternative recipient vessels sites are addressed to manage the challenge of the vessel-depleted neck. The current indications, advantages and disadvantages of local, regional and free-flap reconstructive options available for maxillectomy defects are highlighted in order to aid the surgeon in appropriate flap selection. A myriad of reconstructive options are available to restore maxillectomy defects. The surgeon must consider each defect and the needs of the individual patient when choosing the best suited reconstructive technique.

Recent trends and future directions for the medical treatment of ulcerative colitis.

PubMed

Naganuma, Makoto; Mizuno, Shinta; Nanki, Kosaku; Sugimoto, Shinya; Kanai, Takanori

2016-12-01

Recently, several medical treatments for ulcerative colitis (UC) have been developed, including 5-aminosalicylic acids (5-ASAs), corticosteroids, thiopurine, calcineurin inhibitors, and anti-tumor necrosis factor (TNF) α treatments. Treatment options including calcineurin inhibitors and anti-TNF treatment for refractory UC are discussed in this article. Furthermore, upcoming treatments are introduced, such as golimumab, vedolizumab, AJM300, tofacitinib. Budesonide foamwill be used as one treatment option in patients with distal colitis. Herbal medicine, such as Qing-Dai is also effective for active UC and may be useful for patients who are refractory to anti-TNFα treatments. In the near future, physicians will able to use many different treatments for UC patients. However, we should not forget 5-ASA and corticosteroids as the fundamental treatments for UC patients.

Recent concepts in missions to Mars - Extraterrestrial processes

NASA Technical Reports Server (NTRS)

Ramohalli, K. N.; Ash, R. L.; Lawton, E. A.; French, J. R.; Frisbee, R. H.

1986-01-01

This paper presents some recent concepts in Mars Sample Return (MSR) missions that utilize extraterrestrial resources. The concepts examined include the power and energy needs of this mission. It is shown that solar energy is not especially attractive. Radioisotopic power generator and a Rankine cycle use are seen to be viable options. Quantitative estimates, taking into consideration state-of-the-art and projected technologies indicate that the power/energy per se is not critical to the mission - but reliability is. Hence, various modern options for the components of the power generation and utilization are discussed. The dramatic savings in Shuttle (or other) vehicle launches are quantitatively plotted. The basic system that is discussed here is the production of hydrocarbon (methane) fuel and oxygen from Martian atmosphere. For the simplest mission, it is seen that earth-carried methane burned with oxygen produced on site provides the best system.

Solar System Exploration Augmented by In-Situ Resource Utilization: Human Mercury and Saturn Exploration

NASA Technical Reports Server (NTRS)

Palaszewski, Bryan

2015-01-01

Human and robotic missions to Mercury and Saturn are presented and analyzed. Unique elements of the local planetary environments are discussed and included in the analyses and assessments. Using historical studies of space exploration, in-situ resource utilization (ISRU), and industrialization all point to the vastness of natural resources in the solar system. Advanced propulsion benefitted from these resources in many way. While advanced propulsion systems were proposed in these historical studies, further investigation of nuclear options using high power nuclear thermal and nuclear pulse propulsion as well as advanced chemical propulsion can significantly enhance these scenarios. Updated analyses based on these historical visions will be presented. Nuclear thermal propulsion and ISRU enhanced chemical propulsion landers are assessed for Mercury missions. At Saturn, nuclear pulse propulsion with alternate propellant feed systems and Titan exploration with chemical propulsion options are discussed.

Open access to scientific articles: a review of benefits and challenges.

PubMed

Björk, Bo-Christer

2017-03-01

The Internet has fundamentally changed the publishing of scholarly peer reviewed journals, and the way readers find and access articles. Digital access is nowadays the norm, in particular for researchers. The Internet has enabled a totally new business model, Open Access (OA), in which an article is openly available in full text for anyone with Internet access. This article reviews the different options to achieve this, whether by journals changing their revenue structures from subscription to publishing charges, or authors utilizing a number of options for posting OA versions of article manuscripts in repositories. It also discusses the regrettable emergence of "predatory" publishers, who spam academics, and make money by promising them rapid publication with only the semblance of peer review. The situation is further discussed from the viewpoints of different stakeholders, including academics as authors and readers, practicing physicians and the general public.

Amount of substance and the proposed redefinition of the mole

NASA Astrophysics Data System (ADS)

Milton, M. J. T.; Mills, I. M.

2009-06-01

There has been considerable discussion about the merits of redefining four of the base units of the SI, including the mole. In this paper, the options for implementing a new definition for the mole based on a fixed value for the Avogadro constant are discussed. They are placed in the context of the macroscopic nature of the quantity amount of substance and the opportunity to introduce a system for molar and atomic masses with unchanged values and consistent relative uncertainties.

Near-term hybrid vehicle program, phase 1

NASA Technical Reports Server (NTRS)

1979-01-01

The preliminary design of a hybrid vehicle which fully meets or exceeds the requirements set forth in the Near Term Hybrid Vehicle Program is documented. Topics addressed include the general layout and styling, the power train specifications with discussion of each major component, vehicle weight and weight breakdown, vehicle performance, measures of energy consumption, and initial cost and ownership cost. Alternative design options considered and their relationship to the design adopted, computer simulation used, and maintenance and reliability considerations are also discussed.

Atypical Facial and Head Pain in Childhood and Adolescence.

PubMed

Grazzi, Licia; Sansone, Emanuela; Rizzoli, Paul

2018-05-03

This review will consider forms of atypical facial and head pain in children and adolescents. A brief and general overview of typical head and facial pains and treatments will be offered. Moreover, atypical head and face pain will be discussed with treatment options. The most recent literature including case reports will be evaluated; possible pathophysiological mechanisms, resulting disabilities, and family and social impact will be discussed. General indications for pharmacological treatment will be reviewed, when needed in more disabling cases. Also, non-pharmacological treatments that are especially suitable for this category of patients will be illustrated and discussed.

Meta Search Engines.

ERIC Educational Resources Information Center

Garman, Nancy

1999-01-01

Describes common options and features to consider in evaluating which meta search engine will best meet a searcher's needs. Discusses number and names of engines searched; other sources and specialty engines; search queries; other search options; and results options. (AEF)

Percept User Manual.

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

Carnes, Brian; Kennon, Stephen Ray

2017-05-01

This document is the main user guide for the Sierra/Percept capabilities including the mesh_adapt and mesh_transfer tools. Basic capabilities for uniform mesh refinement (UMR) and mesh transfers are discussed. Examples are used to provide illustration. Future versions of this manual will include more advanced features such as geometry and mesh smoothing. Additionally, all the options for the mesh_adapt code will be described in detail. Capabilities for local adaptivity in the context of offline adaptivity will also be included. This page intentionally left blank.

Feasibility of recycling thorium in a fusion-fission hybrid/PWR symbiotic system

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

Josephs, J.M.

1980-12-31

A study was made of the economic impact of high levels of radioactivity in the thorium fuel cycle. The sources of this radioactivity and means of calculating the radioactive levels at various stages in the fuel cycle are discussed and estimates of expected levels are given. The feasibility of various methods of recycling thorium is discussed. These methods include direct recycle, recycle after storage for 14 years to allow radioactivity to decrease, shortening irradiation times to limit radioactivity build up, and the use of the window in time immediately after reprocessing where radioactivity levels are diminished. An economic comparison ismore » made for the first two methods together with the throwaway option where thorium is not recycled using a mass energy flow model developed for a CTHR (Commercial Tokamak Hybrid Reactor), a fusion fission hybrid reactor which serves as fuel producer for several PWR reactors. The storage option is found to be most favorable; however, even this option represents a significant economic impact due to radioactivity of 0.074 mills/kW-h which amounts to $4 x 10/sup 9/ over a 30 year period assuming a 200 gigawatt supply of electrical power.« less

Plantar Hyperhidrosis: An Overview.

PubMed

Vlahovic, Tracey C

2016-07-01

Plantar hyperhidrosis, excessive sweating on the soles of feet, can have a significant impact on patients' quality of life and emotional well-being. Hyperhidrosis is divided into primary and secondary categories, depending on the cause of the sweating, with plantar hyperhidrosis typically being primary and idiopathic. There is an overall increased risk of cutaneous infection in the presence of hyperhidrosis, including fungal, bacterial, and viral infections. This article discusses a range of treatment options including topical aluminum chloride, iontophoresis, injectable botulinum toxin A, glycopyrrolate, oxybutynin, laser, and endoscopic lumbar sympathectomy. Lifestyle changes regarding hygiene, shoe gear, insoles, and socks are also discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Policy options for increasing the supply of transplantable kidneys in Singapore

PubMed Central

Chong, Jia Loon

2016-01-01

Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation. I conclude by highlighting the most feasible policies to be considered. PMID:27779281

Dish systems for CSP

DOE PAGES

Coventry, Joe; Andraka, Charles

2017-03-22

Parabolic dish technology, for concentrating solar power (CSP) applications, has been continuously modified and improved since the pioneering work in the 1970s. Best practice dishes now have features such as lightweight structure, balanced design, high-quality, low-cost mirror panels, and can be deployed rapidly with little in-field labour. This review focuses on the evolution of dish design, by examining features such as mode of tracking, structure and mirror design, for a wide selection of CSP dish examples. Finally, the review includes a brief summary of power generation options – both on-dish and central plant – as well as a discussion aboutmore » options for storage and hybridisation.« less

Portal Vein Embolization: State-of-the-Art Technique and Options to Improve Liver Hypertrophy.

PubMed

Huang, Steven Y; Aloia, Thomas A

2017-12-01

Portal vein embolization (PVE) is associated with a high technical and clinical success rate for induction of future liver remnant hypertrophy prior to surgical resection. The degree of hypertrophy is variable and depends on multiple factors, including technical aspects of the procedure and underlying chronic liver disease. For patients with insufficient liver volume following PVE, adjunctive techniques, such as intra-portal administration of stem cells, dietary supplementation, transarterial embolization, and hepatic vein embolization, are available. Our purpose is to review the state-of-the-art technique associated with high-quality PVE and to discuss options to improve hypertrophy of the future liver remnant.

Pawnee Nation Energy Option Analyses

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

Matlock, M.; Kersey, K.; Riding In, C.

2009-07-31

In 2003, the Pawnee Nation leadership identified the need for the tribe to comprehensively address its energy issues. During a strategic energy planning workshop a general framework was laid out and the Pawnee Nation Energy Task Force was created to work toward further development of the tribe’s energy vision. The overarching goals of the “first steps” project were to identify the most appropriate focus for its strategic energy initiatives going forward, and to provide information necessary to take the next steps in pursuit of the “best fit” energy options. Based on the request of Pawnee Nation’s Energy Task Force themore » research team, consisting Tribal personnel and Summit Blue Consulting, focused on a review of renewable energy resource development potential, funding sources and utility organizational along with energy savings options. Elements of the energy demand forecasting and characterization and demand side options review remained in the scope of work, but were only addressed at a high level. Description of Activities Performed Renewable Energy Resource Development Potential The research team reviewed existing data pertaining to the availability of biomass (focusing on woody biomass, agricultural biomass/bio-energy crops, and methane capture), solar, wind and hydropower resources on the Pawnee-owned lands. Using these data, combined with assumptions about costs and revenue streams, the research team performed preliminary feasibility assessments for each resource category. The research team also reviewed available funding resources and made recommendations to Pawnee Nation highlighting those resources with the greatest potential for financially-viable development, both in the near-term and over a longer time horizon. Energy Efficiency Options While this was not a major focus of the project, the research team highlighted common strategies for reducing energy use in buildings. The team also discussed the benefits of adopting a building energy code and introduced two model energy codes Pawnee Nation should consider for adoption. Summary of Current and Expected Future Electricity Usage The research team provided a summary overview of electricity usage patterns in current buildings and included discussion of known plans for new construction. Utility Options Review Pawnee Nation electric utility options were analyzed through a four-phase process, which included: 1) summarizing the relevant utility background information; 2) gathering relevant utility assessment data; 3) developing a set of realistic Pawnee electric utility service options, and 4) analyzing the various Pawnee electric utility service options for the Pawnee Energy Team’s consideration. III. Findings and Recommendations Due to a lack of financial incentives for renewable energy, particularly at the state level, combined mediocre renewable energy resources, renewable energy development opportunities are limited for Pawnee Nation. However, near-term potential exists for development of solar hot water at the gym, and an exterior wood-fired boiler system at the tribe’s main administrative building. Pawnee Nation should also explore options for developing LFGTE resources in collaboration with the City of Pawnee. Significant potential may also exist for development of bio-energy resources within the next decade. Pawnee Nation representatives should closely monitor market developments in the bio-energy industry, establish contacts with research institutions with which the tribe could potentially partner in grant-funded research initiatives. In addition, a substantial effort by the Kaw and Cherokee tribes is underway to pursue wind development at the Chilocco School Site in northern Oklahoma where Pawnee is a joint landowner. Pawnee Nation representatives should become actively involved in these development discussions and should explore the potential for joint investment in wind development at the Chilocco site.« less

75 FR 14427 - Gulf of Mexico Fishery Management Council (Council); Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-25

.... Stephen Bortone, Executive Director, Gulf of Mexico Fishery Management Council; telephone: 813- 348-1630... Reef Fish Scientific and Statistical Committee; discuss Options Paper for Amendment 32 Gag/Red Grouper... Statistical Committee Acceptable Biological Catch Control Rule Report; discuss the Options Paper for the...

Payload Crew Training Complex (PCTC) utilization and training plan

NASA Technical Reports Server (NTRS)

Self, M. R.

1980-01-01

The physical facilities that comprise the payload crew training complex (PCTC) are described including the host simulator; experiment simulators; Spacelab aft flight deck, experiment pallet, and experiment rack mockups; the simulation director's console; payload operations control center; classrooms; and supporting soft- and hardware. The parameters of a training philosophy for payload crew training at the PCTC are established. Finally the development of the training plan is addressed including discussions of preassessment, and evaluation options.

Considerations for Solar Energy Technologies to Make Progress Towards Grid Price Parity

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

Woodhouse, Michael; Fu, Ran; Chung, Donald

2015-11-07

In this seminar the component costs for solar photovoltaics module and system prices will be highlighted. As a basis for comparison to other renewable and traditional energy options, the metric of focus will be total lifecycle cost-of-energy (LCOE). Several innovations to traditional photovoltaics technologies (including crystalline silicon, CdTe, and CIGS) and developing technologies (including organics and perovskites) that may close the gaps in LCOE will be discussed.

Evaluating fractionated space systems - Status

NASA Astrophysics Data System (ADS)

Cornford, S.; Jenkins, S.; Wall, S.; Cole, B.; Bairstow, B.; Rouquette, N.; Dubos, G.; Ryan, T.; Zarifian, P.; Boutwell, J.

DARPA has funded a number of teams to further refine its Fractionated Spacecraft vision. Several teams, including this team led by JPL, have been tasked to develop a tool for the evaluation of the Business case for a fractionated system architecture. This evaluation is to understand under what conditions and constraints the fractionated architecture make more sense (in a cost/benefit sense) than the traditional monolithic paradigm. Our approach to this evaluation is to generate and evaluate a variety of trade space options. These options include various sets of stimuli, various degrees of fractionation and various subsystem element properties. The stimuli include many not normally modeled such as technology obsolescence, funding profile changes and changes in mission objectives during the mission itself. The degrees of fractionation enable various traditional subsystem elements to be distributed across different free flyers which then act in concert as needed. This will enable key technologies to be updated as need dictates and availability allows. We have described our approach in a previous IEEE Aerospace conference paper but will briefly summarize here. Our approach to generate the Business Case evaluation is to explicitly model both the implementation and operation phases for the life cycle of a fractionated constellation. A variety of models are integrated into the Phoenix ModelCenter framework and are used to generate various intermediate data which is aggregated into the Present Strategic Value (PSV). The PSV is essentially the value (including the value of the embedded real options) minus the cost. These PSVs are calculated for a variety of configurations and scenarios including variations of various stimuli or uncertainties (e.g. supply chain delays, launch vehicle failures and orbital debris events). There are various decision options (e.g. delay, accelerate, cancel) which can now be exercised for each stimulus. We can compute the PSV for the various comb- nations and populate a tradespace. We have developed tooling to allow models to be automatically created and executed allowing us to explore large numbers of options with no human intervention. The methodology, models and the process by which they are integrated were a key subset of the previous paper. We will present the results of the Business Case analyses for a variety of configurations and scenarios, present the populated tradespace, show the GUI we have developed to facilitate the use of the tool and discuss the implications of both the results and our work to date. We will also discuss future work and possible approaches for that work.

'We have to discuss it': cancer patients' advance care planning impressions following educational information about cardiopulmonary resuscitation.

PubMed

Epstein, A S; Shuk, E; O'Reilly, E M; Gary, K A; Volandes, A E

2015-12-01

Most cancer patients desire information about care options at the end of life, including cardiopulmonary resuscitation (CPR). Communicating such care options can be challenging and is part of advance care planning (ACP). Our prior studies with video educational media produced data on patients' categoric preferences (yes/no/unsure) for CPR; however, the thematic underpinnings of these educated preferences in patients treated for advanced cancer aren't well known. Qualitative thematic content analysis of participants' responses in a randomized trial of an educational video (V) or narrative (N) about CPR in patients with advanced gastrointestinal cancers. Responses were independently coded and categorized for thematic content by two reviewers. Of 54 study participants, 26 total (41% of V arm, 56% of N arm) articulated questions, comments, or both. Reviewer analyses demonstrated thematic consensus and resulted in seven distinct themes listed in decreasing order of prevalence: (a) ACP should be started early; (b) educational information about CPR affirmed participants' existing beliefs/knowledge/values about advanced illness; (c) participants were apprehensive about ACP but wanted to discuss it; (d) gaps in knowledge about ACP emerged; (e) CPR information was helpful/acceptable; (f) physicians should be involved in ACP; and (g) medical questions about critical illness arose. Findings identified that while sometimes difficult to discuss, advance care planning is desired, deemed helpful, and ideally begun early by clinicians, and that video education is an appropriate and affirming initiator of discussions. These themes are incorporated into our ongoing research on cancer patient-specific values and education about care options. Copyright © 2015 John Wiley & Sons, Ltd.

Space Operations Center system analysis study extension. Volume 2: Programmatics and cost

NASA Technical Reports Server (NTRS)

1982-01-01

A summary of Space Operations Center (SOC) orbital space station costs, program options and program recommendations is presented. Program structure, hardware commonality, schedules and program phasing are considered. Program options are analyzed with respect to mission needs, design and technology options, and anticipated funding constraints. Design and system options are discussed.

Help Options in CALL: A Systematic Review

ERIC Educational Resources Information Center

Cardenas-Claros, Monica S.; Gruba, Paul A.

2009-01-01

This paper is a systematic review of research investigating help options in the different language skills in computer-assisted language learning (CALL). In this review, emerging themes along with is-sues affecting help option research are identified and discussed. We argue that help options in CALL are application resources that do not only seem…

AVA Guide to Federal Funding for Tech Prep.

ERIC Educational Resources Information Center

Brustein, Michael

This handbook outlines the options and requirements for federal support for tech prep in the Perkins law. It explains what educators must do and not do to assure compliance with all the law's mandates and to avoid audit exceptions. The guide also covers new tech prep provisions that were included in the Higher Education Act of 1992. Discussed in…

Commentary to "Multiple Grammars and Second Language Representation," by Luiz Amaral and Tom Roeper

ERIC Educational Resources Information Center

Pérez-Leroux, Ana T.

2014-01-01

In this commentary, the author defends the Multiple Grammars (MG) theory proposed by Luiz Amaral and Tom Roepe (A&R) in the present issue. Topics discussed include second language acquisition, the concept of developmental optionality, and the idea that structural decisions involve the lexical dimension. The author states that A&R's…

Sourcebook for English Teachers: Directed Reading/Teaching Guides for Selected Literacy Works. Volume 2.

ERIC Educational Resources Information Center

Ley, Terry C., Ed.

This sourcebook presents reading guides for 27 literary works frequently used by secondary school English teachers. The guides contain an overview of the work, a pool of instructional objectives for each work, a variety of activities, a series of discussion options, suggestions for evaluation, and annotated lists of related works. Included are:…

Omnivorous Representation Might Lead to Indigestion: Commentary on Amaral and Roeper

ERIC Educational Resources Information Center

Slabakova, Roumyana

2014-01-01

This article offers commentary that the Multiple Grammar (MG) language acquisition theory proposed by Luiz Amaral and Tom Roeper (A&R) in the present issue lacks elaboration of the psychological mechanisms at work in second language acquisition. Topics discussed include optionality in a speaker's grammar and the rules of verb position in…

Approaches to the Teaching of Bioethics and Professional Ethics in Undergraduate Courses

ERIC Educational Resources Information Center

Downie, Roger; Clarkeburn, Henriikka

2005-01-01

The role of ethics in bioscience undergraduate degrees is now widely accepted, but how ethics should be taught, who should teach it and what the curriculum should include are matters for debate. This article discusses teaching strategies: specialist options, or embed ethics in other courses, or both; use of professional philosophers, or…

Sourcebook for English Teachers: Directed Reading/Teaching Guides for Selected Literary Works. Volume 1.

ERIC Educational Resources Information Center

Ley, Terry C., Ed.

This sourcebook presents reading guides for 22 literary works frequently used by secondary school English teachers. The guides contain an overview of the work, a pool of instructional objectives for each work, a variety of activities, a series of discussion options, suggestions for evaluation, and annotated lists of related works. Included are:…

Dynamic overset grid communication on distributed memory parallel processors

NASA Technical Reports Server (NTRS)

Barszcz, Eric; Weeratunga, Sisira K.; Meakin, Robert L.

1993-01-01

A parallel distributed memory implementation of intergrid communication for dynamic overset grids is presented. Included are discussions of various options considered during development. Results are presented comparing an Intel iPSC/860 to a single processor Cray Y-MP. Results for grids in relative motion show the iPSC/860 implementation to be faster than the Cray implementation.

Making the Choice: Helping Your Students Explore College Options.

ERIC Educational Resources Information Center

Cantor, Jonathan

2002-01-01

Notes that for prospective theater majors, the choice between pursuing the Bachelor of Fine Arts or the Bachelor of Arts degree is crucial to the student's chances of success in college. Discusses how the degrees differ and how to advise students. Includes some questions that prospective students should ask of theatre programs, and notes answers…

Sourcebook for English Teachers: Directed Reading/Teaching Guides for Selected Literacy Works. Volume 3.

ERIC Educational Resources Information Center

Ley, Terry C., Ed.

This sourcebook presents reading guides for 39 literary works frequently used by scondary school English teachers. The guides contain an overview of the work, a pool of instructional objectives for each work, a variety of activities, a series of discussion options, suggestions for evaluation, and annotated lists of related works. Included are:…

78 FR 62775 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... Purpose of, and Statutory Basis for, the Proposed Rule Change In its filing with the Commission, the Exchange included statements concerning the purpose of and basis for the proposed rule change and discussed... Organization's Statement of the Purpose of, and Statutory Basis for, the Proposed Rule Change 1. Purpose By way...

Duloxetine for the treatment of fibromyalgia

PubMed Central

Wright, Cheryl L; Mist, Scott D; Ross, Rebecca L; Jones, Kim D

2011-01-01

This article presents a brief review of the physiologic abnormalities seen in fibromyalgia, current theories of widespread pain, and treatment options, including emerging therapeutics, with a focus on the use of duloxetine to manage fibromyalgia symptoms. Major clinical trials that examine the efficacy and effectiveness of duloxetine to date are reviewed, and safety issues are discussed. PMID:20828282

Office-based anesthesia for the urologist.

PubMed

Galway, Ursula; Borkowski, Raymond

2013-11-01

This article describes office-based surgery and office-based anesthesia (OBA), including the safe setup of OBA and safety concerns regarding OBA. Also discussed are the preoperative selection and workup of a patient undergoing OBA, anesthetic options, the prevention and treatment of postoperative nausea, vomiting, and pain, and planning for safe discharge. Copyright © 2013 Elsevier Inc. All rights reserved.

Multi-Modal Traveler Information System - Gateway Design Options

DOT National Transportation Integrated Search

1997-05-19

The purpose of this working paper is to provide insight into the options that are available from which to design the Gateway Traveler Information System (TIS). This working paper will discuss each option in a general manner without becoming overly te...

Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment.

PubMed

Liu, James K; Gottfried, Oren N; Amini, Amin; Couldwell, William T

2004-11-15

Aneurysms arising in the petrous segment of the internal carotid artery (ICA) are rare. Although the causes of petrous ICA aneurysms remain unclear, traumatic, infectious, and congenital origins have been implicated in their development. These lesions can be detected incidentally on routine neuroimaging. Patients can also present with a wide spectrum of signs and symptoms, including cranial nerve palsies, Horner syndrome, pulsatile tinnitus, epistaxis, and otorrhagia. The treatment of petrous ICA aneurysms remains challenging. Treatment options include close observation, endovascular therapies, and surgical trapping with or without revascularization. Management dilemmas exist, particularly for incidental lesions found in asymptomatic patients. The authors review the literature and discuss the anatomy of the petrous ICA as well as the pathophysiological features of aneurysms arising in this region, and they propose a management paradigm with current treatment options.

Management options of varicoceles

PubMed Central

Chan, Peter

2011-01-01

Varicocele is one of the most common causes of male infertility. Treatment options for varicoceles includes open varicocelectomy performed at various anatomical levels. Laparoscopic varicocelectomy has been established to be a safe and effective treatment for varicoceles. Robotic surgery has been introduced recently as an alternative surgical option for varicocelectomy. Microsurgical varicocelectomy has gained increasing popularity among experts in male reproductive medicine as the treatment of choice for varicocele because of its superior surgical outcomes. There is a growing volume of literature in the recent years on minimal invasive varicocele treatment with percutaneous retrograde and anterograde venous embolization/sclerotherapy. In this review, we will discuss the advantages and limitations associated with each treatment modality for varicoceles. Employment of these advanced techniques of varicocelectomy can provide a safe and effective approach aiming to eliminate varicocele, preserve testicular function and, in a substantial number of men, increase semen quality and the likelihood of pregnancy. PMID:21716892

Multicriteria mapping of stakeholder preferences in regulating nanotechnology

NASA Astrophysics Data System (ADS)

Hansen, Steffen Foss

2010-08-01

In order to facilitate stakeholder discussions on how to regulate nanotechnology, the opensource program multicriteria mapping (MCM) was used to structure 26 interviews with stakeholders in the USA. MCM offers a systematic part quantitative, part qualitative approach to clarify why some regulatory options (bans, moratoriums, voluntary measures, etc.) were deemed to be acceptable/unacceptable by various stakeholders and which criteria stakeholders used to evaluate the different regulatory options. Adopting an incremental approach and implementing a new regulatory framework was evaluated as the best options whereas a complete ban and no additional regulation of nanotechnology were found to be the least favorable. Criteria applied differed substantially among stakeholders and included social, ethical, regulatory, environmental, and health issues. Opinions on future regulation seem far less polarized than expected and it seems that stakeholders would welcome a combination of voluntary measures, an incremental approach and forming of a new regulatory framework.

Technology Needs to Support Future Mars Exploration

NASA Technical Reports Server (NTRS)

Nilsen, Erik N.; Baker, John; Lillard, Randolph P.

2013-01-01

The Mars Program Planning Group (MPPG) under the direction of Dr. Orlando Figueroa, was chartered to develop options for a program-level architecture for robotic exploration of Mars consistent with the objective to send humans to Mars in the 2030's. Scientific pathways were defined for future exploration, and multiple architectural options were developed that meet current science goals and support the future human exploration objectives. Integral to the process was the identification of critical technologies which enable the future scientific and human exploration goals. This paper describes the process for technology capabilities identification and examines the critical capability needs identified in the MPPG process. Several critical enabling technologies that have been identified to support the robotic exploration goals and with potential feedforward application to human exploration goals. Potential roadmaps for the development and validation of these technologies are discussed, including options for subscale technology demonstrations of future human exploration technologies on robotic missions.

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes.

PubMed

Sangkum, P; Levy, J; Yafi, F A; Hellstrom, W J G

2015-05-01

Urethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized. © 2015 American Society of Andrology and European Academy of Andrology.

Nonanalytic Laboratory Automation: A Quarter Century of Progress.

PubMed

Hawker, Charles D

2017-06-01

Clinical laboratory automation has blossomed since the 1989 AACC meeting, at which Dr. Masahide Sasaki first showed a western audience what his laboratory had implemented. Many diagnostics and other vendors are now offering a variety of automated options for laboratories of all sizes. Replacing manual processing and handling procedures with automation was embraced by the laboratory community because of the obvious benefits of labor savings and improvement in turnaround time and quality. Automation was also embraced by the diagnostics vendors who saw automation as a means of incorporating the analyzers purchased by their customers into larger systems in which the benefits of automation were integrated to the analyzers.This report reviews the options that are available to laboratory customers. These options include so called task-targeted automation-modules that range from single function devices that automate single tasks (e.g., decapping or aliquoting) to multifunction workstations that incorporate several of the functions of a laboratory sample processing department. The options also include total laboratory automation systems that use conveyors to link sample processing functions to analyzers and often include postanalytical features such as refrigerated storage and sample retrieval.Most importantly, this report reviews a recommended process for evaluating the need for new automation and for identifying the specific requirements of a laboratory and developing solutions that can meet those requirements. The report also discusses some of the practical considerations facing a laboratory in a new implementation and reviews the concept of machine vision to replace human inspections. © 2017 American Association for Clinical Chemistry.

NSUF Ion Beam Investment Options Workshop Report

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

Heidrich, Brenden John

2016-03-01

The workshop that generated this data was convened to develop a set of recommendations (a priority list) for possible funding in the area of US domestic ion beam irradiation capabilities for nuclear energy-focused RD&D. The results of this workshop were intended for use by the Department of Energy - Office of Nuclear Energy (DOE-NE) for consideration of support for these facilities. The workshop considered, as part of the initial potential future support discussions, input submitted through the Office of Nuclear Energy Request for Information (RFI) (DE-SOL-0008318, April 13, 2015), but welcomed discussion (and presentation) of other options, whether specific ormore » general in scope. Input from users, including DOE-NE program interests and needs for ion irradiation RD&D were also included. Participants were selected from various sources: RFI respondents, NEUP/NEET infrastructure applicants, universities with known expertise in nuclear engineering and materials science and other developed sources. During the three days from March 22-24, 2016, the workshop was held at the Idaho National Laboratory Meeting Center in the Energy Innovation Laboratory at 775 University Drive, Idaho Falls, ID 83401. Thirty-one members of the ion beam community attended the workshop, including 15 ion beam facilities, six representatives of Office of Nuclear Energy R&D programs, an industry representative from EPRI and the chairs of the NSUF User’s Organization and the NSUF Scientific Review Board. Another four ion beam users were in attendance acting as advisors to the process, but did not participate in the options assessment. Three members of the sponsoring agency, the Office of Science and Technology Innovation (NE-4) also attended the workshop.« less

Tracheostomy: pediatric considerations.

PubMed

Deutsch, Ellen S

2010-08-01

Pediatric patients for whom tracheotomy is a consideration have different anatomy, medical conditions, and prognoses than adults; even the tracheotomy tubes are different. Indications for pediatric tracheotomy generally include bypassing airway obstruction, providing access for prolonged mechanical ventilation, and facilitating tracheobronchial toilet. Subglottic stenosis is an important indication for tracheotomy in children; its etiology, prevention, and alternative options for management are presented. Discussion includes the benefits, risks, impact on families, techniques for tracheotomy tube changes, and alternatives to tracheotomy, with illustrative photographs and diagrams.

Discussion of Policies for Achieving Continuous Improvement in Community Colleges. Commission on Innovation Policy Discussion Paper Number 1.

ERIC Educational Resources Information Center

BW Associates, Berkeley, CA.

Intended to provide background information and preliminary options for the California Community Colleges' Commission on Innovation, this document describes the principles of Continuous Quality Improvement (CQI) and describes policy options for implementation in the state's community colleges. Following introductory materials, the paper recommends…

TECHNOLOGICAL OPTIONS FOR ACID RAIN CONTROL

EPA Science Inventory

The paper discusses technological options for acid rain control. Compliance with Title IV of the Clean Air Act Amendments of 1990 will require careful scrutiny of a number of issues before selecting control options to reduce sulfur dioxide (SO2) and nitrogen oxide (NOx) emissions...

SPAN security policies and guidelines

NASA Technical Reports Server (NTRS)

Sisson, Patricia L.; Green, James L.

1989-01-01

A guide is provided to system security with emphasis on requirements and guidelines that are necessary to maintain an acceptable level of security on the network. To have security for the network, each node on the network must be secure. Therefore, each system manager, must strictly adhere to the requirements and must consider implementing the guidelines discussed. There are areas of vulnerability within the operating system that may not be addressed. However, when a requirement or guideline is discussed, implementation techniques are included. Information related to computer and data security is discussed to provide information on implementation options. The information is presented as it relates to a VAX computer environment.

The utilization of solar energy to help meet our nation's energy needs

NASA Technical Reports Server (NTRS)

Thomas, R. L.

1973-01-01

The nation's energy needs, domestic energy resources, and possible future energy resources are briefly discussed in this paper. Three potential solutions, coal, nuclear and solar are compared as to benefits and problems. The paper primarily discusses the options available in using solar energy as a natural energy resource. These options are discussed under the generation of electricity, heating and cooling of buildings, and the production of clean fuel.

A space parasol as a countermeasure against the greenhouse effect

NASA Technical Reports Server (NTRS)

Hudson, H. S.

1991-01-01

It is suggested that the deployment of a 'space parasol' at the L1 Langrangian point of the earth-sun system would serve to intercept some desired fraction of the solar radiant energy, thereby lessening the impact of the greenhouse effect. The parasol satellites are described and possible orbit configurations are discussed. Orbital possibilities include Low Earth Orbit, Geosynchronous orbit, and L1 which appears to be the best option. Structural strength, control, and use of extraterrestrial material in the construction of the parasol are discussed.

Enhancing the online presence of a dental practice.

PubMed

McLeod, Neil S

2012-04-01

This article describes methods for enhancing the online presence of a dental practice to gain market share and facilitate communication with current and prospective patients. Topics discussed include creation of a website that will help patients easily locate the practice. The importance of back links and embedded keywords is stressed. A method for identifying competitors' online marketing strategies also is presented, along with discussions of patient reviews and pay-per-click advertising options. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Referenced-site environmental document for a Monitored Retrievable Storage facility: backup waste management option for handling 1800 MTU per year

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

Silviera, D.J.; Aaberg, R.L.; Cushing, C.E.

This environmental document includes a discussion of the purpose of a monitored retrievable storage facility, a description of two facility design concepts (sealed storage cask and field drywell), a description of three reference sites (arid, warm-wet, and cold-wet), and a discussion and comparison of the impacts associated with each of the six site/concept combinations. This analysis is based on a 15,000-MTU storage capacity and a throughput rate of up to 1800 MTU per year.

The How-To for Type 2: An Overview of Diagnosis and Management of Type 2 Diabetes Mellitus.

PubMed

Dodds, Seliece

2017-12-01

This article presents an overview of type 2 diabetes diagnosis and management. A brief discussion of epidemiology, including incidence, prevalence, and etiology, provides the basis for the importance of the discussion. The review then proceeds to outline diagnostic criteria and follow-up monitoring guidelines. Recommendations for evidence-based lifestyle measures and current pharmacologic options are addressed. A priority on individualized, holistic care with patient-specified goals and the management of comorbidities is emphasized. Copyright © 2017 Elsevier Inc. All rights reserved.

The Global Challenge of Antimicrobial Resistance: Insights from Economic Analysis

PubMed Central

Eggleston, Karen; Zhang, Ruifang; Zeckhauser, Richard J.

2010-01-01

The prevalence of antimicrobial resistance (AR) limits the therapeutic options for treatment of infections, and increases the social benefit from disease prevention. Like an environmental resource, antimicrobials require stewardship. The effectiveness of an antimicrobial agent is a global public good. We argue for greater use of economic analysis as an input to policy discussion about AR, including for understanding the incentives underlying health behaviors that spawn AR, and to supplement other methods of tracing the evolution of AR internationally. We also discuss integrating antimicrobial stewardship into global health governance. PMID:20948953

Satellite Power System. Concept development and evaluation program, volume 6: Construction and operations

NASA Technical Reports Server (NTRS)

Benson, H.; Jenkins, L. M.

1981-01-01

The construction, operation, and maintenance requirements for a solar power satellite, including the space and ground systems, are reviewed. The basic construction guidelines are explained, and construction location options are discussed. The space construction tasks, equipment, and base configurations are discussed together with the operations required to place a solar power satellite in geosynchronous orbit. A rectenna construction technique is explained, and operation with the grid is defined. Maintenance requirements are summarized for the entire system. Key technology issues required for solar power satellite construction operations are defined.

Treatment options for chronic pancreatitis.

PubMed

Issa, Yama; Bruno, Marco J; Bakker, Olaf J; Besselink, Marc G; Schepers, Nicolien J; van Santvoort, Hjalmar C; Gooszen, Hein G; Boermeester, Marja A

2014-09-01

This Review covers the latest developments in the treatment options for chronic pancreatitis. Pain is the most frequent and dominant symptom in patients with chronic pancreatitis, which ranges from severe disabling continuous pain to mild pain attacks and pain-free periods. Conventional treatment strategies and recent changes in the treatment of pain in patients with chronic pancreatitis are outlined. The different treatment options for pain consist of medical therapy, endoscopy or surgery. Their related merits and drawbacks are discussed. Finally, novel insights in the field of genetics and microbiota are summarized, and future perspectives are discussed.

Low cost solar cell arrays

NASA Technical Reports Server (NTRS)

Iles, P. A.; Mclennan, H.

1975-01-01

Limitations in both space and terrestial markets for solar cells are described. Based on knowledge of the state-of-the-art, six cell options are discussed; as a result of this discussion, the three most promising options (involving high, medium and low efficiency cells respectively) were selected and analyzed for their probable costs. The results showed that all three cell options gave promise of costs below $10 per watt in the near future. Before further cost reductions can be achieved, more R and D work is required; suggestions for suitable programs are given.

Preanesthetic Assessment of the Jehovah's Witness Patient

PubMed Central

Lin, Eric S.; Kaye, Alan D.; Baluch, Amir R.

2012-01-01

The Jehovah's Witnesses, a religious group of 7 million people in more than 200 countries, teaches its followers to not accept blood, resulting in potentially challenging and ethical dilemmas for anesthesiologists. In recent years, Jehovah's Witnesses changed certain elements of their approach to blood transfusion practice, including accepting autologous transfusions in certain circumstances. We examine mechanisms to resolve ethical conflicts, such as additional medical consultations with other involved physicians, surgeons, and anesthesiologists; short-term counseling or psychiatric consultation for patient and family; case management conferences; consultation with individuals trained in clinical ethics or a hospital-based ethics committee; and discussions with hospital administration. We also discuss treatment options, including certain blood products, anesthetic techniques, and pharmacological interventions. PMID:22438784

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

The Guaranteed Student Loan Program: Options for Controlling Federal Costs While Preserving Needed Credit for College. A Discussion Paper.

ERIC Educational Resources Information Center

College Entrance Examination Board, Washington, DC.

The Reagan Administration's proposals concerning the Guaranteed Student Loan (GSL) Program and possible alternatives are examined. A variety of proposals are analyzed in terms of the estimated cost savings and potential effects on the supply of and demand for student loans. Background is also included on the history of legislative changes and…

A Balanced Marine Aquarium [and] The Biology of Marine Aquarium Fishes Collected in Monroe County, Florida. A Two-Paper NOAA Technical Memorandum.

ERIC Educational Resources Information Center

Palko, Barbara Jayne; And Others

This document consists of two separate papers. The first paper, "A Balanced Marine Aquarium" (Barbara Jayne Palko), discusses various aspects of a balanced marine aquarium. Information provided includes the basic and optional equipment needed to construct a balanced aquarium, preparations for setting up the aquarium, preparing the…

Well Wishes: A Case on Septic Systems and Well Water Requiring In-Depth Analysis and Including Optional Laboratory Experiments

ERIC Educational Resources Information Center

Walczak, Mary M.; Lantz, Juliette M.

2004-01-01

The case of Well Wishes involves students in a thorough examination of the interaction among nitrogen-composed species in the septic systems and well water, which helps to clean household water. The case supports the attainment of five goals for students, and can be analyzed through classroom discussions or laboratory experiments.

Non-extraction treatment of a Class III skeletal case.

PubMed

Gonzalez, Bulmario

2009-01-01

Adult Class III Skeletal treatment options have generally included some form of surgery (Maxillary advancement in midface deficient cases and/or Mandibular set-back). This article discusses non-surgical treatment of an adult patient using the combined concepts of mandibular molar distalization enhanced with TADs and non-extraction camouflage dental correction through maxillary incisor protraction and mandibular incisor lingualization.

[Vasovagal syncope as a cause of serious body injury - two case reports].

PubMed

Gajek, Jacek; Zyśko, Dorota

2003-04-01

Vasovagal syncope is a reflex reaction, leading to marked hypotension and/or bradycardia with transient loss of consciousness and the postural muscle tone. The recovery is spontaneous and usually rapid. Serious body injuries caused by fainting are rare. We present two patients with vasovagal syncope which caused serious injury. Different therapeutic options, including pacemaker implantation, are discussed.

College Today, Part III: College Closings. Options in Education Transcript: Program No. 121.

ERIC Educational Resources Information Center

George Washington Univ., Washington, DC. Inst. for Educational Leadership.

The closing of a college is the topic of the third in a series of four transcripts of radio programs on college today. The dialogue includes: a press conference at Lone Mountain College, with a discussion of financial problems by the president and comments by Lone Mountain's student body president, college vice president, art department chairman,…

The Role of the MELVYL System in University of California Library Automation: The Next Five Years. Technical Report No. 5.

ERIC Educational Resources Information Center

California Univ., Oakland. Div. of Library Automation.

This report on options for developing the University of California (UC) MELVYL online library system discusses the system in relationship to the current environment, including national and network information resources, electronic publishing, campus libraries, and changing user expectations; and places the growth of the MELVYL system in the…

Non-pharmacological treatment options for refractory epilepsy: an overview of human treatment modalities and their potential utility in dogs.

PubMed

Martlé, Valentine; Van Ham, Luc; Raedt, Robrecht; Vonck, Kristl; Boon, Paul; Bhatti, Sofie

2014-03-01

Refractory epilepsy is a common disorder both in humans and dogs and treatment protocols are difficult to optimise. In humans, different non-pharmacological treatment modalities currently available include surgery, the ketogenic diet and neurostimulation. Surgery leads to freedom from seizures in 50-75% of patients, but requires strict patient selection. The ketogenic diet is indicated in severe childhood epilepsies, but efficacy is limited and long-term compliance can be problematic. In the past decade, various types of neurostimulation have emerged as promising treatment modalities for humans with refractory epilepsy. Currently, none of these treatment options are used in routine daily clinical practice to treat dogs with the condition. Since many dogs with poorly controlled seizures do not survive, the search for alternative treatment options for canine refractory epilepsy should be prioritised. This review provides an overview of non-pharmacological treatment options for human refractory epilepsy. The current knowledge and limitations of these treatments in canine refractory epilepsy is also discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Recurrent pericarditis: new and emerging therapeutic options.

PubMed

Imazio, Massimo; Lazaros, George; Brucato, Antonio; Gaita, Fiorenzo

2016-02-01

Recurrent pericarditis is one of the most common and troublesome complications after an episode of pericarditis, and affects 20-50% of patients treated for pericarditis. In most of these patients, the pericarditis remains idiopathic, although an immune-mediated (either autoimmune or autoinflammatory) pathogenesis is often presumed. The mainstay of therapy for recurrences is aspirin or NSAIDs, with the adjunct of colchicine. Corticosteroids are a second-line option to be considered for specific indications, such as connective tissue disease or pregnancy; contraindications or intolerance to aspirin, NSAIDs, and/or colchicine; or insufficient response to these medications. Furthermore, corticosteroids can be added to NSAIDs and colchicine in patients with persistent symptoms. In patients who do not respond adequately to any of these conventional therapies, alternative treatment options include azathioprine, intravenous human immunoglobulins, and anakinra. An improved understanding of how recurrent pericarditis develops after an initiating event is critical to prevent this complication, and further research is needed into the pathogenesis of recurrences. We discuss the aetiology and diagnosis of recurrent pericarditis, and extensively review the treatment options for this condition.

Principles of treatment for mammary gland tumors.

PubMed

Novosad, C Andrew

2003-05-01

The mammary glands are frequent locations for the development of tumors. In the dog and cat, early detection and rapid therapy are necessary to prevent both local and distant metastasis. In the dog, this disease can have a range of biologic behaviors, whereas in the cat it is almost always an extremely aggressive disease. Treatment options depend on tumor staging and can include surgery, radiation therapy, chemotherapy, or a combination. As we become better at early diagnosis and are able to implement aggressive therapy, we are becoming more and more successful in the treatment of this disease. In the following article, we will discuss current thoughts surrounding the diagnosis and treatment options for both canine and feline mammary gland tumors.

Policy options for increasing the supply of transplantable kidneys in Singapore.

PubMed

Chong, Jia Loon

2016-10-01

Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation. I conclude by highlighting the most feasible policies to be considered. Copyright: © Singapore Medical Association.

The pricing of European options on two underlying assets with delays

NASA Astrophysics Data System (ADS)

Lin, Lisha; Li, Yaqiong; Wu, Jing

2018-04-01

In the paper, the pricing of European options on two underlying assets with delays is discussed. By using the approach of equivalent martingale measure transformation, the market is proved to be complete. With exchange option as a particular example, we obtain the explicit pricing formula in a subinterval of option period. The robust Euler-Maruyama method is combined with the Monte Carlo simulation to compute exchange option prices within the whole option period. Numerical experiments indicate that there is an increasing possibility of the difference between the delayed and Black-Scholes option prices with the increase of delay.

Cost, energy, global warming, eutrophication and local human health impacts of community water and sanitation service options.

PubMed

Schoen, Mary E; Xue, Xiaobo; Wood, Alison; Hawkins, Troy R; Garland, Jay; Ashbolt, Nicholas J

2017-02-01

We compared water and sanitation system options for a coastal community across selected sustainability metrics, including environmental impact (i.e., life cycle eutrophication potential, energy consumption, and global warming potential), equivalent annual cost, and local human health impact. We computed normalized metric scores, which we used to discuss the options' strengths and weaknesses, and conducted sensitivity analysis of the scores to changes in variable and uncertain input parameters. The alternative systems, which combined centralized drinking water with sanitation services based on the concepts of energy and nutrient recovery as well as on-site water reuse, had reduced environmental and local human health impacts and costs than the conventional, centralized option. Of the selected sustainability metrics, the greatest advantages of the alternative community water systems (compared to the conventional system) were in terms of local human health impact and eutrophication potential, despite large, outstanding uncertainties. Of the alternative options, the systems with on-site water reuse and energy recovery technologies had the least local human health impact; however, the cost of these options was highly variable and the energy consumption was comparable to on-site alternatives without water reuse or energy recovery, due to on-site reuse treatment. Future work should aim to reduce the uncertainty in the energy recovery process and explore the health risks associated with less costly, on-site water treatment options. Copyright © 2016 Elsevier Ltd. All rights reserved.

Spacelab experiment computer study. Volume 1: Executive summary (presentation)

NASA Technical Reports Server (NTRS)

Lewis, J. L.; Hodges, B. C.; Christy, J. O.

1976-01-01

A quantitative cost for various Spacelab flight hardware configurations is provided along with varied software development options. A cost analysis of Spacelab computer hardware and software is presented. The cost study is discussed based on utilization of a central experiment computer with optional auxillary equipment. Groundrules and assumptions used in deriving the costing methods for all options in the Spacelab experiment study are presented. The groundrules and assumptions, are analysed and the options along with their cost considerations, are discussed. It is concluded that Spacelab program cost for software development and maintenance is independent of experimental hardware and software options, that distributed standard computer concept simplifies software integration without a significant increase in cost, and that decisions on flight computer hardware configurations should not be made until payload selection for a given mission and a detailed analysis of the mission requirements are completed.

Causes and Diagnosis of Abnormal Vaginal Bleeding.

PubMed

Sokol, Elizabeth; Peddinti, Radhika

2015-07-01

Abnormal vaginal bleeding in a postmenarchal adolescent patient is most often related to dysfunctional uterine bleeding. However, there are other potential etiologies, including hematologic disorders, infections, and oncologic problems. We present a 12-year-old girl who presented with prolonged vaginal bleeding and was ultimately diagnosed with rhabdomyosarcoma. In this article, we discuss the approach to a patient with vaginal bleeding along with a more in-depth review of risk stratification in rhabdomyosarcoma, including treatment options such as chemotherapy, surgery, and radiation therapy. Copyright 2015, SLACK Incorporated.

Social cost considerations and legal constraints in implementing modular integrated utility systems

NASA Technical Reports Server (NTRS)

Lede, N. W.; Dixon, H. W.; King, O.; Hill, D. K.

1974-01-01

Social costs associated with the design, demonstration, and implementation of the Modular Integrated Utility System are considered including the social climate of communities, leadership patterns, conflicts and cleavages, specific developmental values, MIUS utility goal assessment, and the suitability of certian alternative options for use in a program of implementation. General considerations are discussed in the field of socio-technological planning. These include guidelines for understanding the conflict and diversity; some relevant goal choices and ideas useful to planners of the MIUS facility.

Real options analysis for land use management: Methods, application, and implications for policy.

PubMed

Regan, Courtney M; Bryan, Brett A; Connor, Jeffery D; Meyer, Wayne S; Ostendorf, Bertram; Zhu, Zili; Bao, Chenming

2015-09-15

Discounted cash flow analysis, including net present value is an established way to value land use and management investments which accounts for the time-value of money. However, it provides a static view and assumes passive commitment to an investment strategy when real world land use and management investment decisions are characterised by uncertainty, irreversibility, change, and adaptation. Real options analysis has been proposed as a better valuation method under uncertainty and where the opportunity exists to delay investment decisions, pending more information. We briefly review the use of discounted cash flow methods in land use and management and discuss their benefits and limitations. We then provide an overview of real options analysis, describe the main analytical methods, and summarize its application to land use investment decisions. Real options analysis is largely underutilized in evaluating land use decisions, despite uncertainty in policy and economic drivers, the irreversibility and sunk costs involved. New simulation methods offer the potential for overcoming current technical challenges to implementation as demonstrated with a real options simulation model used to evaluate an agricultural land use decision in South Australia. We conclude that considering option values in future policy design will provide a more realistic assessment of landholder investment decision making and provide insights for improved policy performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strategy for the Identification of an INL Comprehensive Utility Corridor

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

John Reisenauer

2011-05-01

This report documents the strategy developed to identify a comprehensive utility corridor (CUC) on the Idaho National Laboratory (INL) Site. The strategy established the process for which the Campus Development Office will evaluate land management issues. It is a process that uses geographical information system geospatial technology to layer critical INL mission information in a way that thorough evaluations can be conducted and strategies developed. The objective of the CUC Project was to develop a process that could be implemented to identify potential utility corridor options for consideration. The process had to take into account all the missions occurring onmore » the INL and other land-related issues. The process for developing a CUC strategy consists of the following four basic elements using geographical information system capabilities: 1. Development of an INL base layer map; this base layer map geospatially references all stationary geographical features on INL and sitewide information. 2. Development of current and future mission land-use need maps; this involved working with each directorate to identify current mission land use needs and future land use needs that project 30 years into the future. 3. Development of restricted and potential constraint maps; this included geospatially mapping areas such as wells, contaminated areas, firing ranges, cultural areas, ecological areas, hunting areas, easement, and grazing areas. 4. Development of state highway and power line rights of way map; this included geospatially mapping rights-of-way along existing state highways and power lines running through the INL that support INL operations. It was determined after completing and evaluating the geospatial information that the area with the least impact to INL missions was around the perimeter of the INL Site. Option 1, in this document, identifies this perimeter; however, it does not mean the entire perimeter is viable. Many places along the perimeter corridor cannot be used or are not economically viable. Specific detailed studies will need to be conducted on a case-by-case basis to clearly identify which sections along the perimeter can and cannot be used. Option 2, in this document, identifies areas along existing highways that could be a viable option. However, discussions would have to take place with the State of Idaho to use their easement as part of the corridor and mission impact would need to be evaluated if a specific request was made to the Department of Energy, Idaho Operations Office. Option 3, in this document, is a combination of Options 1 and 2. This option provides the most flexibility to minimize impacts to INL missions. As with the other two options, discussions and agreements with the State of Idaho would be needed and any specific route would need to be thoroughly evaluated for impact, implementation, and operability beyond just a strategy.« less

The Concept of a Single-sex Optional Discussion Session in Introductory Astronomy at a Publicly Funded University

NASA Astrophysics Data System (ADS)

Shawl, S.

1996-12-01

The concept of single-sex education for science and mathematics has recently received renewed discussion in both the popular and professional literature. So important is the topic within higher education that the Duke Journal of Gender Law and Policy sponsored a symposium called "Gender & The Higher Education Classroom: Maximizing the Learning Environment" in February 1996 (http://www.duke.edu/ jrd4/djgcnf96.htm). The concept is especially controversial in publicly supported educational institutions. The idea of offering an optional discussion session limited to a single sex in a university-level introductory astronomy course at a State-supported school was considered through discussions with a number of faculty and administrators, and through a questionnaire aimed at determining student attitudes toward the concept. The results of the student questionnaire will be presented. (While the questionnaire results will be seen to be in favor of such an optional discussion session, such sessions have not been offered.)

Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults

PubMed Central

Hendricks, Katherine A.; Wright, Mary E.; Shadomy, Sean V.; Bradley, John S.; Morrow, Meredith G.; Pavia, Andy T.; Rubinstein, Ethan; Holty, Jon-Erik C.; Messonnier, Nancy E.; Smith, Theresa L.; Pesik, Nicki; Treadwell, Tracee A.

2014-01-01

The Centers for Disease Control and Prevention convened panels of anthrax experts to review and update guidelines for anthrax postexposure prophylaxis and treatment. The panels included civilian and military anthrax experts and clinicians with experience treating anthrax patients. Specialties represented included internal medicine, pediatrics, obstetrics, infectious disease, emergency medicine, critical care, pulmonology, hematology, and nephrology. Panelists discussed recent patients with systemic anthrax; reviews of published, unpublished, and proprietary data regarding antimicrobial drugs and anthrax antitoxins; and critical care measures of potential benefit to patients with anthrax. This article updates antimicrobial postexposure prophylaxis and antimicrobial and antitoxin treatment options and describes potentially beneficial critical care measures for persons with anthrax, including clinical procedures for infected nonpregnant adults. Changes from previous guidelines include an expanded discussion of critical care and clinical procedures and additional antimicrobial choices, including preferred antimicrobial drug treatment for possible anthrax meningitis. PMID:24447897

Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults.

PubMed

Hendricks, Katherine A; Wright, Mary E; Shadomy, Sean V; Bradley, John S; Morrow, Meredith G; Pavia, Andy T; Rubinstein, Ethan; Holty, Jon-Erik C; Messonnier, Nancy E; Smith, Theresa L; Pesik, Nicki; Treadwell, Tracee A; Bower, William A

2014-02-01

The Centers for Disease Control and Prevention convened panels of anthrax experts to review and update guidelines for anthrax postexposure prophylaxis and treatment. The panels included civilian and military anthrax experts and clinicians with experience treating anthrax patients. Specialties represented included internal medicine, pediatrics, obstetrics, infectious disease, emergency medicine, critical care, pulmonology, hematology, and nephrology. Panelists discussed recent patients with systemic anthrax; reviews of published, unpublished, and proprietary data regarding antimicrobial drugs and anthrax antitoxins; and critical care measures of potential benefit to patients with anthrax. This article updates antimicrobial postexposure prophylaxis and antimicrobial and antitoxin treatment options and describes potentially beneficial critical care measures for persons with anthrax, including clinical procedures for infected nonpregnant adults. Changes from previous guidelines include an expanded discussion of critical care and clinical procedures and additional antimicrobial choices, including preferred antimicrobial drug treatment for possible anthrax meningitis.

Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms

PubMed Central

Singh, Rahul; Nguyen, Linda; Motwani, Kartik; Swatek, Michelle

2016-01-01

Pediatric traumatic brain injury (TBI) and autism spectrum disorder (ASD) are two serious conditions that affect youth. Recent data, both preclinical and clinical, show that pediatric TBI and ASD share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. Prominent symptoms for both disorders include gastrointestinal problems, learning difficulties, seizures, and sensory processing disruption. In this review, we highlight some of these shared mechanisms in order to discuss potential treatment options that might be applied for each condition. We discuss potential therapeutic and pharmacologic options as well as potential novel drug targets. Furthermore, we highlight advances in understanding of brain circuitry that is being propelled by improved imaging modalities. Going forward, advanced imaging will help in diagnosis and treatment planning strategies for pediatric patients. Lessons from each field can be applied to design better and more rigorous trials that can be used to improve guidelines for pediatric patients suffering from TBI or ASD. PMID:28074078

The genetic basis of intradural spinal tumors and its impact on clinical treatment.

PubMed

Karsy, Michael; Guan, Jian; Sivakumar, Walavan; Neil, Jayson A; Schmidt, Meic H; Mahan, Mark A

2015-08-01

Genetic alterations in the cells of intradural spinal tumors can have a significant impact on the treatment options, counseling, and prognosis for patients. Although surgery is the primary therapy for most intradural tumors, radiochemothera-peutic modalities and targeted interventions play an ever-evolving role in treating aggressive cancers and in addressing cancer recurrence in long-term survivors. Recent studies have helped delineate specific genetic and molecular differences between intradural spinal tumors and their intracranial counterparts and have also identified significant variation in therapeutic effects on these tumors. This review discusses the genetic and molecular alterations in the most common intradural spinal tumors in both adult and pediatrie patients, including nerve sheath tumors (that is, neurofibroma and schwannoma), meningioma, ependymoma, astrocytoma (that is, low-grade glioma, anaplastic astrocytoma, and glioblastoma), hemangioblastoma, and medulloblastoma. It also examines the genetics of metastatic tumors to the spinal cord, arising either from the CNS or from systemic sources. Importantly, the impact of this knowledge on therapeutic options and its application to clinical practice are discussed.

Nystagmus and oscillopsia.

PubMed

Straube, A; Bronstein, A; Straumann, D

2012-01-01

The ocular motor system consists of several subsystems, including the vestibular ocular nystagmus saccade system, the pursuit system, the fixation and gaze-holding system and the vergence system. All these subsystems aid the stabilization of the images on the retina during eye and head movements and any kind of disturbance of one of the systems can cause instability of the eyes (e.g. nystagmus) or an inadequate eye movement causing a mismatch between head and eye movement (e.g. bilateral vestibular failure). In both situations, the subjects experience a movement of the world (oscillopsia) which is quite disturbing. New insights into the patho-physiology of some of the ocular motor disorders have helped to establish new treatment options, in particular in downbeat nystagmus, upbeat nystagmus, periodic alternating nystagmus, acquired pendular nystagmus and paroxysmal vestibular episodes/attacks. The discussed patho-physiology of these disorders and the current literature on treatment options are discussed and practical treatment recommendations are given in the paper. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

Decision Aid for Cigarette Smokers Scheduled for Elective Surgery.

PubMed

Warner, David O; LeBlanc, Annie; Kadimpati, Sandeep; Vickers, Kristin S; Shi, Yu; Montori, Victor M

2015-07-01

Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care. The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including two to three pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (P < 0.05) improved measures of decisional quality and patient involvement in decision making (Cohen's d effect sizes of 0.76 and 1.20 for the Decisional Conflict Scale and Observing PatienT involvement In decisiON-making scale, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices. Although the use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior.

Surgical margins in head and neck squamous cell carcinoma: what is 'close'?

PubMed

Alicandri-Ciufelli, Matteo; Bonali, Marco; Piccinini, Alessia; Marra, Laura; Ghidini, Angelo; Cunsolo, Elio Maria; Maiorana, Antonino; Presutti, Livio; Conte, Pier Franco

2013-09-01

The aim of this systematic review is to evaluate the definition of close margin in head and neck squamous cell carcinoma (HNSCC), and its possible prognostic significance. An appropriate string was run on PubMed to retrieve articles discussing the 'close' surgical margin issue in HNSCC. A double cross-check was performed on citations and full-text articles retrieved. In total, 348 articles were identified. Further references were included by using the option "Titles in your search terms" option in PubMed. 15 papers were finally included for qualitative synthesis. In vocal cord surgery of HNSCC, a close margin could be considered to be ≤1 mm, in the larynx ≤5 mm, in the oral cavity ≤4 mm, and in the oropharynx ≤5 mm. In each patient, the choice of extent of close margin should be balanced against general condition, tumor stage, and functional issues to indicate appropriate adjuvant therapy.

Biology of Acinetobacter baumannii: Pathogenesis, Antibiotic Resistance Mechanisms, and Prospective Treatment Options

PubMed Central

Lee, Chang-Ro; Lee, Jung Hun; Park, Moonhee; Park, Kwang Seung; Bae, Il Kwon; Kim, Young Bae; Cha, Chang-Jun; Jeong, Byeong Chul; Lee, Sang Hee

2017-01-01

Acinetobacter baumannii is undoubtedly one of the most successful pathogens responsible for hospital-acquired nosocomial infections in the modern healthcare system. Due to the prevalence of infections and outbreaks caused by multi-drug resistant A. baumannii, few antibiotics are effective for treating infections caused by this pathogen. To overcome this problem, knowledge of the pathogenesis and antibiotic resistance mechanisms of A. baumannii is important. In this review, we summarize current studies on the virulence factors that contribute to A. baumannii pathogenesis, including porins, capsular polysaccharides, lipopolysaccharides, phospholipases, outer membrane vesicles, metal acquisition systems, and protein secretion systems. Mechanisms of antibiotic resistance of this organism, including acquirement of β-lactamases, up-regulation of multidrug efflux pumps, modification of aminoglycosides, permeability defects, and alteration of target sites, are also discussed. Lastly, novel prospective treatment options for infections caused by multi-drug resistant A. baumannii are summarized. PMID:28348979

Current Standard and Investigational Approaches to the Management of Hormone-Refractory Prostate Cancer

PubMed Central

Mendiratta, Prateek; Armstrong, Andrew J; George, Daniel J

2007-01-01

Prostate cancer is a common cause of death in men and remains incurable in the metastatic setting. In 2004, 2 landmark trials using docetaxel-based chemotherapy, TAX 327 and SWOG 99-16, showed a survival benefit for the first time in metastatic, hormone-refractory prostate cancer. Current research suggests that several distinct mechanisms of androgen-refractory disease may converge in patients with disease progression on androgen deprivation therapy. These findings have identified several potential targets for therapeutic intervention. Current standard and investigational treatment options for this disease are discussed, including chemotherapy and rapidly evolving therapies in phase II/III trials involving antiangiogenic therapies, signal transduction inhibitors, immunomodulatory agents, and nuclear receptor targets. In light of a growing array of treatment options and an increasingly chronic natural history, this review supports a multidisciplinary care approach to these patients, including medical oncologists, urologists, and radiation oncologists, to optimize survival and quality of life. PMID:17387372

Space station systems analysis study. Part 2, Volume 3: Appendixes, Book 1. Program requirements documentation

NASA Technical Reports Server (NTRS)

1977-01-01

The objective elements representative of the kinds of space activities that will be supported by the space construction base (SCB) are discussed in (1) a brief mission overview including the primary purpose and general objectives; (2) descriptions of the processes involved (where applicable), the mission hardware, the principal activities to be undertaken, the test requirements, and the principal tests; and (3) the SCB requirements including such items as special devices (e.g., fabrication modules, assembly or construction fixtures, cranes, and airlocks), power, data management and communications, waste management, environmental control, safety, and logistics. Each program option is then described in terms of the objective elements it supports, its orbit, the general makeup of the SCB, the transportation approach, and the program schedule goals. The specific requirements that are imposed on the SCB in order to support program option L are given.

Microenterprise Development: An Employment Option for Welfare Recipients.

ERIC Educational Resources Information Center

Friedman, Pamela

2001-01-01

This document examines microenterprise development as an employment option for Temporary Assistance for Needy Families (TANF) recipients. The document begins with a brief discussion of the feasibility of self-employment as an option for TANF recipients, particularly in a slow economy. The next section answers policy questions pertaining to the…

32 CFR 211.9 - Mitigation Options.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Mitigation Options. 211.9 Section 211.9 National... MISSION COMPATIBILITY EVALUATION PROCESS Project Evaluation Procedures § 211.9 Mitigation Options. (a) In discussing mitigation to avoid an unacceptable risk to the national security of the United States, the DoD...

32 CFR 211.9 - Mitigation options.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Mitigation options. 211.9 Section 211.9 National... MISSION COMPATIBILITY EVALUATION PROCESS Project Evaluation Procedures § 211.9 Mitigation options. (a) In discussing mitigation to avoid an unacceptable risk to the national security of the United States, the DoD...

32 CFR 211.9 - Mitigation Options.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Mitigation Options. 211.9 Section 211.9 National... MISSION COMPATIBILITY EVALUATION PROCESS Project Evaluation Procedures § 211.9 Mitigation Options. (a) In discussing mitigation to avoid an unacceptable risk to the national security of the United States, the DoD...

Pneumocystis jirovecii Pneumonia in the Non-HIV-Infected Population.

PubMed

Avino, Laura J; Naylor, Shane M; Roecker, Andrew M

2016-08-01

Summarize data on the pathophysiology, treatment, and prevention options for non-AIDS immunocompromised patients who have Pneumocystis jirovecii pneumonia (PJP); review the epidemiology of patients presenting with PJP; and discuss the first and second-line pharmacological options for treatment and prophylaxis of PJP in this population. MEDLINE (1989-February 2016) searched. Terms searched included combinations of Pneumocystis jirovecii, Pneumocystis carinii, non-HIV, infected, patients, prevention, prophylaxis, Bactrim, treatment, AIDS, opportunistic, immunocompromised, cancer, and pathophysiology Articles included had the most relevant information on PJP pathophysiology, and first-/second-line treatment and prophylactic options. Inclusion criteria were met and evaluated with 43 sources. P jirovecii has a complicated life-cycle; it seeks to find compromised immune systems in order to replicate, causing life-threatening complications. With immunosuppressive medications coming to market for immunomodulating diseases, PJP has become a prevalent opportunistic infection in the non-HIV population. CD4+ lymphocyte count <200 cells/µL is the primary risk factor for PJP presentation in these patients. With data from clinical trials, trimethoprim/sulfamethoxazole (TMP/SMX) has become the primary treatment and prophylaxis of PJP in the non-HIV population, although second-line options are available. PJP is a health problem that may result in an increased concern as more immunomodulating medications to treat various disease states are developed. Patients on these drugs or those with immunosuppressive diseases should have their CD4+ count monitored. Health care providers should continue to use TMP/SMX as the primary option in non-HIV, immunocompromised patients for treatment and prophylaxis of PJP. © The Author(s) 2016.

Including the online feedback site, Patient Opinion, in the nursing curriculum: Exploratory study.

PubMed

Jones, Ray; Young, Kim; Munro, James; Miller, Heather; Brelsford, Stephanie; Aronsson, Jennie; Goodman, Benny; Peters, Jane

2017-10-01

Globally, universities aim to involve people who use health services to enrich the nursing curriculum for students, but there can be barriers to this involvement. Many also want students to contribute to local communities. Online communication can help connect students to service users to achieve these aims. The online British patient feedback site, Patient Opinion, gathers comments from service users about services and encourages service responses to the comments. To explore the feasibility and acceptability of five ways of including Patient Opinion in the undergraduate nursing curriculum. Five case studies using mixed data collection methods. British University with nursing students across two campuses, accustomed to using webinars, video presentations and social media. Students from different years participated in the five approaches of making use of Patient Opinion in the curriculum; 18 students took part in an online forum to discuss Patient Opinion in the curriculum. We trialled timetabled webinars, video-linked lectures, optional enhanced access for self-study, optional audit of service user comments for two local hospitals, and optional Twitter and Tweetchat. Students discussed the aims and approaches in an online forum. Of the five approaches trialled, webinars seemed effective in ensuring that all nursing students engaged with the topic. Video-linked lectures provided an alternative when timetabling did not allow webinars, but were less interactive. The three optional approaches (Tweetchats, audit exercise, self-directed study) provided opportunities for some students to enhance their learning but students needed guidance. Sending a summary of student reviews of patients' feedback to local hospitals illustrated how students might be agents of change in local health services. Experience from these case studies suggests that webinars followed by use of Patient Opinion preparing for placements may be a sustainable way of embedding feedback sites in the nursing curriculum. Copyright © 2017 Elsevier Ltd. All rights reserved.

Early Childhood Programs and Policy in the Northwest and Hawaii: Early Childhood Policy Issues and Options.

ERIC Educational Resources Information Center

Conklin, Nancy Faires; And Others

Discussed are early childhood policy issues and options for Alaska, Hawaii, Idaho, Montana, Oregon, and Washington. Section I explores federal and state directions in terms of levels of policy making, federal and state issues, and interested parties. Section II focuses on policy issues in its discussions of the political climate, long-term…

Eco-efficiency improvements in industrial water-service systems: assessing options with stakeholders.

PubMed

Levidow, Les; Lindgaard-Jørgensen, Palle; Nilsson, Asa; Skenhall, Sara Alongi; Assimacopoulos, Dionysis

2014-01-01

The well-known eco-efficiency concept helps to assess the economic value and resource burdens of potential improvements by comparison with the baseline situation. But eco-efficiency assessments have generally focused on a specific site, while neglecting wider effects, for example, through interactions between water users and wastewater treatment (WWT) providers. To address the methodological gap, the EcoWater project has developed a method and online tools for meso-level analysis of the entire water-service value chain. This study investigated improvement options in two large manufacturing companies which have significant potential for eco-efficiency gains. They have been considering investment in extra processes which can lower resource burdens from inputs and wastewater, as well as internalising WWT processes. In developing its methodology, the EcoWater project obtained the necessary information from many agents, involved them in the meso-level assessment and facilitated their discussion on alternative options. Prior discussions with stakeholders stimulated their attendance at a workshop to discuss a comparative eco-efficiency assessment for whole-system improvement. Stakeholders expressed interest in jointly extending the EcoWater method to more options and in discussing investment strategies. In such ways, optimal solutions will depend on stakeholders overcoming fragmentation by sharing responsibility and knowledge.

Use of a birth plan within woman-held maternity records: a qualitative study with women and staff in northeast Scotland.

PubMed

Whitford, Heather M; Entwistle, Vikki A; van Teijlingen, Edwin; Aitchison, Patricia E; Davidson, Tracey; Humphrey, Tracy; Tucker, Janet S

2014-09-01

Birth plans are written preferences for labor and birth which women prepare in advance. Most studies have examined them as a novel intervention or "outside" formal care provision. This study considered use of a standard birth plan section within a national, woman-held maternity record. Exploratory qualitative interviews were conducted with women (42) and maternity service staff (24) in northeast Scotland. Data were analyzed thematically. Staff and women were generally positive about the provision of the birth plan section within the record. Perceived benefits included the opportunity to highlight preferences, enhance communication, stimulate discussions, and address anxieties. However, not all women experienced these benefits or understood the birth plan's purpose. Some were unaware of the opportunity to complete it or could not access the support they needed from staff to discuss or be confident about their options. Some were reluctant to plan too much. Staff recognized the need to support women with birth plan completion but noted practical challenges to this. A supportive antenatal opportunity to allow discussion of options may be needed to realize the potential benefits of routine inclusion of birth plans in maternity notes. © 2014 Wiley Periodicals, Inc.

Clinically Applicable Inhibitors Impacting Genome Stability.

PubMed

Prakash, Anu; Garcia-Moreno, Juan F; Brown, James A L; Bourke, Emer

2018-05-13

Advances in technology have facilitated the molecular profiling (genomic and transcriptomic) of tumours, and has led to improved stratification of patients and the individualisation of treatment regimes. To fully realize the potential of truly personalised treatment options, we need targeted therapies that precisely disrupt the compensatory pathways identified by profiling which allow tumours to survive or gain resistance to treatments. Here, we discuss recent advances in novel therapies that impact the genome (chromosomes and chromatin), pathways targeted and the stage of the pathways targeted. The current state of research will be discussed, with a focus on compounds that have advanced into trials (clinical and pre-clinical). We will discuss inhibitors of specific DNA damage responses and other genome stability pathways, including those in development, which are likely to synergistically combine with current therapeutic options. Tumour profiling data, combined with the knowledge of new treatments that affect the regulation of essential tumour signalling pathways, is revealing fundamental insights into cancer progression and resistance mechanisms. This is the forefront of the next evolution of advanced oncology medicine that will ultimately lead to improved survival and may, one day, result in many cancers becoming chronic conditions, rather than fatal diseases.

Update on the Diagnosis and Treatment of Cholangiocarcinoma.

PubMed

Doherty, Bryan; Nambudiri, Vinod E; Palmer, William C

2017-01-01

Cholangiocarcinoma is a rare biliary adenocarcinoma associated with poor outcomes. Cholangiocarcinoma is subdivided into extrahepatic and intrahepatic variants. Intrahepatic cholangiocarcinoma is then further differentiated into (1) peripheral mass-forming tumors and (2) central periductal infiltrating tumors. We aimed to review the currently known risk factors, diagnostic tools, and treatment options, as well as highlight the need for further clinical trials and research to improve overall survival rates. Cholangiocarcinoma has seen significant increase in incidence rates over the last several decades. Most patients do not carry the documented risk factors, which include infections and inflammatory conditions, but cholangiocarcinoma typically forms in the setting of cholestasis and chronic inflammation. Management strategies include multispecialty treatments, with consideration of surgical resection, systemic chemotherapy, and targeted radiation therapy. Surgically resectable disease is the only curable treatment option, which may involve liver transplantation in certain selected cases. Referrals to centers of excellence, along with enrollment in novel clinical trials are recommended for patients with unresectable or recurrent disease. This article provides an overview of cholangiocarcinoma and discusses the current diagnosis and treatment options. While incidence is increasing and more risk factors are being discovered, much more work remains to improve outcomes of this ominous disease.

Dying in the age of choice.

PubMed

Black, Kathy; Csikai, Ellen L

2015-01-01

Due to the unprecedented increase in the United States aging demographics, many more people are living longer and reaching older ages than ever before. However, a longer life is not necessarily a better life, as the vast majority will face a period of prolonged deteriorating health prior to death. Although notable efforts have been underway that are designed to improve the end-of-life experience, increasing numbers of individuals express a desire and/or act upon an intent to end their lives precipitously. Though still limited, the options to actively participate in their own deaths are growing. Requests for a hastened death can occur among people of all ages and includes those with advanced illness as well as others wanting to die due to unbearable suffering. This article provides an overview of the ongoing discourse about the experience of dying faced by many older adults, including aspects frequently associated with "a good death." The limitations of established practices which seek to provide a "better" dying experience are identified followed by discussion of the growing availability of alternative options. Reflective considerations are presented to guide practice vis-à-vis the changing landscape surrounding options in dying.

Linux containers for fun and profit in HPC

DOE PAGES

Priedhorsky, Reid; Randles, Timothy C.

2017-10-01

This article outlines options for user-defined software stacks from an HPC perspective. Here, we argue that a lightweight approach based on Linux containers is most suitable for HPC centers because it provides the best balance between maximizing service of user needs and minimizing risks. We also discuss how containers work and several implementations, including Charliecloud, our own open-source solution developed at Los Alamos.

Determining the Best-Fit FPGA for a Space Mission: An Analysis of Cost, SEU Sensitivity,and Reliability

NASA Technical Reports Server (NTRS)

Berg, Melanie; LaBel, Ken

2007-01-01

This viewgraph presentation reviews the selection of the optimum Field Programmable Gate Arrays (FPGA) for space missions. Included in this review is a discussion on differentiating amongst various FPGAs, cost analysis of the various options, the investigation of radiation effects, an expansion of the evaluation criteria, and the application of the evaluation criteria to the selection process.

Linux containers for fun and profit in HPC

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

Priedhorsky, Reid; Randles, Timothy C.

This article outlines options for user-defined software stacks from an HPC perspective. Here, we argue that a lightweight approach based on Linux containers is most suitable for HPC centers because it provides the best balance between maximizing service of user needs and minimizing risks. We also discuss how containers work and several implementations, including Charliecloud, our own open-source solution developed at Los Alamos.

Space Station needs, attributes and architectural options. Volume 2, book 1, part 1: Mission requirements

NASA Technical Reports Server (NTRS)

1983-01-01

The baseline mission model used to develop the space station mission-related requirements is described as well as the 90 civil missions that were evaluated, (including the 62 missions that formed the baseline model). Mission-related requirements for the space station baseline are defined and related to space station architectural development. Mission-related sensitivity analyses are discussed.

Proton Therapy for Thoracoabdominal Tumors

NASA Astrophysics Data System (ADS)

Sakurai, Hideyuki; Okumura, Toshiyuki; Sugahara, Shinji; Nakayama, Hidetsugu; Tokuuye, Koichi

In advanced-stage disease of certain thoracoabdominal tumors, proton therapy (PT) with concurrent chemotherapy may be an option to reduce side effects. Several technological developments, including a respiratory gating system and implantation of fiducial markers for image guided radiation therapy (IGRT), are necessary for the treatment in thoracoabdominal tumors. In this chapter, the role of PT for tumors of the lung, the esophagus, and liver are discussed.

The common cold: current therapy and natural history.

PubMed

Spector, S L

1995-05-01

Despite its prevalence, the common cold is complicated and can be difficult to treat, even symptomatically. There is still no cure for the myriad of viruses that cause the common cold. Many of the most popular remedies are either ineffective or counterproductive. This paper reviews the causes and course of upper respiratory infections, and discusses treatment options, including a new anticholinergic aqueous formulation for controlling rhinorrhea.

Physiotherapists use a great variety of motor learning options in neurological rehabilitation, from which they choose through an iterative process: a retrospective think-aloud study.

PubMed

Kleynen, Melanie; Moser, Albine; Haarsma, Frederike A; Beurskens, Anna J; Braun, Susy M

2017-08-01

The goal of this study was to examine which motor learning options are applied by experienced physiotherapists in neurological rehabilitation, and how they choose between the different options. A descriptive qualitative approach was used. A purposive sample of five expert physiotherapists from the neurological ward of a rehabilitation center participated. Data were collected using nine videotaped therapy situations. During retrospective think-aloud interviews, the physiotherapists were instructed to constantly "think aloud" while they were watching their own videos. Five "operators" were identified: "act", "know", "observe", "assess" and "argue". The "act" operator consisted of 34 motor learning options, which were clustered into "instruction", "feedback" and "organization". The "know", "observe", "assess" and "argue" operators explained how therapists chose one of these options. The four operators seem to be interrelated and together lead to a decision to apply a particular motor learning option. Results show that the participating physiotherapists used a great variety of motor learning options in their treatment sessions. Further, the decision-making process with regard to these motor learning options was identified. Results may support future intervention studies that match the content and process of therapy in daily practice. The study should be repeated with other physiotherapists. Implications for Rehabilitation The study provided insight into the way experienced therapist handle the great variety of possible motor learning options, including concrete ideas on how to operationalize these options in specific situations. Despite differences in patients' abilities, it seems that therapists use the same underlying clinical reasoning process when choosing a particular motor learning option. Participating physiotherapists used more than the in guidelines suggested motor learning options and considered more than the suggested factors, hence adding practice based options of motor learning to the recommended ones in the guidelines. A think-aloud approach can be considered for peer-to-peer and student coaching to enhance discussion on the motor learning options applied and the underlying choices and to encourage research by practicing clinicians.

Solar Power System Options for the Radiation and Technology Demonstration Spacecraft

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.; Haraburda, Francis M.; Riehl, John P.

2000-01-01

The Radiation and Technology Demonstration (RTD) Mission has the primary objective of demonstrating high-power (10 kilowatts) electric thruster technologies in Earth orbit. This paper discusses the conceptual design of the RTD spacecraft photovoltaic (PV) power system and mission performance analyses. These power system studies assessed multiple options for PV arrays, battery technologies and bus voltage levels. To quantify performance attributes of these power system options, a dedicated Fortran code was developed to predict power system performance and estimate system mass. The low-thrust mission trajectory was analyzed and important Earth orbital environments were modeled. Baseline power system design options are recommended on the basis of performance, mass and risk/complexity. Important findings from parametric studies are discussed and the resulting impacts to the spacecraft design and cost.

Weighing the options for limiting surplus animals.

PubMed

Asa, Cheryl

2016-05-01

The unsustainability of many animal programs managed by zoos and aquariums has brought renewed attention to unresolved questions about various management strategies. Solving the "sustainability crisis" for many species will require housing more adults and producing more offspring than there are existing spaces in accredited zoos and aquariums. Careful reproductive management is central to addressing this challenge, but opinions differ about which management strategies are best for an individual, for a species, for an institution, or for a country or region. The primary options for limiting the number of animals that would be surplus to the population are to prevent reproduction or to euthanize. However, there is much misunderstanding about methods for controlling reproduction, in particular about contraceptives and species differences in their effects. Careful weighing of all the options is called for. Lifetime Reproductive Planning may help increase breeding success through careful reproductive management but cannot eliminate production of surplus animals. Limiting reproduction does not address the problem of animals already in the population. Despite best efforts and planning, consistently hitting target numbers for a population may never be achieved. Increasing capacity provides a temporary patch when targets are exceeded, but is not a long-term solution, since each generation potentially produces even more individuals needing even more space. Welfare considerations should be included in discussions of management euthanasia and its alternatives. Such discussions will be most productive if based on full awareness of the advantages and disadvantages of all the options. Zoo Biol. 35:183-186, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

How to buy a medical home? Policy options and practical questions.

PubMed

Berenson, Robert A; Rich, Eugene C

2010-06-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for "new" PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations.

How to Buy a Medical Home? Policy Options and Practical Questions

PubMed Central

Berenson, Robert A.

2010-01-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for “new” PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations. PMID:20467911

On Ramps: Options and Issues in Accessing the Internet.

ERIC Educational Resources Information Center

Bocher, Bob

1995-01-01

Outlines the basic options that schools and libraries have for accessing the Internet, focusing on four models: direct connection; dial access using SLIP/PPP (Serial Line Internet Protocol/Point-to-Point Protocol); dial-up using terminal emulation mode; and dial access through commercial online services. Discusses access option issues such as…

A Guide to Courseware Authoring Options in ESL/FL Instruction.

ERIC Educational Resources Information Center

Hampson, S. L.

A guide to courseware authoring aids for computer-assisted language instruction (CALIS) gives suggestions for the selection and use of programing options and provides an annotated listing of those options. Introductory sections discuss the use of computer-assisted language teaching, the selection of quality courseware, the types of authoring aids…

Industrial Scale Energy Systems Integration; NREL (National Renewable Energy Laboratory)

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

Ruth, Mark

2015-07-28

The industrial sector consumes 25% of the total energy in the U.S. and produces 18% of the greenhouse gas (GHG) emissions. Energy Systems Integration (ESI) opportunities can reduce those values and increase the profitability of that sector. This presentation outlines several options. Combined heat and power (CHP) is an option that is available today for many applications. In some cases, it can be extended to trigeneration by adding absorbtion cooling. Demand response is another option in use by the industrial sector - in 2012, industry provided 47% of demand response capacity. A longer term option that combines the benefits ofmore » CHP with those of demand response is hybrid energy systems (HESs). Two possible HESs are described and development implications discussed. extended to trigeneration by adding absorbtion cooling. Demand response is another option in use by the industrial sector - in 2012, industry provided 47% of demand response capacity. A longer term option that combines the benefits of CHP with those of demand response is hybrid energy systems (HESs). Two possible HESs are described and development implications discussed.« less

Wellness in Sickness and Health (The W.I.S.H. Project): Advance Care Planning Preferences and Experiences Among Elderly Latino Patients.

PubMed

Maldonado, Lauren Y; Goodson, Ruth B; Mulroy, Matthew C; Johnson, Emily M; Reilly, Jo M; Homeier, Diana C

2017-10-25

To assess advance care planning (ACP) preferences, experiences, and comfort in discussing end-of-life (EOL) care among elderly Latinos. Patients aged 60 and older from the Los Angeles County and University of Southern California (LAC+USC) Medical Center Geriatrics Clinic (n = 41) participated in this intervention. Trained staff conducted ACP counseling with participants in their preferred language, which included: (a) pre-counseling survey about demographics and EOL care attitudes, (b) discussion of ACP and optional completion of an advance directive (AD), and (c) post-session survey. Patients were primarily Spanish speaking with an average of 2.7 chronic medical conditions. Most had not previously documented (95%) or discussed (76%) EOL wishes. Most were unaware they had control over their EOL treatment (61%), but valued learning about EOL options (83%). Post-counseling, 85% reported comfort discussing EOL goals compared to 66% pre-session, and 88% elected to complete an AD. Nearly half of patients reported a desire to discuss EOL wishes sooner. Elderly Latino patients are interested in ACP, given individualized, culturally competent counseling in their preferred language. Patients should be offered the opportunity to discuss and document EOL wishes at all primary care appointments, regardless of health status. Counseling should be completed in the patient's preferred language, using culturally competent materials, and with family members present if this is the patient's preference. Cultural-competency training for providers could enhance the impact of EOL discussions and improve ACP completion rates for Latino patients.

48 CFR 536.213-371 - Bids that include options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Bids that include options... Contracting for Construction 536.213-371 Bids that include options. (a) Subject to the limitations in paragraph (c) of this section, you may include options in contracts if it is in the Government's interest...

RATFOR user's guide version 2.0

NASA Technical Reports Server (NTRS)

Helmle, L. C.

1985-01-01

This document is a user's guide for RATFOR at Ames Research Center. The main part of the document is a general description of RATFOR, and the appendix is devoted to a machine specific implementation for the Cray X-MP. The general stylistic features of RATFOR are discussed, including the block structure, keywords, source code, format, and the notion of tokens. There is a section on the basic control structures (IF-ELSE, ELSE IF, WHILE, FOR, DO, REPEAT-UNTIL, BREAK, NEXT), and there is a section on the statements that extend FORTRAN's capabilities (DEFINE, MACRO, INCLUDE, STRING). THE appendix discusses everything needed to compile and run a basic job, the preprocessor options, the supported character sets, the generated listings, fatal errors, and program limitations and the differences from standard FORTRAN.

NOx control techniques for the CPI

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

Lambert, D.; McGowan, T.F.

1996-06-01

After years of air pollution control innovation, the control of emissions of nitrogen oxide compounds stands out as an area where much work remains to be performed in the chemical process industries (CPI). Federal regulations, ozone non-attainment areas, acid rain provisions of the US Clean Air Act, and corporate goals for emission reductions are all motivators. Primary CPI sources are high-temperature combustion systems, including fired heaters, boilers and Kilns. Nitrogen-based processes such as nitric acid manufacture also contribute. The paper discusses the regulations which define the problem and some solutions. These include fuel switching, low-excess air burners, fluegas recirculation, stagedmore » combustion, out of service burners, and wet scrubbing of flue gas. The paper briefly discusses costs of these options.« less

Development and pilot testing of a Decision Aid (DA) for women with early-stage breast cancer considering contralateral prophylactic mastectomy.

PubMed

Ager, B; Jansen, J; Porter, D; Phillips, K A; Glassey, R; Butow, P

2018-05-22

Describe the development, acceptability and feasibility of a Decision Aid (DA) for women with early-stage breast cancer (BC) at average contralateral breast cancer (CBC) risk considering contralateral prophylactic mastectomy (CPM). The DA was developed using the International Patient Decision Aid Standards (IPDAS) and the Ottawa Decision Support Framework. It provides evidence-based information about CPM in a booklet format combining text, graphs and images of surgical options. Twenty-three women with a history of early-stage breast cancer were interviewed in person or over the phone using a 'think aloud approach'. Framework analysis was used to code and analyse data. Twenty-three women participated in the study. Mean age of participants was 58.6 years and time since diagnosis ranged from 14 months to 21 years. Five women had CPM and eighteen had not. Women strongly endorsed the DA. Many felt validated by a section on appearance and found information on average risk of recurrence and metastases helpful, however, noted the importance of discussing personal risk with their surgeon. Many requested more information on surgery details (time taken, recovery) and costs of the different options. The DA was acceptable to women, including the format, content and proposed implementation strategies. Practical and financial issues are important to women in considering treatment options. Women appreciate information about CPM at diagnosis and emphasised the importance of discussing potential downsides of the procedure in addition to benefits. The DA was considered acceptable to facilitate such discussions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Challenges in shared decision making in advanced cancer care: a qualitative longitudinal observational and interview study.

PubMed

Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W

2017-02-01

Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Psychotherapy

PubMed Central

Sansone, Lori A.

2009-01-01

Clinicians have a number of treatment options for dealing with the emotional ills of patients, including psychoeducation, psychotherapy, and pharmacotherapy. However, after years of experience in the clinical field, we have recognized that these treatment options may not be sufficient to adequately address the problems of some patients. We have found that adding a metaphysical/spiritual component may be helpful, particularly for those patients with histories of childhood trauma. In this edition of The Interface, we discuss four metaphysical techniques for facilitating patient healing—1) refocusing on the present, 2) reframing adversity, 3) practicing surrender, and 4) meditation. These approaches can be mutually integrated and compliment a psychological treatment in either the psychiatric or primary care setting, regardless of whether or not the patient has formal religious beliefs. PMID:20104289

Systems engineering aspects of a preliminary conceptual design of the space station environmental control and life support system

NASA Technical Reports Server (NTRS)

Lin, C. H.; Meyer, M. S.

1983-01-01

The systems engineering aspects of developing a conceptual design of the Space Station Environmental Control and Life Support System (ECLSS) are discussed. Topics covered include defining system requirements and groundrules for approach, formulating possible cycle closure options, and establishing a system-level mass balance on the essential materials processed in oxygen and water cycles. Consideration is also given to the performance of a system trade-off study to determine the best degree of cycle closure for the ECLSS, and the construction of a conceptual design of the ECLSS with subsystem performance specifications and candidate concepts. For the optimum balance between development costs, technological risks, and resupply penalties, a partially closed cycle ECLSS option is suggested.

Therapy Development for the Lysosomal Storage Disease Fucosidosis using the Canine Animal Model.

PubMed

Fletcher, Jessica L; Taylor, Rosanne M

2016-06-01

Abstract Fucosidosis (OMIM 23000) is an inherited neurodegenerative lysosomal storage disease caused by a deficiency of the lysosomal hydrolase a-L-fucosidase due to mutations in the FUCA1 gene. Without enzyme-targeted therapy patients rarely survive beyond the first decade of life, and therapy options other than supportive care are limited. Hematopoietic transplants, first developed in the fucosidosis dog model, are the only treatment option available capable of delaying the disease course. However, due to the risks and exclusion criteria of this treatment additional therapies are required. The development of additional therapies including intravenous and intra-cerebrospinal fluid enzyme replacement therapy and gene therapy, which have been trialed in the canine model, will be discussed.

Spectrum Orbit Utilization Program documentation: SOUP5 version 3.8 user's manual, volume 1, chapters 1 through 5

NASA Technical Reports Server (NTRS)

Davidson, J.; Ottey, H. R.; Sawitz, P.; Zusman, F. S.

1985-01-01

The underlying engineering and mathematical models as well as the computational methods used by the Spectrum Orbit Utilization Program 5 (SOUP5) analysis programs are described. Included are the algorithms used to calculate the technical parameters, and references to the technical literature. The organization, capabilities, processing sequences, and processing and data options of the SOUP5 system are described. The details of the geometric calculations are given. Also discussed are the various antenna gain algorithms; rain attenuation and depolarization calculations; calculations of transmitter power and received power flux density; channelization options, interference categories, and protection ratio calculation; generation of aggregrate interference and margins; equivalent gain calculations; and how to enter a protection ratio template.

Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making.

PubMed

Dalke, Katharine Baratz; Wenzel, Amy; Kim, Deborah R

2016-06-01

Depression and anxiety during pregnancy are common, and patients and providers are faced with complex decisions regarding various treatment modalities. A structured discussion of the risks and benefits of options with the patient and her support team is recommended to facilitate the decision-making process. This clinically focused review, with emphasis on the last 3 years of published study data, evaluates the major risk categories of medication treatments, namely pregnancy loss, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity. Nonpharmacological treatment options, including neuromodulation and psychotherapy, are also briefly reviewed. Specific recommendations, drawn from the literature and the authors' clinical experience, are also offered to help guide the clinician in decision-making.

So you want to be a CEO: lessons from the field.

PubMed

Rothberg, E D

2001-01-01

This article discusses graduate educational options for those seeking to become chief executive officers and examines the subject areas that are important on a practical level. It then discusses six areas that are essential to a successful manager: problem solving, critical thinking, and organizational behavior; breadth of knowledge; financial management; corporate culture; for profit and not for profit, and--politics--internal and external. Each area includes a lesson drawn from experience as a president and CEO. Readers should gain a level of understanding of the scope of responsibilities and skills necessary to succeed in today's health care environment.

MIRAGE: system overview and status

NASA Astrophysics Data System (ADS)

Robinson, Richard M.; Oleson, Jim; Rubin, Lane; McHugh, Stephen W.

2000-07-01

Santa Barbara Infrared's (SBIR) MIRAGE (Multispectral InfraRed Animation Generation Equipment) is a state-of-the-art dynamic infrared scene projector system. Imagery from the first MIRAGE system was presented to the scene simulation community during last year's SPIE AeroSense 99 Symposium. Since that time, SBIR has delivered five MIRAGE systems. This paper will provide an overview of the MIRAGE system and discuss the current status of the MIRAGE. Included is an update of system hardware, and the current configuration. Proposed upgrades to this configuration and options will be discussed. Updates on the latest installations, applications and measured data will also be presented.

Space station needs, attributes, and architectural options study. Volume 2: Program options, architecture, and technology

NASA Technical Reports Server (NTRS)

1983-01-01

Mission scenarios and space station architectures are discussed. Electrical power subsystems (EPS), environmental control and life support, subsystems (ECLSS), and reaction control subsystem (RCS) architectures are addressed. Thermal control subsystems, (TCS), guidance/navigation and control (GN and C), information management systems IMS), communications and tracking (C and T), and propellant transfer and storage systems architectures are discussed.

Restoration of Elbow Flexion.

PubMed

Loeffler, Bryan J; Lewis, Daniel R

2016-08-01

Active elbow flexion is required to position the hand in space, and loss of this function is debilitating. Nerve transfers or nerve grafts to restore elbow flexion may be options when the target muscle is viable, but in delayed reconstruction when the biceps and brachialis are atrophied or damaged, muscle transfer options should be considered. Muscle transfer options are discussed with attention to the advantages and disadvantages of each transfer option. Copyright © 2016 Elsevier Inc. All rights reserved.

Carbon dioxide removal and tradeable put options at scale

NASA Astrophysics Data System (ADS)

Lockley, Andrew; Coffman, D.’Maris

2018-05-01

Options are derivative contracts that give the purchaser the right to buy (call options) or sell (put options) a given underlying asset at a particular price at a future date. The purchaser of a put option may exercise the right to sell the asset to the issuer at any point in the future before the expiration of the contract. These rights may be contracted directly between two parties (i.e. over-the-counter), or may be sold publicly on formal exchanges, such as the Chicago Board Options Exchange. If the latter, they are called tradeable put options (TPOs) because they can be bought and sold by third-parties via a secondary market. The World Bank has a Pilot Auction Facility for methane and carbon mediation which uses TPOs in carbon-relevant markets, giving producers (of e.g. forest restoration) a floor price for their product [1]. This enables long-term producer planning. We discuss the potentially broader use of these options contracts in carbon dioxide removal (CDR) markets generally and at scale. We conclude that they can, if priced correctly, encourage rapid investment both in CDR technology and in operational capacity. TPOs could do this without creating the same type of systemic risk associated with other instruments (e.g. long-dated futures). Nevertheless, the widespread use of such instruments potentially creates novel risks. These include the political risk of premature closure [2] (conventionally rendered as ‘counting your chickens before they are hatched’) and the economic risk of overpaying for carbon removal services. These instruments require careful structuring, and do not inoculate the CDR market against regulatory disruption, or political pressure. Accordingly, we note the potential for the development of TPO markets in CDR, but we urge caution in respect of identified risks.

Dancing around death: hospitalist-patient communication about serious illness.

PubMed

Anderson, Wendy G; Kools, Susan; Lyndon, Audrey

2013-01-01

Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient's understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues.

Dancing Around Death: Hospitalist-Patient Communication About Serious Illness

PubMed Central

Anderson, Wendy G.; Kools, Susan; Lyndon, Audrey

2012-01-01

Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient’s understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues. PMID:23034778

Forensic issues in medical evaluation: competency and end-of-life issues.

PubMed

Soliman, Sherif; Hall, Ryan C W

2015-01-01

Decision-making capacity is a common reason for psychiatric consultation that is likely to become more common as the population ages. Capacity assessments are frequently compromised by misconceptions, such as the belief that incapacity is permanent or that patients with dementia categorically lack capacity. This chapter will review the conceptual framework of decision-making capacity and discuss its application to medical decision-making. We will review selected developments in capacity assessment and recommend an approach to assessing decision-making capacity. We will discuss the unique challenges posed by end-of-life care, including determining capacity, identifying surrogate decision-makers, and working with surrogate decision-makers. We will discuss clinical and legal approaches to incapacity, including advance directives, surrogate decision-makers, and guardians. We will discuss the legal standards based on which surrogates make medical decisions and outline options for resolving disagreements between clinical staff and surrogate decision-makers. We will offer recommendations for approaching decision-making capacity assessments. © 2015 S. Karger AG, Basel.

Exploring the Experiences of Women and Health Care Workers in the Context of PMTCT Option B Plus in Malawi.

PubMed

Cataldo, Fabian; Chiwaula, Levison; Nkhata, Misheck; van Lettow, Monique; Kasende, Florence; Rosenberg, Nora E; Tweya, Hannock; Sampathkumar, Veena; Hosseinipour, Mina; Schouten, Erik; Kapito-Tembo, Atupele; Eliya, Michael; Chimbwandira, Frank; Phiri, Sam

2017-04-15

Malawi has embarked on a "test-and-treat" approach to prevent mother-to-child transmission (PMTCT) of HIV, known as "Option B+," offering all HIV-infected pregnant and breastfeeding women lifelong antiretroviral therapy (ART) regardless of CD4 count or clinical stage. A cross-sectional qualitative study was conducted to explore early experiences surrounding "Option B+" for patients and health care workers (HCWs) in Malawi. Study participants were purposively selected across 6 health facilities in 3 regional health zones in Malawi. Semi-structured interviews were conducted with women enrolled in "Option B+" (n = 24), and focus group discussions were conducted with HCWs providing Option B+ services (n = 6 groups of 8 HCWs). Data were analyzed using a qualitative thematic coding framework. Patients and HCWs identified the lack of male involvement as a barrier to retention in care and expressed concerns at the rapidity of the test-and-treat process, which makes it difficult for patients to "digest" a positive diagnosis before starting ART. Fear regarding the breach of privacy and confidentiality were also identified as contributing to loss to follow-up of women initiated under the Option B+. Disclosure remains a difficult process within families and couples. Lifelong ART was also perceived as an opportunity to plan future pregnancies. As "Option B+" continues to be rolled out, novel interventions to support and retain women into care must be implemented. These include providing space, time, and support to accept a diagnosis before starting ART, engaging partners and families, and addressing the need for peer support and confidentiality.

Comparing the nine-item Shared Decision-Making Questionnaire to the OPTION Scale - an attempt to establish convergent validity.

PubMed

Scholl, Isabelle; Kriston, Levente; Dirmaier, Jörg; Härter, Martin

2015-02-01

While there has been a clear move towards shared decision-making (SDM) in the last few years, the measurement of SDM-related constructs remains challenging. There has been a call for further psychometric testing of known scales, especially regarding validity aspects. To test convergent validity of the nine-item Shared Decision-Making Questionnaire (SDM-Q-9) by comparing it to the OPTION Scale. Cross-sectional study. Data were collected in outpatient care practices. Patients suffering from chronic diseases and facing a medical decision were included in the study. Consultations were evaluated using the OPTION Scale. Patients completed the SDM-Q-9 after the consultation. First, the internal consistency of both scales and the inter-rater reliability of the OPTION Scale were calculated. To analyse the convergent validity of the SDM-Q-9, correlation between the patient (SDM-Q-9) and expert ratings (OPTION Scale) was calculated. A total of 21 physicians provided analysable data of consultations with 63 patients. Analyses revealed good internal consistency of the SDM-Q-9 and limited internal consistency of the OPTION Scale. Inter-rater reliability of the latter was less than optimal. Association between the total scores of both instruments was weak with a Spearman correlation of r = 0.19 and did not reach statistical significance. By the use of the OPTION Scale convergent validity of the SDM-Q-9 could not be established. Several possible explanations for this result are discussed. This study shows that the measurement of SDM remains challenging. © 2012 John Wiley & Sons Ltd.

Broadening the use of antiretroviral therapy: the case for feline leukemia virus

PubMed Central

Greggs, Willie M; Clouser, Christine L; Patterson, Steven E; Mansky, Louis M

2011-01-01

Antiretroviral drugs have saved and extended the lives of millions of individuals infected with HIV. The major classes of anti-HIV drugs include reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, and entry/fusion inhibitors. While antiretroviral drug regimens are not commonly used to treat other types of retroviral infections, there are instances where there is a perceived need for re-evaluation of the benefits of antiretroviral therapy. One case in point is that of feline leukemia virus (FeLV), an infection of companion felines. While vaccines exist to prevent FeLV infection and spread, they have not eliminated FeLV infection. For FeLV-infected felines and their human companions, antiretroviral therapy would be desirable and of practical importance if good options were available. Here, we discuss FeLV biology and current treatment options, and propose that there is a need for antiretroviral treatment options for FeLV infection. The comparative use and analysis of antiretroviral therapy can provide new insights into the mechanism of antiretroviral drug action. PMID:21479142

Comparison of Propulsion Options for Human Exploration of Mars

NASA Technical Reports Server (NTRS)

Drake, Bret G.; McGuire, Melissa L.; McCarty, Steven L.

2018-01-01

NASA continues to advance plans to extend human presence beyond low-Earth orbit leading to human exploration of Mars. The plans being laid out follow an incremental path, beginning with initial flight tests followed by deployment of a Deep Space Gateway (DSG) in cislunar space. This Gateway, will serve as the initial transportation node for departing and returning Mars spacecraft. Human exploration of Mars represents the next leap for humankind because it will require leaving Earth on a long mission with very limited return, rescue, or resupply capabilities. Although Mars missions are long, approaches and technologies are desired which can reduce the time that the crew is away from Earth. This paper builds off past analyses of NASA's exploration strategy by providing more detail on the performance of alternative in-space transportation options with an emphasis on reducing total mission duration. Key options discussed include advanced chemical, nuclear thermal, nuclear electric, solar electric, as well as an emerging hybrid propulsion system which utilizes a combination of both solar electric and chemical propulsion.

Mars Missions Using Emerging Commercial Space Transportation Capabilities

NASA Technical Reports Server (NTRS)

Gonzales, Andrew A.

2016-01-01

New Discoveries regarding the Martian Environment may impact Mars mission planning. Transportation of investigation payloads can be facilitated by Commercial Space Transportation options. The development of Commercial Space Transportation. Capabilities anticipated from various commercial entities are examined objectively. The potential for one of these options, in the form of a Mars Sample Return mission, described in the results of previous work, is presented to demonstrate a high capability potential. The transportation needs of the Mars Environment Team Project at ISU 2016 may fit within the payload capabilities of a Mars Sample Return mission, but the payload elements may or may not differ. Resource Modules will help you develop a component of a strategy to address the Implications of New Discoveries in the Martian Environment using the possibility of efficient, commercial space transportation options. Opportunities for open discussions as appropriate during the team project formulation period at the end of each Resource Module. The objective is to provide information that can be incorporated into your work in the Team Project including brainstorming.

Multicriteria mapping of stakeholder preferences in regulating nanotechnology.

PubMed

Hansen, Steffen Foss

2010-08-01

In order to facilitate stakeholder discussions on how to regulate nanotechnology, the opensource program multicriteria mapping (MCM) was used to structure 26 interviews with stakeholders in the USA. MCM offers a systematic part quantitative, part qualitative approach to clarify why some regulatory options (bans, moratoriums, voluntary measures, etc.) were deemed to be acceptable/unacceptable by various stakeholders and which criteria stakeholders used to evaluate the different regulatory options. Adopting an incremental approach and implementing a new regulatory framework was evaluated as the best options whereas a complete ban and no additional regulation of nanotechnology were found to be the least favorable. Criteria applied differed substantially among stakeholders and included social, ethical, regulatory, environmental, and health issues. Opinions on future regulation seem far less polarized than expected and it seems that stakeholders would welcome a combination of voluntary measures, an incremental approach and forming of a new regulatory framework. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11051-010-0006-3) contains supplementary material, which is available to authorized users.

Current decision-making in prostate cancer therapy.

PubMed

Cox, Jared; Amling, Christopher L

2008-05-01

Prostate cancer continues to be the most prevalent cancer among American men. Localized prostate cancer is commonly diagnosed because of improved screening practices nationwide. Several options exist for the treatment of localized prostate cancer, and this review discusses the decision-making process facing patients diagnosed with this disease. No one treatment for localized prostate cancer has proven superior to date. For this reason patients have been found to use a number of resources to make an informed decision. These include physicians, spouses, family, friends, and different media. Urologists serve as the primary and most influential physicians and play an important role in the decision-making process. Patients, however, are assuming a more active role in this process as time evolves, especially with ease of access to multiple information resources. In deciding on a treatment for localized prostate cancer, patients must weigh the risks and benefits of each option. Urologists must provide patients with up-to-date information on these options and be aware of the different influences that surround these men during the decision-making process.

Mixed waste management options

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

Owens, C.B.; Kirner, N.P.

1991-12-31

Disposal fees for mixed waste at proposed commercial disposal sites have been estimated to be $15,000 to $40,000 per cubit foot. If such high disposal fees are imposed, generators may be willing to apply extraordinary treatment or regulatory approaches to properly dispose of their mixed waste. This paper explores the feasibility of several waste management scenarios and attempts to answer the question: Can mixed waste be managed out of existence? Existing data on commercially generated mixed waste streams are used to identify the realm of mixed waste known to be generated. Each waste stream is evaluated from both a regulatorymore » and technical perspective in order to convert the waste into a strictly low-level radioactive or a hazardous waste. Alternative regulatory approaches evaluated in this paper include a delisting petition, no migration petition, and a treatability variance. For each waste stream, potentially available treatment options are identified that could lead to these variances. Waste minimization methodology and storage for decay are also considered. Economic feasibility of each option is discussed broadly.« less

Graduate Education.

ERIC Educational Resources Information Center

Eng, Jacqueline; And Others

1991-01-01

Discusses the advantages of getting graduate degrees in pharmaceutical sciences, physical therapy, occupational therapy, nursing, and respiratory therapy. Looks at the cost of education, degrees offered, research and clinical options, availability of programs, and career options. (JOW)

Patient-physician communication about early stage prostate cancer: analysis of overall visit structure.

PubMed

Henry, Stephen G; Czarnecki, Danielle; Kahn, Valerie C; Chou, Wen-Ying Sylvia; Fagerlin, Angela; Ubel, Peter A; Rovner, David R; Alexander, Stewart C; Knight, Sara J; Holmes-Rovner, Margaret

2015-10-01

We know little about patient-physician communication during visits to discuss diagnosis and treatment of prostate cancer. To examine the overall visit structure and how patients and physicians transition between communication activities during visits in which patients received new prostate cancer diagnoses. Forty veterans and 18 urologists at one VA medical centre. We coded 40 transcripts to identify major communication activities during visits and used empiric discourse analysis to analyse transitions between activities. We identified five communication activities that occurred in the following typical sequence: 'diagnosis delivery', 'risk classification', 'options talk', 'decision talk' and 'next steps'. The first two activities were typically brief and involved minimal patient participation. Options talk was typically the longest activity; physicians explicitly announced the beginning of options talk and framed it as their professional responsibility. Some patients were unsure of the purpose of visit and/or who should make treatment decisions. Visits to deliver the diagnosis of early stage prostate cancer follow a regular sequence of communication activities. Physicians focus on discussing treatment options and devote comparatively little time and attention to discussing the new cancer diagnosis. Towards the goal of promoting patient-centred communication, physicians should consider eliciting patient reactions after diagnosis delivery and explaining the decision-making process before describing treatment options. © 2013 John Wiley & Sons Ltd.

Strategic considerations in SETI, and a microwave approach. [Search for ExtraTerrestrial Intelligence

NASA Technical Reports Server (NTRS)

Seeger, C. L.

1977-01-01

Plausible options in the search for extraterrestrial intelligence (SETI), and the need to reserve a suitable portion of the EM (microwave) spectrum for SETI research, are discussed. Reasons for selection of a portion of the spectrum, specifically the 'water hole' near 1.5 GHz in the terrestrial microwave window (1-25 GHz), are presented, and competition with various emitters for that band (existing satellite downlink transmissions) is discussed. SETI search policies and options are summarized in a table. Speculative considerations guiding initial phases of the SETI pursuit are discussed.

Recent surgical options for vestibular vertigo

PubMed Central

Volkenstein, Stefan; Dazert, Stefan

2017-01-01

Vertigo is not a well-defined disease but a symptom that can occur in heterogeneous entities diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine, and primary care physicians. Most vertigo syndromes have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe and discuss different surgical therapy options for hydropic inner ear diseases, Menière’s disease, dehiscence syndromes, perilymph fistulas, and benign paroxysmal positional vertigo. At the end, we shortly introduce the most recent developments in regard to vestibular implants. Surgical therapy is still indicated for vestibular disease in selected patients nowadays when conservative options did not reduce symptoms and patients are still suffering. Success depends on the correct diagnosis and choosing among different procedures the ones going along with an adequate patient selection. With regard to the invasiveness and the possible risks due to surgery, in depth individual counseling is absolutely necessary. Ablative and destructive surgical procedures usually achieve a successful vertigo control, but are associated with a high risk for hearing loss. Therefore, residual hearing has to be included in the decision making process for surgical therapy. PMID:29279721

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

Hightower, Marion Michael; Baca, Michael J.; VanderMey, Carissa

In June 2016, the Department of Energy's (DOE's) Office of Energy Efficiency and Renewable Energy (EERE) in collaboration with the Renewable Energy Branch for the Hawaii State Energy Office (HSEO), the Hawaii Community Development Authority (HCDA), the United States Navy (Navy), and Sandia National Laboratories (Sandia) established a project to 1) assess the current functionality of the energy infrastructure at the Kalaeloa Community Development District, and 2) evaluate options to use both existing and new distributed and renewable energy generation and storage resources within advanced microgrid frameworks to cost-effectively enhance energy security and reliability for critical stakeholder needs during bothmore » short-term and extended electric power outages. This report discusses the results of a stakeholder workshop and associated site visits conducted by Sandia in October 2016 to identify major Kalaeloa stakeholder and tenant energy issues, concerns, and priorities. The report also documents information on the performance and cost benefits of a range of possible energy system improvement options including traditional electric grid upgrade approaches, advanced microgrid upgrades, and combined grid/microgrid improvements. The costs and benefits of the different improvement options are presented, comparing options to see how well they address the energy system reliability, sustainability, and resiliency priorities identified by the Kalaeloa stakeholders.« less

78 FR 21443 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... (``ETF'') option (as discussed below, excluding mini options) ADV, as reported by the Options Clearing... Exchange notes that Equity and ETF Customer volume is a widely followed benchmark of industry volume and is... product categories: equity and ETF volume and index volume, and the information can be filtered to show...

A Review of Research Methods Used to Examine Employee Assistance Program Delivery Options.

ERIC Educational Resources Information Center

Csiernik, Rick

1995-01-01

This review of literature on Employee Assistance Programs (EAPs) focuses on EAP delivery options. More than half of the 48 studies reviewed used a case study approach. EAPs provided by on-staff professionals were the most frequently discussed delivery option, although this is not the most dominant form of EAP provision. (SLD)

Excellence at Work. Policy Option Papers for the National Governors' Association.

ERIC Educational Resources Information Center

Ganzglass, Evelyn, Ed.

This volume contains an introduction and four policy option papers that explore key issues affecting the economy and state options to address the issues within the context of the U.S. workplace. "Introduction" (David Bedford, Evelyn Ganzglass) discusses the issues identified in the first phase of the governors' initiative on Excellence at Work and…

42 CFR 436.201 - Individuals included in optional groups.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals included in optional groups. 436.201... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Options for Coverage as Categorically Needy § 436.201 Individuals included in optional groups. (a) The...

Fertility concerns in men with genitourinary malignancies: Treatment dilemmas, fertility options, and medicolegal considerations.

PubMed

Polland, Allison; Berookhim, Boback M

2016-09-01

With increasing genitourinary cancer survivorship in patients of reproductive age, fertility preservation has become a greater focus in the management of these patients. We performed a review of articles pertaining to male infertility, fertility preservation, and genitourinary cancers. The aim was to review causes of infertility in patients with cancer, current options for fertility preservation, research that may expand preservation options, and ethical as well as medicolegal considerations. There are multiple causes of infertility in male patients with cancer, including the malignancy itself, and the treatments required to achieve a potential cure. Surgery can affect the normal pathways for erection, emission, and ejaculation. Chemotherapy can have a profound negative effect on spermatogenesis by causing chromosomal aberrations, maturation arrest, mutagenesis, and impaired spermatozoa motility. Radiation can cause cellular apoptosis with resultant reduction in spermatogonial stem cells. There are numerous methods to secure fertility before cancer treatment with the aid of cryopreservation ranging from simple patient-provided semen samples to complex sperm retrieval techniques. Research in the field of spermatogenic stem cells may lead to improved treatment options such as autotransplant of stem cells for repopulation of the testes after cancer treatment. Early discussion of possible fertility effects in patients undergoing genitourinary cancer treatment is critical in this era of increasing survivorship. Although current cancer treatments can cause infertility, there are well-established options for fertility preservation and current research will likely lead to improved treatment options. Copyright © 2016 Elsevier Inc. All rights reserved.

The Decline of the Breast: An Examination of Its Impact on Fertility and Health, and Its Relation to Socioeconomic Status. Cornell International Nutrition Monograph Series, Number 10 (1982).

ERIC Educational Resources Information Center

Latham, Michael C., Ed.

The three papers in this collection discuss, respectively, the relationship of breastfeeding to human fertility, strategies to improve feeding of infants and young children, and infant feeding options for Thai professional women residing in Bangkok. Specific topics addressed in the first paper include the physiological role of lactation on…

Aspects of job scheduling

NASA Technical Reports Server (NTRS)

Phillips, K.

1976-01-01

A mathematical model for job scheduling in a specified context is presented. The model uses both linear programming and combinatorial methods. While designed with a view toward optimization of scheduling of facility and plant operations at the Deep Space Communications Complex, the context is sufficiently general to be widely applicable. The general scheduling problem including options for scheduling objectives is discussed and fundamental parameters identified. Mathematical algorithms for partitioning problems germane to scheduling are presented.

Post Flight Analysis of Optical Specimens from MISSE7

NASA Technical Reports Server (NTRS)

Stewart, Alan F.; Finckenor, Miria

2012-01-01

More than 100 optical specimens were flown on the MISSE7 platform. These included bare substrates in addition to coatings designed to exhibit clearly defined or enhanced sensitivity to the accumulation of contamination. Measurements were performed using spectrophotometers operating from the UV through the IR as well as ellipsometry. Results will be presented in addition to discussion of the best options for design of samples for future exposure experiments.

ICU nurses and physicians dialogue regarding patients clinical status and care options-a focus group study.

PubMed

Kvande, Monica; Lykkeslet, Else; Storli, Sissel Lisa

2017-12-01

Nurses and physicians work side-by-side in the intensive care unit (ICU). Effective exchanges of patient information are essential to safe patient care in the ICU. Nurses often rate nurse-physician communication lower than physicians and report that it is difficult to speak up, that disagreements are not resolved and that their input is not well received. Therefore, this study explored nurses' dialogue with physicians regarding patients' clinical status and the prerequisites for effective and accurate exchanges of information. We adopted a qualitative approach, conducting three focus group discussions with five to six nurses and physicians each (14 total). Two themes emerged. The first theme highlighted nurses' contributions to dialogues with physicians; nurses' ongoing observations of patients were essential to patient care discussions. The second theme addressed the prerequisites of accurate and effective dialogue regarding care options, comprising three subthemes: nurses' ability to speak up and present clinical changes, establishment of shared goal and clinical understanding, and open dialogue and willingness to listen to each other. Nurses should understand their essential role in conducting ongoing observations of patients and their right to be included in care-related decision-making processes. Physicians should be willing to listen to and include nurses' clinical observations and concerns.

Incentives for Blood Donation: A Discrete Choice Experiment to Analyze Extrinsic Motivation.

PubMed

Sadler, Andrew; Shi, Ling; Bethge, Susanne; Mühlbacher, Axel

2018-04-01

Background: Demographic trends affect size and age structure of populations. One of the consequences will be an increasing need for blood products to treat age-related diseases. Donation services rely on voluntariness and charitable motivation. It might be questioned whether there will be sufficient blood supply with voluntary donation. The present study focused on elicitation of preferences for incentives and aimed to contribute to the discussion on how to increase donation rates. Methods: A self-administered discrete choice experiment (DCE) was applied. Respondents were repeatedly asked to choose between hypothetical blood donation centers. In case of reluctance to receiving incentives a none-option was included. Random parameter logit (RPL) and latent class models (LCM) were used for analysis. Results: The study sample included 416 college students from the US and Germany. Choice decisions were significantly influenced by the characteristics of the donation center in the DCE. Incentives most preferred were monetary compensation, paid leave, and blood screening test. LCM identified subgroups with preference heterogeneity. Small subgroups indicated moderate to strong aversion to incentives. Conclusion: The majority of the sample positively responded to incentives and indicated a willingness to accept incentives. In face of future challenges, the judicious use and appropriate utilization of incentives might be an option to motivate potential donors and should be open to discussion.

No option would satisfy everyone. [Decision making for decontamination of groundwater

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

Krause, C.

1991-01-01

In an address to registered sanitarians and restaurant inspectors, the Environmental Risk Coordinator for Oak Ridge National Laboratory discussed health risks and the cost of remediation for a typical site with contaminated groundwater. After consideration of each option it was clear that no option satisfied everyone in the group. Even though most members wanted aggressive treatment, they were frustrated to learn that aggressive and expensive treatments were no more effective than the no action option.

Scaling and long-range dependence in option pricing V: Multiscaling hedging and implied volatility smiles under the fractional Black-Scholes model with transaction costs

NASA Astrophysics Data System (ADS)

Wang, Xiao-Tian

2011-05-01

This paper deals with the problem of discrete time option pricing using the fractional Black-Scholes model with transaction costs. Through the ‘anchoring and adjustment’ argument in a discrete time setting, a European call option pricing formula is obtained. The minimal price of an option under transaction costs is obtained. In addition, the relation between scaling and implied volatility smiles is discussed.

Electric Power System Technology Options for Lunar Surface Missions

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.

2005-01-01

In 2004, the President announced a 'Vision for Space Exploration' that is bold and forward-thinking, yet practical and responsible. The vision explores answers to longstanding questions of importance to science and society and will develop revolutionary technologies and capabilities for the future, while maintaining good stewardship of taxpayer dollars. One crucial technology area enabling all space exploration is electric power systems. In this paper, the author evaluates surface power technology options in order to identify leading candidate technologies that will accomplish lunar design reference mission three (LDRM-3). LDRM-3 mission consists of multiple, 90-day missions to the lunar South Pole with 4-person crews starting in the year 2020. Top-level power requirements included a nominal 50 kW continuous habitat power over a 5-year lifetime with back-up or redundant emergency power provisions and a nominal 2-kW, 2-person unpressurized rover. To help direct NASA's technology investment strategy, this lunar surface power technology evaluation assessed many figures of merit including: current technology readiness levels (TRLs), potential to advance to TRL 6 by 2014, effectiveness of the technology to meet the mission requirements in the specified time, mass, stowed volume, deployed area, complexity, required special ground facilities, safety, reliability/redundancy, strength of industrial base, applicability to other LDRM-3 elements, extensibility to Mars missions, costs, and risks. For the 50-kW habitat module, dozens of nuclear, radioisotope and solar power technologies were down-selected to a nuclear fission heat source with Brayton, Stirling or thermoelectric power conversion options. Preferred energy storage technologies included lithium-ion battery and Proton Exchange Membrane (PEM) Regenerative Fuel Cells (RFC). Several AC and DC power management and distribution architectures and component technologies were defined consistent with the preferred habitat power generation technology option and the overall lunar surface mission. For rover power, more than 20 technology options were down-selected to radioisotope Stirling, liquid lithium-ion battery, PEM RFC, or primary fuel cell options. The author discusses various conclusions that can be drawn from the findings of this surface power technologies evaluation.

Current issues and challenges in the management of bariatric patients.

PubMed

Bell, Sue Ellen

2005-01-01

Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage. A comparison between benefits and coverage for bariatric surgery and angioplasty/stent placement is included.

Retrofit energy studies of a recreation center

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

Haberl, J.S.; Claridge, D.

1985-01-01

Retrofit energy options for the Student Recreation Center at the University of Colorado have been evaluated using the DOE-2.1b simulation program. This building has two major systems that are not included in the program - an ice rink and a swimming pool. The approach used to model these systems and the use of the program for other applications not included in the program, such as duty cycling and night cycling of fans for freeze protection, are emphasized. Measures that help streamline the usage of the program on a minicomputer are also discussed.

Marine Envenomation.

PubMed

Hornbeak, Kirsten B; Auerbach, Paul S

2017-05-01

Venomous aquatic animals are hazardous to swimmers, surfers, divers, and fishermen. Exposures include mild stings, bites, abrasions, and lacerations. Severe envenomations can be life threatening. This article reviews common marine envenomations, exploring causative species, clinical presentation, and current treatment recommendations. Recommendations are included for cnidaria, sponges, bristle worms, crown-of-thorns starfish, sea urchins, venomous fish, stingrays, cone snails, stonefish, blue-ringed octopus, and sea snakes. Immediate and long-term treatment options and management of common sequelae are reviewed. Antivenom administration, treatment of anaphylaxis, and surgical indications are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Tracking and Data Relay Satellite System configuration and tradeoff study. Volume 3: Atlas Centaur launched TDRSS. Part 2: Final Report, 22 August 1972 - 1 April 1973

NASA Technical Reports Server (NTRS)

1973-01-01

Configuration data and design information for the Atlas Centaur launched configuration are presented. Overall system definition, operations and control, and telecommunication service system, including link budgets, are discussed. A brief description of the user telecommunications equipment and ground station is presented. A summary description of the TDR spacecraft and all the subsystems is included. The data presented are largely in tabular form. A brief treatment of an optional configuration with enhanced telecommunications service is described.

Advancing palliative care in the Uganda health system: an evidence-based policy brief.

PubMed

Nabudere, Harriet; Obuku, Ekwaro; Lamorde, Mohammed

2014-12-01

This paper describes the development and findings for a policy brief on "Advancing the Integration of Palliative Care into the National Health System" and the subsequent use of this report. Key stakeholders involved with palliative care helped identify the problem and potential policy solutions to scale up these services within the health system. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved. The palliative burden is not only high but increasing due to the rise in population and life expectancy. A few options for holistic, supportive care include: Home-based care increases chances of a peaceful death for the terminally ill surrounded by their loved ones; supporting informal caregivers improves their quality of life and discharge planning reduces unscheduled admissions and has the potential to free up capacity for acute care services. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article. The policy brief report was used as a background document for two stakeholder dialogues whose main outcome was that a comprehensive national palliative care policy should be instituted to include all the options, which need to be integrated within the public health system. A draft policy is now in process.

Time to Improve Informed Consent for Dialysis: An International Perspective.

PubMed

Brennan, Frank; Stewart, Cameron; Burgess, Hannah; Davison, Sara N; Moss, Alvin H; Murtagh, Fliss E M; Germain, Michael; Tranter, Shelley; Brown, Mark

2017-06-07

The literature reveals that current nephrology practice in obtaining informed consent for dialysis falls short of ethical and legal requirements. Meeting these requirements represents a significant challenge, especially because the benefits and risks of dialysis have shifted significantly with the growing number of older, comorbid patients. The importance of informed consent for dialysis is heightened by several concerns, including: ( 1 ) the proportion of predialysis patients and patients on dialysis who lack capacity in decision making and ( 2 ) whether older, comorbid, and frail patients understand their poor prognosis and the full implications to their independence and functional status of being on dialysis. This article outlines the ethical and legal requirements for a valid informed consent to dialysis: ( 1 ) the patient was competent, ( 2 ) the consent was made voluntarily, and ( 3 ) the patient was given sufficient information in an understandable manner to make the decision. It then considers the application of these requirements to practice across different countries. In the process of informed consent, the law requires a discussion by the physician of the material risks associated with dialysis and alternative options. We argue that, legally and ethically, this discussion should include both the anticipated trajectory of the illness and the effect on the life of the patient with particular regard to the outcomes most important to the individual. In addition, a discussion should occur about the option of a conservative, nondialysis pathway. These requirements ensure that the ethical principle of respect for patient autonomy is honored in the context of dialysis. Nephrologists need to be open to, comfortable with, and skillful in communicating this information. From these clear, open, ethically, and legally valid consent discussions, a significant dividend will hopefully flow for patients, families, and nephrologists alike. Copyright © 2017 by the American Society of Nephrology.

Limitations of Reliability for Long-Endurance Human Spaceflight

NASA Technical Reports Server (NTRS)

Owens, Andrew C.; de Weck, Olivier L.

2016-01-01

Long-endurance human spaceflight - such as missions to Mars or its moons - will present a never-before-seen maintenance logistics challenge. Crews will be in space for longer and be farther way from Earth than ever before. Resupply and abort options will be heavily constrained, and will have timescales much longer than current and past experience. Spare parts and/or redundant systems will have to be included to reduce risk. However, the high cost of transportation means that this risk reduction must be achieved while also minimizing mass. The concept of increasing system and component reliability is commonly discussed as a means to reduce risk and mass by reducing the probability that components will fail during a mission. While increased reliability can reduce maintenance logistics mass requirements, the rate of mass reduction decreases over time. In addition, reliability growth requires increased test time and cost. This paper assesses trends in test time requirements, cost, and maintenance logistics mass savings as a function of increase in Mean Time Between Failures (MTBF) for some or all of the components in a system. In general, reliability growth results in superlinear growth in test time requirements, exponential growth in cost, and sublinear benefits (in terms of logistics mass saved). These trends indicate that it is unlikely that reliability growth alone will be a cost-effective approach to maintenance logistics mass reduction and risk mitigation for long-endurance missions. This paper discusses these trends as well as other options to reduce logistics mass such as direct reduction of part mass, commonality, or In-Space Manufacturing (ISM). Overall, it is likely that some combination of all available options - including reliability growth - will be required to reduce mass and mitigate risk for future deep space missions.

42 CFR 435.201 - Individuals included in optional groups.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Individuals included in optional groups. 435.201... Individuals included in optional groups. (a) The agency may choose to cover as optional categorically needy any group or groups of the following individuals who are not receiving cash assistance and who meet...

Greening America's Capitals - Madison, WI

EPA Pesticide Factsheets

This report discusses design options that could help Madison, WI, improve the Triangle neighborhood by making it easier for residents to get around. Design options could also help protect water quality and create new amenities for residents.

Implications of alternate revenue sources for transportation planning.

DOT National Transportation Integrated Search

2011-12-01

This report focuses on selected issues associated with alternative sources of : transportation funding. In particular, this report: presents a list of funding options, : discusses the advantages and disadvantages of each option, explores public attit...

Assessment of function and clinical utility of alcohol and other drug web sites: An observational, qualitative study

PubMed Central

2011-01-01

Background The increasing popularity and use of the internet makes it an attractive option for providing health information and treatment, including alcohol/other drug use. There is limited research examining how people identify and access information about alcohol or other drug (AOD) use online, or how they assess the usefulness of the information presented. This study examined the strategies that individuals used to identify and navigate a range of AOD websites, along with the attitudes concerning presentation and content. Methods Members of the general community in Brisbane and Roma (Queensland, Australia) were invited to participate in a 30-minute search of the internet for sites related to AOD use, followed by a focus group discussion. Fifty one subjects participated in the study across nine focus groups. Results Participants spent a maximum of 6.5 minutes on any one website, and less if the user was under 25 years of age. Time spent was as little as 2 minutes if the website was not the first accessed. Participants recommended that AOD-related websites should have an engaging home or index page, which quickly and accurately portrayed the site's objectives, and provided clear site navigation options. Website content should clearly match the title and description of the site that is used by internet search engines. Participants supported the development of a portal for AOD websites, suggesting that it would greatly facilitate access and navigation. Treatment programs delivered online were initially viewed with caution. This appeared to be due to limited understanding of what constituted online treatment, including its potential efficacy. Conclusions A range of recommendations arise from this study regarding the design and development of websites, particularly those related to AOD use. These include prudent use of text and information on any one webpage, the use of graphics and colours, and clear, uncluttered navigation options. Implications for future website development are discussed. PMID:21545748

Exploring the Options. Curriculum Documents and Support Materials for the General Curriculum Options Stream of the Certificates of General Education for Adults.

ERIC Educational Resources Information Center

Johnson, Marlene, Ed.; Brearley, Laura, Ed.

This document contains detailed curriculum outlines and teacher support materials for the General Curriculum Options (GCO) stream of the Certificates of General Education (CGE) for Adults in Victoria, Australia. The following topics are discussed in the introduction: purpose of the guide, details of GCO subject areas, accreditation framework and…

Variation in Women's Understanding of Prenatal Testing.

PubMed

Bryant, Allison S; Norton, Mary E; Nakagawa, Sanae; Bishop, Judith T; Pena, Sherri; Gregorich, Steven E; Kuppermann, Miriam

2015-06-01

To investigate women's understanding of prenatal testing options and of their own experience with screening, diagnostic genetic testing, or both. This was a secondary analysis of data from a randomized controlled trial of enhanced information and values clarification regarding prenatal genetic testing in the absence of financial barriers to testing. Women in the third trimester of pregnancy were asked whether they had discussed prenatal genetic testing with their health care providers, whether they understood this testing was optional, and whether they had undergone testing during their pregnancy. Multivariable logistic regression models were fit to determine independent predictors of these outcomes. Data were available from 710 study participants. Discussions about screening tests were reported by 654 participants (92%); only 412 (58%) reported discussing diagnostic testing. That screening and diagnostic testing were optional was evident to approximately two thirds of women (n=470 and 455, respectively). Recall of actual tests undergone was correct for 626 (88%) for screening and for 700 (99%) for diagnostic testing. Racial, ethnic and socioeconomic variation existed in the understanding of whether screening and diagnostic tests were optional and in the correct recall of whether screening had been undertaken in the current pregnancy. In the usual care group, women receiving care in low-income settings were less likely to recall being offered diagnostic testing (adjusted odds ratio 0.23 [0.14-0.39]). Disparities exist in women's recall of prenatal genetic testing discussions and their understanding of their own experience. Interventions that explain testing options to women and help clarify their preferences may help to eliminate these differences.

Photovoltaic options for solar electric propulsion

NASA Technical Reports Server (NTRS)

Stella, Paul M.; Flood, Dennis J.

1990-01-01

During the past decade, a number of advances have occurred in solar cell and array technology. These advances have lead to performance improvement for both conventional space arrays and for advanced technology arrays. Performance enhancements have occurred in power density, specific power, and environmental capability. Both state-of-the-art and advanced development cells and array technology are discussed. Present technology will include rigid, rollout, and foldout flexible substrate designs, with silicon and GaAs solar cells. The use of concentrator array systems is also discussed based on both DOD and NASA efforts. The benefits of advanced lightweight array technology, for both near term and far term utilization, and of advanced high efficiency, thin, radiation resistant cells is examined. This includes gallium arsenide on germaniun substrates, indium phosphide, and thin film devices such as copper indium diselenide.

Advisory Committee on the Redesign of the Space Station

NASA Astrophysics Data System (ADS)

1993-06-01

The Space Station Program was initiated in 1984 to provide for permanent human presence in an orbiting laboratory. This program evolved into Space Station Freedom, later identified as a component to facilitate a return of astronauts to the Moon, followed by the exploration of Mars. In March 1993 the Clinton Administration directed NASA to undertake an intense effort to redesign the space station at a substantial cost savings relative to Space Station Freedom. The Advisory Committee on the Redesign of the Space Station was established in March 1993 to provide independent assessment of the advantages and disadvantages of the redesign options. The results of the Committee's work is described. Discussion describes the mission that the Administration has articulated for the Space Station Program and the scientific and technical characteristics that a redesigned station must possess to fulfill those objectives. A description of recommended management, operations, and acquisition strategies for the redesigned program is provided. The Committee's assessment of the redesign options against five criteria are presented. The five criteria are technical capabilities, research capabilities, schedule, cost, and risk. A discussion of general mission risk is included.

Exploring the benefits of an optional theatre module on medical student well-being.

PubMed

Nagji, Alim; Brett-MacLean, Pamela; Breault, Lorraine

2013-01-01

Medical students struggle with varied stressors and developing adequate coping mechanisms is essential. This study examined medical student perceptions of the well-being impact of a theatre-based course. Eighteen 1st-year medical students at the University of Alberta participated in 3 focus groups following the conclusion of a theatre-based module that was piloted in the first quarter of 2010. A semistructured protocol was used to guide the focus groups, which were audiotaped and transcribed. Along with general feedback, impact on personal development and student well-being were discussed. Thematic aspects of these discussions were qualitatively analyzed. During the focus groups, medical students identified three aspects of the theatre-based module that contributed to their sense of overall well-being. These included (a) fun/relaxation, (b) enhanced relationships with each other, and (c) personal growth/resilience. Our findings suggest that participating in an optional theatre module can enhance medical student well-being. Our analysis suggests the need to consider novel, humanities-based curriculum offerings in relation to personal development and well- being.

Mitigating amphibian chytridiomycosis in nature

USGS Publications Warehouse

Garner, Trenton W. J.; Schmidt, Benedikt R.; Martel, An; Pasmans, Frank; Muths, Erin L.; Cunningham, Andrew A.; Weldon, Che; Fisher, Matthew C.; Bosch, Jaime

2016-01-01

Amphibians across the planet face the threat of population decline and extirpation caused by the disease chytridiomycosis. Despite consensus that the fungal pathogens responsible for the disease are conservation issues, strategies to mitigate their impacts in the natural world are, at best, nascent. Reducing risk associated with the movement of amphibians, non-amphibian vectors and other sources of infection remains the first line of defence and a primary objective when mitigating the threat of disease in wildlife. Amphibian-associated chytridiomycete fungi and chytridiomycosis are already widespread, though, and we therefore focus on discussing options for mitigating the threats once disease emergence has occurred in wild amphibian populations. All strategies have shortcomings that need to be overcome before implementation, including stronger efforts towards understanding and addressing ethical and legal considerations. Even if these issues can be dealt with, all currently available approaches, or those under discussion, are unlikely to yield the desired conservation outcome of disease mitigation. The decision process for establishing mitigation strategies requires integrated thinking that assesses disease mitigation options critically and embeds them within more comprehensive strategies for the conservation of amphibian populations, communities and ecosystems.

Covered stent graft for treatment of a pseudoaneurysm and carotid blowout syndrome

PubMed Central

Janjua, Nazli; Alkawi, Ammar; Georgiadis, Alexandros L.; Kirmani, Jawad F.; Qureshi, Adnan I.

2008-01-01

Background Carotid blowout syndrome with pseudoaneurysm, a rapidly progressive pathology, may present emergently with massive oral hemorrhage. Use of an endograft prosthesis offers a treatment strategy with salvation of the carotid artery. Case History: A 55 year old man with advanced squamous cell carcinoma of the head and neck presented with recurrent transoral hemorrhage, requiring endovascular treatment. Technical Report: Coil embolization was initially performed with little impact on the hemorrhage. A 7 x 40 mm Fluency® Plus covered stent (Bard Peripheral Vascular, Tempe, Arizona, USA) was placed and was supplemented by a second 8 x 40 mm Fluency Plus stent, with resulting cessation of active contrast extravasation. Discussion: The risks and benefits of various treatment options of carotid pseudoaneurysm with blowout are discussed including the use or omission of antiplatelet and anticoagulant regimens, with reference to previously reported cases. Conclusion: Tandem, overlapping covered stent placement in the common carotid artery is feasible and offers a treatment option for carotid blowout syndrome. Risks of aggravation of hemorrhage versus long-term thromboembolic events without antiplatelet therapy must be considered in cases of active ongoing hemorrhage. PMID:22518207

Advisory Committee on the Redesign of the Space Station

NASA Technical Reports Server (NTRS)

1993-01-01

The Space Station Program was initiated in 1984 to provide for permanent human presence in an orbiting laboratory. This program evolved into Space Station Freedom, later identified as a component to facilitate a return of astronauts to the Moon, followed by the exploration of Mars. In March 1993 the Clinton Administration directed NASA to undertake an intense effort to redesign the space station at a substantial cost savings relative to Space Station Freedom. The Advisory Committee on the Redesign of the Space Station was established in March 1993 to provide independent assessment of the advantages and disadvantages of the redesign options. The results of the Committee's work is described. Discussion describes the mission that the Administration has articulated for the Space Station Program and the scientific and technical characteristics that a redesigned station must possess to fulfill those objectives. A description of recommended management, operations, and acquisition strategies for the redesigned program is provided. The Committee's assessment of the redesign options against five criteria are presented. The five criteria are technical capabilities, research capabilities, schedule, cost, and risk. A discussion of general mission risk is included.

Racial Differences in the Perception of Contraception Option Attributes.

ERIC Educational Resources Information Center

McDermott, Robert J.; Gold, Robert S.

1987-01-01

More than 600 never-married college students completed a questionnaire regarding their attitudes toward 10 contraceptive options. Results were analyzed separately for Blacks and Whites, and then for males and females. Findings are discussed. (MT)

Clostridium difficile infection: management strategies for a difficult disease

PubMed Central

Pardi, Darrell S.

2014-01-01

Clostridium difficile was first described as a cause of diarrhea in 1978 and in the last three decades has reached an epidemic state with increasing incidence and severity in both healthcare and community settings. There also has been a rise in severe outcomes from C. difficile infection (CDI). There have been tremendous advancements in the field of CDI with the identification of newer risk factors, recognition of CDI in populations previously thought not at risk and development of better diagnostic modalities. Several treatment options are available for CDI apart from metronidazole and vancomycin, and include new drugs such as fidaxomicin and other options such as fecal microbiota transplantation. This review discusses the epidemiology, risk factors and outcomes from CDI, and focuses primarily on existing and evolving treatment modalities. PMID:24587820

Psychotherapy: What's Metaphysical Got to Do With It?

PubMed

Sansone, Randy A; Sansone, Lori A

2009-12-01

Clinicians have a number of treatment options for dealing with the emotional ills of patients, including psychoeducation, psychotherapy, and pharmacotherapy. However, after years of experience in the clinical field, we have recognized that these treatment options may not be sufficient to adequately address the problems of some patients. We have found that adding a metaphysical/spiritual component may be helpful, particularly for those patients with histories of childhood trauma. In this edition of The Interface, we discuss four metaphysical techniques for facilitating patient healing-1) refocusing on the present, 2) reframing adversity, 3) practicing surrender, and 4) meditation. These approaches can be mutually integrated and compliment a psychological treatment in either the psychiatric or primary care setting, regardless of whether or not the patient has formal religious beliefs.

[Jellyfish sting injuries].

PubMed

Mebs, D

2014-10-01

Jellyfish are distributed worldwide; they cause local skin injuries upon contact which are often followed by systemic signs of envenoming. Which jellyfish species are of medical importance, which skin reactions and systemic symptoms occur, which first-aid measures and treatment options exist? Review of the medical literature and discussion of first-aid and therapeutic options. Jellyfish capable of causing skin injuries occur in almost all oceans. Several jellyfish species may cause severe, potentially lethal, systemic symptoms; they include the Portuguese man-of-war (Physalia physalis) and box jellyfish (Chironex fleckeri, Carukia barnesi, Chiropsalmus quadrigatus). Among the injuries and envenoming symptoms caused by marine organisms, jellyfish dermatitis should not be underestimated. Skin reactions may not only a dermatological problem, but also be accompanied by complex systemic toxic symptoms which are a challenge for internists.

Acquiring Spectra of Solar System Objects with the NIRSpec Instrument on the James Webb Space Telescope

NASA Astrophysics Data System (ADS)

Proffitt, Charles R.; Birkmann, Stephan; Ferruit, Pierre; Guilbert, Aurelie; Holler, Bryan J.; Stansberry, John

2017-10-01

The NIRSpec Instrument on the James Webb Space Telescope will allow near-IR spectroscopy in the wavelength range between 0.6 and 5.3 microns with resolving power of ~100, 1000, or 2700. We review strategies for performing spectral observations of solar system objects using each of NIRSpec's available observing modes, including the integral field unit (IFU), multi-Object Spectroscopy (MOS), and fixed slit (FS) templates, and discuss how the choice of mode affects the limiting target brightness as well as the detailed wavelength and spatial coverage obtained. We also discuss the expected pointing accuracy and target acquisition options for moving targets, including the use and limitations of the Wide Aperture Target Acquisition (WATA) capability and of the pre-defined field points that will be available for use with the MOS template to enable the use of custom micro-shutter patterns including ones emulating very long slits.

Access with evidence development: the US experience.

PubMed

Mohr, Penny E; Tunis, Sean R

2010-01-01

The concept of access with evidence development (AED), also known as 'coverage with evidence development' in the Medicare programme, has long been discussed as a policy option for ensuring more appropriate use of new technologies in the US. This article provides a comprehensive overview of more than 10 years of US experience with AED, both in the public and private healthcare sectors. Beginning with a discussion of the successes of private plans' conditional coverage for high-density chemotherapy for autologous bone marrow transplants for metastatic breast cancer and Medicare's conditional coverage of lung-volume-reduction surgery in the 1990s, the article moves on to describe how Medicare worked to codify AED as one of its coverage policy options in the early part of this decade. More recent private and public sector initiatives are also discussed, including an overview of barriers to implementing AED. Despite the complexity of political, financial and ethical issues faced in implementation, AED is now a permanent fixture of US coverage policy. Future initiatives within the Medicare programme and with private payers in the US are much more likely to succeed by relying upon the simple but consequential principles laid out at a Summit convened in Banff, Alberta, Canada in 2009 and presented in another article in this issue.

Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement.

PubMed

Aherne, Declan; Farrant, Katie; Hickey, Louise; Hickey, Emma; McGrath, Lisa; McGrath, Deirdre

2016-08-18

Medical practitioners and students are at increased risk of a number of personal and psychological problems. Stress and anxiety due to work-load and study requirements are common and self-care methods are important in maintaining well-being. The current study examines perceptions of and satisfaction ratings with a mindfulness based stress reduction (MBSR) programme for 1(st) year (compulsory) and 2(nd) year (optional) Graduate Entry Medical School students. A mixed method pre and post study of Year 1 (n = 140) and Year 2 (n = 88) medical students completing a 7 week MBSR course compared student satisfaction ratings. Thematic analysis of feedback from the students on their perception of the course was also carried out. Year 1 students (compulsory course) were less satisfied with content and learning outcomes than Year 2 students (optional course) (p < .0005). Thematic analysis of year 1 student feedback identified themes including great concept, poorly executed; and less discussion, more practice. Year 2 themes included session environment and satisfaction with tutors. The MBSR course was associated with high levels of satisfaction and positive feedback when delivered on an optional basis. Catering for the individual needs of the participant and promoting a safe environment are core elements of a successful self-care programme.

Recent Advances and Developments in Knee Surgery: Principles of Periprosthetic Knee Fracture Management

PubMed Central

Chimutengwende-Gordon, Mukai; Khan, Wasim; Johnstone, David

2012-01-01

The management of distal femoral, tibial and patellar fractures after total knee arthroplasty can be complex. The incidence of these fractures is increasing as the number of total knee arthroplasties being performed and patient longevity is increasing. There is a wide range of treatment options including revision arthroplasty for loose implants. This review article discusses the epidemiology, risk factors, classification and treatment of these fractures. PMID:22888380

Quality of care received and patient-reported regret in prostate cancer: Analysis of a population-based prospective cohort.

PubMed

Holmes, Jordan A; Bensen, Jeannette T; Mohler, James L; Song, Lixin; Mishel, Merle H; Chen, Ronald C

2017-01-01

Meeting quality of care standards in oncology is recognized as important by physicians, professional organizations, and payers. Data from a population-based cohort of patients with prostate cancer were used to examine whether receipt of care was consistent with published consensus metrics and whether receiving high-quality care was associated with less patient-reported treatment decisional regret. Patients with incident prostate cancer were enrolled in collaboration with the North Carolina Central Cancer Registry, with an oversampling of minority patients. Medical record abstraction was used to determine whether participants received high-quality care based on 5 standards: 1) discussion of all treatment options; 2) complete workup (prostate-specific antigen, Gleason grade, and clinical stage); 3) low-risk participants did not undergo a bone scan; 4) high-risk participants treated with radiotherapy (RT) received androgen deprivation therapy; and 5) participants treated with RT received conformal or intensity-modulated RT. Treatment decisional regret was assessed using a validated instrument. A total of 804 participants were analyzed. Overall, 66% of African American and 73% of white participants received care that met all standards (P = .03); this racial difference was confirmed by multivariable analysis. Care that included "discussion of all treatment options" was found to be associated with less patient-reported regret on univariable analysis (P = .03) and multivariable analysis (odds ratio, 0.59; 95% confidence interval, 0.37-0.95). The majority of participants received high-quality care, but racial disparity existed. Participants who discussed all treatment options appeared to have less treatment decisional regret. To the authors' knowledge, this is the first study to demonstrate an association between a quality of care metric and patient-reported outcome. Cancer 2017;138-143. © 2016 American Cancer Society. © 2016 American Cancer Society.

Age, Loss Minimization, and the Role of Probability for Decision-Making.

PubMed

Best, Ryan; Freund, Alexandra M

2018-04-05

Older adults are stereotypically considered to be risk averse compared to younger age groups, although meta-analyses on age and the influence of gain/loss framing on risky choices have not found empirical evidence for age differences in risk-taking. The current study extends the investigation of age differences in risk preference by including analyses on the effect of the probability of a risky option on choices in gain versus loss situations. Participants (n = 130 adults aged 19-80 years) chose between a certain option and a risky option of varying probability in gain- and loss-framed gambles with actual monetary outcomes. Only younger adults displayed an overall framing effect. Younger and older adults responded differently to probability fluctuations depending on the framing condition. Older adults were more likely to choose the risky option as the likelihood of avoiding a larger loss increased and as the likelihood of a larger gain decreased. Younger adults responded with the opposite pattern: they were more likely to choose the risky option as the likelihood of a larger gain increased and as the likelihood of avoiding a (slightly) larger loss decreased. Results suggest that older adults are more willing to select a risky option when it increases the likelihood that larger losses be avoided, whereas younger adults are more willing to select a risky option when it allows for slightly larger gains. This finding supports expectations based on theoretical accounts of goal orientation shifting away from securing gains in younger adulthood towards maintenance and avoiding losses in older adulthood. Findings are also discussed in respect to the affective enhancement perspective and socioemotional selectivity theory. © 2018 S. Karger AG, Basel.

Technical options for the mitigation of direct methane and nitrous oxide emissions from livestock: a review.

PubMed

Gerber, P J; Hristov, A N; Henderson, B; Makkar, H; Oh, J; Lee, C; Meinen, R; Montes, F; Ott, T; Firkins, J; Rotz, A; Dell, C; Adesogan, A T; Yang, W Z; Tricarico, J M; Kebreab, E; Waghorn, G; Dijkstra, J; Oosting, S

2013-06-01

Although livestock production accounts for a sizeable share of global greenhouse gas emissions, numerous technical options have been identified to mitigate these emissions. In this review, a subset of these options, which have proven to be effective, are discussed. These include measures to reduce CH4 emissions from enteric fermentation by ruminants, the largest single emission source from the global livestock sector, and for reducing CH4 and N2O emissions from manure. A unique feature of this review is the high level of attention given to interactions between mitigation options and productivity. Among the feed supplement options for lowering enteric emissions, dietary lipids, nitrates and ionophores are identified as the most effective. Forage quality, feed processing and precision feeding have the best prospects among the various available feed and feed management measures. With regard to manure, dietary measures that reduce the amount of N excreted (e.g. better matching of dietary protein to animal needs), shift N excretion from urine to faeces (e.g. tannin inclusion at low levels) and reduce the amount of fermentable organic matter excreted are recommended. Among the many 'end-of-pipe' measures available for manure management, approaches that capture and/or process CH4 emissions during storage (e.g. anaerobic digestion, biofiltration, composting), as well as subsurface injection of manure, are among the most encouraging options flagged in this section of the review. The importance of a multiple gas perspective is critical when assessing mitigation potentials, because most of the options reviewed show strong interactions among sources of greenhouse gas (GHG) emissions. The paper reviews current knowledge on potential pollution swapping, whereby the reduction of one GHG or emission source leads to unintended increases in another.

Acceptability of lifelong treatment among HIV-positive pregnant and breastfeeding women (Option B+) in selected health facilities in Zimbabwe: a qualitative study.

PubMed

Chadambuka, Addmore; Katirayi, Leila; Muchedzi, Auxilia; Tumbare, Esther; Musarandega, Reuben; Mahomva, Agnes I; Woelk, Godfrey

2017-07-25

Zimbabwe's Ministry of Health and Child Care (MOHCC) adopted 2013 World Health Organization (WHO) prevention of mother-to-child HIV transmission (PMTCT) guidelines recommending initiation of HIV-positive pregnant and breastfeeding women (PPBW) on lifelong antiretroviral treatment (ART) irrespective of clinical stage (Option B+). Option B+ was officially launched in Zimbabwe in November 2013; however the acceptability of life-long ART and its potential uptake among women was not known. A qualitative study was conducted at selected sites in Harare (urban) and Zvimba (rural) to explore Option B+ acceptability; barriers, and facilitators to ART adherence and service uptake. In-depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with PPBW, healthcare providers, and community members. All interviews were audio-recorded, transcribed, and translated; data were coded and analyzed in MaxQDA v10. Forty-three IDIs, 22 FGDs, and five KIIs were conducted. The majority of women accepted lifelong ART. There was however, a fear of commitment to taking lifelong medication because they were afraid of defaulting, especially after cessation of breastfeeding. There was confusion around dosage; and fear of side effects, not having enough food to take drugs, and the lack of opportunities to ask questions in counseling. Participants reported the need for strengthening community sensitization for Option B+. Facilitators included receiving a simplified pill regimen; ability to continue breastfeeding beyond 6 months like HIV-negative women; and partner, community and health worker support. Barriers included distance of health facility, non-disclosure of HIV status, poor male partner support and knowing someone who had negative experience on ART. This study found that Option B+ is generally accepted among PPBW as a means to strengthen their health and protect their babies. Consistent with previous literature, this study demonstrated the importance of male partner and community support in satisfactory adherence to ART and enhancing counseling techniques. Strengthening community sensitization and male knowledge is critical to encourage women to disclose their HIV status and ensure successful adherence to ART. Targeting and engaging partners of women will remain key determinants to women's acceptance and adherence on ART under Option B+.

Application of an extreme winter storm scenario to identify vulnerabilities, mitigation options, and science needs in the Sierra Nevada mountains, USA

USGS Publications Warehouse

Albano, Christine M.; Dettinger, Michael; McCarthy, Maureen; Schaller, Kevin D.; Wellborn, Toby; Cox, Dale A.

2016-01-01

In the Sierra Nevada mountains (USA), and geographically similar areas across the globe where human development is expanding, extreme winter storm and flood risks are expected to increase with changing climate, heightening the need for communities to assess risks and better prepare for such events. In this case study, we demonstrate a novel approach to examining extreme winter storm and flood risks. We incorporated high-resolution atmospheric–hydrologic modeling of the ARkStorm extreme winter storm scenario with multiple modes of engagement with practitioners, including a series of facilitated discussions and a tabletop emergency management exercise, to develop a regional assessment of extreme storm vulnerabilities, mitigation options, and science needs in the greater Lake Tahoe region of Northern Nevada and California, USA. Through this process, practitioners discussed issues of concern across all phases of the emergency management life cycle, including preparation, response, recovery, and mitigation. Interruption of transportation, communications, and interagency coordination were among the most pressing concerns, and specific approaches for addressing these issues were identified, including prepositioning resources, diversifying communications systems, and improving coordination among state, tribal, and public utility practitioners. Science needs included expanding real-time monitoring capabilities to improve the precision of meteorological models and enhance situational awareness, assessing vulnerabilities of critical infrastructure, and conducting cost–benefit analyses to assess opportunities to improve both natural and human-made infrastructure to better withstand extreme storms. Our approach and results can be used to support both land use and emergency planning activities aimed toward increasing community resilience to extreme winter storm hazards in mountainous regions.

New therapeutic directions for advanced pancreatic cancer: cell cycle inhibitors, stromal modifiers and conjugated therapies.

PubMed

Matera, Robert; Saif, Muhammad Wasif

2017-09-01

Pancreatic adenocarcinoma is a devastating malignancy with an extremely poor prognosis. These tumors progress rapidly and somewhat silently with few specific symptoms and are relatively resistant to chemotherapeutic agents. Many agents, including cell cycle inhibitors, are under development for the treatment of this cancer for which there are disappointingly few treatment options. Areas covered: Here we outline the existing approved treatments for advanced pancreatic disease and discuss a range of novel therapies currently under development including cell cycle inhibitors, stromal modifiers and conjugated therapies. We also describe the current state of the pancreatic cancer therapeutics market both past and future. Expert opinion: Despite the recent explosion of novel therapies with an array of unique targets, the core treatment of pancreatic cancer still with traditional cytotoxic agents with a few exceptions. However, as these novel treatments move through the pipeline, we are hopeful that there will soon be a number of effective options for patients with advanced pancreatic cancer.

Evolutionary use of nuclear electric propulsion

NASA Technical Reports Server (NTRS)

Hack, K. J.; George, J. A.; Riehl, J. P.; Gilland, J. H.

1990-01-01

Evolving new propulsion technologies through a rational and conscious effort to minimize development costs and program risks while maximizing the performance benefits is intuitively practical. A phased approach to the evolution of nuclear electric propulsion from use on planetary probes, to lunar cargo vehicles, and finally to manned Mars missions with a concomitant growth in technology is considered. Technology levels and system component makeup are discussed for nuclear power systems and both ion and magnetoplasmadynamic thrusters. Mission scenarios are described, which include analysis of a probe to Pluto, a lunar cargo mission, Martian split, all-up, and quick-trip mission options. Evolutionary progression of the use of NEP in such missions is discussed.

Deflection Missions for Asteroid 2011 AG5

NASA Technical Reports Server (NTRS)

Grebow, Daniel; Landau, Damon; Bhaskaran, Shyam; Chodas, Paul; Chesley, Steven; Yeomans, Don; Petropoulos, Anastassios; Sims, Jon

2012-01-01

The recently discovered asteroid 2011 AG5 currently has a 1-in-500 chance of impacting Earth in 2040. In this paper, we discuss the potential of future observations of the asteroid and their effects on the asteroid's orbital uncertainty. Various kinetic impactor mission scenarios, relying on both conventional chemical as well as solar-electric propulsion, are presented for deflecting the course of the asteroid safely away from Earth. The times for the missions range from pre-keyhole passage (pre-2023), and up to five years prior to the 2040 Earth close approach. We also include a brief discussion on terminal guidance, and contingency options for mission planning.

Evaluation and management of "sinus headache" in the otolaryngology practice.

PubMed

Patel, Zara M; Setzen, Michael; Poetker, David M; DelGaudio, John M

2014-04-01

Patients, primary care doctors, neurologists and otolaryngologists often have differing views on what is truly causing headache in the sinonasal region. This review discusses common primary headache diagnoses that can masquerade as "sinus headache" or "rhinogenic headache," such as migraine, trigeminal neuralgia, tension-type headache, temporomandibular joint dysfunction, giant cell arteritis (also known as temporal arteritis) and medication overuse headache, as well as the trigeminal autonomic cephalalgias, including cluster headache, paroxysmal hemicrania, and hemicrania continua. Diagnostic criteria are discussed and evidence outlined that allows physicians to make better clinical diagnoses and point patients toward better treatment options. Copyright © 2014 Elsevier Inc. All rights reserved.

Insurance and indemnification implications of future space projects

NASA Technical Reports Server (NTRS)

O'Brien, John E.

1987-01-01

NASA options regarding insurance and indemnification policies as they relate to NASA customers and contractors are described. The foundation for the discussion is the way in which NASA is planning to return the Space Shuttle fleet to safe flight as well as current U.S. policy concerning future uses of the Shuttle fleet. Issues discussed include: the nature of the Shuttle manifest; the policy regarding property damage or destruction; insurance against liability to third parties; the reduction of the scope of the risk to be insured; NASA as the insurer; a sharing arrangement between the user and NASA; and contractors and subcontractors involved in Shuttle operations.

Project identification for methane reduction options

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

Kerr, T.

1996-12-31

This paper discusses efforts directed at reduction in emission of methane to the atmosphere. Methane is a potent greenhouse gas, which on a 20 year timeframe may present a similar problem to carbon dioxide. In addition, methane causes additional problems in the form of smog and its longer atmospheric lifetime. The author discusses strategies for reducing methane emission from several major sources. This includes landfill methane recovery, coalbed methane recovery, livestock methane reduction - in the form of ruminant methane reduction and manure methane recovery. The author presents examples of projects which have implemented these ideas, the economics of themore » projects, and additional gains which come from the projects.« less

Acute Neurological Issues in Pregnancy and the Peripartum

PubMed Central

Hosley, Catherine M.; McCullough, Louise D.

2011-01-01

Acute neurological diseases requiring hospitalization are relatively rare in women of childbearing age. However, during pregnancy and the postpartum period, several diseases increase in prevalence. Some are unique to the pregnant/postpartum state including preeclampsia and delivery-associated neuropathies. Others, although indirectly related to pregnancy, such as cerebral venous thrombosis, ischemic stroke, and intracerebral hemorrhage, increase in frequency and carry considerable risk of morbidity and mortality. In addition, treatment options are often limited. This review discusses the diseases more commonly seen during pregnancy and the postpartum period, with a focus on emergent neurological diseases and their management. Interventional therapies will also be discussed. PMID:23983844

48 CFR 552.217-71 - Notice Regarding Option(s).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to [Insert...

Biological Treatment of Drinking Water: Applications, Advantages and Disadvantages

EPA Science Inventory

The fundamentals of biological treatment are presented to an audience of state drinking water regulators. The presentation covers definitions, applications, the basics of bacterial metabolism, a discussion of treatment options, and the impact that implementation of these options...

76 FR 12771 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... reciprocity in matching other exchanges' Weekly option choices, BOX discontinues trading Weekly option classes... management purposes. \\5\\ As discussed above, because of the reciprocity provision of the Weeklys Program, the...

MODELING CONCEPTS FOR BMP/LID SIMULATION

EPA Science Inventory

Enhancement of simulation options for stormwater best management practices (BMPs) and hydrologic source control is discussed in the context of the EPA Storm Water Management Model (SWMM). Options for improvement of various BMP representations are presented, with emphasis on inco...

Variable speed generator technology options for wind turbine generators

NASA Technical Reports Server (NTRS)

Lipo, T. A.

1995-01-01

The electrical system options for variable speed operation of a wind turbine generator are treated in this paper. The key operating characteristics of each system are discussed and the major advantages and disadvantages of each are identified

American option pricing in Gauss-Markov interest rate models

NASA Astrophysics Data System (ADS)

Galluccio, Stefano

1999-07-01

In the context of Gaussian non-homogeneous interest-rate models, we study the problem of American bond option pricing. In particular, we show how to efficiently compute the exercise boundary in these models in order to decompose the price as a sum of a European option and an American premium. Generalizations to coupon-bearing bonds and jump-diffusion processes for the interest rates are also discussed.

78 FR 36812 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... are not discussed below, are and shall continue to be \\1/10\\th of the fees for standard options.\\4\\ \\3... charge fees for regular orders in mini options at a rate that is \\1/10\\th the rate of fees the Exchange... light of the fact that mini options have a smaller exercise and assignment value, specifically \\1/ 10\\th...

A Review of the Tawny Crazy Ant, Nylanderia fulva, an Emergent Ant Invader in the Southern United States: Is Biological Control a Feasible Management Option?

PubMed

Wang, Zinan; Moshman, Lori; Kraus, Emily C; Wilson, Blake E; Acharya, Namoona; Diaz, Rodrigo

2016-12-15

The tawny crazy ant, Nylanderia fulva (Mayr) (Hymenoptera: Formicidae), has invaded states of the U.S. including Texas, Louisiana, Mississippi, Alabama, Florida, and Georgia. Native to South America, N. fulva is considered a pest in the U.S. capable of annoying homeowners and farmers, as well as displacing native ant species. As it continues to expand its range, there is a growing need to develop novel management techniques to control the pest and prevent further spread. Current management efforts rely heavily on chemical control, but these methods have not been successful. A review of the biology, taxonomy, ecology, and distribution of N. fulva , including discussion of ecological and economic consequences of this invasive species, is presented. Options for future management are suggested focusing on biological control, including parasitoid flies in the genus Pseudacteon , the microsporidian parasite Myrmecomorba nylanderiae , and a novel polynucleotide virus as potential biological control agents. We suggest further investigation of natural enemies present in the adventive range, as well as foreign exploration undertaken in the native range including Paraguay, Brazil, and Argentina. We conclude that N. fulva may be a suitable candidate for biological control.

A Review of the Tawny Crazy Ant, Nylanderia fulva, an Emergent Ant Invader in the Southern United States: Is Biological Control a Feasible Management Option?

PubMed Central

Wang, Zinan; Moshman, Lori; Kraus, Emily C.; Wilson, Blake E.; Acharya, Namoona; Diaz, Rodrigo

2016-01-01

The tawny crazy ant, Nylanderia fulva (Mayr) (Hymenoptera: Formicidae), has invaded states of the U.S. including Texas, Louisiana, Mississippi, Alabama, Florida, and Georgia. Native to South America, N. fulva is considered a pest in the U.S. capable of annoying homeowners and farmers, as well as displacing native ant species. As it continues to expand its range, there is a growing need to develop novel management techniques to control the pest and prevent further spread. Current management efforts rely heavily on chemical control, but these methods have not been successful. A review of the biology, taxonomy, ecology, and distribution of N. fulva, including discussion of ecological and economic consequences of this invasive species, is presented. Options for future management are suggested focusing on biological control, including parasitoid flies in the genus Pseudacteon, the microsporidian parasite Myrmecomorba nylanderiae, and a novel polynucleotide virus as potential biological control agents. We suggest further investigation of natural enemies present in the adventive range, as well as foreign exploration undertaken in the native range including Paraguay, Brazil, and Argentina. We conclude that N. fulva may be a suitable candidate for biological control. PMID:27983690

International consensus on Vibrant Soundbridge® implantation in children and adolescents.

PubMed

Cremers, Cor W R J; O'Connor, Alec Fitzgerald; Helms, Jan; Roberson, Joseph; Clarós, Pedro; Frenzel, Henning; Profant, Milan; Schmerber, Sébastien; Streitberger, Christian; Baumgartner, Wolf-Dieter; Orfila, Daniel; Pringle, Mike; Cenjor, Carlos; Giarbini, Nadia; Jiang, Dan; Snik, Ad F M

2010-11-01

Active middle ear implants augment hearing in patients with sensorineural, conductive, and mixed hearing losses with great success. However, the application of active middle ear implants has been restricted to compromised ears in adults only. Recently, active middle ear implants have been successfully implanted in patients younger than 18 years of age with all types of hearing losses. The Vibrant Soundbridge (VSB) active middle ear implant has been implanted in more than 60 children and adolescents worldwide by the end of 2008. In October 2008, experts from the field with experience in this population met to discuss VSB implantation in patients below the age of 18. A consensus meeting was organized including a presentation session of cases from worldwide centers and a discussion session in which implantation, precautions, and alternative means of hearing augmentation were discussed. At the end of the meeting, a consensus statement was written by the participating experts. The present consensus paper describes the outcomes and medical/surgical complications: the outcomes are favourable in terms of hearing thresholds, speech intelligibility in quiet and in noise, with a low incidence of intra- and postoperative complications. Taken together, the VSB offers another viable treatment for children and adolescents with compromised hearing. However, other treatment options should also be taken into consideration. The advantages and disadvantages of all possible treatment options should be weighed against each other in the light of each individual case to provide the best solution; counseling should include a.o. surgical issues and MRI compatibility. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Somatic Treatments for Mood Disorders

PubMed Central

Rosa, Moacyr A; Lisanby, Sarah H

2012-01-01

Somatic treatments for mood disorders represent a class of interventions available either as a stand-alone option, or in combination with psychopharmacology and/or psychotherapy. Here, we review the currently available techniques, including those already in clinical use and those still under research. Techniques are grouped into the following categories: (1) seizure therapies, including electroconvulsive therapy and magnetic seizure therapy, (2) noninvasive techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and cranial electric stimulation, (3) surgical approaches, including vagus nerve stimulation, epidural electrical stimulation, and deep brain stimulation, and (4) technologies on the horizon. Additionally, we discuss novel approaches to the optimization of each treatment, and new techniques that are under active investigation. PMID:21976043

Table of Policy Options for Smart Growth Fixes for Climate Adaptation and Resilience

EPA Pesticide Factsheets

Sortable table of policy options discussed in the publication Smart Growth Fixes for Climate Adaptation and Resilience, which can help local governments prepare for climate change while gaining other environmental, economic, health, and social benefits

Cyanobacterial Treatment Options: Permanganate and Powdered Activated Carbon

EPA Science Inventory

This presentation will begin with a brief overview of drinking water treatment options for cyanobacteria and their toxins. The treatment discussion will focus on the impacts of permanganate addition to suspensions of toxin-producing Microcystis aeruginosa, followed by powdered ac...

Carbon tax and greenhouse gas control : options and considerations for Congress

DOT National Transportation Integrated Search

2009-02-23

This report prepared by the Congressional Research Service discusses the current policy tools available for use in bridging the gap between a carbon tax and a cap-and-trade program, implementation issues and options for revenue distribution.

75 FR 71773 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... securities index options, index futures, and options on index futures to be included along with the ETF in an... hedged not only with SPY shares, but with S&P 500 options, S&P 500 futures, options on S&P 500 futures or... on a delta basis. \\9\\ ``Other units of trade'' would include, for example, options or futures...

Lookback Option Pricing with Fixed Proportional Transaction Costs under Fractional Brownian Motion.

PubMed

Sun, Jiao-Jiao; Zhou, Shengwu; Zhang, Yan; Han, Miao; Wang, Fei

2014-01-01

The pricing problem of lookback option with a fixed proportion of transaction costs is investigated when the underlying asset price follows a fractional Brownian motion process. Firstly, using Leland's hedging method a partial differential equation satisfied by the value of the lookback option is derived. Then we obtain its numerical solution by constructing a Crank-Nicolson format. Finally, the effectiveness of the proposed form is verified through a numerical example. Meanwhile, the impact of transaction cost rate and volatility on lookback option value is discussed.

Lookback Option Pricing with Fixed Proportional Transaction Costs under Fractional Brownian Motion

PubMed Central

Sun, Jiao-Jiao; Zhou, Shengwu; Zhang, Yan; Han, Miao; Wang, Fei

2014-01-01

The pricing problem of lookback option with a fixed proportion of transaction costs is investigated when the underlying asset price follows a fractional Brownian motion process. Firstly, using Leland's hedging method a partial differential equation satisfied by the value of the lookback option is derived. Then we obtain its numerical solution by constructing a Crank-Nicolson format. Finally, the effectiveness of the proposed form is verified through a numerical example. Meanwhile, the impact of transaction cost rate and volatility on lookback option value is discussed. PMID:27433525

Carotid artery stenting: current and emerging options

PubMed Central

Morr, Simon; Lin, Ning; Siddiqui, Adnan H

2014-01-01

Carotid artery stenting technologies are rapidly evolving. Options for endovascular surgeons and interventionists who treat occlusive carotid disease continue to expand. We here present an update and overview of carotid stenting devices. Evidence supporting carotid stenting includes randomized controlled trials that compare endovascular stenting to open surgical endarterectomy. Carotid technologies addressed include the carotid stents themselves as well as adjunct neuroprotective devices. Aspects of stent technology include bare-metal versus covered stents, stent tapering, and free-cell area. Drug-eluting and cutting balloon indications are described. Embolization protection options and new direct carotid access strategies are reviewed. Adjunct technologies, such as intravascular ultrasound imaging and risk stratification algorithms, are discussed. Bare-metal and covered stents provide unique advantages and disadvantages. Stent tapering may allow for a more fitted contour to the caliber decrement between the common carotid and internal carotid arteries but also introduces new technical challenges. Studies regarding free-cell area are conflicting with respect to benefits and associated risk; clinical relevance of associated adverse effects associated with either type is unclear. Embolization protection strategies include distal filter protection and flow reversal. Though flow reversal was initially met with some skepticism, it has gained wider acceptance and may provide the advantage of not crossing the carotid lesion before protection is established. New direct carotid access techniques address difficult anatomy and incorporate sophisticated flow-reversal embolization protection techniques. Carotid stenting is a new and exciting field with rapidly advancing technologies. Embolization protection, low-risk deployment, and lesion assessment and stratification are active areas of research. Ample room remains for further innovations and developments. PMID:25349483

Penile anomalies in adolescence.

PubMed

Wood, Dan; Woodhouse, Christopher

2011-03-07

This article considers the impact and outcomes of both treatment and underlying condition of penile anomalies in adolescent males. Major congenital anomalies (such as exstrophy/epispadias) are discussed, including the psychological outcomes, common problems (such as corporal asymmetry, chordee, and scarring) in this group, and surgical assessment for potential surgical candidates. The emergence of new surgical techniques continues to improve outcomes and potentially raises patient expectations. The importance of balanced discussion in conditions such as micropenis, including multidisciplinary support for patients, is important in order to achieve appropriate treatment decisions. Topical treatments may be of value, but in extreme cases, phalloplasty is a valuable option for patients to consider. In buried penis, the importance of careful assessment and, for the majority, a delay in surgery until puberty has completed is emphasised. In hypospadias patients, the variety of surgical procedures has complicated assessment of outcomes. It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There is also a brief discussion of acquired penile anomalies, including causation and treatment of lymphoedema, penile fracture/trauma, and priapism.

Innovative options for the doctoral dissertation in nursing.

PubMed

Robinson, Susan; Dracup, Kathleen

2008-01-01

The doctoral dissertation is the capstone event of doctoral study. While developing their dissertations, graduate students discover the cutting edge of the discipline, learn the intricacies of the research process, and engage in scientific dialogue with experts in the field. Traditional dissertation formats are confined to the Dissertation Abstracts International and are not easily accessed by clinicians, administrators, and researchers who are most in need of the information. Consequently, the number of universities offering options to the traditional dissertation format is growing. This article describes and compares 2 formats: the traditional dissertation and the publication option. The benefits and challenges of each format to doctoral students and faculty are discussed. The discussion reflects changing trends in the nursing profession as an academic discipline.

Default neglect in attempts at social influence.

PubMed

Zlatev, Julian J; Daniels, David P; Kim, Hajin; Neale, Margaret A

2017-12-26

Current theories suggest that people understand how to exploit common biases to influence others. However, these predictions have received little empirical attention. We consider a widely studied bias with special policy relevance: the default effect, which is the tendency to choose whichever option is the status quo. We asked participants (including managers, law/business/medical students, and US adults) to nudge others toward selecting a target option by choosing whether to present that target option as the default. In contrast to theoretical predictions, we find that people often fail to understand and/or use defaults to influence others, i.e., they show "default neglect." First, in one-shot default-setting games, we find that only 50.8% of participants set the target option as the default across 11 samples ( n = 2,844), consistent with people not systematically using defaults at all. Second, when participants have multiple opportunities for experience and feedback, they still do not systematically use defaults. Third, we investigate beliefs related to the default effect. People seem to anticipate some mechanisms that drive default effects, yet most people do not believe in the default effect on average, even in cases where they do use defaults. We discuss implications of default neglect for decision making, social influence, and evidence-based policy.

[Perinatal bioethics: euthanasia or end-of-life decisions? Analysis of the Groningen Protocol].

PubMed

Halac, Jacobo; Halac, Eduardo; Moya, Martín P; Olmas, José M; Dopazo, Silvina L; Dolagaray, Nora

2009-12-01

The so called "Groningen Protocol" was conceived as a framework to discuss the euthanasia in neonates. Originally, it presents three groups of babies who might be candidates to this option. We analyzed the protocol in its original context and that of the Dutch society in which it was created. The analysis started with a careful reading of the protocol in both English and Dutch versions, translated later into Spanish. The medical and nursing staff participated in discussing it. A final consensus was reached. The Institutional Ethics Committee at our hospital discussed it freely and made recommendations for its application as a guideline to honestly discuss with parents the clinical condition of their babies, without permitting the option included literally in the word euthanasia. We selected four extremely ill infants. Their parents were interviewed at least twice daily: three stages were identified: the initial one of promoting all possible treatments; a second one of guarded and cautious request for the staff to evaluate "suffering", and a last one where requests were made to reduce therapeutic efforts to provide dignified death. A week after the death of their infants, they were presented with the facts of the protocol and the limits of our legal system. In all four cases the parents suggested that they would have chosen ending the life of their infants, in order to avoid them undue suffering. They clearly pointed out that this option emerged as a viable one to them once the ultimate outcome was evident. The protocol must not be viewed as a guideline for euthanasia in newborns, but rather as a mean to discuss the critical condition of an infant with the parents. Its direct implementation in our setting remains difficult. As a clear limitation for its overall application remains the definition of what is considered "unbearable suffering" in newborns, and how to certify when the infant has "no prospect". We emphasize the benefits of securing the help of the Ethics Committee and of "second opinions" from authorized physicians.

Age differences in the effect of framing on risky choice: A meta-analysis

PubMed Central

Best, Ryan; Charness, Neil

2015-01-01

The framing of decision scenarios in terms of potential gains versus losses has been shown to influence choice preferences between sure and risky options. Normative cognitive changes associated with aging have been known to affect decision-making, which has led to a number of studies investigating the influence of aging on the effect of framing. Mata, Josef, Samanez-Larkin, and Hertwig (2011) systematically reviewed the available literature using a meta-analytic approach, but did not include tests of homogeneity nor subsequent moderator variable analyses. The current review serves to extend the previous analysis to include such tests as well as update the pool of studies available for analysis. Results for both positively and negatively framed conditions were reviewed using two meta-analyses encompassing data collected from 3,232 subjects across 18 studies. Deviating from the previous results, the current analysis finds a tendency for younger adults to choose the risky option more often than older adults for positively framed items. Moderator variable analyses find this effect to likely be driven by the specific decision scenario, showing a significant effect with younger adults choosing the risky option more often in small-amount financial and large-amount mortality-based scenarios. For negatively framed items, the current review found no overall age difference in risky decision making, confirming the results from the prior meta-analysis. Moderator variable analyses conducted to address heterogeneity found younger adults to be more likely than older adults to choose the risky option for negatively framed high-amount mortality-based decision scenarios. Practical implications for older adults are discussed. PMID:26098168

Age differences in the effect of framing on risky choice: A meta-analysis.

PubMed

Best, Ryan; Charness, Neil

2015-09-01

The framing of decision scenarios in terms of potential gains versus losses has been shown to influence choice preferences between sure and risky options. Normative cognitive changes associated with aging have been known to affect decision making, which has led to a number of studies investigating the influence of aging on the effect of framing. Mata, Josef, Samanez-Larkin, and Hertwig (2011) systematically reviewed the available literature using a meta-analytic approach, but did not include tests of homogeneity or subsequent moderator variable analyses. The current review serves to extend the previous analysis to include such tests as well as update the pool of studies available for analysis. Results for both positively and negatively framed conditions were reviewed using 2 meta-analyses encompassing data collected from 3,232 subjects across 18 studies. Deviating from the previous results, the current analysis found a tendency for younger adults to choose the risky option more often than older adults for positively framed items. Moderator variable analyses found this effect likely to be driven by the specific decision scenario, showing a significant effect, with younger adults choosing the risky option more often in small-amount financial and large-amount mortality-based scenarios. For negatively framed items, the current review found no overall age difference in risky decision making, confirming the results from the prior meta-analysis. Moderator variable analyses conducted to address heterogeneity found younger adults to be more likely than older adults to choose the risky option for negatively framed high-amount mortality-based decision scenarios. Practical implications for older adults are discussed. (c) 2015 APA, all rights reserved).

Onychomycosis: diagnosis and systemic treatment.

PubMed

Milles, C L; Riley, P A; Kessenich, C R

1998-12-01

Onychomycosis, a persistent fungal infection affecting the toenails and fingernails, can interfere with standing, walking, and exercising. Associated physical impairments can result in paresthesia, pain, discomfort, and loss of manual dexterity. Patients may also suffer from loss of self-esteem and social interaction. A definitive diagnosis is crucial for effective treatment, because many other skin and nail disorders mimic onychomycosis. Diagnosis involves microscopic potassium hydroxide preparation, cultures, nail biopsy, and histologic analysis. Treatment can include topical and systemic antifungal therapies as well as nonpharmaceutical methods. This paper discusses pathophysiology, diagnosis, and treatment options for this common nail dystrophy, including the newer antifungal medications now available.

Systemic and topical drugs for aging skin.

PubMed

Kockaert, Michael; Neumann, Martino

2003-08-01

The rejuvenation of aging skin is a common desire for our patients, and several options are available. Although there are some systemic methods, the most commonly used treatments for rejuvenation of the skin are applied topically. The most frequently used topical drugs include retinoids, alpha hydroxy acids (AHAs), vitamin C, beta hydroxy acids, anti-oxidants, and tocopherol. Combination therapy is frequently used; particularly common is the combination of retinoids and AHAs. Systemic therapies available include oral retinoids and vitamin C. Other available therapies such as chemical peels, face-lifts, collagen, and botulinum toxin injections are not discussed in this article.

Prologue: 2017 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

PubMed

Helliwell, Philip S; Gladman, Dafna D; Gottlieb, Alice B

2018-06-01

The 2017 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in Amsterdam, the Netherlands, and was attended by rheumatologists, dermatologists, representatives of biopharmaceutical companies, and patients. As in previous years, GRAPPA members held a symposium for trainees to discuss their research in psoriatic disease with experts in the field. Other subjects featured during the annual meeting included a discussion of the history, clinical features, controversies, and immunogenetics of juvenile psoriatic arthritis; updates from working groups in Outcome Measures in Rheumatology and International Dermatology Outcome Measures; a discussion of the benefits and challenges of setting up a longitudinal psoriatic arthritis (PsA) database; 3 separate discussions of the effects of the microbiome on skin and joints in psoriasis and PsA; a discussion of options for assessing joints and entheses in PsA by ultrasonography and magnetic resonance imaging; an update on GRAPPA's research and educational projects; a discussion of patient centricity, including the incorporation of patient research partners (PRP) into psoriasis and PsA research and educational efforts, from GRAPPA's PRP; and a discussion of the GRAPPA-Collaborative Research Network's inaugural meeting. In this prologue, we introduce the papers that summarize that meeting.

Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease.

PubMed

Ahmed, Kamran A; Torres-Roca, Javier F

2016-01-01

The treatment of oligometastatic disease has become common as imaging techniques have advanced and the management of systemic disease has improved. Use of highly targeted, hypofractionated regimens of stereotactic body radiotherapy (SBRT) is now a primary management option for patients with oligometastatic disease. The properties of SBRT are summarized and the results of retrospective and prospective studies of SBRT use in the management of oligometastases are reviewed. Future directions of SBRT, including optimizing dose and fractionation schedules, are also discussed. SBRT can deliver highly conformal, dosed radiation treatments for ablative tumors in a few treatment sessions. Phase 1/2 trials and retrospective institutional results support use of SBRT as a treatment option for oligometastatic disease metastasized to the lung, liver, and spine, and SBRT offers adequate toxicity profiles with good rates of local control. Future directions will involve optimizing dose and fractionation schedules for select histologies to improve rates of local control while limiting toxicity to normal structures. SBRT offers an excellent management option for patients with oligometastases. However, additional research is still needed to optimize dose and fractionation schedules.

Cost and risk assessment for spacecraft operation decisions caused by the space debris environment

NASA Astrophysics Data System (ADS)

Schaub, Hanspeter; Jasper, Lee E. Z.; Anderson, Paul V.; McKnight, Darren S.

2015-08-01

Space debris is a topic of concern among many in the space community. Most forecasting analyses look centuries into the future to attempt to predict how severe debris densities and fluxes will become in orbit regimes of interest. Conversely, space operators currently do not treat space debris as a major mission hazard. This survey paper outlines the range of cost and risk evaluations a space operator must consider when determining a debris-related response. Beyond the typical direct costs of performing an avoidance maneuver, the total cost including indirect costs, political costs and space environmental costs are discussed. The weights on these costs can vary drastically across mission types and orbit regimes flown. The operator response options during a mission are grouped into four categories: no action, perform debris dodging, follow stricter mitigation, and employ ADR. Current space operations are only considering the no action and debris dodging options, but increasing debris risk will eventually force the stricter mitigation and ADR options. Debris response equilibria where debris-related risks and costs settle on a steady-state solution are hypothesized.

Active surveillance for nonmuscle invasive bladder cancer.

PubMed

Miyake, Makito; Fujimoto, Kiyohide; Hirao, Yoshihiko

2016-06-01

Nonmuscle invasive bladder cancer (NMIBC) is known to be a heterogeneous malignancy that requires varying treatment modalities and follow-up schedules. Low-grade Ta papillary tumors are categorized as low-risk NMIBC because of their favorable prognosis. There is an expanding movement that overdiagnosis and overtreatment should be avoided considering the economic impact and the patients' quality of life. It has been over 10 years since the initial assessment of active surveillance for low-risk NMIBC suggested its feasibility and safety. However, urologists are still unfamiliar with this treatment option, which can be ideal in appropriately selected patients. In this review article, we focus on active surveillance for low-risk NMIBC and discuss the evidence and rationale for this treatment option. There are several issues to resolve in order to advocate active surveillance as a standard option in selected patients. A specific follow-up protocol including intervals of cystoscopy, urine cytology, urine markers, and other radiographic examinations need to be optimized and validated. Finally, we integrate the available data into the follow-up strategy and propose a new surveillance protocol for active surveillance of recurrent low-risk bladder cancer.

Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer.

PubMed

Lousberg, Laurence; Jerusalem, Guy

2016-01-01

Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus-exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile.

Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer

PubMed Central

Lousberg, Laurence; Jerusalem, Guy

2016-01-01

Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus–exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile. PMID:28096680

Advancing universal coverage of healthcare in China: translating political will into policy and practice.

PubMed

Tang, Shenglan; Brixi, Hana; Bekedam, Henk

2014-01-01

China launched its new health system reform plan in 2009 to advance its universal coverage of healthcare, after more than 4 years' consultations and discussions with various stakeholders including the public. This paper aims to introduce and discuss the context and process of China's current health system reform and analyse how political will in China has been translated into policy practice over the past decade. The paper also shares the insights of World Health Organization's contribution to China's health system reform, as the authors advised the Chinese government on the reform options and process. Furthermore, the paper describes and discusses key challenges in the implementation of the reform plan over the past 3 years and draws lessons for other countries. Copyright © 2013 John Wiley & Sons, Ltd.

Energy Options for the Future

NASA Astrophysics Data System (ADS)

Sheffield, John; Obenschain, Stephen; Conover, David; Bajura, Rita; Greene, David; Brown, Marilyn; Boes, Eldon; McCarthy, Kathyrn; Christian, David; Dean, Stephen; Kulcinski, Gerald; Denholm, P. L.

2004-06-01

This paper summarizes the presentations and discussion at the Energy Options for the Future meeting held at the Naval Research Laboratory in March of 2004. The presentations covered the present status and future potential for coal, oil, natural gas, nuclear, wind, solar, geothermal, and biomass energy sources and the effect of measures for energy conservation. The longevity of current major energy sources, means for resolving or mitigating environmental issues, and the role to be played by yet to be deployed sources, like fusion, were major topics of presentation and discussion.

Joint Peru/United States report on Peru/United States cooperative energy assessment. Volume 4 of 4 Volumes Annexes 8-11

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

Not Available

1979-08-01

A comprehensive assessment of the biofuel potential of Peru is presented. Topics discussed cover current biofuel utilization practices; evaluation of Peruvian biomass productivity; identification of Peruvian agricultural and forestry resources; assessment of resource development and management concerns; identification of market considerations; description of biofuel technological options; and regional identification of biofuel technology applications. The discussion of current biofuel utilization centers on a qualitative description of the main conversion approaches now being practiced in Peru. Biomass productivity is evaluated in the context of the terrain, soil, and climatic conditions found in Peru. A quantitative description of the energy potential that couldmore » be realized from agricultural and forestry resources of Peru follows. A regional picture is given for the production of agricultural residues and forest resources that could potentially supply energy. The assessment of resource development and management concerns focuses on harvesting, reforestation, training, and the environmental consequences of utilization of forest resources. Market factors assessed include: importation, internal market development, external market development, energy policy and pricing, and transportation. Ten biofuel technology options for Peru were identified: small- to medium-scale gasification, a wood waste inventory, stationary and mobile charcoal production systems, wood distillation, forest resource development and management, electrical cogeneration, anaerobic digestion technology, development of ethanol production capabilities, and agricultural strategies for fuel production.Based upon these biofuel options, nine applications were identified for the Costa Region, eight for the Sierra Region, and ten for the Selva Region.« less

Harsh environment fiber optic connectors/testing

NASA Astrophysics Data System (ADS)

Parker, Douglas A.

2014-09-01

Fiber optic systems are used frequently in military, aerospace and commercial aviation programs. There is a long history of implementing fiber optic data transfer for aircraft control, for harsh environment use in local area networks and more recently for in-flight entertainment systems. The advantages of fiber optics include high data rate capacity, low weight, immunity to EMI/RFI, and security from signal tapping. Technicians must be trained particularly to install and maintain fiber systems, but it is not necessarily more difficult than wire systems. However, the testing of the fiber optic interconnection system must be conducted in a standardized manner to assure proper performance. Testing can be conducted with slight differences in the set-up and procedure that produce significantly different test results. This paper reviews various options of interconnect configurations and discusses how these options can affect the performance, maintenance required and longevity of a fiber optic system, depending on the environment. Proper test methods are discussed. There is a review of the essentials of proper fiber optic testing and impact of changing such test parameters as input launch conditions, wavelength considerations, power meter options and the basic methods of testing. This becomes important right from the start when the supplier test data differs from the user's data check upon receiving the product. It also is important in periodic testing. Properly conducting the fiber optic testing will eliminate confusion and produce meaningful test results for a given harsh environment application.

Robotics, assistive technology, and occupational therapy management to improve upper limb function in pediatric neuromuscular diseases.

PubMed

Rahman, Tariq; Basante, Joseph; Alexander, Michael

2012-08-01

This article presents an overview of occupational therapy assessments and treatment options for individuals with neuromuscular disabilities, with a particular focus on children with neuromuscular disorders. The discussion includes descriptions of standard treatments, commercial adaptive equipment, and homemade adaptive solutions. The state of the art in therapeutic and assistive robots and orthoses for the upper and lower extremity is also provided. Copyright © 2012. Published by Elsevier Inc.

Space Station crew safety alternatives study. Volume 2: Threat development

NASA Technical Reports Server (NTRS)

Raasch, R. F.; Peercy, R. L., Jr.; Rockoff, L. A.

1985-01-01

The first 15 years of accumulated space station concepts for initial operational capability (IOC) during the early 1990's were considered. Twenty-five threats to the space station are identified and selected threats addressed as impacting safety criteria, escape and rescue, and human factors safety concerns. Of the 25 threats identified, eight are discussed including strategy options for threat control: fire, biological or toxic contamination, injury/illness, explosion, loss of pressurization, radiation, meteoroid penetration, and debris.

Space station crew safety alternatives study, volume 1

NASA Technical Reports Server (NTRS)

Peercy, R. L., Jr.; Raasch, R. F.; Rockoff, L. A.

1985-01-01

The first 15 years of accumulated space station concepts for initial operational capability (IOC) during the early 1990's were considered. Twenty-five threats to the space station are identified and selected threats addressed as impacting safety criteria, escape and rescue, and human factors safety concerns. Of the 25 threats identified, eight are discussed including strategy options for threat control: fire, biological or toxic contamination, injury/illness, explosion, loss of pressurization, radiation, meteoroid penetration and debris.

Matrix computations in MACSYMA

NASA Technical Reports Server (NTRS)

Wang, P. S.

1977-01-01

Facilities built into MACSYMA for manipulating matrices with numeric or symbolic entries are described. Computations will be done exactly, keeping symbols as symbols. Topics discussed include how to form a matrix and create other matrices by transforming existing matrices within MACSYMA; arithmetic and other computation with matrices; and user control of computational processes through the use of optional variables. Two algorithms designed for sparse matrices are given. The computing times of several different ways to compute the determinant of a matrix are compared.

Evaluation of organic carbon analyzers for space application. [for water reclamation

NASA Technical Reports Server (NTRS)

1984-01-01

The state-of-the-art technology for organic carbon analysis in space applications is evaluated. An investigation into total organic carbon (TOC) analysis has identified a variety of schemes which include different methods for: (1) separation of inorganic carbon from organic carbon and/or differentiation of inorganic carbon from organic carbon; (2) reaction of organic carbon to form a quantifiable species; and (3) detection and measurement of that species. Each method option is discussed.

Energy conservation: Industry. Citations from the NITS data base

NASA Astrophysics Data System (ADS)

Hundemann, A. S.

1980-07-01

The 335 citations, 37 of which are new entries, discuss potential methods of conserving energy. Many abstracts deal with reports that also cover processes used, amount of energy consumed, and environmental considerations of energy conserving options. Industries covered include food, paper, chemical, cement, metals, petroleum refining, contract construction, synthetic rubber, plastics, drug manufacturing, and stone, clay, and glass. Energy conservation through the use of waste heat is covered in a related Published Search entitled Waste Heat Utilization.

CFB repowering options

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

Gittinger, J.

1996-12-31

Circulating fluidized bed CFB repowering options are summarized. The following topics are discussed: why repower with CFB technology; advantages of repowering; two forms of of repowering; B and N`s internal recirculation CFB; space-saving design features; cost-saving design features; Ukrainian repowering project; and candidates for repowering.

Current methods of burn reconstruction.

PubMed

Orgill, Dennis P; Ogawa, Rei

2013-05-01

After reading this article, the participant should be able to: 1. Explain the present challenges in reconstructive burn surgery. 2. Describe the most appropriate treatment methods and techniques for specific burn injury types, including skin grafts, dermal substitutes, and a variety of flap options. 3. Identify the appropriate use, advantages, and disadvantages of specific flaps in the treatment of burn injuries, including local, regional, superthin, prefabricated, prelaminated, and free flaps. Victims of thermal burns often form heavy scars and develop contractures around joints, inhibiting movement. As burns can occur in all cutaneous areas of the body, a wide range of reconstructive options have been utilized. Each method has advantages and disadvantages that must be considered by both patients and surgeons. The authors reviewed the literature for burn reconstruction and focused their discussion on areas that have been recently developed. They reviewed the mechanism of burn injury and discussed how this relates to the pathophysiology of the burn injury. Surgeons now have a wide array of plastic surgical techniques that can be used to treat burn victims. These range from skin grafts and local flaps to free flaps, prefabricated flaps, superthin flaps, and dermal scaffolds. Recent advances in burn reconstruction provide methods to decrease scar tissue and joint contractures. In the future, the authors hope that further developments in burn treatment will foster the development of new technologies that will allow site-specific reconstruction with minimal donor-site morbidity.

Fertility Preservation for Pediatric Patients: Current State and Future Possibilities.

PubMed

Johnson, Emilie K; Finlayson, Courtney; Rowell, Erin E; Gosiengfiao, Yasmin; Pavone, Mary Ellen; Lockart, Barbara; Orwig, Kyle E; Brannigan, Robert E; Woodruff, Teresa K

2017-07-01

This review provides an overview of pediatric fertility preservation. Topics covered include the patient populations who could benefit, the current state of fertility preservation options and research, and considerations related to ethics and program development. A broad Embase® and PubMed® search was performed to identify publications discussing investigational, clinical, ethical and health care delivery issues related to pediatric fertility preservation. Relevant publications were reviewed and summarized. Populations who could benefit from fertility preservation in childhood/adolescence include oncology patients, patients with nononcologic conditions requiring gonadotoxic chemotherapy, patients with differences/disorders of sex development and transgender individuals. Peripubertal and postpubertal fertility preservation options are well established and include cryopreservation of oocytes, embryos or sperm. Prepubertal fertility preservation is experimental. Multiple lines of active research aim to develop technologies that will enable immature eggs and sperm to be matured and used to produce a biological child in the future. Ethical challenges include the need for parental proxy decision making and the fact that fertility preservation procedures can be considered not medically necessary. Successful multidisciplinary fertility preservation care teams emphasize partnerships with adult colleagues, prioritize timely consultations and use standardized referral processes. Some aspects of fertility preservation are not covered by insurance and out-of-pocket costs can be prohibitive. Pediatric fertility preservation is an emerging, evolving field. Fertility preservation options for prepubertal patients with fertility altering conditions such as cancer and differences/disorders of sex development are currently limited. However, multiple lines of active research hold promise for the future. Key considerations include establishing a multidisciplinary team to provide pediatric fertility preservation services, an appreciation for relevant ethical issues and cost. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Treatment challenges for community oncologists treating postmenopausal women with endocrine-resistant, hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer

PubMed Central

Gradishar, William J

2016-01-01

Community-based oncologists are faced with challenges and opportunities when delivering quality patient care, including high patient volumes and diminished resources; however, there may be the potential to deliver increased patient education and subsequently improve outcomes. This review discusses the treatment of postmenopausal women with endocrine-resistant, hormone receptor-positive, human epidermal growth factor receptor 2- negative advanced breast cancer in order to illustrate considerations in the provision of pertinent quality education in the treatment of these patients and the management of therapy-related adverse events. An overview of endocrine-resistant breast cancer and subsequent treatment challenges is also provided. Approved treatment options for endocrine-resistant breast cancer include hormonal therapies and mammalian target of rapamycin inhibitors. Compounds under clinical investigation are also discussed. PMID:27468248

Manned Mars mission cost estimate

NASA Technical Reports Server (NTRS)

Hamaker, Joseph; Smith, Keith

1986-01-01

The potential costs of several options of a manned Mars mission are examined. A cost estimating methodology based primarily on existing Marshall Space Flight Center (MSFC) parametric cost models is summarized. These models include the MSFC Space Station Cost Model and the MSFC Launch Vehicle Cost Model as well as other modes and techniques. The ground rules and assumptions of the cost estimating methodology are discussed and cost estimates presented for six potential mission options which were studied. The estimated manned Mars mission costs are compared to the cost of the somewhat analogous Apollo Program cost after normalizing the Apollo cost to the environment and ground rules of the manned Mars missions. It is concluded that a manned Mars mission, as currently defined, could be accomplished for under $30 billion in 1985 dollars excluding launch vehicle development and mission operations.

Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

PubMed Central

Herndon, C.D. Anthony

2006-01-01

The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702

Conceptual Design of the ITER ECE Diagnostic - An Update

NASA Astrophysics Data System (ADS)

Austin, M. E.; Pandya, H. K. B.; Beno, J.; Bryant, A. D.; Danani, S.; Ellis, R. F.; Feder, R.; Hubbard, A. E.; Kumar, S.; Ouroua, A.; Phillips, P. E.; Rowan, W. L.

2012-09-01

The ITER ECE diagnostic has recently been through a conceptual design review for the entire system including front end optics, transmission line, and back-end instruments. The basic design of two viewing lines, each with a single ellipsoidal mirror focussing into the plasma near the midplane of the typical operating scenarios is agreed upon. The location and design of the hot calibration source and the design of the shutter that directs its radiation to the transmission line are issues that need further investigation. In light of recent measurements and discussion, the design of the broadband transmission line is being revisited and new options contemplated. For the instruments, current systems for millimeter wave radiometers and broad-band spectrometers will be adequate for ITER, but the option for employing new state-of-the-art techniques will be left open.

DEALING WITH DENTAL IMPLANT FAILURES

PubMed Central

Levin, Liran

2008-01-01

An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them. PMID:19089213

Moving toward integrated value-based planning: The issues

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

Chamberlin, J.H.; Braithwait, C.L.

1988-07-01

Integrated Value-Based Planning (IVP) is a promising new planning approach that uses value, as well as cost, as the common denominator for evaluating supply and demand resource options. Planning based on value yields an ''apples to apples'' comparison of utility and customer options. The IVP approach can form the cornerstone of a successful market-driven utility planning strategy. This conference will raise questions, discuss issues, and further the exchange of information regarding the tools, concepts, and techniques needed to put IVP into the utility planner's toolbox. This proceedings is more than a compendium of papers. It is designed to let bothmore » participants and non-participants exchange information. To this end, listings and cross-listings of papers, speakers and participant interest areas, along with the ever-invaluable phone number have been included.« less

42 CFR 435.201 - Individuals included in optional groups.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Individuals included in optional groups. 435.201... optional groups. (a) The agency may choose to cover as optional categorically needy any group or groups of... eligibility criteria for groups specified in the separate sections of this subpart: (1) Aged individuals (65...

78 FR 75642 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... Amending the NYSE Amex Options Fee Schedule To Include FLEX Option Transactions in the Strategy Execution...'') to include FLEX Option transactions in the strategy execution fee cap. The Exchange proposes to... Option transactions in the strategy execution fee cap. The Exchange proposes to implement the fee change...

Temporary stream and wetland crossing options for forest management.

Treesearch

Charles R. Blinn; Rick Dahlman; Lola Hislop; Michael A. Thompson

1998-01-01

Discusses temporary options for crossing streams and wetland soils with forest harvesting and transportation equipment. Reviews the available literature on the environmental effects of temporary crossings. Provides an overview of regulations pertaining to temporary crossings for several jurisdictions in the Great Lakes Region.

Temporary stream and wetland crossing options for forest management

Treesearch

Charles R. Blinn; Rick Dahlman; Lola Hislop; Michael A. Thompson

1998-01-01

Discusses temporary options for crossing streams and wetland soils with forest harvesting and transportation equipment. Reviews the available literature on the environmental effects of temporary crossings. Provides an overview of regulations pertaining to temporary crossings for several jurisdictions in the Great Lakes Region.

77 FR 58983 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-25

...-0492. SUPPLEMENTARY INFORMATION: The Habitat Advisory Panel and Plan Development Team will review and further develop alternatives for Omnibus Essential Fish Habitat Amendment 2. Related to gear modification options for Habitat Management Areas, they will discuss ground cable modification options in general and...

Charter Schools: A Viable Public School Choice Option?

ERIC Educational Resources Information Center

Geske, Terry G.; And Others

1997-01-01

Overviews the charter-school phenomenon and these schools' basic design. Discusses the government's role in education and identifies various school-choice options. Explores overall autonomy via legislative provisions and examines empirical evidence on charter schools' innovative features, teacher and student characteristics, and parental contracts…

Diesel plant retrofitting options to enhance decentralized electricity supply in Indonesia

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

Baring-Gould, E I; Barley, C D; Drouilhet, S

1997-09-01

Over the last 20 years, the government of Indonesia has undertaken an extensive program to provide electricity to the population of that country. The electrification of rural areas has been partially achieved through the use of isolated diesel systems, which account for about 20% of the country`s generated electricity. Due to many factors related to inefficient power production with diesels, the National Renewable Energy Laboratory, in conjunction with PLN, the Indonesian national utility, Community Power Corporation, and Idaho Power Company, analyzed options for retrofitting existing diesel power systems. This study considered the use of different combinations of advanced diesel control,more » the addition of wind generators, photovoltaics and batteries to reduce the systems of overall cost and fuel consumption. This analysis resulted in a general methodology for retrofitting diesel power systems. This paper discusses five different retrofitting options to improve the performance of diesel power systems. The systems considered in the Indonesian analysis are cited as examples for the options discussed.« less

Management of stage IV rectal cancer: Palliative options

PubMed Central

Ronnekleiv-Kelly, Sean M; Kennedy, Gregory D

2011-01-01

Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease. PMID:21412493

Application of a robot for critical care rounding in small rural hospitals.

PubMed

Murray, Cindy; Ortiz, Elizabeth; Kubin, Cay

2014-12-01

The purpose of this article is to present an option for a model of care that allows small rural hospitals to be able to provide specialty physicians for critical care patient needs in lieu of on-site critical care physician coverage. A real-time, 2-way audio and video remote presence robot is used to bring a specialist to the bedside to interact with patients. This article discusses improvements in quality and finance outcomes as well as care team and patient satisfaction associated with this model. Discussion also includes expansion of the care model to the emergency department for acute stroke care. Copyright © 2014 Elsevier Inc. All rights reserved.

Beyond ITER: neutral beams for a demonstration fusion reactor (DEMO) (invited).

PubMed

McAdams, R

2014-02-01

In the development of magnetically confined fusion as an economically sustainable power source, International Tokamak Experimental Reactor (ITER) is currently under construction. Beyond ITER is the demonstration fusion reactor (DEMO) programme in which the physics and engineering aspects of a future fusion power plant will be demonstrated. DEMO will produce net electrical power. The DEMO programme will be outlined and the role of neutral beams for heating and current drive will be described. In particular, the importance of the efficiency of neutral beam systems in terms of injected neutral beam power compared to wallplug power will be discussed. Options for improving this efficiency including advanced neutralisers and energy recovery are discussed.

Applied Information Systems Research Program Workshop

NASA Technical Reports Server (NTRS)

1991-01-01

The first Applied Information Systems Research Program (AISRP) Workshop provided the impetus for several groups involved in information systems to review current activities. The objectives of the workshop included: (1) to provide an open forum for interaction and discussion of information systems; (2) to promote understanding by initiating a dialogue with the intended benefactors of the program, the scientific user community, and discuss options for improving their support; (3) create an advocacy in having science users and investigators of the program meet together and establish the basis for direction and growth; and (4) support the future of the program by building collaborations and interaction to encourage an investigator working group approach for conducting the program.

The Regulatory Perspectives on Endoscopic Devices for Obesity.

PubMed

Marrone, April K; Antonino, Mark J; Silverstein, Joshua S; Betz, Martha W; Venkataraman-Rao, Priya; Golding, Martin; Cordray, Diane; Cooper, Jeffrey W

2017-04-01

The recent increase in US Food and Drug Administration-approved weight-loss devices has diversified obesity treatment options. The regulatory pathways for endoscopically placed weight-loss devices and considerations for clinical trials are discussed, including the benefit-risk paradigm intended to aid in weight-loss-device trial development. Also discussed is the benefit-risk analysis of recently approved endoscopic devices. A strategic priority of the FDA Center for Devices and Radiological Health is to increase the use of patient input in decision making. Thus, we consider how endoscopic weight-loss devices with profiles similar to those that have been approved may be viewed in a patient preference study. Published by Elsevier Inc.

Healthcare administration education in the 21st century: the case for entrepreneurship.

PubMed

Williams, David R; Duncan, W Jack; Ginter, Peter M

2005-01-01

This paper recommends the broadening of the course content in several of the current required courses within the core curriculum of healthcare management education to include entrepreneurship topics and the inclusion of a separate entrepreneurship course. The current state of entrepreneurship within healthcare is described through the discussion of a healthcare entrepreneurship continuum. Because of the evolution of the healthcare industry in the past ten years, healthcare administration programs must also evolve to make our curriculum more relevant and increase student placement options. The current healthcare administration education shortcomings are discussed and recommendations for curriculum change are presented. Finally, a readings and resources list is provided as a basis for further curriculum development.

TU-E-BRB-03: Overview of Proposed TG-132 Recommendations

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

Brock, K.

2015-06-15

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will alsomore » discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.« less

Multirole cargo aircraft options and configurations

NASA Technical Reports Server (NTRS)

Conner, D. W.; Vaughan, J. C., III

1979-01-01

The paper discusses multirole cargo aircraft options and configurations. It was shown that derivatives of current wide-body aircraft would be economically attractive through 2008, but new dedicated airfreighters incorporating 1990 technology would offer little or no economic incentive. Option studies indicate that Mach 0.7 propfans would be economically attractive in trip cost, aircraft price, and airline ROI; spanloaders would be lower priced with higher ROI, but would have a relatively higher trip cost because of aerodynamic inefficiencies. Finally, air cushion landing gear configurations are identified as an option for avoiding runway constraints on airport accommodation of very large airfreighters.

Contemporary management of cancer of the oral cavity

PubMed Central

Genden, Eric M.; Silver, Carl E.; Takes, Robert P.; Suárez, Carlos; Owen, Randall P.; Haigentz, Missak; Stoeckli, Sandro J.; Shaha, Ashok R.; Rapidis, Alexander D.; Rodrigo, Juan Pablo; Rinaldo, Alessandra

2010-01-01

Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers. PMID:20155361

Job Hunting in Tougher Times.

ERIC Educational Resources Information Center

Ross, Steven S.

1985-01-01

Several resources to consider are offered to ease the squeeze created by the computer market downturn. Areas addressed include: job-shop option; other-industries option; overseas option; graduate school option; entrepreneurial option; military option; job fairs; and weighing locations. Notes that colleges are looking for engineering teachers,…

Bariatric surgery options.

PubMed

Woodward, Bryan G

2003-01-01

There are multiple surgical procedures used for weight loss. The concept of achieving malabsorption through manipulation of the gastrointestinal contract is briefly discussed. Various surgical options are considered with their advantages and disadvantages, namely vertical banded gastroplasty, gastric banding, Roux-en-y gastric bypass, distal gastric bypass billiopancreatic diversion, and duodental switch.

The Structural Algebra Option: A Discussion Paper.

ERIC Educational Resources Information Center

Kirshner, David

The goal of this paper is to renew interest in the structural option to algebra instruction. Concern for the usual secondary school algebra curriculum related to simplifying expressions, solving equations, and rationalizing numerators and denominators is viewed from three pedagogical approaches: (1) structural approach, (2) empirical approach, and…

The Chinese brain drain and policy options.

PubMed

Chang, P; Deng, Z

1992-01-01

The authors discuss the growing problem caused by the increasing reluctance of Chinese receiving higher education overseas to return to China following completion of their studies. They note that the Tiananmen incident of June 1989 exacerbated this problem. The policy options open to the Chinese government are reviewed.

Exploring Policy Options To Restructure Education.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO.

Designed to assist state and district policymakers in developing a policy framework to encourage educational restructuring at all levels, this document begins by describing the need for restructuring and by discussing elements of the policymaker's role such as establishing a vision, reviewing existing policies, debating options, making policy…

Cooperative Education. Cosmetic Science: A Career Option for Majors in Chemistry.

ERIC Educational Resources Information Center

Lichtin, J. Leon; Radd, Billie L.

1987-01-01

Discusses the growing field of cosmetic science as a career option for chemistry majors. Outlines the design, formulation, manufacture, stabilization, evaluation, control management, safety, mechanism of action, and claim substantiation of cosmetic products. Provides information on the concerns and professional responsibilities of the cosmetic…

Cooperative Monitoring Center Occasional Paper/8: Cooperative Border Security for Jordan: Assessment and Options

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

Qojas, M.

1999-03-01

This document is an analysis of options for unilateral and cooperative action to improve the security of Jordan's borders. Sections describe the current political, economic, and social interactions along Jordan's borders. Next, the document discusses border security strategy for cooperation among neighboring countries and the adoption of confidence-building measures. A practical cooperative monitoring system would consist of hardware for early warning, command and control, communications, and transportation. Technical solutions can expand opportunities for the detection and identification of intruders. Sensors (such as seismic, break-wire, pressure-sensing, etc.) can warn border security forces of intrusion and contribute to the identification of themore » intrusion and help formulate the response. This document describes conceptual options for cooperation, offering three scenarios that relate to three hypothetical levels (low, medium, and high) of cooperation. Potential cooperative efforts under a low cooperation scenario could include information exchanges on military equipment and schedules to prevent misunderstandings and the establishment of protocols for handling emergency situations or unusual circumstances. Measures under a medium cooperation scenario could include establishing joint monitoring groups for better communications, with hot lines and scheduled meetings. The high cooperation scenario describes coordinated responses, joint border patrols, and sharing border intrusion information. Finally, the document lists recommendations for organizational, technical, and operational initiatives that could be applicable to the current situation.« less

Triple-negative breast cancer: treatment challenges and solutions

PubMed Central

Collignon, Joëlle; Lousberg, Laurence; Schroeder, Hélène; Jerusalem, Guy

2016-01-01

Triple-negative breast cancers (TNBCs) are defined by the absence of estrogen and progesterone receptors and the absence of HER2 overexpression. These cancers represent a heterogeneous breast cancer subtype with a poor prognosis. Few systemic treatment options exist besides the use of chemotherapy (CT). The heterogeneity of the disease has limited the successful development of targeted therapy in unselected patient populations. Currently, there are no approved targeted therapies for TNBC. However, intense research is ongoing to identify specific targets and develop additional and better systemic treatment options. Standard adjuvant and neoadjuvant regimens include anthracyclines, cyclophosphamide, and taxanes. Platinum-based CT has been proposed as another CT option of interest in TNBC. We review the role of this therapy in general, and particularly in patients carrying BRCA germ-line mutations. Available data concerning the role of platinum-based CT in TNBC were acquired primarily in the neoadjuvant setting. The routine use of platinum-based CT is not yet recommended by available guidelines. Many studies have reported the molecular characterization of TNBCs. Several actionable targets have been identified. Novel therapeutic strategies are currently being tested in clinical trials based on promising results observed in preclinical studies. These targets include androgen receptor, EGFR, PARP, FGFR, and the angiogenic pathway. We review the recent data on experimental drugs in this field. We also discuss the recent data concerning immunologic checkpoint inhibitors. PMID:27284266

Satellite Power System (SPS): an Overview of Prospective Organizational Structures in the Solar Satellite Field

NASA Technical Reports Server (NTRS)

Edler, H. G.

1978-01-01

A literature survey, interviews with acknowledged experts in the fields of organizational entities, space, solar energy, and the SPS concept, and an analysis of these inputs to identify the organizational alternatives and make judgments as to their feasibility to serve as patterns for a future SPS entity are presented. Selection and evaluation criteria were determined to include timeliness, reliability, and adequacy to contribute meaningfully to the U.S. supply; political feasibility (both national and international) and cost-effectiveness (including environmental and other external costs). Based on these criteria, four organizational alternatives are discussed which offer reasonable promise as potential options for SPS. These included three domestic alternatives and one international alternative.

Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

PubMed

Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

2016-08-01

Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

Hiking with DiabetesRisks and Benefits.

PubMed

Jenkins, David W; Jenks, Alexander

2017-09-01

Exercise is highly beneficial for persons with diabetes. Similar to many other patients, those with diabetes may be reluctant to exercise given a lack of motivation and proper instruction regarding an exercise prescription. In general, medical providers are poorly equipped to develop an exercise prescription and furnish motivation. Attempts to find activities that not only provide effective aerobic challenges but also are enjoyable to participate in are fraught with difficulty. Hiking as a potential option for a safe and enjoyable activity is discussed, including the possible downsides. Multiple publications were reviewed using key words. A review of the literature uncovered limited publications or controlled trials that discussed the use of hiking per se as an activity for the management of diabetes. Newer studies reviewing weightbearing exercise and diabetic polyneuropathy and those discussing the advantages of trekking poles for balance and proprioception are cited in support of the recommendation for hiking as an activity for those with diabetes. Exercise has been shown to substantially benefit individuals with diabetes, but convincing patients with diabetes to exercise is daunting. Hiking, unlike other, more tedious exercise programs, may be an exercise option that persons with diabetes might find enjoyable. Hiking may encourage balance training and reduced ground reaction forces. These benefits may be augmented by trekking poles, which may likewise counter the concerns of the uneven surfaces that present challenges to the hiker with diabetes.

The Women's EMPOWER Survey: Women's Knowledge and Awareness of Treatment Options for Vulvar and Vaginal Atrophy Remains Inadequate.

PubMed

Krychman, Michael; Graham, Shelli; Bernick, Brian; Mirkin, Sebastian; Kingsberg, Sheryl A

2017-03-01

Postmenopausal women's knowledge about vulvar and vaginal atrophy (VVA) and available treatment options has historically been inadequate. Recent direct-to-consumer marketing and educational efforts would have been expected to increase awareness and treatment options. To compare results of the Women's EMPOWER survey with other available VVA surveys to assess progress in women's understanding and approaches to treatment of VVA. The Women's EMPOWER survey, an internet-based survey of US women with VVA symptoms, assessed women's awareness of VVA and their behaviors and attitudes associated with symptom treatment. These survey results were compared with previously published results of the Revealing Vaginal Effects at Mid-Life (REVEAL), Women's Voices in Menopause (WVM), Vaginal Health: Insight, Views, & Attitudes (VIVA), Clarifying Vaginal Atrophy's Impact on Sex and Relationship (CLOSER), and Real Women's Views of Treatment Options for Menopausal Vaginal Changes (REVIVE) surveys. Results of the Women's EMPOWER survey were consistent with those of past VVA surveys and showed that postmenopausal women generally failed to recognize VVA and its chronic, progressive process and that they were reluctant to discuss vaginal or sexual symptoms with their health care professionals (HCPs). However, women indicated a strong desire for accurate medical information about VVA from their health care professionals and a willingness to learn if HCPs would initiate the conversation. Most women believed that vaginal symptoms are a normal part of aging and they just need to cope with the symptoms. In the United States, women were most concerned with safety-related issues, including increased risk of breast cancer, side effects, and systemic absorption. The Women's EMPOWER survey demonstrates and reinforces that even with multimedia marketing and educational strategies in the years after other major VVA surveys, minimal progress has been made toward increasing women's awareness of, knowledge about, or understanding of VVA. Based on these data, a focus on initiating discussions and education with postmenopausal women so that they better comprehend VVA as a chronic progressive medical condition (not just aging), the symptoms associated with VVA, and the benefit-risk profile regarding treatment options is warranted. Krychman M, Graham S, Bernick B, et al. The Women's EMPOWER Survey: Women's Knowledge and Awareness of Treatment Options for Vulvar and Vaginal Atrophy Remains Inadequate. J Sex Med 2017;14:425-433. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Preparing for an Academic Career Workshops: Resources for Graduate Students and Post-Doctoral Fellows

NASA Astrophysics Data System (ADS)

Dunbar, R. W.; MacDonald, R.

2004-12-01

The professional development program, "On the Cutting Edge", offers annual multi-day workshops for graduate students and post-doctoral fellows interested in pursuing academic careers. Goals are to prepare participants to become more effective teachers, stronger candidates for academic positions, and more aware of the realities of academic jobs. Insights that participants especially hope to gain from these workshops include feedback on the application process, especially an understanding of how search committees work; the different realities of balancing teaching, research, and personal life in a range of academic institutions; and expectations for tenure. The ten-person leadership team represents, by design, a wide range of academic career paths and institutions, and provides approximately 1:6 leader: participant ratio. Specific sessions include research on learning, an introduction to course and lab design, effective teaching and assessment strategies, developing a teaching statement, time management and early career faculty success, and moving research forward into new settings. Optional workshop sessions and discussions include the following topics: dual-career couples; families and careers; teaching portfolios; effective negotiation strategies; tenure and promotion; effective field trips; getting started in undergraduate research; opportunities in K-12 education; career options beyond faculty positions. Highlights of the workshop are faculty panel discussions about career paths and the academic job search. By workshop end, participants complete a goal setting and action planning activity. Two years of evaluation data suggest our goals are being met. Participants particularly appreciate the practical ideas and the opportunity to interact with, and learn from, a diverse leadership team and other participants.

Electromechanical Power for NASA Missions

NASA Technical Reports Server (NTRS)

Manzo, Michelle A.

2005-01-01

NASA has a wide range of missions that require electrochemical power sources. These needs are met with a variety of options that include primary and secondary cells and batteries, fuel cells, and regenerative fuel cells. This presentation wil cover an overview of NASA missions and requirements for electrochemical power sources and investigate the synergy and diversity that exist between NASA's requirements and those for military tactical power sources. Current development programs at GRC and other NASA centers, aimed at meeting NASA's future requirements will also be discussed.

Applications of artificial intelligence V; Proceedings of the Meeting, Orlando, FL, May 18-20, 1987

NASA Technical Reports Server (NTRS)

Gilmore, John F. (Editor)

1987-01-01

The papers contained in this volume focus on current trends in applications of artificial intelligence. Topics discussed include expert systems, image understanding, artificial intelligence tools, knowledge-based systems, heuristic systems, manufacturing applications, and image analysis. Papers are presented on expert system issues in automated, autonomous space vehicle rendezvous; traditional versus rule-based programming techniques; applications to the control of optional flight information; methodology for evaluating knowledge-based systems; and real-time advisory system for airborne early warning.

Erectile Dysfunction in the Older Adult Male.

PubMed

Mola, Joanna R

2015-01-01

Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options.

Marketing your medical practice with an effective web presence.

PubMed

Finch, Tammy

2004-01-01

The proliferation of the World Wide Web has provided an opportunity for medical practices to sell themselves through low-cost marketing on the Internet. A Web site is a quick and effective way to provide patients with up-to-date treatment and procedure information. This article provides suggestions on what to include on a medical practice's Web site, how the Web can assist office staff and physicians, and cost options for your Web site. The article also discusses design tips, such as Web-site optimization.

Random harmonic analysis program, L221 (TEV156). Volume 1: Engineering and usage

NASA Technical Reports Server (NTRS)

Miller, R. D.; Graham, M. L.

1979-01-01

A digital computer program capable of calculating steady state solutions for linear second order differential equations due to sinusoidal forcing functions is described. The field of application of the program, the analysis of airplane response and loads due to continuous random air turbulence, is discussed. Optional capabilities including frequency dependent input matrices, feedback damping, gradual gust penetration, multiple excitation forcing functions, and a static elastic solution are described. Program usage and a description of the analysis used are presented.

Challenges and issues facing lithium metal for solid-state rechargeable batteries

NASA Astrophysics Data System (ADS)

Mauger, A.; Armand, M.; Julien, C. M.; Zaghib, K.

2017-06-01

The commercial use of lithium metal batteries was delayed because of dendrite formation on the surface of the lithium electrode, and the difficulty finding a suitable electrolyte that has both the mechanical strength and ionic conductivity required for solid electrolytes. Recently, strategies have developed to overcome these difficulties, so that these batteries are currently an option for different applications, including electric cars. In this work, we review these strategies, and discuss the different routes that are promising for progress in the near future.

Hot zero power reactor calculations using the Insilico code

DOE PAGES

Hamilton, Steven P.; Evans, Thomas M.; Davidson, Gregory G.; ...

2016-03-18

In this paper we describe the reactor physics simulation capabilities of the insilico code. A description of the various capabilities of the code is provided, including detailed discussion of the geometry, meshing, cross section processing, and neutron transport options. Numerical results demonstrate that the insilico SP N solver with pin-homogenized cross section generation is capable of delivering highly accurate full-core simulation of various PWR problems. Comparison to both Monte Carlo calculations and measured plant data is provided.

Proceedings of the nineteenth LAMPF Users Group meeting

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

Bradbury, J.N.

1986-02-01

Separate abstracts were prepared for eight invited talks on various aspects of nuclear and particle physics as well as status reports on LAMPF and discussions of upgrade options. Also included in these proceedings are the minutes of the working groups for: energetic pion channel and spectrometer; high resolution spectrometer; high energy pion channel; neutron facilities; low-energy pion work; nucleon physics laboratory; stopped muon physics; solid state physics and material science; nuclear chemistry; and computing facilities. Recent LAMPF proposals are also briefly summarized. (LEW)

System design and installation for RS600 programmable control system for solar heating and cooling

NASA Technical Reports Server (NTRS)

1978-01-01

Procedures for installing, operating, and maintaining a programmable control system which utilizes a F8 microprocessor to perform all timing, control, and calculation functions in order to customize system performance to meet individual requirements for solar heating, combined heating and cooling, and/or hot water systems are described. The manual discusses user configuration and options, displays, theory of operation, trouble-shooting procedures, and warranty and assistance. Wiring lists, parts lists, drawings, and diagrams are included.

Drug-induced gynecomastia.

PubMed

Eckman, Ari; Dobs, Adrian

2008-11-01

Gynecomastia is caused by drugs in 10 - 25% of all cases. The pathophysiologic mechanism for some drugs includes exogenous estrogens exposure, medications that cause hypogonadism, anti-androgenic effects and hyperprolactinemia. This manuscript reviews common examples of drug-induced gynecomastia, discussing the mechanisms and possible treatments. Discontinuing the medication is always the best choice; however, if this is not possible, then testosterone replacement therapy may be needed for hypogonadism. When a man is euogonadal, a trial of the anti-estrogen, tamoxifen or an aromatase inhibitor may be an option.

Access to augmentative and alternative communication: new technologies and clinical decision-making.

PubMed

Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

2012-01-01

Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

Space Station crew safety alternatives study. Volume 4: Appendices

NASA Technical Reports Server (NTRS)

Peercy, R. L., Jr.; Raasch, R. F.; Rockoff, L. A.

1985-01-01

The scope of this study considered the first 15 years of accumulated space station concepts for Initial Operational Capability (10C) during the early 1990's. Twenty-five threats to the space station are identified and selected threats addressed as impacting safety criteria, escape and rescue, and human factors safety concerns. Of the 25 threats identified, eight are discussed including strategy options for threat control: fire, biological or toxic contamination, injury/illness, explosion, loss of pressurization, radiation, meteoroid penetration and debris.

Pegademase bovine (PEG-ADA) for the treatment of infants and children with severe combined immunodeficiency (SCID).

PubMed

Booth, Claire; Gaspar, H Bobby

2009-01-01

Adenosine deaminase deficiency (ADA) is a rare, inherited disorder of purine metabolism characterized by immunodeficiency, failure to thrive and metabolic abnormalities. A lack of the enzyme ADA allows accumulation of toxic metabolites causing defects of both cell mediated and humoral immunity leading to ADA severe combined immune deficiency (SCID), a condition that can be fatal in early infancy if left untreated. Hematopoietic stem cell transplant is curative but is dependent on a good donor match. Other therapeutic options include enzyme replacement therapy (ERT) with pegademase bovine (PEG-ADA) and more recently gene therapy. PEG-ADA has been used in over 150 patients worldwide and has allowed stabilization of patients awaiting more definitive treatment with hematopoietic stem cell transplant. It affords both metabolic detoxification and protective immune function with patients remaining clinically well, but immune reconstitution is often suboptimal and may not be long lived. We discuss the pharmacokinetics, immune reconstitution, effects on systemic disease and side effects of treatment with PEG-ADA. We also review the long-term outcome of patients receiving ERT and discuss the role of PEG-ADA in the management of infants and children with ADA-SCID, alongside other therapeutic options.

Refractory overactive bladder: Beyond oral anticholinergic therapy

PubMed Central

Glinski, Ronald W.; Siegel, Steven

2007-01-01

Objectives: In this review, we discuss the treatment of refractory overactive bladder (OAB) that has not adequately responded to medication therapy and we propose an appropriate care pathway to the treatment of OAB. We also attempt to address the cost of OAB treatments. Materials and Methods: A selective expert review of the current literature on the subject of refractory OAB using MEDLINE was performed and the data is summarized. We also review our experience in treating refractory OAB. The role and outcomes of various treatment options for refractory OAB are discussed and combined therapy with oral anticholinergics is explored. Emerging remedies including intravesical botulinum toxin injection and pudendal neuromodulation are also reviewed, along with conventional surgical options. Results: In general behavioral therapy, pelvic floor electrical stimulation, magnetic therapy and posterior tibial nerve stimulation (PTNS), have shown symptom decreases in 50-80% of patients with OAB. Depending on the study, combination therapy with oral anticholinergics seems to improve efficacy of behavioral therapy and PTNS in approximately 10-30%. In multicenter, long-term randomized controlled trials, sacral neuromodulation has been shown to improve symptoms of OAB and OAB incontinence in up to 80% of the patients treated. Studies involving emerging therapies such as pudendal serve stimulation suggest that there may be a 15-20% increase in efficacy over sacral neuromodulation, but long-term studies are not yet available. Another emerging therapy, botulinum toxin, is also showing similar success in reducing OAB symptoms in 80-90% of patients. Surgical approaches, such as bladder augmentation, are a last resort in the treatment of OAB and are rarely used at this point unless upper tract damage is a concern and all other treatment options have been exhausted. Conclusion: The vast majority of OAB patients can be managed successfully by behavioral options with or without anticholinergic medications. When those fail, neuromodulation or intravesical botulinum toxin therapies are successful alternatives for most of the remaining group. We encourage practitioners responsible for the care of OAB patients to gain experience with these options. More research is needed to assess the cost-effectiveness of various OAB treatments PMID:19675795

Suppressing ghost beams: Backlink options for LISA

NASA Astrophysics Data System (ADS)

Isleif, K.-S.; Gerberding, O.; Penkert, D.; Fitzsimons, E.; Ward, H.; Robertson, D.; Livas, J.; Mueller, G.; Reiche, J.; Heinzel, G.; Danzmann, K.

2017-05-01

In this article we discuss possible design options for the optical phase reference system, the so called backlink, between two moving optical benches in a LISA satellite. The candidates are based on two approaches: Fiber backlinks, with additional features like mode cleaning cavities and Faraday isolators, and free beam backlinks with angle compensation techniques. We will indicate dedicated ghost beam mitigation strategies for the design options and we will point out critical aspects in case of an implementation in LISA.

76 FR 38237 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... Change To Include Text in Its Options Rules Governing the Use of Its Affiliate Broker-Dealer, Archipelago Securities LLC for Outbound Routing of Option Orders, and To Adopt Text in Its Options Rules To Permit the... include text in its options rules governing the use of its affiliate broker-dealer, Archipelago Securities...

Doing More with Lease.

ERIC Educational Resources Information Center

Burdick, Barry

1999-01-01

Discusses the use of leasing programs as an equipment-acquisition tool to help schools conserve valuable capital. Discusses why leasing is a viable option and describes the different types of leasing plans. (GR)

Molecular approaches for classifying endometrial carcinoma.

PubMed

Piulats, Josep M; Guerra, Esther; Gil-Martín, Marta; Roman-Canal, Berta; Gatius, Sonia; Sanz-Pamplona, Rebeca; Velasco, Ana; Vidal, August; Matias-Guiu, Xavier

2017-04-01

Endometrial carcinoma is the most common cancer of the female genital tract. This review article discusses the usefulness of molecular techniques to classify endometrial carcinoma. Any proposal for molecular classification of neoplasms should integrate morphological features of the tumors. For that reason, we start with the current histological classification of endometrial carcinoma, by discussing the correlation between genotype and phenotype, and the most significant recent improvements. Then, we comment on some of the possible flaws of this classification, by discussing also the value of molecular pathology in improving them, including interobserver variation in pathologic interpretation of high grade tumors. Third, we discuss the importance of applying TCGA molecular approach to clinical practice. We also comment on the impact of intratumor heterogeneity in classification, and finally, we will discuss briefly, the usefulness of TCGA classification in tailoring immunotherapy in endometrial cancer patients. We suggest combining pathologic classification and the surrogate TCGA molecular classification for high-grade endometrial carcinomas, as an option to improve assessment of prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Organizational Design within University Extension Units: Some Concepts, Options, and Guidelines

ERIC Educational Resources Information Center

Baker, Harold R.

1976-01-01

Drawing on the behavioral sciences, the author outlines alternative modes of structuring and organizing an extension unit. The advantages and disadvantages of several organizational design options, the purposes and management of the temporary task force, and some general guidelines for making organizational design decisions are discussed.…

Work and Family Resource Kit.

ERIC Educational Resources Information Center

Women's Bureau (DOL), Washington, DC.

This kit is designed to help employers understand the range of family needs emerging in the workplace and the numerous options for a company response. An introduction discusses the need for child care services, dependent care problems, and how employers respond and benefit. Sections address the following: selecting the right option in relation to…

The Whole PIC Catalog: Organization, Planning and Service Delivery Options under JTPA.

ERIC Educational Resources Information Center

National Alliance of Business, Inc., Washington, DC.

This handbook illustrates and discusses organizational options for the delivery of employment and training services within service delivery areas (SDAs) mandated by the Job Training Partnership Act (JTPA) of 1982. Addressed primarily to members of private industry councils (PICs), representatives of local governments, and employment and training…

PRELIMINARY PERFORMANCE AND COST ESTIMATES OF MERCURY EMISSION CONTROL OPTIONS FOR ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper discusses preliminary performance and cost estimates of mercury emission control options for electric utility boilers. Under the Clean Air Act Amendments of 1990, EPA had to determine whether mercury emissions from coal-fired power plants should be regulated. To a...

The "Lethal Chamber": Further Evidence of the Euthanasia Option.

ERIC Educational Resources Information Center

Elks, Martin A.

1993-01-01

Historical discussions of the euthanasia or "lethal chamber" option in relation to people with mental retardation are presented. The paper concludes that eugenic beliefs in the primacy of heredity over environment and the positive role of natural selection may have condoned the poor conditions characteristic of large, segregated institutions and…