Sample records for panel consequence management

  1. NIMH/NIH Consensus Development Conference statement. Mood disorders: pharmacologic prevention of recurrences. Consensus Development Panel.

    PubMed

    1985-04-01

    This report represents the consensus of a panel of representatives from psychiatry, psychology, pharmacology, epidemiology, internal medicine, and the general public regarding the use of pharmacologic agents to prevent recurrences of mood disorders. The panel concluded that recurrent mood disorders, which have a high prevalence and serious consequences, are underdiagnosed and undertreated. Applying appropriate strategies to the management and use of pharmacologic agents will enhance the likelihood of compliance and the prevention of recurrence with a minimum of bothersome side effects. Such strategies should be used within the context of a supportive relationship among doctor, patient, and family.

  2. Role delineation study for the American Society for Pain Management Nursing.

    PubMed

    Willens, Joyce S; DePascale, Christine; Penny, James

    2010-06-01

    A role delineation study, or job analysis, is a necessary step in the development of a quality credentialing program. The process requires a logical approach and systematic methods to have an examination that is legally defensible. There are three main phases: initial development and evaluation, validation study, and development of test specifications. In the first phase, the content expert panel discussed performance domains that exist in pain management nursing. The six domains developed were: 1) assessment, monitoring, and evaluation of pain; 2) pharmacologic pain management; 3) nonpharmacologic pain management; 4) therapeutic communication and counseling; 5) patient and family teaching; and 6) collaborative and organizational activities. The panel then produced a list of 70 task statements to develop an online survey which was sent to independent reviewers with expertise in pain management nursing. After the panel reviewed the results of the pilot test, it was decided to clarify a few items that did not perform as expected. After the questionnaire was finalized it was distributed to 1,500 pain management nurses. The final yield was 585 usable returns, for a response rate of 39%. Thirty-three percent of the respondents reported a bachelor's degree in nursing as the highest degree awarded. Over 80% indicated that they were certified in pain management. Over 35% reported working in a staff position, 14% as a nurse practitioner, and 13% as a clinical nurse specialist. Part of the questionnaire asked the participants to rate performance expectation, consequence or the likelihood that the newly certified pain management nurse could cause harm, and the frequency of how often that nurse performs in each of the performance domains. The performance expectation was rated from 0 (the newly certified pain management nurse was not at all expected to perform the domain task) to 2 (after 6 months the newly certified pain management nurse would be expected to perform the domain task). The consequences of the degree would be the inability of the newly certified pain management nurse to perform duties or tasks in each domain was rated from 0 (no harm) to 4 (extreme harm). The first domain received the highest average frequency rating. The pharmacologic domain received the highest mean rating on consequence. The reliability of all scales was 0.95 or higher, which indicated that the questionnaire consistently measured what it was intended to measure. The quality of the questionnaire is an indicator that certification is one measure of nursing excellence. (c) 2010 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  3. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    PubMed

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  4. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    PubMed Central

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  5. 76 FR 54399 - Airworthiness Directives; The Boeing Company Model 737-200, -200C, -300, -400, and -500 Series...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ... result in sudden fracture and failure of the fuselage skin panels, and consequent rapid decompression of..., which could result in sudden fracture and failure of the fuselage skin panels, and consequent rapid... fuselage skin panels at the chem-milled steps, which could result in sudden fracture and failure of the...

  6. Latin-American guidelines for cancer pain management.

    PubMed

    Lara-Solares, Argelia; Ahumada Olea, Marisol; Basantes Pinos, Amparito de Los Ángeles; Bistre Cohén, Sara; Bonilla Sierra, Patricia; Duarte Juárez, Eva Rossina; Símon Escudero, Omar A; Santacruz Escudero, Juan Guillermo; Flores Cantisani, José Alberto

    2017-07-01

    Cancer is a major public health issue. Poor pain management has devastating consequences that seriously affect quality of life, diminish functionality and place a huge emotional burden on patients and their relatives. A group of Latin American opinion leaders were invited to participate in a meeting to discuss areas associated with cancer pain. The expert panel reviewed the latest literature to draft region-specific guidelines for effective pain management. The guidelines make recommendations on tailoring treatment to the specific type of pain and provide local physicians with the state-of-the art findings in the field. Management should be with pharmacological approaches (nonopioid, adjuvant and opioid analgesics, as well as oncologic therapies and interventional procedures) and nonpharmacological approaches.

  7. Do competition and managed care improve quality?

    PubMed

    Sari, Nazmi

    2002-10-01

    In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts. Copyright 2002 John Wiley & Sons, Ltd.

  8. Are the psychosocial aspects of weapons of mass destruction incidents addressed in the Federal Response Plan: summary of an expert panel.

    PubMed

    Becker, S M

    2001-12-01

    Within the domestic preparedness community, there is a growing recognition of the importance of psychosocial issues in weapons of mass destruction (WMD) incidents. Whereas social and behavioral issues were only infrequently considered just a few years ago, they are now coming to be seen as central to consequence management efforts. As a result, discussions in the domestic preparedness community are beginning to consider the extent to which psychosocial effects are addressed in the Federal Response Plan and the degree to which additional preparedness and response steps may be needed. To grapple with this crucial issue, an expert panel was brought together at the International Conference on the Operational Impact of Psychological Casualties from Weapons of Mass Destruction. The panel brought together a wide range of specialists from federal agencies, the armed services, and the academic community. This article summarizes the views and assessments of the panelists as well as their policy recommendations for enhancing preparedness.

  9. Panel Management to Improve Smoking and Hypertension Outcomes by VA Primary Care Teams: A Cluster-Randomized Controlled Trial.

    PubMed

    Schwartz, Mark D; Jensen, Ashley; Wang, Binhuan; Bennett, Katelyn; Dembitzer, Anne; Strauss, Shiela; Schoenthaler, Antoinette; Gillespie, Colleen; Sherman, Scott

    2015-07-01

    Panel Management can expand prevention and chronic illness management beyond the office visit, but there is limited evidence for its effectiveness or guidance on how best to incorporate it into practice. We aimed to test the effectiveness of incorporating panel management into clinical practice by incorporating Panel Management Assistants (PMAs) into primary care teams with and without panel management education. We conducted an 8-month cluster-randomized controlled trial of panel management for improving hypertension and smoking cessation outcomes among veterans. Twenty primary care teams from the Veterans Affairs New York Harbor were randomized to control, panel management support, or panel management support plus education groups. Teams included 69 clinical staff serving 8,153 hypertensive and/or smoking veterans. Teams assigned to the intervention groups worked with non-clinical Panel Management Assistants (PMAs) who monitored care gaps and conducted proactive patient outreach, including referrals, mail reminders and motivational interviewing by telephone. Measurements included mean systolic and diastolic blood pressure, proportion of patients with controlled blood pressure, self-reported quit attempts, nicotine replacement therapy (NRT) prescriptions, and referrals to disease management services. Change in mean blood pressure, blood pressure control, and smoking quit rates were similar across study groups. Patients on intervention teams were more likely to receive NRT (OR = 1.4; 95% CI 1.2-1.6) and enroll in the disease management services MOVE! (OR = 1.2; 95% CI 1.1-1.6) and Telehealth (OR = 1.7, 95% CI 1.4-2.1) than patients on control teams. Panel Management support for primary care teams improved process, but not outcome variables among veterans with hypertension and smoking. Incorporating PMAs into teams was feasible and highly valued by the clinical staff, but clinical impact may require a longer intervention.

  10. Reduced SNP Panels for Genetic Identification and Introgression Analysis in the Dark Honey Bee (Apis mellifera mellifera)

    PubMed Central

    Muñoz, Irene; Henriques, Dora; Johnston, J. Spencer; Chávez-Galarza, Julio; Kryger, Per; Pinto, M. Alice

    2015-01-01

    Beekeeping activities, especially queen trading, have shaped the distribution of honey bee (Apis mellifera) subspecies in Europe, and have resulted in extensive introductions of two eastern European C-lineage subspecies (A. m. ligustica and A. m. carnica) into the native range of the M-lineage A. m. mellifera subspecies in Western Europe. As a consequence, replacement and gene flow between native and commercial populations have occurred at varying levels across western European populations. Genetic identification and introgression analysis using molecular markers is an important tool for management and conservation of honey bee subspecies. Previous studies have monitored introgression by using microsatellite, PCR-RFLP markers and most recently, high density assays using single nucleotide polymorphism (SNP) markers. While the latter are almost prohibitively expensive, the information gained to date can be exploited to create a reduced panel containing the most ancestry-informative markers (AIMs) for those purposes with very little loss of information. The objective of this study was to design reduced panels of AIMs to verify the origin of A. m. mellifera individuals and to provide accurate estimates of the level of C-lineage introgression into their genome. The discriminant power of the SNPs using a variety of metrics and approaches including the Weir & Cockerham’s FST, an FST-based outlier test, Delta, informativeness (In), and PCA was evaluated. This study shows that reduced AIMs panels assign individuals to the correct origin and calculates the admixture level with a high degree of accuracy. These panels provide an essential tool in Europe for genetic stock identification and estimation of admixture levels which can assist management strategies and monitor honey bee conservation programs. PMID:25875986

  11. An assessment of risk posed by a Campylobacter-positive puppy living in an Australian residential aged-care facility.

    PubMed

    Moffatt, Cameron; Appuhamy, Ranil; Andrew, Will; Wynn, Sandy; Roberts, Jan; Kennedy, Karina

    2014-01-01

    In April and June 2012, two outbreaks of Campylobacter gastroenteritis were investigated in an Australian aged-care facility (ACF); a Campylobacter-positive puppy was identified as a potential source of infection. An expert panel was convened to assess transmission risk from the puppy to elderly residents and to guide further public health action. Criteria considered as part of the panel's assessment included the puppy's infectivity, the bacterium's transmissibility, puppy-resident contact, infection control and cleaning practices and animal management at the facility. A literature review was used to assist the panel, with a final risk being determined using a likelihood and consequence matrix. The panel determined that the setting and low infective dose made transmission likely despite varying degrees of contact between the puppy and cases. While infection control practices were generally appropriate, the facility's animal policy did not adequately address potential zoonotic risk. In summary, puppies should not be considered as companion animals in ACFs due to high rates of Campylobacter carriage and the underlying susceptibility of the elderly. Infection control and animal policies in ACFs should reflect an awareness of zoonotic disease potential.

  12. 76 FR 31305 - Pacific Whiting; Advisory Panel and Joint Management Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... experienced in the harvesting, processing, marketing, management, conservation, or research of the offshore... Whiting; Advisory Panel and Joint Management Committee AGENCY: National Oceanic and Atmospheric.... SUMMARY: NMFS solicits nominations for the Advisory Panel (AP) and the Joint Management Committee (JMC) on...

  13. Interagency Nuclear Safety Review Panel: Biomedical and Environmental Effects Subpanel report for Galileo

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

    Anspaugh, L.R.; Blanton, J.O.; Bollinger, L.J.

    1989-10-01

    This report of the Biomedical and Environmental Effects Subpanel (BEES) of the Interagency Nuclear Safety Review Panel (INSRP), for the Galileo space mission addresses the possible radiological consequences of postulated accidents that release radioactivity into the environment. This report presents estimates of the consequences and uncertainties given that the source term is released into the environment. 10 refs., 6 tabs.

  14. Panel management, team culture, and worklife experience.

    PubMed

    Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; O'Brien, Bridget; Earnest, Gillian; Gupta, Reena; Shunk, Rebecca; Grumbach, Kevin

    2015-09-01

    Burnout and professional dissatisfaction are threats to the primary care workforce. We investigated the relationship between panel management capability, team culture, cynicism, and perceived "do-ability" of primary care among primary care providers (PCPs) and staff in primary care practices. We surveyed 326 PCPs and 142 staff members in 10 county-administered, 6 university-run, and 3 Veterans Affairs primary care clinics in a large urban area in 2013. Predictor variables included capability for performing panel management and perception of team culture. Outcome variables included 2 work experience measures--the Maslach Burnout Inventory cynicism scale and a 1-item measure of the "do-ability" of primary care this year compared with last year. Generalized Estimation Equation (GEE) models were used to account for clustering at the clinic level. Greater panel management capability and higher team culture were associated with lower cynicism among PCPs and staff and higher reported "do-ability" of primary care among PCPs. Panel management capability and team culture interacted to predict the 2 work experience outcomes. Among PCPs and staff reporting high team culture, there was little association between panel management capability and the outcomes, which were uniformly positive. However, there was a strong relationship between greater panel management capability and improved work experience outcomes for PCPs and staff reporting low team culture. Team-based processes of care such as panel management may be an important strategy to protect against cynicism and dissatisfaction in primary care, particularly in settings that are still working to improve their team culture. (c) 2015 APA, all rights reserved).

  15. The Integrated Mode Management Interface

    NASA Technical Reports Server (NTRS)

    Hutchins, Edwin

    1996-01-01

    Mode management is the processes of understanding the character and consequences of autoflight modes, planning and selecting the engagement, disengagement and transitions between modes, and anticipating automatic mode transitions made by the autoflight system itself. The state of the art is represented by the latest designs produced by each of the major airframe manufacturers, the Boeing 747-400, the Boeing 777, the McDonnell Douglas MD-11, and the Airbus A320/A340 family of airplanes. In these airplanes autoflight modes are selected by manipulating switches on the control panel. The state of the autoflight system is displayed on the flight mode annunciators. The integrated mode management interface (IMMI) is a graphical interface to autoflight mode management systems for aircraft equipped with flight management computer systems (FMCS). The interface consists of a vertical mode manager and a lateral mode manager. Autoflight modes are depicted by icons on a graphical display. Mode selection is accomplished by touching (or mousing) the appropriate icon. The IMMI provides flight crews with an integrated interface to autoflight systems for aircraft equipped with flight management computer systems (FMCS). The current version is modeled on the Boeing glass-cockpit airplanes (747-400, 757/767). It runs on the SGI Indigo workstation. A working prototype of this graphics-based crew interface to the autoflight mode management tasks of glass cockpit airplanes has been installed in the Advanced Concepts Flight Simulator of the CSSRF of NASA Ames Research Center. This IMMI replaces the devices in FMCS equipped airplanes currently known as mode control panel (Boeing), flight guidance control panel (McDonnell Douglas), and flight control unit (Airbus). It also augments the functions of the flight mode annunciators. All glass cockpit airplanes are sufficiently similar that the IMMI could be tailored to the mode management system of any modern cockpit. The IMMI does not replace the functions of the FMCS control and display unit. The purpose of the INMI is to provide flight crews with a shared medium in which they can assess the state of the autoflight system, take control actions on it, reason about its behavior, and communicate with each other about its behavior. The design is intended to increase mode awareness and provide a better interface to autoflight mode management. This report describes the IMMI, the methods that were used in designing and developing it, and the theory underlying the design and development processes.

  16. The effects of climate-change-induced drought and freshwater wetlands

    USGS Publications Warehouse

    Middleton, B.A.; Kleinebecker, Till; Middleton, B.A.

    2012-01-01

    Drought cycles in wetlands may become more frequent and severe in the future, with consequences for wetland distribution and function. According to the Intergovernmental Panel on Climate Change (Intergovernmental Panel on Climate Change [IPCC], Managing the risks of extreme events and disasters to advance climate change adaptation, 2012. Online: http://ipcc-wg2.gov/SREX/images/uploads/SREX-All_FINAL.pdf, climate-change is likely to affect precipitation and evapotranspiration patterns so that the world’s wetlands may have more frequent episodes of extreme flooding and drought. This chapter contributes to a worldwide view of how wetland processes may be affected by these predicted changes in climate. Specifically, the occurrence of drought may increase, and that increase may affect the critical processes that sustain biodiversity in wetlands. We include specific examples that explore the effects of drought and other climate-change factors on wetland function in various parts of the world. In a concluding section we discuss management strategies for climate-change in wetlands. The synthesis of information in this chapter will contribute to a better understanding of how climate-change-induced drought may affect the function and distribution of wetlands in the future.

  17. Expert Panel Recommendations for the Identification and Management of Hyperkalemia and Role of Patiromer in Patients with Chronic Kidney Disease and Heart Failure.

    PubMed

    Rafique, Zubaid; Weir, Matthew R; Onuigbo, Macaulay; Pitt, Bertram; Lafayette, Richard; Butler, Javed; Lopes, Maria; Farnum, Carolyn; Peacock, W Frank

    2017-04-01

    Virtual panel meetings were conducted among 7 physicians, all of whom are independent experts, including 3 nephrologists, 2 cardiologists, and 2 emergency medicine physicians (the panel). The panel met with the purpose of discussing the current treatment landscape, treatment challenges, economic impact, and gaps in care for patients with hyperkalemia that is associated with heart failure and chronic kidney disease. The stated goal of the panel discussion was to develop practical solutions in the identification and management of hyperkalemia in this patient population. The panel noted that hyperkalemia is a serious condition that can lead to life-threatening complications, yet the treatment paradigm for hyperkalemia has remained without major advances for approximately 50 years, until the approval of patiromer. A number of issues still exist in the management of this patient population, including the lack of uniform treatment guidelines and consensus regarding the approach to treatment. As part of its effort, the panel developed an algorithm, the Proposed Diagnostic Algorithm for Hyperkalemia Treatment in the Acute Care Setting/Chronic Care. The panel agreed that patiromer appears to be a viable option for the management of hyperkalemia in patients with chronic kidney disease and/or heart failure and in patients who experience chronic hyperkalemia. This panel discussion was funded by Relypsa and facilitated by Magellan Rx Management. Rafique is a principal investigator for Relypsa and serves as a consultant for Instrumentation Laboratory, Magellan Health, Relypsa, and ZS-Pharma. Butler serves as consultant for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, CardioCell, Janssen, Merck, Novartis, Relypsa, and ZS-Pharma. Lopes and Farnum are employed by Magellan Rx Management. Rafique designed the management protocol for this panel discussion and contributed to the writing and editing of this report document. The other authors report no conflicting interests. Relypsa is the manufacturer of Veltassa (patiromer).

  18. A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people

    PubMed Central

    Gibson-Smith, Kathrine; MacLure, Katie; Mair, Alpana; Alonso, Albert; Codina, Carles; Cittadini, Antonio; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Junius-Walker, Ulrike; Kardas, Przemysław; Kempen, Thomas; Kinnear, Moira; Lewek, Pawel; Malva, Joao; McIntosh, Jennifer; Scullin, Claire; Wiese, Birgitt

    2017-01-01

    Background Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people. Methods Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement. Panel members were strategists (e.g. directors, leading clinicians and commissioners) from each of the 28 EU member states, with a target recruitment of five per member state. Three Delphi rounds were conducted via email, with panel members being provided with summative results and collated, anonymised comments at the commencement of Rounds 2 and 3. Results Ninety panel members were recruited (64.3% of target), with high participation levels throughout the three Delphi rounds (91.1%, 83.3%, 72.2%). During Round 1, consensus was obtained for 27/46 statements (58.7%), with an additional two statements in Round 2 and none in Round 3. Consensus was obtained for statements relating to: potential gain arising from polypharmacy management (3/4 statements); strategic development (7/7); change management (5/7) indicator measures (4/6); legislation (0/3); awareness raising (5/5); polypharmacy reviews (5/7); and EU vision (0/7). Analysis of free text comments indicated that the vision statements were too ambitious and not achievable by the specified timeframe of 2025. Conclusion Consensus was obtained amongst key EU strategists around many aspects of polypharmacy management in older people. Notably, no consensus was achieved in relation to statements relating to the need to alter legislation in areas of healthcare delivery, remuneration and practitioner scope of practice. While the vision for the EU by 2025 was considered rather ambitious, there is great potential and clear opportunity to advance polypharmacy management throughout the EU and beyond. PMID:29155870

  19. A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people.

    PubMed

    Stewart, Derek; Gibson-Smith, Kathrine; MacLure, Katie; Mair, Alpana; Alonso, Albert; Codina, Carles; Cittadini, Antonio; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Junius-Walker, Ulrike; Kardas, Przemysław; Kempen, Thomas; Kinnear, Moira; Lewek, Pawel; Malva, Joao; McIntosh, Jennifer; Scullin, Claire; Wiese, Birgitt

    2017-01-01

    Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people. Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement. Panel members were strategists (e.g. directors, leading clinicians and commissioners) from each of the 28 EU member states, with a target recruitment of five per member state. Three Delphi rounds were conducted via email, with panel members being provided with summative results and collated, anonymised comments at the commencement of Rounds 2 and 3. Ninety panel members were recruited (64.3% of target), with high participation levels throughout the three Delphi rounds (91.1%, 83.3%, 72.2%). During Round 1, consensus was obtained for 27/46 statements (58.7%), with an additional two statements in Round 2 and none in Round 3. Consensus was obtained for statements relating to: potential gain arising from polypharmacy management (3/4 statements); strategic development (7/7); change management (5/7) indicator measures (4/6); legislation (0/3); awareness raising (5/5); polypharmacy reviews (5/7); and EU vision (0/7). Analysis of free text comments indicated that the vision statements were too ambitious and not achievable by the specified timeframe of 2025. Consensus was obtained amongst key EU strategists around many aspects of polypharmacy management in older people. Notably, no consensus was achieved in relation to statements relating to the need to alter legislation in areas of healthcare delivery, remuneration and practitioner scope of practice. While the vision for the EU by 2025 was considered rather ambitious, there is great potential and clear opportunity to advance polypharmacy management throughout the EU and beyond.

  20. Practical Problems with Medication Use that Older People Experience: A Qualitative Study

    PubMed Central

    Notenboom, Kim; Beers, Erna; van Riet-Nales, Diana A; Egberts, Toine C G; Leufkens, Hubert G M; Jansen, Paul A F; Bouvy, Marcel L

    2014-01-01

    Objectives To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. Design Qualitative study with semistructured face-to-face interviews. Setting A community pharmacy and a geriatric outpatient ward. Participants Community-dwelling people aged 70 and older (N = 59). Measurements Participants were interviewed at home. Two researchers coded the reported problems and management strategies independently according to a coding scheme. An expert panel classified the potential clinical relevance of every identified practical problem and associated management strategy using a 3-point scale. Results Two hundred eleven practical problems and 184 management strategies were identified. Ninety-five percent of the participants experienced one or more practical problems with the use of their medicines: problems reading and understanding the instructions for use, handling the outer packaging, handling the immediate packaging, completing preparation before use, and taking the medicine. For 10 participants, at least one of their problems, in combination with the applied management strategy, had potential clinical consequences and 11 cases (5% of the problems) had the potential to cause moderate or severe clinical deterioration. Conclusion Older people experience a number of practical problems using their medicines, and their strategies to manage these problems are sometimes suboptimal. These problems can lead to incorrect medication use with clinically relevant consequences. The findings pose a challenge for healthcare professionals, drug developers, and regulators to diminish these problems. PMID:25516030

  1. Use of risk assessment panels during revision of the Tongass Land and Resource Management Plan.

    Treesearch

    Charles G. Shaw

    1999-01-01

    This paper describes the process used to conduct the 16 risk assessment panels and a subsistence working group held during revision of the Tongass land management plan. It provides an overview of how results from the panels were used by forest managers in plan-related decisionmaking, discusses some reactions to the effort, and identifies some opportunities to improve...

  2. The Glen Canyon Dam Adaptive Management Program: An experiment in science-based resource management

    NASA Astrophysics Data System (ADS)

    kaplinski, m

    2001-12-01

    In 1996, Glen Canyon Dam Adaptive Management (GCDAMP) program was established to provide input on Glen Canyon Dam operations and their affect on the Colorado Ecosystem in Grand Canyon. The GCDAMP is a bold experiment in federal resource management that features a governing partnership with all relevant stakeholders sitting at the same table. It is a complicated, difficult process where stakeholder-derived management actions must balance resource protection with water and power delivery compacts, the Endangered Species Act, the National Historical Preservation Act, the Grand Canyon Protection Act, National Park Service Policy, and other stakeholder concerns. The program consists of four entities: the Adaptive Management Workgroup (AMWG), the Technical Workgroup (TWG), the Grand Canyon Monitoring and Research Center (GCMRC), and independent review panels. The AMWG and TWG are federal advisory committees that consists of federal and state resource managers, Native American tribes, power, environmental and recreation interests. The AMWG is develops, evaluates and recommends alternative dam operations to the Secretary. The TWG translates AMWG policy and goals into management objectives and information needs, provides questions that serve as the basis for long-term monitoring and research activities, interprets research results from the GCMRC, and prepares reports as required for the AMWG. The GCMRC is an independent science center that is responsible for all GCDAMP monitoring and research activities. The GCMRC utilizes proposal requests with external peer review and an in-house staff that directs and synthesizes monitoring and research results. The GCMRC meets regularly with the TWG and AMWG and provides scientific information on the consequences of GCDAMP actions. Independent review panels consist of external peer review panels that provide reviews of scientific activities and the program in general, technical advice to the GCMRC, TWG and AMWG, and play a critical balancing role to ensure overall scientific credibility to the program. Many lessons have been learned and many challenges remain. Incorporation of social issues such as recreation experience and non-use economic valuation has been especially difficult and not entirely satisfactory to many stakeholders. Adaptive management can be frustrating and a fragile spirit of cooperation exists between stakeholders with opposing interests. Communication and flexibility is the key to program success. Scientific results need to be clearly stated to keep results relevant to managers, and managers must embrace the uncertainty of scientific endeavors. Managers must remain flexible in creating and revising program goals and objectives to incorporate new scientific results into meaningful management strategies.

  3. Frequency domain analysis of the random loading of cracked panels

    NASA Technical Reports Server (NTRS)

    Doyle, James F.

    1994-01-01

    The primary effort concerned the development of analytical methods for the accurate prediction of the effect of random loading on a panel with a crack. Of particular concern was the influence of frequency on the stress intensity factor behavior. Many modern structures, such as those found in advanced aircraft, are lightweight and susceptible to critical vibrations, and consequently dynamic response plays a very important role in their analysis. The presence of flaws and cracks can have catastrophic consequences. The stress intensity factor, K, emerges as a very significant parameter that characterizes the crack behavior. In analyzing the dynamic response of panels that contain cracks, the finite element method is used, but because this type of problem is inherently computationally intensive, a number of ways of calculating K more efficiently are explored.

  4. Space station operations task force. Panel 4 report: Management integration

    NASA Technical Reports Server (NTRS)

    1987-01-01

    The Management Integration Panel of the Space Station Operations Task Force was chartered to provide a structure and ground rules for integrating the efforts of the other three panels and to address a number of cross cutting issues that affect all areas of space station operations. Issues addressed include operations concept implementation, alternatives development and integration process, strategic policy issues and options, and program management emphasis areas.

  5. Panel Resource Management (PRM) Implementation and Effects within Safety Review Panel Settings and Dynamics

    NASA Technical Reports Server (NTRS)

    Taylor, Robert W.; Nash, Sally K.

    2007-01-01

    While technical training and advanced degree's assure proficiency at specific tasks within engineering disciplines, they fail to address the potential for communication breakdown and decision making errors familiar to multicultural environments where language barriers, intimidating personalities and interdisciplinary misconceptions exist. In an effort to minimize these pitfalls to effective panel review, NASA's lead safety engineers to the ISS Safety Review Panel (SRP), and Payload Safety Review Panel (PSRP) initiated training with their engineers, in conjunction with the panel chairs, and began a Panel Resource Management (PRM) program. The intent of this program focuses on the ability to reduce the barriers inhibiting effective participation from all panel attendees by bolstering participants confidence levels through increased communication skills, situational awareness, debriefing, and a better technical understanding of requirements and systems.

  6. Command and Control Workshop: Structures and Processes for R&D Service Delivery

    DTIC Science & Technology

    1996-12-01

    syndicates. After getting direction from Deputy Chief of Defence Staff (DCDS) and CRAD as well as a panel of senior officers and managers , the workshop...prepared speeches providing direction to the attendees. This was followed by presentations from a panel of senior officers and civilian managers which...On the morning of the final day, the panel of senior officers and managers reconvened to hear summary presentations of the previous days

  7. 77 FR 36206 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-18

    ... experienced smoke and heat damage from insulation blankets that smoldered after molten debris from a P200 ELMS power panel fell on the insulation blankets. When a contactor in the ELMS panel fails and overheats, the... ELMS contactor breakdown, consequent smoke and heat damage to airplane structure and equipment during...

  8. Environmental effects of ozone depletion and its interactions with climate change: progress report, 2015

    EPA Science Inventory

    The Environmental Effects Assessment Panel (EEAP) is one of three Panels that regularly informs the Parties (countries) to the Montreal Protocol on the effects of ozone depletion and the consequences of climate change interactions with respect to human health, animals, plants, bi...

  9. EVALUATION OF METEOROLOGICAL ALERT CHAIN IN CASTILLA Y LEÓN (SPAIN): How can the meteorological risk managers help researchers?

    NASA Astrophysics Data System (ADS)

    López, Laura; Guerrero-Higueras, Ángel Manuel; Sánchez, José Luis; Matía, Pedro; Ortiz de Galisteo, José Pablo; Rodríguez, Vicente; Lorente, José Manuel; Merino, Andrés; Hermida, Lucía; García-Ortega, Eduardo; Fernández-Manso, Oscar

    2013-04-01

    Evaluating the meteorological alert chain, or, how information is transmitted from the meteorological forecasters to the final users, passing through risk managers, is a useful tool that benefits all the links of the chain, especially the meteorology researchers and forecasters. In fact, the risk managers can help significantly to improve meteorological forecasts in different ways. Firstly, by pointing out the most appropriate type of meteorological format, and its characteristics when representing the meteorological information, consequently improving the interpretation of the already-existing forecasts. Secondly, by pointing out the specific predictive needs in their workplaces related to the type of significant meteorological parameters, temporal or spatial range necessary, meteorological products "custom-made" for each type of risk manager, etc. In order to carry out an evaluation of the alert chain in Castilla y León, we opted for the creation of a Panel of Experts made up of personnel specialized in risk management (Responsible for Protection Civil, Responsible for Alert Services and Hydrological Planning of Hydrographical Confederations, Responsible for highway maintenance, and management of fires, fundamentally). In creating this panel, a total of twenty online questions were evaluated, and the majority of the questions were multiple choice or open-ended. Some of the results show how the risk managers think that it would be interesting, or very interesting, to carry out environmental educational campaigns about the meteorological risks in Castilla y León. Another result is the elevated importance that the risk managers provide to the observation data in real-time (real-time of wind, lightning, relative humidity, combined indices of risk of avalanches, snowslides, index of fires due to convective activity, etc.) Acknowledgements The authors would like to thank the Junta de Castilla y León for its financial support through the project LE220A11-2.

  10. Use of questionnaires and an expert panel to judge the environmental consequences of chemical spills for the development of an environment-accident index.

    PubMed

    Andersson, Asa Scott; Stjernström, Olof; Fängmark, Ingrid

    2005-05-01

    Assessing the environmental consequences of a chemical accident is a complex task. To date, the methods used to evaluate the environmental effects of an acute release of a chemical have often been based on measurements of chemical and physical variables deemed to be important, such as the concentration of the chemical. However, a broader strategy is needed to predict the environmental consequences of potential accidents during the planning process. An Environment-Accident Index (EAI), a simple tool based on such a strategy, has been developed to facilitate the consideration of a multitude of influential variables. The objectives of this study were to evaluate whether questionnaire-based expert panel's judgements could provide useful data on the environmental consequences of chemical spills, and an effective basis for further development of the EAI. As expected, the judgements did not agree perfectly, but they do give rough indications of the environmental effects, and highlight consistent trends that should be useful inputs for planning, prevention and decontamination processes. The different accidents were also judged to have caused everything from minor to very major effects in the environment, implying that a wide range of accident scenarios were represented in the material and covered by the EAI. Therefore, questionnaires and expert panel judgements can be used to collect useful data for estimating the likely environmental consequences of chemical accidents and for further development of the EAI.

  11. 75 FR 76757 - Licensing Support System Advisory Review Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-09

    ... provide advice on the fundamental issues of design and development of an electronic information management... electronic information management system was known as the Licensing Support System (LSS). In November, 1998... experience in electronic information management systems may also participate on the Panel. The Nuclear...

  12. Stable Postdivorce Family Structures during Late Adolescence and Socioeconomic Consequences in Adulthood

    ERIC Educational Resources Information Center

    Sun, Yongmin; Li, Yuanzhang

    2008-01-01

    Using four waves of panel data from 6,954 American young adults in the National Education Longitudinal Study, we compare the long-term socioeconomic consequences of growing up in two types of divorced families. Our findings show that the negative socioeconomic consequences of growing up in unstable postdivorce families are at least twice as large…

  13. 77 FR 30015 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... announced below concerns Characterizing the Short and Long Term Consequences of Traumatic Brain Injury (TBI... ``Characterizing the Short and Long Term Consequences of Traumatic Brain Injury (TBI) among Children in the United...

  14. Human-rights consequences of the proposed trans-Siberian natural gas pipeline. Hearing before the Subcommittee on International Finance and Monetary Policy of the Committee on Banking, Housing, and Urban Affairs, United States, Senate, Ninety-Seventh Congress, Second Session, June 18, 1982

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

    Not Available

    1982-01-01

    A Russian human-rights activist and several Vietnamese participated in a hearing panel exploring reports of Soviet plans to use imported Vietnamese labor form reeducation camps to build the trans-Siberian pipeline in exchange for Soviet assistance to the Communist government of Vietnam. The panel investigated moral as well as economic and strategic consequences to detente and East-West trade relationships. At issue was US political and economic support of a regime drawing on labor from concentration camps. The panel reviewed the record of conscripted labor, the death rate of prisoners, and the experience of Vietnamese workers in France in the context ofmore » East-West trade. (DCK)« less

  15. Heaven Knows I'm Miserable Now: Overeducation and Reduced Life Satisfaction

    ERIC Educational Resources Information Center

    Piper, Alan

    2015-01-01

    Recently the supply of young graduates entering the UK labour market has undergone a sharp increase. A possible consequence of this is an increase in the number of individuals who are overeducated for the jobs that they do subsequent to participating in higher education. Using British panel data and dynamic panel analysis, I demonstrate that…

  16. Systematic review of prevention and management strategies for the consequences of gender-based violence in refugee settings.

    PubMed

    Asgary, Ramin; Emery, Eleanor; Wong, Marcia

    2013-06-01

    Uncertainties continue regarding effective strategies to prevent and address the consequences of gender-based violence (GBV) among refugees. The databases of PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, Anthropology Plus, EMBASE, DARE, Google Scholar, MSF Field Research, UNHCR and the regional and global indices of the WHO Global Health Library were searched twice within a 6-month period (April and September 2011) for English-language clinical, public health, basic and social science studies evaluating strategies to prevent and manage health sequelae of GBV among refugees before September 2011. Studies not primarily about prevention and treatment, and not describing population, health outcome and interventions, were excluded. The literature search for the prevention and management arms produced 1212 and 1106 results, respectively. After reviewing the titles and abstracts, 29 and 27 articles were selected for review in their entirety, none of which met the inclusion criteria. Multiple panels of expert recommendations and guidelines were not supported by primary data on actual displaced populations. There is a dire need for research that evaluates the efficacy and effectiveness of various responses to GBV to ultimately allow a transition from largely theoretical and expertise driven to a more evidence-based field. We recommend strategies to improve data collection and to overcome barriers in primary data driven research.

  17. Future Defence Budget Constraints: Challenges and Opportunities (Contraintes futures sur les budgets de defense: Defis et opportunites)

    DTIC Science & Technology

    2016-12-01

    collaborative effort is addressed by six Technical Panels who manage a wide range of scientific research activities, a Group specialising in modelling and...HFM Human Factors and Medicine Panel • IST Information Systems Technology Panel • NMSG NATO Modelling and Simulation Group • SAS System Analysis...and Studies Panel • SCI Systems Concepts and Integration Panel • SET Sensors and Electronics Technology Panel These Panels and Group are the

  18. The importance of assessment and management of morning stiffness in Asian patients with rheumatoid arthritis: Recommendations from an expert panel.

    PubMed

    Mok, Chi Chiu; Cha, Hoon Suk; Hidayat, Rudy; Nguyen, Lan Thi Ngoc; Perez, Emmanuel C; Ramachandran, Raveendran; Tsay, Gregory J; Yoo, Dae Hyun

    2016-01-01

    In patients with rheumatoid arthritis (RA), morning stiffness is linked more to functional disability and pain than disease activity, as assessed by joint counts and markers of inflammation. As part of the Asia Pacific Morning Stiffness in Rheumatoid Arthritis Expert Panel, a group of eight rheumatologists met to formulate consensus points and develop recommendations for the assessment and management of morning stiffness in RA. On the basis of a systematic literature review and expert opinion, a panel of Asian rheumatologists formulated recommendations for the assessment and medical treatment of RA. The panel agreed upon 10 consensus statements on morning stiffness, its assessment and treatment. Specifically, the panel recommended that morning stiffness, pain and impaired morning function should be routinely assessed in clinical practice. Although there are currently no validated tools for these parameters, they should be assessed as part of the patients' reported outcomes in RA. The panel also agreed on the benefits of low-dose glucocorticoids in RA, particularly for the improvement of morning stiffness. These recommendations serve to guide rheumatologists and other stakeholders on the assessment and management of morning stiffness, and help implement the treat-to-target principle in the management of RA. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  19. Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.

    PubMed

    Sanders, Gillian D; Neumann, Peter J; Basu, Anirban; Brock, Dan W; Feeny, David; Krahn, Murray; Kuntz, Karen M; Meltzer, David O; Owens, Douglas K; Prosser, Lisa A; Salomon, Joshua A; Sculpher, Mark J; Trikalinos, Thomas A; Russell, Louise B; Siegel, Joanna E; Ganiats, Theodore G

    2016-09-13

    Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers. In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process. The concept of a "reference case" and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an "impact inventory," which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health outcomes, and the reporting of cost-effectiveness analyses. The Second Panel reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations. Major changes include the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.

  20. 50 CFR 600.754 - Decision to establish a fishery negotiation panel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Decision to establish a fishery negotiation panel. 600.754 Section 600.754 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.754 Decision to establish a fishery negotiation panel. (a) Determination...

  1. 50 CFR 600.756 - Conduct and operation of a fishery negotiation panel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... negotiation panel. 600.756 Section 600.756 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.756 Conduct and operation of a fishery negotiation panel. (a) Roles and... represent the Council or NMFS in the discussions and negotiations of the FNP. ...

  2. 50 CFR 600.756 - Conduct and operation of a fishery negotiation panel.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... negotiation panel. 600.756 Section 600.756 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.756 Conduct and operation of a fishery negotiation panel. (a) Roles and... represent the Council or NMFS in the discussions and negotiations of the FNP. ...

  3. 50 CFR 600.755 - Establishment of a fishery negotiation panel.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Establishment of a fishery negotiation panel. 600.755 Section 600.755 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL... Negotiation Panels § 600.755 Establishment of a fishery negotiation panel. (a) General authority. (1) A...

  4. 50 CFR 600.754 - Decision to establish a fishery negotiation panel.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Decision to establish a fishery negotiation panel. 600.754 Section 600.754 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.754 Decision to establish a fishery negotiation panel. (a) Determination...

  5. 50 CFR 600.755 - Establishment of a fishery negotiation panel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Establishment of a fishery negotiation panel. 600.755 Section 600.755 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL... Negotiation Panels § 600.755 Establishment of a fishery negotiation panel. (a) General authority. (1) A...

  6. 50 CFR 600.754 - Decision to establish a fishery negotiation panel.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Decision to establish a fishery negotiation panel. 600.754 Section 600.754 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.754 Decision to establish a fishery negotiation panel. (a) Determination...

  7. 50 CFR 600.756 - Conduct and operation of a fishery negotiation panel.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... negotiation panel. 600.756 Section 600.756 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.756 Conduct and operation of a fishery negotiation panel. (a) Roles and... represent the Council or NMFS in the discussions and negotiations of the FNP. ...

  8. 50 CFR 600.755 - Establishment of a fishery negotiation panel.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Establishment of a fishery negotiation panel. 600.755 Section 600.755 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL... Negotiation Panels § 600.755 Establishment of a fishery negotiation panel. (a) General authority. (1) A...

  9. 50 CFR 600.755 - Establishment of a fishery negotiation panel.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Establishment of a fishery negotiation panel. 600.755 Section 600.755 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL... Negotiation Panels § 600.755 Establishment of a fishery negotiation panel. (a) General authority. (1) A...

  10. 50 CFR 600.755 - Establishment of a fishery negotiation panel.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Establishment of a fishery negotiation panel. 600.755 Section 600.755 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL... Negotiation Panels § 600.755 Establishment of a fishery negotiation panel. (a) General authority. (1) A...

  11. 50 CFR 600.754 - Decision to establish a fishery negotiation panel.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Decision to establish a fishery negotiation panel. 600.754 Section 600.754 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.754 Decision to establish a fishery negotiation panel. (a) Determination...

  12. 50 CFR 600.754 - Decision to establish a fishery negotiation panel.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Decision to establish a fishery negotiation panel. 600.754 Section 600.754 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.754 Decision to establish a fishery negotiation panel. (a) Determination...

  13. 50 CFR 600.756 - Conduct and operation of a fishery negotiation panel.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... negotiation panel. 600.756 Section 600.756 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.756 Conduct and operation of a fishery negotiation panel. (a) Roles and... represent the Council or NMFS in the discussions and negotiations of the FNP. ...

  14. 50 CFR 600.756 - Conduct and operation of a fishery negotiation panel.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... negotiation panel. 600.756 Section 600.756 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.756 Conduct and operation of a fishery negotiation panel. (a) Roles and... represent the Council or NMFS in the discussions and negotiations of the FNP. ...

  15. [Methodology for construction of a panel of indicators for monitoring and evaluation of unified health system (SUS) management].

    PubMed

    Tamaki, Edson Mamoru; Tanaka, Oswaldo Yoshimi; Felisberto, Eronildo; Alves, Cinthia Kalyne de Almeida; Drumond Junior, Marcos; Bezerra, Luciana Caroline de Albuquerque; Calvo, Maria Cristina Marino; Miranda, Alcides Silva de

    2012-04-01

    This study sought to develop methodology for the construction of a Panel for the Monitoring and Evaluation of Management of the Unified Health System (SUS). The participative process used in addition to the systematization conducted made it possible to identify an effective strategy for building management tools in partnership with researchers, academic institutions and managers of the SUS. The final systematization of the Panel selected indicators for the management of the SUS in terms of Demand, Inputs, Processes, Outputs and Outcomes in order to provide a simple, versatile and useful tool for evaluation at any level of management and more transparent and easier communication with all stakeholders in decision-making. Taking the management of the SUS as the scope of these processes and practices in all normative aspects enabled dialog between systemic theories and those which consider the centrality of the social actor in the decision-making process.

  16. Assessing management of raptor predation management for snowy plover recovery

    Treesearch

    Bruce G. Marcot; Daniel C. Elbert

    2015-01-01

    On February 4, 2014, a seven-member expert panel provided objective technical information on the potential effectiveness and feasibility of activities to manage raptors (northern harriers and great horned owls) to aid the recovery of western snowy plovers. The panel discussed and scored the 26 raptor control techniques in nine main categories of habitat modification,...

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

    Morris, John; Gilchrist, Phillip Charles

    Processes, systems, devices, and articles of manufacture are provided. Each may include adapting micro-inverters initially configured for frame-mounting to mounting on a frameless solar panel. This securement may include using an adaptive clamp or several adaptive clamps secured to a micro-inverter or its components, and using compressive forces applied directly to the solar panel to secure the adaptive clamp and the components to the solar panel. The clamps can also include compressive spacers and safeties for managing the compressive forces exerted on the solar panels. Friction zones may also be used for managing slipping between the clamp and the solarmore » panel during or after installation. Adjustments to the clamps may be carried out through various means and by changing the physical size of the clamps themselves.« less

  18. Global status of recycling waste solar panels: A review.

    PubMed

    Xu, Yan; Li, Jinhui; Tan, Quanyin; Peters, Anesia Lauren; Yang, Congren

    2018-05-01

    With the enormous growth in the development and utilization of solar-energy resources, the proliferation of waste solar panels has become problematic. While current research into solar panels has focused on how to improve the efficiency of the production capacity, the dismantling and recycling of end-of-life (EOL) panels are seldom considered, as can be seen, for instance, in the lack of dedicated solar-panel recycling plants. EOL solar-panel recycling can effectively save natural resources and reduce the cost of production. To address the environmental conservation and resource recycling issues posed by the huge amount of waste solar panels regarding environmental conservation and resource recycling, the status of the management and recycling technologies for waste solar panels are systemically reviewed and discussed in this article. This review can provide a quantitative basis to support the recycling of PV panels, and suggests future directions for public policy makers. At present, from the technical aspect, the research on solar panel recovery is facing many problems, and we need to further develop an economically feasible and non-toxic technology. The research on solar photovoltaic panels' management at the end of life is just beginning in many countries, and there is a need for further improvement and expansion of producer responsibility. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Assessment of commercial lamb meat quality by British and Spanish taste panels.

    PubMed

    Sañudo, C; Nute, G R; Campo, M M; María, G; Baker, A; Sierra, I; Enser, M E; Wood, J D

    1998-01-01

    Trained sensory panels in Britain and Spain assessed loin meat from commercial lambs purchased in Spain, which included Welsh lamb (imported from Britain) and two Spanish breeds (Merino and Rasa Aragonesa). The British panel also assessed British lamb purchased in local butcher shops and supermarkets. Sensory panels, in each country, received meat from the same lambs and used their local methods of cooking and assessment. Spanish panels used unstructured line scales to measure lamb odour intensity, tenderness, juiciness, lamb flavour intensity and two hedonic scales of flavour liking and overall liking. The British panel used 8 point category scales with the same attributes. Results from both panels in objective parameters were in agreement, hence showing that different trained sensory panels may arrive at the same conclusion. However, when panellists were allowed to make hedonic judgements (preference), the British panel preferred British lamb and the Spanish panel preferred Spanish lamb. This finding has important consequences for lamb producers who export their lambs and demonstrates that the underlying reasons for different preferences should be investigated. Production variables are discussed in relation to their influence on lamb eating quality and as a way to tailor lamb eating quality attributes familiar to consumers in the importing country.

  20. Integrated corridor management initiative: survey Dallas traveler response panel

    DOT National Transportation Integrated Search

    2017-03-01

    This report presents findings from the Integrated Corridor Management (ICM) traveler behavior surveys, a set of panel surveys of US-75 corridor users, conducted before and after the deployment of ICM. The purpose of the surveys was to measure the imp...

  1. Proceedings of the conference on coastal erosion and wetland modification in Louisiana: causes, consequences, and options

    USGS Publications Warehouse

    Boesch, Donald F.

    1982-01-01

    This volume contains 16 papers and panel discussions from a conference held in Baton Rouge, La., 5-6 October 1981. The presentations consider the causes and consequences of coastal erosion and wetland modification in Louisiana and the mitigative options available to slow or reverse the rapid rate of coastal land loss. Detailed habitat mapping studies have allowed accurate estimates of coastal habitat change and land loss through 1978. Projections from these rates of change indicate an annual rate of land loss in coastal Louisiana in the early 1980's of approximately 130 km2/yr (50 m2/yr).The projected effects of wetland modification on the bountiful living resources of coastal Louisiana (fisheries, fur and hide bearers and waterfowl) are major because of the close dependence of these resources on estuarine wetlands. These changes and others related to flood protection, transportation and ownership of mineral resources are projected to have extensive social and economic consequences.Options proposed to slow coastal land loss include major and minor diversion of the Mississippi River, barrier island and shoreline restoration protection, hydrological management of wetlands and more restrictive permitting of dredging activities.

  2. 50 CFR 600.753 - Notice of intent to establish a fishery negotiation panel.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Notice of intent to establish a fishery negotiation panel. 600.753 Section 600.753 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.753 Notice of intent to establish a fishery negotiation panel. (a...

  3. 50 CFR 600.753 - Notice of intent to establish a fishery negotiation panel.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Notice of intent to establish a fishery negotiation panel. 600.753 Section 600.753 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.753 Notice of intent to establish a fishery negotiation panel. (a...

  4. 50 CFR 600.751 - Determination of need for a fishery negotiation panel.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Determination of need for a fishery negotiation panel. 600.751 Section 600.751 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.751 Determination of need for a fishery negotiation panel. A Council or...

  5. 50 CFR 600.753 - Notice of intent to establish a fishery negotiation panel.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Notice of intent to establish a fishery negotiation panel. 600.753 Section 600.753 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.753 Notice of intent to establish a fishery negotiation panel. (a...

  6. 50 CFR 600.751 - Determination of need for a fishery negotiation panel.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Determination of need for a fishery negotiation panel. 600.751 Section 600.751 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.751 Determination of need for a fishery negotiation panel. A Council or...

  7. 50 CFR 600.751 - Determination of need for a fishery negotiation panel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Determination of need for a fishery negotiation panel. 600.751 Section 600.751 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.751 Determination of need for a fishery negotiation panel. A Council or...

  8. 50 CFR 600.753 - Notice of intent to establish a fishery negotiation panel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Notice of intent to establish a fishery negotiation panel. 600.753 Section 600.753 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.753 Notice of intent to establish a fishery negotiation panel. (a...

  9. 50 CFR 600.753 - Notice of intent to establish a fishery negotiation panel.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Notice of intent to establish a fishery negotiation panel. 600.753 Section 600.753 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.753 Notice of intent to establish a fishery negotiation panel. (a...

  10. 50 CFR 600.751 - Determination of need for a fishery negotiation panel.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Determination of need for a fishery negotiation panel. 600.751 Section 600.751 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.751 Determination of need for a fishery negotiation panel. A Council or...

  11. 50 CFR 600.751 - Determination of need for a fishery negotiation panel.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Determination of need for a fishery negotiation panel. 600.751 Section 600.751 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT... Fishery Negotiation Panels § 600.751 Determination of need for a fishery negotiation panel. A Council or...

  12. Annual update of how each state stands on legislative issues affecting advanced nursing practice.

    PubMed

    Pearson, L J

    1996-01-01

    The change from a free-for-service system to a system run by managed-care organizations has caused dramatic shifts in where and how health care is delivered. Within the managed-care systems, administrators need to show a good bottom line. Rapid restructuring of the system and the need for profit create many potential consequences (e.g., APNs squeezed out of participation on some provider panels; previously unattractive poor patients are now attractive because they can provide an ongoing revenue base; the use of more unlicensed personnel to provide patient services). Private businesses and the federal government like managed-care health care systems as an answer to the out-of-control escalating costs of health care. Managed care is likely to stay with us for a long while. Because political force comes from money and there is plenty of that in health care insurance corporations, managed care is likely to be with us for a long time. Regulations and control of these managed-care systems will probably be difficult. However, though big business has the money, APNs have the feet, hands and patience to seek further regulation of these huge corporations (e.g., antidiscrimination language to prevent exclusion from provider panels). With the reality of managed care, MDs are no longer in control of the health care system. The AMA's recent attempt to control other providers is tantamount to one ship officer attempting to control another on the Titanic's (i.e., fee-for-service system's) last evening. In a few states, fee-for-service is still predominant, but the majority of states are rapidly moving into megaconglomerate, finance-driven managed care run by business administrators. Things are getting so complex in today's world of corporate takeovers, managed-care megaconglomerates, and power-brokering politics that it is easy to understand why millions of Americans drown themselves in relatively simplistic good-versus-evil entertainment dramas. Huge changes in how the system operates have happened this year while the nation was busy following the Simpson trial. But NPs and other APNs must be very vigilant. We must ensure a place in this new system. Our patients and the nation need us!

  13. Sensitive Equipment Decontamination

    DTIC Science & Technology

    2017-10-01

    tomorrow’s CBRN threats. The document was elaborated by a group of scientists and CBRN specialists, all being members of the Hazard Management ... Management Panel within NATO Joint CBRN Defence Capability Development Group ii STO-TR-HFM-233 The NATO Science and Technology...accordance with NATO policies. The total spectrum of this collaborative effort is addressed by six Technical Panels who manage a wide range of scientific

  14. Integrated corridor management initiative : overview of the Dallas traveler response panel survey.

    DOT National Transportation Integrated Search

    2017-03-01

    This report presents findings from the Integrated Corridor Management (ICM) traveler behavior surveys, a set of panel surveys of US-75 corridor users, conducted before and after the deployment of ICM. The purpose of the surveys was to measure the imp...

  15. 77 FR 5775 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... Caribbean Fishery Management Council's (Council) Outreach and Education Advisory Panel (OEAP) will hold a...--Miguel Rol[oacute]n --Goals and Objectives of the CFMC Outreach and Education Advisory Panel (OEAP... --Bulletin/Newsletter --Social Network Pages --Streaming of Council Meetings --Other Business The meeting is...

  16. DOD Financial Management: Continued Actions Needed to Address Congressional Committee Panel Recommendations

    DTIC Science & Technology

    2015-09-01

    which was intended to fundamentally transform DOD’s financial management operations and achieve clean financial 12GAO-15-290. 13GAO-15-290. 14Pub...Actions to Implement the Panel on Defense Financial Management and Auditability Reform Recommendations valuations for these assets. For example, DOD’s...governance, the department is managing its business systems, including ERP systems, as portfolios of investments . The goal is to aggregate data from

  17. A multi-criteria decision analysis assessment of waste paper management options.

    PubMed

    Hanan, Deirdre; Burnley, Stephen; Cooke, David

    2013-03-01

    The use of Multi-criteria Decision Analysis (MCDA) was investigated in an exercise using a panel of local residents and stakeholders to assess the options for managing waste paper on the Isle of Wight. Seven recycling, recovery and disposal options were considered by the panel who evaluated each option against seven environmental, financial and social criteria. The panel preferred options where the waste was managed on the island with gasification and recycling achieving the highest scores. Exporting the waste to the English mainland for incineration or landfill proved to be the least preferred options. This research has demonstrated that MCDA is an effective way of involving community groups in waste management decision making. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. The role of tramadol in pain management in Latin America: a report by the Change Pain Latin America Advisory Panel.

    PubMed

    Santos Garcia, Joäo Batista; Lech, Osvandré; Campos Kraychete, Durval; Rico, María Antonieta; Hernández-Castro, John Jairo; Colimon, Frantz; Guerrero, Carlos; Sempértegui Gallegos, Manuel; Lara-Solares, Argelia; Flores Cantisani, José Alberto; Amescua-Garcia, César; Guillén Núñez, María Del Rocío; Berenguel Cook, María Del Rosario; Jreige Iskandar, Aziza; Bonilla Sierra, Patricia

    2017-09-01

    Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its seventh meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on pain care quality. The experts agreed that tramadol is used to treat a wide spectrum of non-oncological pain conditions (e.g. post-surgical, musculoskeletal, post-traumatic, neuropathic, fibromyalgia), as well as cancer pain. Its relevance when treating special patient groups (e.g. the elderly) is recognized. The main reasons for tramadol's high significance as a treatment option are: its broad efficacy, an inconspicuous safety profile and its availability, considering that access to strong analgesics - mainly controlled drugs (classical opioids) - is highly restricted in some countries. The CPLA also agreed that tramadol is well tolerated, without the safety issues associated with long-term nonsteroidal anti-inflammatory drug (NSAID) use, with fewer opioid-like side effects than classical opioids and lower abuse risk. In Latin America, tramadol is a valuable and frequently used medication for treating moderate to severe pain. More stringent regulations would have significant impact on its availability, especially for outpatients. This could cause regression to older and frequently inadequate pain management methods, resulting in unnecessary suffering for many Latin American patients.

  19. 76 FR 30308 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ... Stock Assessment Review Panel (STAR Panel) for the Pacific ocean perch and petrale sole stock assessments will hold a work session that is open to the public. DATES: The STAR Panel for Pacific ocean perch... 5:30 p.m. or as necessary to complete business for the day. The STAR panel will reconvene on Tuesday...

  20. 76 FR 55943 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  1. 76 FR 10388 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-24

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  2. 75 FR 79017 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  3. 77 FR 21806 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  4. 75 FR 17433 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  5. 75 FR 52370 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-25

    ...] Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  6. 78 FR 4870 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

  7. 76 FR 41767 - Mid-Atlantic Fishery Management Council (MAFMC); Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... Summer Flounder, Scup, Black Sea Bass, and Bluefish Industry Advisory Panels will hold public meetings..., Summer Flounder, and Bluefish Industry Advisory Panels will discuss the 2012 annual catch targets (ACTs) and management measures to achieve ACTs for the summer flounder, scup, black sea bass, and bluefish...

  8. 7 CFR 1940.968 - Rural Economic Development Review Panel Grant (Panel Grant).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... sources; (iv) Financial management system in place or proposed. The system will account for grant funds in... financial management system of the State shall provide for effective control and accountability of all funds... AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery...

  9. 76 FR 26252 - Gulf of Mexico Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... Vessel Monitoring System (VMS) Advisory Panel will meet to discuss operation, design, usage of vessel monitoring systems (VMS), and resulting data from these systems. The Advisory Panel will discuss the current.... SUMMARY: The Gulf of Mexico Fishery Management Council will convene a meeting of the Vessel Monitoring...

  10. Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Hamilton, D.; Jones, J. A.; Alexander, D.

    2008-01-01

    Currently there are several physiological monitoring requirements for Extravehicular Activity (EVA) in the Human-Systems Interface Requirements (HSIR) document, including continuous heart rhythm monitoring. However, it is not known whether heart rhythm monitoring in the lunar surface space suit is a necessary capability for lunar surface operations or in launch/landing suit the event of a cabin depressurization enroute to or from the moon. Methods: Current US astronaut corps demographic information was provided to an expert panel of cardiovascular medicine experts, including specialists in electrophysiology, exercise physiology, interventional cardiology and arrhythmia. This information included averages for male/female age, body mass index (BMI), blood pressure, cholesterol, inflammatory markers, echocardiogram, ranges for coronary artery calcium (CAC) scores for long duration astronauts, and ranges for heart rate (HR) and metabolic (MET) rates obtained during microgravity and lunar EVA. Results: The panel determined that no uncontrolled hazard was likely to occur in the suit during lunar surface or contingency microgravity ops that would require ECG monitoring in the highly screened US astronaut population. However having the capability for rhythm monitoring inside the vehicle (IVA) was considered critical to manage an astronaut in distress. Discussion: Heart rate (HR) monitoring alone allows effective monitoring of astronaut health and function. Consequently, electrocardiographic (ECG) monitoring capability as a clinical tool is not essential in the lunar or launch/landing space suit. However, the panel considered that rhythm monitoring could be useful in certain clinical situations, it was not considered required for safe operations. Also, lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG (derived 12- lead) for IVA medical assessments.

  11. Interaction of Sound from Supersonic Jets with Nearby Structures

    NASA Technical Reports Server (NTRS)

    Fenno, C. C., Jr.; Bayliss, A.; Maestrello, L.

    1997-01-01

    A model of sound generated in an ideally expanded supersonic (Mach 2) jet is solved numerically. Two configurations are considered: (1) a free jet and (2) an installed jet with a nearby array of flexible aircraft type panels. In the later case the panels vibrate in response to loading by sound from the jet and the full coupling between the panels and the jet is considered, accounting for panel response and radiation. The long time behavior of the jet is considered. Results for near field and far field disturbance, the far field pressure and the vibration of and radiation from the panels are presented. Panel response crucially depends on the location of the panels. Panels located upstream of the Mach cone are subject to a low level, nearly continuous spectral excitation and consequently exhibit a low level, relatively continuous spectral response. In contrast, panels located within the Mach cone are subject to a significant loading due to the intense Mach wave radiation of sound and exhibit a large, relatively peaked spectral response centered around the peak frequency of sound radiation. The panels radiate in a similar fashion to the sound in the jet, in particular exhibiting a relatively peaked spectral response at approximately the Mach angle from the bounding wall.

  12. 75 FR 39212 - Establishment of Department of Defense Federal Advisory Committee; Independent Panel Review of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... of the Navy. The Panel shall: a. Carry out a study of the policies and management and organizational... to fulfill the legal mission of the Department of the Navy. b. In carrying out the study, the Panel... purposes of the study. In carrying out its study the Panel may review, and incorporate as appropriate, the...

  13. High-Risk Drinking in College: What We Know and What We Need To Learn. Final Report of the Panel on Contexts and Consequences.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    Alcohol on college campuses is not a new problem, but recent concerns have centered on heavy episodic drinking, binge drinking. To address these concerns, the National Advisory Council on Alcohol Abuse and Alcoholism established two panels of nongovernmental experts to help develop a national research agenda. This report represents the work of one…

  14. Viscosupplementation for Osteoarthritis of the Knee: A Key Opinion Leader Panel Discussion.

    PubMed

    Bert, Jack; Kenney, Jim; Sgaglione, Nicholas A; McClelland, Scott; Brophy, Robert; Toth, John; Ruane, Joseph; Ali, Yousaf; Arquette, Sheila; Dasa, Vinod; Lopes, Maria

    2018-06-01

    With a sharp rise in the prevalence of osteoarthritis of the knee (OAK) in a younger population, new management strategies are needed to preserve mobility, improve patients' quality of life, and reduce the effects of potential disease-related comorbidities. Viscosupplementation with the use of hyaluronic acid (HA) injection is a treatment option for OAK that can provide lubrication and elastic shock absorption, leading to potential pain relief, improved function, and reduced stiffness. A key opinion leader (KOL) panel discussion was held December 3, 2016, with the objective of sharing opinions, ideas, information, and trends regarding OAK and the potential treatment and management offered by viscosupplementation. The panel concluded that viscosupplementation with HA injections presents a viable, cost-effective, and safe alternative for the treatment of OAK. This panel discussion and report was facilitated by Magellan Rx Manage-ment and funded by Sanofi. Bert and Ruane report fees from Sanofi outside of this project. Sgaglione reports royalty payments from Zimmer Biomet and Wolters Kluwer. Dasa has received fees from Bioventus and Myoscience. All the authors received an honorarium for work on this project. Lopes is employed by Magellan Rx Management.

  15. The Report of the Expert Panel on the Sustainable Management of Groundwater in Canada: The Council of Canadian Academies

    NASA Astrophysics Data System (ADS)

    Bruce, J. P.

    2009-05-01

    The Expert Panel on Groundwater was established in response to a request from the Minister of Natural Resources Canada, asking the Council of Canadian Academies to assess what is needed to achieve sustainable management of Canada's groundwater resources, from a science perspective. To this end, the Council of Canadian Academies assembled an interdisciplinary panel of experts who interpreted science, in the context of this assessment, to include natural and social sciences as well as local, provincial, and federal governance. The panel's report, released on May 11th 2009, noted that nearly 10 million Canadians rely on groundwater for household purposes, in addition to uses for agriculture and industry. Both media and public have expressed many recent concerns about water supplies and their quality. The concept of groundwater sustainability developed by the panel encompasses five interrelated goals: three that involve primarily the physical sciences and engineering, and two that are essentially socio-economic in nature. These goals are as follows: i. Protection of groundwater supplies from depletion ii. Protection of groundwater quality from contamination iii. Protection of ecosystem viability iv. Achievement of economic and social well-being v. Application of good governance The achievement of groundwater sustainability requires a careful analysis and balancing of the five goals; a comprehensive sustainability framework for groundwater has not yet been implemented in Canada. Adoption by federal, provincial and local jurisdictions of such a framework, based on the goals outlined above, would be invaluable in guiding efforts to improve the understanding and management of groundwater. To contextualize the components of the sustainability framework, the panel examined a series of case studies that typify examples along a spectrum, from near-sustainable, to situations that are fail to meet the outlined criteria. The panel identified the fragmentation of water management at all levels, between groundwater and surface water and between quantity and quality, as a major hindrance to the sustainable management of groundwater in Canada. Several problem areas were highlighted in the report, including the need for a cooperative data management system; inadequate numbers of well-trained hydrogeologists and other water specialists; and a frequent failure to consider groundwater as part of the hydrological cycle in watersheds or ground-watersheds. A series of recommendations to address these, and other problems, were developed by the Panel and will be outlined in the presentation.

  16. 3D Modelling of Urban Terrain (Modelisation 3D de milieu urbain)

    DTIC Science & Technology

    2011-09-01

    Panel • IST Information Systems Technology Panel • NMSG NATO Modelling and Simulation Group • SAS System Analysis and Studies Panel • SCI... Systems Concepts and Integration Panel • SET Sensors and Electronics Technology Panel These bodies are made up of national representatives as well as...of a part of it may be made for individual use only. The approval of the RTA Information Management Systems Branch is required for more than one

  17. Which potential harms and benefits of using ginger in the management of nausea and vomiting of pregnancy should be addressed? a consensual study among pregnant women and gynecologists.

    PubMed

    Shawahna, Ramzi; Taha, Assim

    2017-04-08

    Nausea and vomiting of pregnancy (NVP) affect approximately 80-90% of the pregnant women. Ginger (Zingiber officinale Roscoe) is the most widely used herbal therapy in the management of NVP. Like conventional therapies, herbal therapies have potential harms and benefits that patients need to be informed about in order to develop their therapy preferences. The aim of this study was to achieve consensus among women who suffered NVP and physicians often consulted by pregnant women on a core list of potential harms and benefits of using ginger to manage NVP to be addressed during clinical consultations. In this study, the Delphi technique was used to achieve consensus on a core list of important harms and benefits of using ginger in the management of NVP to be addressed during the clinical consultation. A Delphi process was followed in two panels in parallel sessions. One panel was composed of 50 gynecologists and other physicians who are often consulted by pregnant women suffering NVP and the other panel was composed of 50 women who suffered NVP. Consensus was achieved on 21 (75%) of the 28 potential harms presented to the panelists. Panelists agreed that potential harms of the anticoagulant effects of ginger, risk with other co-morbidities, and risk of potential allergic reactions are important to address during the clinical consultation. Of the 14 potential benefits presented to the panelists in both panels, consensus was achieved on 13 (92.9%). Partial consensus on 7 potential harms and 1 potential benefit was achieved in both panels. Addressing important potential harms and benefits of using ginger for the management of NVP during the clinical consultations is important in promoting congruence and reducing patient dissatisfaction in clinical practice. Consensus was achieved on a core list of important harms and benefits of using ginger for the management of NVP to be addressed during the clinical consultations by a panel of women and a panel of physicians. Further studies are still needed to investigate what is being addressed during clinical consultations.

  18. 75 FR 159 - Notice of Public Meeting, North Slope Science Initiative, Science Technical Advisory Panel, Alaska

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-04

    ...] Notice of Public Meeting, North Slope Science Initiative, Science Technical Advisory Panel, Alaska AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and...

  19. Benefits of improved municipal solid waste management on greenhouse gas reduction in Luangprabang, Laos.

    PubMed

    Vilaysouk, Xaysackda; Babel, Sandhya

    2017-07-01

    Climate change is a consequence of greenhouse gas emissions. Greenhouse gas (GHG) emissions from the waste sector contribute to 3% of total anthropogenic emissions. In this study, applicable solutions for municipal solid waste (MSW) management in Luangprabang (LPB) and Laos were examined. Material flow analysis of MSW was performed to estimate the amount of MSW generated in 2015. Approximately 29,419 tonnes of MSW is estimated for 2015. Unmanaged landfilling was the main disposal method, while MSW open burning was also practiced to some extent. The International Panel on Climate Change 2006 model and the Atmospheric Brown Clouds Emission Inventory Manual were used to estimate GHG emissions from existing MSW management, and total emissions are 33,889 tonnes/year carbon dioxide-equivalents (CO 2 -eq). Three scenarios were developed in order to reduce GHG emissions and environmental problems. Improvement of the MSW management by expanding MSW collection services, introducing composting and recycling, and avoiding open burning, can be considered as solutions to overcome the problems for LPB. The lowest GHG emissions are achieved in the scenario where composting and recycling are proposed, with the total GHG emissions reduction by 18,264 tonnes/year CO 2 -eq.

  20. Lysosomal storage diseases: diagnostic confirmation and management of presymptomatic individuals.

    PubMed

    Wang, Raymond Y; Bodamer, Olaf A; Watson, Michael S; Wilcox, William R

    2011-05-01

    To develop educational guidelines for the diagnostic confirmation and management of individuals identified by newborn screening, family-based testing after proband identification, or carrier testing in at-risk populations, and subsequent prenatal or postnatal testing of those who are presymptomatic for a lysosomal storage disease. Review of English language literature and discussions in a consensus development panel comprised an international group of experts in the clinical and laboratory diagnosis, treatment and management, newborn screening, and genetic aspects of lysosomal storage diseases. Although clinical trial and longitudinal data were used when available, the evidence in the literature is limited and consequently the recommendations must be considered as expert opinion. Guidelines were developed for Fabry, Gaucher, and Niemann-Pick A/B diseases, glycogen storage type II (Pompe disease), globoid cell leukodystrophy (Krabbe disease), metachromatic leukodystrophy, and mucopolysaccharidoses types I, II, and VI. These guidelines serve as an educational resource for confirmatory testing and subsequent clinical management of presymptomatic individuals suspected to have a lysosomal storage disease; they also help to define a research agenda for longitudinal studies such as the American College of Medical Genetics/National Institutes of Health Newborn Screening Translational Research Network.

  1. Flood Risk Management: Exploring the Impacts of the Community Rating System Program on Poverty and Income Inequality.

    PubMed

    Noonan, Douglas S; Sadiq, Abdul-Akeem A

    2018-03-01

    Flooding remains a major problem for the United States, causing numerous deaths and damaging countless properties. To reduce the impact of flooding on communities, the U.S. government established the Community Rating System (CRS) in 1990 to reduce flood damages by incentivizing communities to engage in flood risk management initiatives that surpass those required by the National Flood Insurance Program. In return, communities enjoy discounted flood insurance premiums. Despite the fact that the CRS raises concerns about the potential for unevenly distributed impacts across different income groups, no study has examined the equity implications of the CRS. This study thus investigates the possibility of unintended consequences of the CRS by answering the question: What is the effect of the CRS on poverty and income inequality? Understanding the impacts of the CRS on poverty and income inequality is useful in fully assessing the unintended consequences of the CRS. The study estimates four fixed-effects regression models using a panel data set of neighborhood-level observations from 1970 to 2010. The results indicate that median incomes are lower in CRS communities, but rise in floodplains. Also, the CRS attracts poor residents, but relocates them away from floodplains. Additionally, the CRS attracts top earners, including in floodplains. Finally, the CRS encourages income inequality, but discourages income inequality in floodplains. A better understanding of these unintended consequences of the CRS on poverty and income inequality can help to improve the design and performance of the CRS and, ultimately, increase community resilience to flood disasters. © 2017 Society for Risk Analysis.

  2. Management of Hypoparathyroidism: Summary Statement and Guidelines.

    PubMed

    Brandi, Maria Luisa; Bilezikian, John P; Shoback, Dolores; Bouillon, Roger; Clarke, Bart L; Thakker, Rajesh V; Khan, Aliya A; Potts, John T

    2016-06-01

    Hypoparathyroidism is a rare disorder characterized by hypocalcemia and absent or deficient PTH. This report presents a summary of current information about epidemiology, presentation, diagnosis, clinical features, and management and proposes guidelines to help clinicians diagnose, evaluate, and manage this disorder. Participants in the First International Conference on the Management of Hypoparathyroidism represented a worldwide constituency with acknowledged interest and expertise in key basic, translational, and clinical aspects of hypoparathyroidism. Three Workshop Panels were constituted to address questions for presentation and discussion at the Conference held in Florence, Italy, May 7-9, 2015. At that time, a series of presentations were made, followed by in-depth discussions in an open forum. Each Workshop Panel also met in closed sessions to formulate the three evidence-based reports that accompany this summary statement. An Expert Panel then considered this information, developed summaries, guidelines, and a research agenda that constitutes this summary statement. Preceding the conference, each Workshop Panel conducted an extensive literature search as noted in the individual manuscripts accompanying this report. All presentations were based upon the best peer-reviewed information taking into account the historical and current literature. This report represents the Expert Panel's synthesis of the conference material placed in a context designed to be relevant to clinicians and those engaged in cutting-edge studies of hypoparathyroidism. This document not only provides a summary of our current knowledge but also places recent advances in its management into a context that should enhance future advances in our understanding of hypoparathyroidism.

  3. Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

    PubMed

    Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

    2017-12-13

    Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.

  4. A Measurement and Power Line Communication System Design for Renewable Smart Grids

    NASA Astrophysics Data System (ADS)

    Kabalci, E.; Kabalci, Y.

    2013-10-01

    The data communication over the electric power lines can be managed easily and economically since the grid connections are already spread around all over the world. This paper investigates the applicability of Power Line Communication (PLC) in an energy generation system that is based on photovoltaic (PV) panels with the modeling study in Matlab/Simulink. The Simulink model covers the designed PV panels, boost converter with Perturb and Observe (P&O) control algorithm, full bridge inverter, and the binary phase shift keying (BPSK) modem that is utilized to transfer the measured data over the power lines. This study proposes a novel method to use the electrical power lines not only for carrying the line voltage but also to transmit the measurements of the renewable energy generation plants. Hence, it is aimed at minimizing the additional monitoring costs such as SCADA, Ethernet-based or GSM based systems by using the proposed technique. Although this study is performed with solar power plants, the proposed model can be applied to other renewable generation systems. Consequently, the usage of the proposed technique instead of SCADA or Ethernet-based systems eliminates additional monitoring costs.

  5. Illumination of dense urban areas by light redirecting panels.

    PubMed

    El-Henawy, Sally I; Mohamed, Mohamed W N; Mashaly, Islam A; Mohamed, Osama N; Galal, Ola; Taha, Iman; Nassar, Khaled; Safwat, Amr M E

    2014-05-05

    With the high population growth rate, especially in developing countries, and the scarcity of land resources, buildings are becoming so close to each other, depriving the lower floors and the alleys from sunlight and consequently causing health problems. Therefore, there is an urgent need for cost-effective efficient light redirecting panels that guide sun rays into those dim places. In this paper, we address this problem. A novel sine wave based panel is presented to redirect/diverge light downward and enhance the illumination level in those dark places. Simulation results show that the proposed panel improves the illuminance values by more than 200% and 400% in autumn and winter respectively, operates over wide solar altitude ranges, and redirects light efficiently. Experimental and simulation results are in good agreement.

  6. Proactive and Early Aggressive Wound Management: A Shift in Strategy Developed by a Consensus Panel Examining the Current Science, Prevention, and Management of Acute and Chronic Wounds.

    PubMed

    Bohn, Gregory A; Schultz, Gregory S; Liden, Brock A; Desvigne, Michael N; Lullove, Eric J; Zilberman, Igor; Regan, Mary B; Ostler, Marta; Edwards, Karen; Arvanitis, Georgia M; Hartman, Jodi F

    2017-11-01

    Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For existing chronic wounds, early aggressive wound management is employed to break the pathophysiology cycle and drive wounds toward healing. Reducing bioburden through debridement and bioburden management and using collagen dressings to balance protease activity prior to the use of advanced modalities may enhance their effectiveness. This early aggressive wound management strategy is recommended for patients at high risk for chronic wound development at a minimum. In their own practices, the panel members apply this systematic strategy for all patients presenting with acute injuries or chronic wounds.

  7. 77 FR 46769 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of... Initiative (NSSI)-- Science Technical Advisory Panel (STAP) will meet as indicated below. DATES: The meeting...

  8. 41 CFR 50-203.16 - Industry panel meetings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Industry panel meetings... Under the Walsh-Healey Public Contracts Act § 50-203.16 Industry panel meetings. The Secretary of Labor may, within his discretion, invite representatives of employers and employees in an industry to meet...

  9. 41 CFR 50-203.16 - Industry panel meetings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Industry panel meetings... Under the Walsh-Healey Public Contracts Act § 50-203.16 Industry panel meetings. The Secretary of Labor may, within his discretion, invite representatives of employers and employees in an industry to meet...

  10. 41 CFR 50-203.16 - Industry panel meetings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Industry panel meetings... Under the Walsh-Healey Public Contracts Act § 50-203.16 Industry panel meetings. The Secretary of Labor may, within his discretion, invite representatives of employers and employees in an industry to meet...

  11. 41 CFR 50-203.16 - Industry panel meetings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Industry panel meetings... Under the Walsh-Healey Public Contracts Act § 50-203.16 Industry panel meetings. The Secretary of Labor may, within his discretion, invite representatives of employers and employees in an industry to meet...

  12. 41 CFR 50-203.16 - Industry panel meetings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Industry panel meetings... Under the Walsh-Healey Public Contracts Act § 50-203.16 Industry panel meetings. The Secretary of Labor may, within his discretion, invite representatives of employers and employees in an industry to meet...

  13. Consensus statement: appropriate consumer education and communication programs for weight- loss agents in Asia.

    PubMed

    Chan, Siew Pheng; Chui, William C; Lo, Kwok Wing; Huang, Kuo-Chin; Leyesa, Normita D; Lin, Wen-Yuan; Mirasol, Roberto C; Robles, Yolanda R; Tey, Beng Hea; Paraidathathu, Thomas

    2012-07-01

    The increasing prevalence of overweight and obesity worldwide demands increased efforts in the prevention and management of obesity. This article aims to present consensus statements promoting appropriate consumer education and communication programs for weight-loss agents in Asia. Panel members from various disciplines developed consensus statements based on an expert meeting on the benefits of consumer education and communication programs for over-the-counter weight-loss agents. Key opinion leaders discussed relevant data that served as the basis of the recommendations. Obesity is a growing epidemic in Asia, turning the region into a potential market for weight-loss products and services. Current trends in direct-to-consumer advertising demonstrate the pervasiveness of false representations lacking adequate substantiation. Relevant issues and recommendations were established. Public education on weight management is a shared responsibility; there is a need to raise public awareness of obesity and its health-related consequences. Advertising guidelines should ensure responsible direct-to-consumer advertising of weight-loss agents.

  14. 76 FR 2083 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

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

  15. Potential biomarker panels in overall breast cancer management: advancements by multilevel diagnostics.

    PubMed

    Girotra, Shantanu; Yeghiazaryan, Kristina; Golubnitschaja, Olga

    2016-09-01

    Breast cancer (BC) prevalence has reached an epidemic scale with half a million deaths annually. Current deficits in BC management include predictive and preventive approaches, optimized screening programs, individualized patient profiling, highly sensitive detection technologies for more precise diagnostics and therapy monitoring, individualized prediction and effective treatment of BC metastatic disease. To advance BC management, paradigm shift from delayed to predictive, preventive and personalized medical services is essential. Corresponding step forwards requires innovative multilevel diagnostics procuring specific panels of validated biomarkers. Here, we discuss current instrumental advancements including genomics, proteomics, epigenetics, miRNA, metabolomics, circulating tumor cells and cancer stem cells with a focus on biomarker discovery and multilevel diagnostic panels. A list of the recommended biomarker candidates is provided.

  16. What is case management in palliative care? An expert panel study

    PubMed Central

    2012-01-01

    Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent. PMID:22709349

  17. Biological Select Agents and Toxins: Risk-Based Assessment Management and Oversight.

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

    Burnett, LouAnn Crawford; Brodsky, Benjamin H.

    Sandia National Laboratories' International Biological and Chemical Threat Reduction (SNL/IBCTR) conducted, on behalf of the Federal Select Agent Program (FSAP), a review of risk assessment in modern select agent laboratories. This review and analysis consisted of literature review, interviews of FSAP staff, entities regulated by FSAP, and deliberations of an expert panel. Additionally, SNL/IBCTR reviewed oversight mechanisms used by industries, US agencies, and other countries for high-consequence risks (e.g, nuclear, chemical, or biological materials, aviation, off-shore drilling, etc.) to determine if alternate oversight mechanisms existed that might be applicable to FSAP oversight of biological select agents and toxins. This reportmore » contains five findings, based on these reviews and analyses, with recommendations and suggested actions for FSAP to consider.« less

  18. 76 FR 18534 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    .... SUMMARY: The review panel (Panel) for assessment methods for data-poor species will hold a work session that is open to the public. DATES: The Review of Assessment Methods for Data-Poor Species will be held... Panel will adjourn on Friday, April 29, 2011. ADDRESSES: The Review of Assessment Methods for Data-Poor...

  19. Defense Automation Resources Management Manual

    DTIC Science & Technology

    1988-09-01

    Electronic Command Signals Programmer, Plugboard Programmers Punch, Card Punch, Paper Tape Reader, Character Reader-Generator, Time Cards Reader...Multiplexor-Shift Register Group Multiplier Panel Control, Plugboard Panel, Interconnection, Digital Computer Panel, Meter-Attenuator, Tape Recorder PC Cards...Perforator, Tape Plug-In Unit Potentiometer, Coefficient, Analog Computer Programmer, Plugboard Punch, Paper Tape Racks Reader, Time Code Reader

  20. 76 FR 20959 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... Review (STAR) Panel meeting that is open to the public. DATES: The meeting will be held Monday, May 2... meeting agenda may come before the STAR Panel for discussion, those issues may not be the subject of formal action during this meeting. STAR Panel action will be restricted to those issues specifically...

  1. A Randomized, Controlled Trial of a Shared Panel Management Program for Small Practices.

    PubMed

    Bishop, Tara F; Ryan, Andrew M; Chen, Melinda A; Mendelsohn, Jayme; Gottlieb, Daniel; Shih, Sarah; Desai, Priya; Wolff, Elizabeth A; Casalino, Lawrence P

    2016-10-01

    To determine whether a shared panel management program was effective at improving quality of care for patients with uncontrolled chronic disease. Data were extracted from electronic health records. Randomized controlled trial of a panel management program initiated by New York City Department of Health and Mental Hygiene. Patients from 20 practices with an uncontrolled chronic disease and a lapse in care were assigned to the intervention (a phone call requesting that the patient schedule a physician appointment) or usual care. Outcomes were visits to physician practices, body mass index measurement, blood pressure measurement and control, use of antithrombotics, and low-density lipoprotein measurement and control. Panel managers were able to successfully speak with 1,676 patients (14.7 percent of the intervention group). There were no significant differences in outcomes between the intervention and usual care groups. Successfully contacted patients were more likely to have an office visit within 1 year of randomization (45.6 percent [95 percent CI: 22.8, 26.9] vs. 38.1 percent [95 percent CI: 36.8, 39.3]) and more likely to be on antithrombotics (24.4 percent [95 percent CI: 17.7, 31.0]) versus those in the usual care group (17.0 percent [95 percent CI: 13.9, 20.0]) but had no other difference in quality. A shared, low-intensity panel management program run by a city health department did not improve quality of care for patients with chronic illnesses and lapses in care. © Health Research and Educational Trust.

  2. Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis.

    PubMed

    2005-09-01

    Osteoarthritis (OA) affects a large and growing proportion of the population. The purpose of this project was to create guidelines for the use of therapeutic exercises and manual therapy in the management of adult patients (>18 years of age) with a diagnosis of OA. All stages of the disease were included in the analysis, and studies of patients who had recent surgery or other rheumatologic, musculoskeletal, or spinal problems or of subjects without known pathology or impairments were excluded. The Ottawa Methods Group used Cochrane Collaboration methods to find and synthesize evidence from comparative controlled trials and then asked stakeholder groups to nominate representatives to serve on a panel of experts. The Ottawa Panel agreed on criteria for grading the strength of the recommendations and their supporting evidence. Of the 609 potential articles on therapeutic exercises for OA that were identified, 113 were considered potentially relevant, and 26 randomized controlled trials and controlled clinical trials were ultimately used. Sixteen positive recommendations of clinical benefit were developed for therapeutic exercises, especially strengthening exercises and general physical activity, particularly for the management of pain and improvement of functional status. Manual therapy combined with exercises also is recommended in the management of patients with OA. The Ottawa Panel recommends the use of therapeutic exercises alone, or combined with manual therapy, for managing patients with OA. There were a total of 16 positive recommendations: 13 grade A and 3 grade C+. The Ottawa Panel recommends the use of therapeutic exercises because of the strong evidence (grades A, B, and C+) in the literature.

  3. Fishing in acid waters: A vulnerability assessment of the Norwegian fishing industry in the face of increasing ocean acidification.

    PubMed

    Heinrich, Luise; Krause, Torsten

    2017-07-01

    Ocean acidification (OA) describes a change in the ocean's carbonate chemistry. Whereas its chemical processes are largely understood, the biological and socioeconomic consequences particularly in relation to fisheries are less known. Norway is a major fishing nation worldwide and is potentially affected by OA. To improve the understanding of the socioeconomic consequences of OA, we conducted a risk assessment among the Norwegian counties using a modified version of a risk assessment framework introduced in the Intergovernmental Panel on Climate Change's "Special Report: Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation," which considers risk to be the sum of hazard, exposure, and vulnerability. Our results show that about 13 of 19 counties are likely to experience moderate to high risk from OA. We highlight that the success of integrated risk assessments highly depends on the availability of detailed environmental, economic, and societal data. In the case of Norway, modeling data regarding the progress of OA, improved information on potential biological impacts on a larger number of species, and statistical data on social variables are required. We conclude that although still in its infancy, integrated risk assessments are important prerequisites for any form of interdisciplinary research on OA and the development of successful response strategies. Integr Environ Assess Manag 2017;13:778-789. ©2016 SETAC. © 2016 SETAC.

  4. Validation of prescribing appropriateness criteria for older Australians using the RAND/UCLA appropriateness method

    PubMed Central

    Basger, Benjamin Joseph; Chen, Timothy Frank; Moles, Rebekah Jane

    2012-01-01

    Objective To further develop and validate previously published national prescribing appropriateness criteria to assist in identifying drug-related problems (DRPs) for commonly occurring medications and medical conditions in older (≥65 years old) Australians. Design RAND/UCLA appropriateness method. Participants A panel of medication management experts were identified consisting of geriatricians/pharmacologists, clinical pharmacists and disease management advisors to organisations that produce Australian evidence-based therapeutic publications. This resulted in a round-one panel of 15 members, and a round-two panel of 12 members. Main outcome measure Agreement on all criteria. Results Forty-eight prescribing criteria were rated. In the first rating round via email, there was disagreement regarding 17 of the criteria according to median panel ratings. During a face-to-face second round meeting, discussion resulted in retention of 25 criteria after amendments, agreement for 14 criteria with no changes required and deletion of 9 criteria. Two new criteria were added, resulting in a final validated list of 41 prescribing appropriateness criteria. Agreement after round two was reached for all 41 criteria, measured by median panel ratings and the amount of dispersion of panel ratings, based on the interpercentile range. Conclusions A set of 41 Australian prescribing appropriateness criteria were validated by an expert panel. Use of these criteria, together with clinical judgement and other medication review processes such as patient interview, is intended to assist in improving patient care by efficiently detecting potential DRPs related to commonly occurring medicines and medical conditions in older Australians. These criteria may also contribute to the medication management education of healthcare professionals. PMID:22983875

  5. An adaptive, comprehensive monitoring strategy for chemicals of emerging concern (CECs) in California's Aquatic Ecosystems.

    PubMed

    Maruya, Keith A; Schlenk, Daniel; Anderson, Paul D; Denslow, Nancy D; Drewes, Jörg E; Olivieri, Adam W; Scott, Geoffrey I; Snyder, Shane A

    2014-01-01

    A scientific advisory panel was convened by the State of California to recommend monitoring for chemicals of emerging concern (CECs) in aquatic systems that receive discharge of municipal wastewater treatment plant (WWTP) effluent and stormwater runoff. The panel developed a risk-based screening framework that considered environmental sources and fate of CECs observed in receiving waters across the State. Using existing occurrence and risk threshold data in water, sediment, and biological tissue, the panel applied the framework to identify a priority list of CECs for initial monitoring in three representative receiving water scenarios. The initial screening list of 16 CECs identified by the panel included consumer and commercial chemicals, flame retardants, pesticides, pharmaceuticals and personal care products, and natural hormones. The panel designed an iterative, phased strategy with interpretive guidelines that direct and update management actions commensurate with potential risk identified using the risk-based framework and monitoring data. Because of the ever-changing nature of chemical use, technology, and management practices, the panel offered recommendations to improve CEC monitoring, including development of bioanalytical screening methods whose responses integrate exposure to complex mixtures and that can be linked to higher-order effects; development or refinement of models that predict the input, fate, and effects of future chemicals; and filling of key data gaps on CEC occurrence and toxicity. Finally, the panel stressed the need for adaptive management, allowing for future review of, and if warranted, modifications to the strategy to incorporate the latest science available to the water resources community. © 2013 SETAC.

  6. Technology Requirements for Information Management

    NASA Technical Reports Server (NTRS)

    Graves, Sara; Knoblock, Craig A.; Lannom, Larry

    2002-01-01

    This report provides the results of a panel study conducted into the technology requirements for information management in support of application domains of particular government interest, including digital libraries, mission operations, and scientific research. The panel concluded that it was desirable to have a coordinated program of R&D that pursues a science of information management focused on an environment typified by applications of government interest - highly distributed with very large amounts of data and a high degree of heterogeneity of sources, data, and users.

  7. Advanced Technology for Aero Gas Turbine Components: Conference Proceedings Held at the Propulsion and Energetics Panel (69th) Symposium in Paris (France) on 4-8 May 1987

    DTIC Science & Technology

    1987-09-01

    v PROPULSION AND ENERGETICS PANEL Chairman: Dr W.L.Macmillan Depuity Chairman: Ing. Principal de l’Armement P.Ramene Project Manager DRET EHF...initiative in historical perspective, describe the HPTET technical/ management approach, discuss some of the Dromising candidate technologies and present...the combustion process must be carefully managed to eliminate fuel-rich areas which could produce visible smoke in the engine exhaust. The combustor

  8. EOS Directory

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This Earth Observing System (EOS) directory is divided into two main sections: white and yellow pages. The white pages list alphabetically the names and addresses -- including e-mail, phone, and fax when available -- of all individuals involved with EOS, from graduate students to panel members to program management and more. The yellow pages list the names, affiliation, and phone number of participants divided by project management, program management, individual project participants, interdisciplinary investigations (listed alphabetically by PI), the Science Executive Committee, various panels, platforms, working groups, fellowships, and contractors.

  9. Why Should We Care about Child Labor? The Education, Labor Market, and Health Consequences of Child Labor

    ERIC Educational Resources Information Center

    Beegle, Kathleen; Dehejia, Rajeev; Gatti, Roberta

    2009-01-01

    Despite the extensive literature on the determinants of child labor, the evidence on the consequences of child labor on outcomes such as education, labor, and health is limited. We evaluate the causal effect of child labor participation among children in school on these outcomes using panel data from Vietnam and an instrumental variables strategy.…

  10. Nuclear thermal propulsion technology: Results of an interagency panel in FY 1991

    NASA Technical Reports Server (NTRS)

    Clark, John S.; Mcdaniel, Patrick; Howe, Steven; Helms, Ira; Stanley, Marland

    1993-01-01

    NASA LeRC was selected to lead nuclear propulsion technology development for NASA. Also participating in the project are NASA MSFC and JPL. The U.S. Department of Energy will develop nuclear technology and will conduct nuclear component, subsystem, and system testing at appropriate DOE test facilities. NASA program management is the responsibility of NASA/RP. The project includes both nuclear electric propulsion (NEP) and nuclear thermal propulsion (NTP) technology development. This report summarizes the efforts of an interagency panel that evaluated NTP technology in 1991. Other panels were also at work in 1991 on other aspects of nuclear propulsion, and the six panels worked closely together. The charters for the other panels and some of their results are also discussed. Important collaborative efforts with other panels are highlighted. The interagency (NASA/DOE/DOD) NTP Technology Panel worked in 1991 to evaluate nuclear thermal propulsion concepts on a consistent basis. Additionally, the panel worked to continue technology development project planning for a joint project in nuclear propulsion for the Space Exploration Initiative (SEI). Five meetings of the panel were held in 1991 to continue the planning for technology development of nuclear thermal propulsion systems. The state-of-the-art of the NTP technologies was reviewed in some detail. The major technologies identified were as follows: fuels, coatings, and other reactor technologies; materials; instrumentation, controls, health monitoring and management, and associated technologies; nozzles; and feed system technology, including turbopump assemblies.

  11. Approaches to the management of agents used for the treatment of multiple sclerosis: consensus statements from a panel of U.S. managed care pharmacists and physicians.

    PubMed

    Miller, Ross M; Happe, Laura E; Meyer, Kellie L; Spear, Rachel J

    2012-01-01

    Multiple sclerosis (MS) is a chronic, disabling, and costly disease with several treatment options available; however, there is variability in evidence-based clinical guidelines. Therefore, payers are at a disadvantage when making management decisions without the benefit of definitive guidance from treatment guidelines. To outline approaches for the management of agents used to treat MS, as determined from a group of U.S. managed care pharmacists and physicians. A modified Delphi process was used to develop consensus statements regarding MS management approaches. The panel was composed of experts in managed care and included 8 pharmacy directors and 6 medical directors presently or previously involved in formulary decision making from 12 health plans, 1 specialty pharmacy, and 1 consulting company. These decision makers, who have experience designing health care benefits that include MS treatments, provided anonymous feedback through 2 rounds of web-based surveys and participated in 1 live panel meeting held in December 2010. Consensus was defined as a mean response of at least 3.3 or 100% of responses either "agree" or "strongly agree" (i.e., no panelist answered "disagree" or "strongly disagree") on a 4-item Likert scale (1=strongly disagree, 2=disagree, 3=agree, 4=strongly agree). After 3 phases, these managed care representatives reached consensus on 25 statements for management of patients with MS. Consistent with managed care principles, this group of managed care experts found that health plans should consider efficacy, effectiveness, and safety, as well as patient preference, when evaluating MS therapies for formulary placement. Cost and contracting should be considered if efficacy and safety are judged to be comparable between agents. The consensus statements developed by a panel of managed care representatives provide some insight into decision making in formulary and utilization management of MS therapies.

  12. Multipurpose panel, phase 1, study report. [display utilizing multiplexing and digital techniques

    NASA Technical Reports Server (NTRS)

    Parkin, W.

    1975-01-01

    The feasibility of a multipurpose panel which provides a programmable electronic display for changeable panel nomenclature, multiplexes similar indicator display signals to the signal display, and demultiplexes command signals is examined. Topics discussed include: electronic display technology, miniaturized electronic and memory devices, and data management systems which employ digital address and multiplexing.

  13. Machine Vision System for Color Sorting Wood Edge-Glued Panel Parts

    Treesearch

    Qiang Lu; S. Srikanteswara; W. King; T. Drayer; Richard Conners; D. Earl Kline; Philip A. Araman

    1997-01-01

    This paper describes an automatic color sorting system for hardwood edge-glued panel parts. The color sorting system simultaneously examines both faces of a panel part and then determines which face has the "better" color given specified color uniformity and priority defined by management. The real-time color sorting system software and hardware are briefly...

  14. Scientific information and the Tongass land management plan: key findings derived from the scientific literature, species assessments, resource analyses, workshops, and risk assessment panels.

    Treesearch

    Douglas N. Swanston; Charles G. Shaw; Winston P. Smith; Kent R. Julin; Guy A. Cellier; Fred H. Everest

    1996-01-01

    This document highlights key items of information obtained from the published literature and from specific assessments, workshops, resource analyses, and various risk assessment panels conducted as part of the Tongass land management planning process. None of this information dictates any particular decision; however, it is important to consider during decisionmaking...

  15. Thermal Management Coating As Thermal Protection System for Space Transportation System

    NASA Technical Reports Server (NTRS)

    Kaul, Raj; Stuckey, C. Irvin

    2003-01-01

    This paper presents viewgraphs on the development of a non-ablative thermal management coating used as the thermal protection system material for space shuttle rocket boosters and other launch vehicles. The topics include: 1) Coating Study; 2) Aerothermal Testing; 3) Preconditioning Environments; 4) Test Observations; 5) Lightning Strike Test Panel; 6) Test Panel After Impact Testing; 7) Thermal Testing; and 8) Mechanical Testing.

  16. Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations.

    PubMed

    Lal, Devyani; Jategaonkar, Ameya A; Borish, Larry; Chambliss, Linda R; Gnagi, Sharon H; Hwang, Peter H; Rank, Matthew A; Stankiewicz, James A; Lund, Valerie J

    2016-06-01

    Management of rhinosinusitis during pregnancy requires special considerations. 1. Conduct a systematic literature review for acute and chronic rhinosinusitis (CRS) management during pregnancy. 2. Make evidence-based recommendations. The systematic review was conducted using MEDLINE and EMBASE databases and relevant search terms. Title, abstract and full manuscript review were conducted by two authors independently. A multispecialty panel with expertise in management of Rhinological disorders, Allergy-Immunology, and Obstetrics-Gynecology was invited to review the systematic review. Recommendations were sought on use of following for CRS management during pregnancy: oral corticosteroids; antibiotics; leukotrienes; topical corticosteroid spray/irrigations/drops; aspirin desensitization; elective surgery for CRS with polyps prior to planned pregnancy; vaginal birth versus planned Caesarian for skull base erosions/ prior CSF rhinorrhea. Eighty-eight manuscripts underwent full review after screening 3052 abstracts. No relevant level 1, 2, or 3 studies were found. Expert panel recommendations for rhinosinusitis management during pregnancy included continuing nasal corticosteroid sprays for CRS maintenance, using pregnancy-safe antibiotics for acute rhinosinusitis and CRS exacerbations, and discontinuing aspirin desensitization for aspirin exacerbated respiratory disease. The manuscript presents detailed recommendations. The lack of evidence pertinent to managing rhinosinusitis during pregnancy warrants future trials. Expert recommendations constitute the current best available evidence.

  17. Applications of random forest feature selection for fine-scale genetic population assignment.

    PubMed

    Sylvester, Emma V A; Bentzen, Paul; Bradbury, Ian R; Clément, Marie; Pearce, Jon; Horne, John; Beiko, Robert G

    2018-02-01

    Genetic population assignment used to inform wildlife management and conservation efforts requires panels of highly informative genetic markers and sensitive assignment tests. We explored the utility of machine-learning algorithms (random forest, regularized random forest and guided regularized random forest) compared with F ST ranking for selection of single nucleotide polymorphisms (SNP) for fine-scale population assignment. We applied these methods to an unpublished SNP data set for Atlantic salmon ( Salmo salar ) and a published SNP data set for Alaskan Chinook salmon ( Oncorhynchus tshawytscha ). In each species, we identified the minimum panel size required to obtain a self-assignment accuracy of at least 90% using each method to create panels of 50-700 markers Panels of SNPs identified using random forest-based methods performed up to 7.8 and 11.2 percentage points better than F ST -selected panels of similar size for the Atlantic salmon and Chinook salmon data, respectively. Self-assignment accuracy ≥90% was obtained with panels of 670 and 384 SNPs for each data set, respectively, a level of accuracy never reached for these species using F ST -selected panels. Our results demonstrate a role for machine-learning approaches in marker selection across large genomic data sets to improve assignment for management and conservation of exploited populations.

  18. Panel: Eco-informatics and decision making managing our natural resources

    USGS Publications Warehouse

    Gushing, J.B.; Wilson, T.; Martin, F.; Schnase, J.; Spengler, S.; Sugarbaker, L.; Pardo, T.

    2006-01-01

    This panel responds to the December 2004 workshop on Eco-Informatics and Decision Making [1], which addressed how informatics tools can help with better management of natural resources and policy making. The workshop was jointly sponsored by the NSF, NBII, NASA, and EPA. Workshop participants recommended that informatics research in four IT areas be funded: modeling and simulation, data quality, information integration and ontologies, and social and human aspects. Additionally, they recommend that funding agencies provide infrastructure and some changes in funding habits to assure cycles of innovation in the domain were addressed. This panel brings issues raised in that workshop to the attention of digital government researchers.

  19. Optimizing urine drug testing for monitoring medication compliance in pain management.

    PubMed

    Melanson, Stacy E F; Ptolemy, Adam S; Wasan, Ajay D

    2013-12-01

    It can be challenging to successfully monitor medication compliance in pain management. Clinicians and laboratorians need to collaborate to optimize patient care and maximize operational efficiency. The test menu, assay cutoffs, and testing algorithms utilized in the urine drug testing panels should be periodically reviewed and tailored to the patient population to effectively assess compliance and avoid unnecessary testing and cost to the patient. Pain management and pathology collaborated on an important quality improvement initiative to optimize urine drug testing for monitoring medication compliance in pain management. We retrospectively reviewed 18 months of data from our pain management center. We gathered data on test volumes, positivity rates, and the frequency of false positive results. We also reviewed the clinical utility of our testing algorithms, assay cutoffs, and adulterant panel. In addition, the cost of each component was calculated. The positivity rate for ethanol and 3,4-methylenedioxymethamphetamine were <1% so we eliminated this testing from our panel. We also lowered the screening cutoff for cocaine to meet the clinical needs of the pain management center. In addition, we changed our testing algorithm for 6-acetylmorphine, benzodiazepines, and methadone. For example, due the high rate of false negative results using our immunoassay-based benzodiazepine screen, we removed the screening portion of the algorithm and now perform benzodiazepine confirmation up front in all specimens by liquid chromatography-tandem mass spectrometry. Conducting an interdisciplinary quality improvement project allowed us to optimize our testing panel for monitoring medication compliance in pain management and reduce cost. Wiley Periodicals, Inc.

  20. Some reflections on the role of the Scientific Advisory Panel to the Marshall Islands nationwide radiological study.

    PubMed

    McEwan, A C; Simon, S L; Baverstock, K F; Trott, K R; Sankaranarayanan, K; Paretzke, H G

    1997-07-01

    As a consequence of the U.S. Atomic Weapons Testing Program in the Trust Territory of the Pacific, now the Republic of the Marshall Islands, numerous scientists have advised the Marshallese on matters of radiation and radioactive contamination. Some of the previous advice has appeared to vary or conflict resulting in consequent uncertainty for the people. In a new initiative in 1989, the RMI Government engaged a five member multi-disciplinary Scientific Advisory Panel to oversee the assessment of, and to advise on, the radiological status of the entire nation. The formation of the Panel was accompanied by the establishment of a Resident Scientist position, and ultimately a small scientific team and laboratory on Majuro. The nationwide radiological study was conducted using ground survey methods over the period 1990-1994. Tasks undertaken by the Panel included formulating reasonable objectives for the study and attempting to establish effective communication and understanding of issues with political leaders and RMI Government agencies and people, as well as advising on and monitoring the scientific integrity of the study itself. The attempt was also made to initiate investigations to address matters of concern that emerged. The problem was faced of providing not only technical guidance on radioactivity and radiation measurements, but also explaining the significance of measured values and concepts, such as risk and probability of health effects to a diverse but nontechnical audience, generally across cultural and language barriers. The experience of the Panel in providing advice and guidance to the Republic of the Marshall Islands, while unique in many ways, parallels the difficulties experienced elsewhere in communicating information about risks from radiation exposure.

  1. Preliminary evaluation of hybrid titanium composite laminates

    NASA Technical Reports Server (NTRS)

    Miller, J. L.; Progar, D. J.; Johnson, W. S.; St.clair, T. L.

    1994-01-01

    In this study, the mechanical response of hybrid titanium composite laminates (HTCL) was evaluated at room and elevated temperatures. Also, the use of an elastic-plastic laminate analysis program for predicting the tensile response from constituent properties was verified. The improvement in mechanical properties achieved by the laminates was assessed by comparing the results of static strength and constant amplitude fatigue tests to those for monolithic titanium sheet. Two HTCL were fabricated with different fiber volume fractions, resin layer thicknesses, and resins. One panel was thicker and was more poorly bonded in comparison to other. Consequently, the former had a lower tensile strength, while fewer cracks grew in this panel and at a slower rate. Both panels showed an improvement in fatigue life of almost two orders of magnitude. The model predictions were also in good agreement with the experimental results for both HTCL panels.

  2. Rules of Attraction

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image composite shows two of the Mars Exploration Rover Opportunity's magnets, the 'capture' magnet (upper portion of left panel) and the 'filter' magnet (lower portion of left panel). Scientists use these tools to study the origins of martian dust in the atmosphere. The left panel was taken by the rover's panoramic camera. The four panels to the right, taken by the microscopic imager, show close-up views of the two magnets. The bull's-eye appearance of the capture magnet is a result of alternating magnetic fields, which are used to increase overall magnetic force. The filter magnet lacks these alternating fields and consequently produces a weaker magnetic force. This weaker force selectively attracts only strong magnetic particles.

    Scientists were surprised by the large dark particles on the magnets because airborne particles are smaller in size. They theorize that these spots might be aggregates of small particles that clump together in a magnetic field.

  3. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council.

    PubMed

    Chou, Roger; Gordon, Debra B; de Leon-Casasola, Oscar A; Rosenberg, Jack M; Bickler, Stephen; Brennan, Tim; Carter, Todd; Cassidy, Carla L; Chittenden, Eva Hall; Degenhardt, Ernest; Griffith, Scott; Manworren, Renee; McCarberg, Bill; Montgomery, Robert; Murphy, Jamie; Perkal, Melissa F; Suresh, Santhanam; Sluka, Kathleen; Strassels, Scott; Thirlby, Richard; Viscusi, Eugene; Walco, Gary A; Warner, Lisa; Weisman, Steven J; Wu, Christopher L

    2016-02-01

    Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pain Society, with input from the American Society of Anesthesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline to promote evidence-based, effective, and safer postoperative pain management in children and adults. The guideline was subsequently approved by the American Society for Regional Anesthesia. As part of the guideline development process, a systematic review was commissioned on various aspects related to various interventions and management strategies for postoperative pain. After a review of the evidence, the expert panel formulated recommendations that addressed various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. The recommendations are based on the underlying premise that optimal management begins in the preoperative period with an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved. The panel found that evidence supports the use of multimodal regimens in many situations, although the exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Although these guidelines are based on a systematic review of the evidence on management of postoperative pain, the panel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supported by high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patient assessment, organizational structures and policies, and transitioning to outpatient care) were made on the basis of low-quality evidence. This guideline, on the basis of a systematic review of the evidence on postoperative pain management, provides recommendations developed by a multidisciplinary expert panel. Safe and effective postoperative pain management should be on the basis of a plan of care tailored to the individual and the surgical procedure involved, and multimodal regimens are recommended in many situations. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  4. Tamarisk beetle (Diorhabda spp.) in the Colorado River basin: Synthesis of an expert panel forum

    USGS Publications Warehouse

    Bloodworth, Benjamin R.; Shafroth, Patrick B.; Sher, Anna A.; Manners, Rebecca B.; Bean, Daniel W.; Johnson, Matthew J.; Hinojosa-Huerta, Osvel

    2016-01-01

    In January 2015, the Tamarisk Coalition convened a panel of experts to discuss and present information on probable ecological trajectories in the face of widespread beetle presence and to consider opportunities for restoration and management of riparian systems in the Colorado River Basin (CRB). An in-depth description of the panel discussion follows. 

  5. 77 FR 2279 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... management of a facility comprised of laundry equipment and vending machines at the Fairton Federal... time and resources to no avail. Thus, the panel majority ruled that fundamental principles of fairness...

  6. Gender Differences in the Consequences of Divorce: A Study of Multiple Outcomes.

    PubMed

    Leopold, Thomas

    2018-06-01

    In this study, I examined gender differences in the consequences of divorce by tracing annual change in 20 outcome measures covering four domains: economic, housing and domestic, health and well-being, and social. I used data from the German Socio-Economic Panel Study (SOEP) and fixed-effects panel regression models on a sample of N = 18,030 individuals initially observed in a marital union, N = 1,220 of whom divorced across the observation period (1984-2015). Three main findings emerged from the analysis. First, men were more vulnerable to short-term consequences of divorce for subjective measures of well-being, but postdivorce adaptation alleviated gender differences in these outcomes. Second, a medium-term view on multiple outcomes showed more similarity than differences between women and men. The medium-term consequences of divorce were similar in terms of subjective economic well-being; mental health, physical health, and psychological well-being; residential moves, homeownership, and satisfaction with housework; and chances of repartnering, social integration with friends and relatives, and feelings of loneliness. Third, the key domain in which large and persistent gender differences emerged were women's disproportionate losses in household income and associated increases in their risk of poverty and single parenting. Taken together, these findings suggest that men's disproportionate strain of divorce is transient, whereas women's is chronic.

  7. Financial valuation of incentive arrangements in managed care contracts: a real options approach.

    PubMed

    Maurer, R T

    2001-01-01

    Managed care provider contracts with risk-based compensation arrangements are similar to derivative securities in that the value of a contract depends on the value of a more fundamental asset: the health plan's investment in the provider's member panel. As such, the financial value of the incentive to avoid investing in the health of the member panel can be modeled using financial engineering techniques.

  8. Data management system DIU test system

    NASA Technical Reports Server (NTRS)

    1976-01-01

    An operational and functional description is given of the data management system. Descriptions are included for the test control unit, analog stimulus panel, discrete stimulus panel, and the precision source. The mechanical configuration is defined and illustrated to provide card and component location for modification or repair. The unit level interfaces are mirror images of the DIU interfaces and are described in the Final Technical Report for NASA-MSFC contract NAS8-29155.

  9. Management of Carpal Tunnel Syndrome.

    PubMed

    Mooar, Pekka A; Doherty, William J; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

    2018-03-15

    The American Academy of Orthopaedic Surgeons (AAOS) has developed Appropriate Use Criteria (AUC) for Management of Carpal Tunnel Syndrome. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. To provide the evidence foundation for this AUC, the AAOS Evidence-Based Medicine Unit provided the writing panel and voting panel with the 2016 AAOS Clinical Practice Guideline titled Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline. The Management of Carpal Tunnel Syndrome AUC clinical patient scenarios were derived from indications typical of patients with suspected carpal tunnel syndrome in clinical practice, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of treatments. The 135 patient scenarios and 6 treatments were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

  10. A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.

    PubMed

    Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George

    2018-01-01

    The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.

  11. Fast tracking the design of theory-based KT interventions through a consensus process.

    PubMed

    Bussières, André E; Al Zoubi, Fadi; Quon, Jeffrey A; Ahmed, Sara; Thomas, Aliki; Stuber, Kent; Sajko, Sandy; French, Simon

    2015-02-11

    Despite available evidence for optimal management of spinal pain, poor adherence to guidelines and wide variations in healthcare services persist. One of the objectives of the Canadian Chiropractic Guideline Initiative is to develop and evaluate targeted theory- and evidence-informed interventions to improve the management of non-specific neck pain by chiropractors. In order to systematically develop a knowledge translation (KT) intervention underpinned by the Theoretical Domains Framework (TDF), we explored the factors perceived to influence the use of multimodal care to manage non-specific neck pain, and mapped behaviour change techniques to key theoretical domains. Individual telephone interviews exploring beliefs about managing neck pain were conducted with a purposive sample of 13 chiropractors. The interview guide was based upon the TDF. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using thematic content analysis. A 15-member expert panel formally met to design a KT intervention. Nine TDF domains were identified as likely relevant. Key beliefs (and relevant domains of the TDF) included the following: influence of formal training, colleagues and patients on clinicians (Social Influences); availability of educational material (Environmental Context and Resources); and better clinical outcomes reinforcing the use of multimodal care (Reinforcement). Facilitating factors considered important included better communication (Skills); audits of patients' treatment-related outcomes (Behavioural Regulation); awareness and agreement with guidelines (Knowledge); and tailoring of multimodal care (Memory, Attention and Decision Processes). Clinicians conveyed conflicting beliefs about perceived threats to professional autonomy (Social/Professional Role and Identity) and speed of recovery from either applying or ignoring the practice recommendations (Beliefs about Consequences). The expert panel mapped behaviour change techniques to key theoretical domains and identified relevant KT strategies and modes of delivery to increase the use of multimodal care among chiropractors. A multifaceted KT educational intervention targeting chiropractors' management of neck pain was developed. The KT intervention consisted of an online education webinar series, clinical vignettes and a video underpinned by the Brief Action Planning model. The intervention was designed to reflect key theoretical domains, behaviour change techniques and intervention components. The effectiveness of the proposed intervention remains to be tested.

  12. 2014 Hypertension Guideline: Recommendation for a Change in Goal Systolic Blood Pressure

    PubMed Central

    Handler, Joel

    2015-01-01

    The 2014 Kaiser Permanente Care Management Institute National Hypertension Guideline was developed to assist primary care physicians and other health care professionals in the outpatient treatment of uncomplicated hypertension in adult men and nonpregnant women aged 18 years and older. The new guideline reflects general acceptance, with minor modifications, of the “Evidence-Based Guideline” report by the panel members appointed to the National Heart, Lung, and Blood Institute 8th Joint National Committee. A major practice change is the recommendation for goal systolic blood pressure less than 150 mmHg in patients aged 60 years and older who are treated for hypertension in the absence of diabetes or chronic kidney disease. This article describes the reasons for, evidence for, and consequences of the change, and is followed by the National Guidelines handout. PMID:26057683

  13. Space and surface power for the space exploration initiative: Results from project outreach

    NASA Technical Reports Server (NTRS)

    Shipbaugh, C.; Solomon, K.; Gonzales, D.; Juncosa, M.; Bauer, T.; Salter, R.

    1991-01-01

    The analysis and evaluations of the Space and Surface Power panel, one of eight panels created by RAND to screen and analyze submissions to the Space Exploration Initiative (SEI) Outreach Program, is documented. In addition to managing and evaluating the responses, or submissions, to this public outreach program, RAND conducted its own analysis and evaluation relevent to SEI mission concepts, systems, and technologies. The Power panel screened and analyzed submissions for which a substantial portion of the concepts involved power generation sources, transmission, distribution, thermal management, and handling of power (including conditioning, conversion, packaging, and enhancements in system components). A background discussion of the areas the Power panel covered and the issues the reviewers considered pertinent to the analysis of power submissions are presented. An overview of each of the highest-ranked submissions and then a discussion of these submissions is presented. The results of the analysis is presented.

  14. Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis.

    PubMed

    Brosseau, Lucie; Wells, George A; Pugh, Arlanna G; Smith, Christine Am; Rahman, Prinon; Àlvarez Gallardo, Inmaculada C; Toupin-April, Karine; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Taki, Jade; Marcotte, Rachel; Fransen, Marlene; Hernandez-Molina, Gabriela; Kenny, Glen P; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; Brooks, Sydney; Laferriere, Lucie; McLean, Linda; Longchamp, Guy

    2016-10-01

    The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p < 0.5), and clinical importance (⩾15% improvement). Four high-quality studies were included, which demonstrated that variations of strength training, stretching, and flexibility exercises are generally effective for improving the management of hip osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion. © The Author(s) 2015.

  15. Developing a framework of, and quality indicators for, general practice management in Europe.

    PubMed

    Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

    2005-04-01

    To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

  16. Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness.

    PubMed

    Azami-Aghdash, Saber; Tabrizi, Jafar Sadegh; Sadeghi-Bazargani, Homayoun; Hajebrahimi, Sakineh; Naghavi-Behzad, Mohammad

    2015-04-01

    This study has been designed and conducted to develop domestic indicators for evaluating the performance of clinical governance in dimensions of risk management and clinical effectiveness. This study implemented a 5-stage process including conducting a comprehensive literature review, expert panel (∼ 1000 h per person per session, 11 experts), semi-structured interviews, a 2-round Delphi study (33 experts were in attendance) and a final expert panel (8 experts were in attendance). East Azerbaijan-Iran Province. Fifty-six specialists and experts in different fields of medical sciences. Importance and applicability of indicators. Using a thorough literature review, 361 indicators (129 risk management indicators in 4 dimensions and 232 clinical effectiveness indicators in 18 dimensions) were found. After conducting expert panels and interviews, the number of indicators decreased to 168 cases (65 risk management indicators in 4 dimensions and 103 clinical effectiveness indicators in 12 dimensions). Two rounds of Delphi identified four indicators that were omitted. The members of the final expert panel agreed on 113 indicators (43 risk management indicators in 4 dimensions and 70 clinical effectiveness indicators in 11 dimensions). In this study, indicators for assessing clinical governance in domains of risk management and clinical effectiveness were designed that can be used by policy-makers and other authorities for improving the quality of services and evaluating the performance of clinical governance. Those indicators can be used with slight modifications in other countries having healthcare systems similar to that of Iran. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  17. Fusion Simulation Project Workshop Report

    NASA Astrophysics Data System (ADS)

    Kritz, Arnold; Keyes, David

    2009-03-01

    The mission of the Fusion Simulation Project is to develop a predictive capability for the integrated modeling of magnetically confined plasmas. This FSP report adds to the previous activities that defined an approach to integrated modeling in magnetic fusion. These previous activities included a Fusion Energy Sciences Advisory Committee panel that was charged to study integrated simulation in 2002. The report of that panel [Journal of Fusion Energy 20, 135 (2001)] recommended the prompt initiation of a Fusion Simulation Project. In 2003, the Office of Fusion Energy Sciences formed a steering committee that developed a project vision, roadmap, and governance concepts [Journal of Fusion Energy 23, 1 (2004)]. The current FSP planning effort involved 46 physicists, applied mathematicians and computer scientists, from 21 institutions, formed into four panels and a coordinating committee. These panels were constituted to consider: Status of Physics Components, Required Computational and Applied Mathematics Tools, Integration and Management of Code Components, and Project Structure and Management. The ideas, reported here, are the products of these panels, working together over several months and culminating in a 3-day workshop in May 2007.

  18. The Management of Information & Knowledge; Meeting of the Panel on Science and Technology with the Committee on Science and Astronautics, U.S. House of Representatives.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Science and Technology.

    The emphasis of the eleventh meeting of the Panel on Science and Technology was on the management of information and knowledge. It was organized essentially as a seminar with two papers given at each session. The topic of the first two papers presented was: "Computers, Communications, and the Economy." The papers given at the second session were…

  19. Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations

    PubMed Central

    Lal, Devyani; Jategaonkar, Ameya A.; Borish, Larry; Chambliss, Linda R.; Gnagi, Sharon H.; Hwang, Peter H.; Rank, Matthew A.; Stankiewicz, James A.; Lund, Valerie J.

    2018-01-01

    Background Management of rhinosinusitis during pregnancy requires special considerations. Objectives 1. Conduct a systematic literature review for acute and chronic rhinosinusitis (CRS) management during pregnancy. 2. Make evidence-based recommendations. Methods The systematic review was conducted using MEDLINE and EMBASE databases and relevant search terms. Title, abstract and full manuscript review were conducted by two authors independently. A multispecialty panel with expertise in management of Rhinological disorders, Allergy-Immunology, and Obstetrics-Gynecology was invited to review the systematic review. Recommendations were sought on use of following for CRS management during pregnancy: oral corticosteroids; antibiotics; leukotrienes; topical corticosteroid spray/irrigations/drops; aspirin desensitization; elective surgery for CRS with polyps prior to planned pregnancy; vaginal birth versus planned Caesarian for skull base erosions/ prior CSF rhinorrhea. Results Eighty-eight manuscripts underwent full review after screening 3052 abstracts. No relevant level 1, 2, or 3 studies were found. Expert panel recommendations for rhinosinusitis management during pregnancy included continuing nasal corticosteroid sprays for CRS maintenance, using pregnancy-safe antibiotics for acute rhinosinusitis and CRS exacerbations, and discontinuing aspirin desensitization for aspirin exacerbated respiratory disease. The manuscript presents detailed recommendations. Conclusions The lack of evidence pertinent to managing rhinosinusitis during pregnancy warrants future trials. Expert recommendations constitute the current best available evidence. PMID:26800862

  20. Electronic toll collection/electronic screening interoperability pilot project : final report synthesis

    DOT National Transportation Integrated Search

    2005-12-02

    In 1998, ITS America established a Blue Ribbon Panel on electronic commerce to study the convergence of transportation and electronic payment systems. Panel members included senior managers from government, toll agencies, motor carrier industry, and ...

  1. Panel workload assessment in US primary care: accounting for non-face-to-face panel management activities.

    PubMed

    Arndt, Brian; Tuan, Wen-Jan; White, Jennifer; Schumacher, Jessica

    2014-01-01

    An understanding of primary care provider (PCP) workload is an important consideration in establishing optimal PCP panel size. However, no widely acceptable measure of PCP workload exists that incorporates the effort involved with both non-face-to-face patient care activities and face-to-face encounters. Accounting for this gap is critical given the increase in non-face-to-face PCP activities that has accompanied electronic health records (EHRs) (eg, electronic messaging). Our goal was to provide a comprehensive assessment of perceived PCP workload, accounting for aspects of both face-to-face and non-face-to-face encounters. Internal medicine, family medicine, and pediatric PCPs completed a self-administered survey about the perceived workload involved with face-to-face and non-face-to-face panel management activities as well as the perceived challenge associated with caring for patients with particular biomedical, demographic, and psychosocial characteristics (n = 185). Survey results were combined with EHR data at the individual patient and PCP service levels to assess PCP panel workload, accounting for face-to-face and non-face-to-face utilization. Of the multiple face-to-face and non-face-to-face activities associated with routine primary care, PCPs considered hospital admissions, obstetric care, hospital discharges, and new patient preventive health visits to be greater workload than non-face-to-face activities such as telephone calls, electronic communication, generating letters, and medication refills. Total workload within PCP panels at the individual patient level varied by overall health status, and the total workload of non-face-to-face panel management activities associated with routine primary care was greater than the total workload associated with face-to-face encounters regardless of health status. We used PCP survey results coupled with EHR data to assess PCP workload associated with both face-to-face as well as non-face-to-face panel management activities in primary care. The non-face-to-face workload was an important contributor to overall PCP workload for all patients regardless of overall health status. This is an important consideration for PCP workload assessment given the changing nature of primary care that requires more non-face-to-face effort, resulting in an overall increase in PCP workload. © Copyright 2014 by the American Board of Family Medicine.

  2. Panel session on "safety, health and the environment: implications of nuclear power growth".

    PubMed

    Bilbao y León, Sama

    2011-01-01

    This paper summarizes the presentations and the insights offered by panelists John P. Winston, Robert Bernero, and Stephen LaMontagne during the Panel on Safety, Health and the Environment: Implications of Nuclear Power Growth that took place during the NCRP 2009 Annual Meeting. The paper describes the opportunities and the challenges faced in the areas of infrastructure development, radiation control, licensing and regulatory issues, and non-proliferation as a consequence of the forecasted growth in nuclear power capacity worldwide. Copyright © 2010 Health Physics Society

  3. Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada.

    PubMed

    Dahrouge, Simone; Hogg, William; Younger, Jaime; Muggah, Elizabeth; Russell, Grant; Glazier, Richard H

    2016-01-01

    The purpose of this study was to determine the relationship between the number of patients under a primary care physician's care (panel size) and primary care quality indicators. We conducted a cross-sectional, population-based study of fee-for-service and capitated interprofessional and non-interprofessional primary health care practices in Ontario, Canada between April 2008 and March 2010, encompassing 4,195 physicians with panel sizes ≥1,200 serving 8.3 million patients. Data was extracted from multiple linked, health-related administrative databases and covered 16 quality indicators spanning 5 dimensions of care: access, continuity, comprehensiveness, and evidence-based indicators of cancer screening and chronic disease management. The likelihood of being up-to-date on cervical, colorectal, and breast cancer screening showed relative decreases of 7.9% (P <.001), 5.9% (P = .01), and 4.6% (P <.001), respectively, with increasing panel size (from 1,200 to 3,900). Eight chronic care indicators (4 medication-based and 4 screening-based) showed no significant association with panel size. The likelihood of individuals with a new diagnosis of congestive heart failure having an echocardiogram, however, increased by a relative 8.1% (P <.001) with higher panel size. Increasing panel size was also associated with a 10.8% relative increase in hospitalization rates for ambulatory-care-sensitive conditions (P = .04) and a 10.8% decrease in non-urgent emergency department visits (P = .004). Continuity was highest with medium panel sizes (P <.001), and comprehensiveness had a small decrease (P = .03) with increasing panel size. Increasing panel size was associated with small decreases in cancer screening, continuity, and comprehensiveness, but showed no consistent relationships with chronic disease management or access indicators. We found no panel size threshold above which quality of care suffered. © 2016 Annals of Family Medicine, Inc.

  4. Cancer pain management: recommendations from a Latin-American experts panel.

    PubMed

    Escobar Alvarez, Yolanda; Agamez Insignares, Claudia; Ahumada Olea, Monica; Barajas, Olga; Calderillo, German; Calvache Guamán, Jenny Cecilia; Caponero, Ricardo; Cavenago Salazar, Benjamín A; Del Giglio, Auro; Pupo Araya, Ana Rocío; Villalobos-Valencia, Ricardo; Yepes Pérez, Andrés; Zumelzu Delgado, Nilda

    2017-11-01

    Generating a consensus in the Latin-American region on cancer pain management is a current need. Thus a panel of Latin-American experts met in Madrid in March 2017 in order to review the published literature, discuss the best approach for cancer pain classification and evaluation and also make recommendations of pharmacological and nonpharmacological therapies for cancer pain management improvement in Latin-American countries. The result of that meeting is presented in this document. The experts participating were from Costa Rica, Mexico, Chile, Colombia, Peru, Brazil and Ecuador, and the project coordinator was from Spain.

  5. Geostationary Space Launch Vehicles and the U.S. Dilemma

    DTIC Science & Technology

    1994-06-17

    solar panels for power generation and no attitude control system for orbit stabilization. The communications circuits were underpowered because the... solar panels were small compared to the ones used on GEO satellites today. Although the lack of attitude control systems greatly reduced the weight of...to ten year useful life has been realized using good fuel management techniques. The size of the solar panels on GEO satellites have been the

  6. DOE Radiation Research Program is floundering - NAS

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

    Lobsenz, G.

    1994-04-20

    The Energy Department's radiation health effects research program is floundering in a morass of administrative confusion due to an ill-considered 1990 joint management agreement between DOE and the Health and Human Services Department, a National Academy of Sciences panel says. The NAS panel said the [open quotes]administrative difficulties[close quotes] created by the DOE-HHS agreement appear to be [open quotes]stifling creativity and efficiency within DOE's Epidemiology Research Program, delaying the completion and publication of research.[close quotes] The panel also expressed concern that DOE has failed to adequately fund or staff its health research office, and that the department had no mastermore » research plan to identify research needs or set forth uniform, scientifically rigorous data collection procedures. The panel said DOE's lack of commitment was particularly evident in its failure to set up an effective health surveillance program for its nuclear work force. In addition, the panel said DOE had fallen short on promises to create a comprehensive computer bank of health research data that would be continually updated with new information gleaned from an ongoing worker surveillance program. While recommending enhancements, the NAS panel emphasized that DOE's health research program would not be able to function effectively until the department revamped its joint management agreement with HHS.« less

  7. Financial arrangement selection for energy management projects

    NASA Astrophysics Data System (ADS)

    Woodroof, Eric Aubrey

    Scope and method of study. The purpose of this study was to develop a model (E-FUND) to help facility managers select financial arrangements for energy management projects (EMPs). The model was developed with the help of a panel of expert financiers. The panel also helped develop a list of key objectives critical to the decision process. The E-FUND model was tested by a population of facility managers in four case studies. Findings and conclusions. The results may indicate that having a high economic benefit (from an EMP) is not overwhelmingly important, when compared to other qualitative objectives. The results may also indicate that the true lease and performance contract may be the most applicable financial arrangements for EMPs.

  8. Expert panel answers questions for Super Safety and Health Day at KSC.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    A panel of NASA and contractor senior staff, plus officers from the 45th Space Wing, discuss safety- and health-related concerns in front of an audience of KSC employees, as part of Super Safety and Health Day. Moderating at the podium is Loren Shriver, deputy director for Launch & Payload Processing. Seated left to right are Burt Summerfield, associate director of the Biomedical Office; Colonel William S. Swindling, commander, 45th Medical Group, Patrick Air Force Base, Fla.; Ron Dittemore, manager, Space Shuttle Programs, Johnson Space Center; Roy Bridges, Center Director; Col. Tom Deppe, vice commander, 45th Space Wing, Patrick Air Force Base; Jim Schoefield, program manager, Payload Ground Operations, Boeing; Bill Hickman, program manager, Space Gateway Support; and Ed Adamek, vice president and associate program manager for Ground Operations, United Space Alliance. The panel was one of the presentations during KSC's second annual day-long dedication to safety. Most normal work activities were suspended to allow personnel to attend related activities. The theme, 'Safety and Health Go Hand in Hand,' emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space-related resources first and foremost. Events also included a keynote address, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television.

  9. Expert panel answers questions for Super Safety and Health Day at KSC.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    A panel of NASA and contractor senior staff, plus officers from the 45th Space Wing, discuss safety- and health-related concerns in front of an audience of KSC employees as part of Super Safety and Health Day. Moderating at the podium is Loren Shriver, deputy director for Launch & Payload Processing. Seated left to right are Burt Summerfield, associate director of the Biomedical Office; Colonel William S. Swindling, commander, 45th Medical Group, Patrick Air Force Base, Fla.; Ron Dittemore, manager, Space Shuttle Programs, Johnson Space Center; Roy Bridges, Center Director; Col. Tom Deppe, vice commander, 45th Space Wing, Patrick Air Force Base; Jim Schoefield, program manager, Payload Ground Operations, Boeing; Bill Hickman, program manager, Space Gateway Support; and Ed Adamek, vice president and associate program manager for Ground Operations, United Space Alliance. Answering a question at the microphone on the floor is Dave King, director, Shuttle Processing. The panel was one of the presentations during KSC's second annual day-long dedication to safety. Most normal work activities were suspended to allow personnel to attend related activities. The theme, 'Safety and Health Go Hand in Hand,' emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space- related resources first and foremost. Events also included a keynote address, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television.

  10. Recommendations for the Critical Care Management of Devastating Brain Injury: Prognostication, Psychosocial, and Ethical Management : A Position Statement for Healthcare Professionals from the Neurocritical Care Society.

    PubMed

    Souter, Michael J; Blissitt, Patricia A; Blosser, Sandralee; Bonomo, Jordan; Greer, David; Jichici, Draga; Mahanes, Dea; Marcolini, Evie G; Miller, Charles; Sangha, Kiranpal; Yeager, Susan

    2015-08-01

    Devastating brain injuries (DBIs) profoundly damage cerebral function and frequently cause death. DBI survivors admitted to critical care will suffer both intracranial and extracranial effects from their brain injury. The indicators of quality care in DBI are not completely defined, and despite best efforts many patients will not survive, although others may have better outcomes than originally anticipated. Inaccuracies in prognostication can result in premature termination of life support, thereby biasing outcomes research and creating a self-fulfilling cycle where the predicted course is almost invariably dismal. Because of the potential complexities and controversies involved in the management of devastating brain injury, the Neurocritical Care Society organized a panel of expert clinicians from neurocritical care, neuroanesthesia, neurology, neurosurgery, emergency medicine, nursing, and pharmacy to develop an evidence-based guideline with practice recommendations. The panel intends for this guideline to be used by critical care physicians, neurologists, emergency physicians, and other health professionals, with specific emphasis on management during the first 72-h post-injury. Following an extensive literature review, the panel used the GRADE methodology to evaluate the robustness of the data. They made actionable recommendations based on the quality of evidence, as well as on considerations of risk: benefit ratios, cost, and user preference. The panel generated recommendations regarding prognostication, psychosocial issues, and ethical considerations.

  11. Central Nervous System Cancers, Version 1.2015.

    PubMed

    Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Baehring, Joachim; Brem, Henry; Brown, Paul; Butowski, Nicholas; Chamberlain, Marc C; Fenstermaker, Robert A; Friedman, Allan; Gilbert, Mark R; Hattangadi-Gluth, Jona; Holdhoff, Matthias; Junck, Larry; Kaley, Thomas; Lawson, Ronald; Loeffler, Jay S; Lovely, Mary P; Moots, Paul L; Mrugala, Maciej M; Newton, Herbert B; Parney, Ian; Raizer, Jeffrey J; Recht, Lawrence; Shonka, Nicole; Shrieve, Dennis C; Sills, Allen K; Swinnen, Lode J; Tran, David; Tran, Nam; Vrionis, Frank D; Weiss, Stephanie; Wen, Patrick Yung; McMillian, Nicole; Engh, Anita M

    2015-10-01

    The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Central Nervous System (CNS) Cancers provide interdisciplinary recommendations for managing adult CNS cancers. Primary and metastatic brain tumors are a heterogeneous group of neoplasms with varied outcomes and management strategies. These NCCN Guidelines Insights summarize the NCCN CNS Cancers Panel's discussion and highlight notable changes in the 2015 update. This article outlines the data and provides insight into panel decisions regarding adjuvant radiation and chemotherapy treatment options for high-risk newly diagnosed low-grade gliomas and glioblastomas. Additionally, it describes the panel's assessment of new data and the ongoing debate regarding the use of alternating electric field therapy for high-grade gliomas. Copyright © 2015 by the National Comprehensive Cancer Network.

  12. Exascale Workshop Panel Report Meeting

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

    Khaleel, Mohammad A.

    2010-07-01

    The Exascale Review Panel consists of 12 scientists and engineers with experience in various aspects of high-performance computing and its application, development, and management. The Panel hear presentations by several representatives of the workshops and town meetings convened over the past few years to examine the need for exascale computation capability and the justification for a U.S. Department of Energy (DOE) program to develop such capability. This report summarizes information provided by the presenters and substantial written reports to the Panel in advance of the meeting in Washington D.C. on January 19-20, 2010. The report also summarizes the Panel's conclusionsmore » with regard to the justification of a DOE-led exascale initiative.« less

  13. Managing the Risk for Early Onset Osteoporosis in Long-Duration Astronauts Due to Spaceflight

    NASA Technical Reports Server (NTRS)

    Sibonga, Jean D.

    2010-01-01

    Early Onset Osteoporosis is probably the most recognized but poorly understood long-term health risk due to spaceflight. Osteoporosis management is primarily prophylactic and clinical interventions rely upon the ability to predict fractures which is currently determined by surrogate measures of bone strength. The RMAT for Early Onset Osteoporosis identified some open issues related to the fact that long-duration astronauts compose a unique group of subjects for which clinical approaches for osteoporosis management do not apply. Long-duration astronauts are healthy, young (25 to 55 years of age), predominantly male, and physical fit relative to the typical osteoporosis patient. Moreover, during prolonged space missions (typically 6-month missions) the skeleton not only adapts to weightlessness, but is influenced by numerous risk factors induced by operational constraints, e.g., inability to maintain preflight weight-bearing and aerobic activities, sub-optimal dietary intake (e.g., high sodium content for food stability, lack of fresh fruit and vegetables), suppression of vitamin D metabolism by uv shielding, and remote medicine care. Moreover, adaptation results in novel changes to astronauts bones that cannot be detected by current medically-useful measures. Consequently, a panel of clinicians (recognized leaders and policy-makers in osteoporosis) was convened to review the dataset of bone measures and bone loss risk factors in long-duration astronauts. Driven by the queries in the RMAT, the panel was charged to determine 1) if an intervention is required to prevent this risk, 2) what type and at what time would intervention be optimal, 3) what is the clinical trigger that would require a medical response from flight surgeons and 4) how should research data be used in the clinical care of astronauts. Hence, the RMAT determined that a bone health policy need to be formulated specific for this unique cohort subjected to a novel skeletal condition

  14. Attachment 1 : appendices : electronic toll collection/electronic screening interoperability pilot project, supplement to the final report

    DOT National Transportation Integrated Search

    2005-07-29

    In 1998, ITS America established a Blue Ribbon Panel on electronic commerce to study the convergence of transportation and electronic payment systems. Panel members included senior managers from government, toll agencies, motor carrier industry, and ...

  15. Changing climate, challenging choices: identifying and evaluating climate change adaptation options for protected areas management in Ontario, Canada.

    PubMed

    Lemieux, Christopher J; Scott, Daniel J

    2011-10-01

    Climate change will pose increasingly significant challenges to managers of parks and other forms of protected areas around the world. Over the past two decades, numerous scientific publications have identified potential adaptations, but their suitability from legal, policy, financial, internal capacity, and other management perspectives has not been evaluated for any protected area agency or organization. In this study, a panel of protected area experts applied a Policy Delphi methodology to identify and evaluate climate change adaptation options across the primary management areas of a protected area agency in Canada. The panel identified and evaluated one hundred and sixty five (165) adaptation options for their perceived desirability and feasibility. While the results revealed a high level of agreement with respect to the desirability of adaptation options and a moderate level of capacity pertaining to policy formulation and management direction, a perception of low capacity for implementation in most other program areas was identified. A separate panel of senior park agency decision-makers used a multiple criterion decision-facilitation matrix to further evaluate the institutional feasibility of the 56 most desirable adaptation options identified by the initial expert panel and to prioritize them for consideration in a climate change action plan. Critically, only two of the 56 adaptation options evaluated by senior decision-makers were deemed definitely implementable, due largely to fiscal and internal capacity limitations. These challenges are common to protected area agencies in developed countries and pervade those in developing countries, revealing that limited adaptive capacity represents a substantive barrier to biodiversity conservation and other protected area management objectives in an era of rapid climate change.

  16. Changing Climate, Challenging Choices: Identifying and Evaluating Climate Change Adaptation Options for Protected Areas Management in Ontario, Canada

    NASA Astrophysics Data System (ADS)

    Lemieux, Christopher J.; Scott, Daniel J.

    2011-10-01

    Climate change will pose increasingly significant challenges to managers of parks and other forms of protected areas around the world. Over the past two decades, numerous scientific publications have identified potential adaptations, but their suitability from legal, policy, financial, internal capacity, and other management perspectives has not been evaluated for any protected area agency or organization. In this study, a panel of protected area experts applied a Policy Delphi methodology to identify and evaluate climate change adaptation options across the primary management areas of a protected area agency in Canada. The panel identified and evaluated one hundred and sixty five (165) adaptation options for their perceived desirability and feasibility. While the results revealed a high level of agreement with respect to the desirability of adaptation options and a moderate level of capacity pertaining to policy formulation and management direction, a perception of low capacity for implementation in most other program areas was identified. A separate panel of senior park agency decision-makers used a multiple criterion decision-facilitation matrix to further evaluate the institutional feasibility of the 56 most desirable adaptation options identified by the initial expert panel and to prioritize them for consideration in a climate change action plan. Critically, only two of the 56 adaptation options evaluated by senior decision-makers were deemed definitely implementable, due largely to fiscal and internal capacity limitations. These challenges are common to protected area agencies in developed countries and pervade those in developing countries, revealing that limited adaptive capacity represents a substantive barrier to biodiversity conservation and other protected area management objectives in an era of rapid climate change.

  17. Detection and location of fouling on photovoltaic panels using a drone-mounted infrared thermography system

    NASA Astrophysics Data System (ADS)

    Zhang, Peng; Zhang, Lifu; Wu, Taixia; Zhang, Hongming; Sun, Xuejian

    2017-01-01

    Due to weathering and external forces, solar panels are subject to fouling and defects after a certain amount of time in service. These fouling and defects have direct adverse consequences such as low-power efficiency. Because solar power plants usually have large-scale photovoltaic (PV) panels, fast detection and location of fouling and defects across large PV areas are imperative. A drone-mounted infrared thermography system was designed and developed, and its ability to detect rapid fouling on large-scale PV panel systems was investigated. The infrared images were preprocessed using the K neighbor mean filter, and the single PV module on each image was recognized and extracted. Combining the local and global detection method, suspicious sites were located precisely. The results showed the flexible drone-mounted infrared thermography system to have a strong ability to detect the presence and determine the position of PV fouling. Drone-mounted infrared thermography also has good technical feasibility and practical value in the detection of PV fouling detection.

  18. To direct the Librarian of Congress to obtain a stained glass panel depicting the seal of the District of Columbia and install the panel among the stained glass panels depicting the seals of States which overlook the Main Reading Room of the Library of Congress Thomas Jefferson Building.

    THOMAS, 113th Congress

    Rep. Norton, Eleanor Holmes [D-DC-At Large

    2014-02-27

    House - 02/28/2014 Referred to the Subcommittee on Economic Development, Public Buildings and Emergency Management. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. Crew Launch Vehicle (CLV) Avionics and Software Integration Overview

    NASA Technical Reports Server (NTRS)

    Monell, Donald W.; Flynn, Kevin C.; Maroney, Johnny

    2006-01-01

    On January 14, 2004, the President of the United States announced a new plan to explore space and extend a human presence across our solar system. The National Aeronautics and Space Administration (NASA) established the Exploration Systems Mission Directorate (ESMD) to develop and field a Constellation Architecture that will bring the Space Exploration vision to fruition. The Constellation Architecture includes a human-rated Crew Launch Vehicle (CLV) segment, managed by the Marshall Space Flight Center (MSFC), comprised of the First Stage (FS), Upper Stage (US), and Upper Stage Engine (USE) elements. The CLV s purpose is to provide safe and reliable crew and cargo transportation into Low Earth Orbit (LEO), as well as insertion into trans-lunar trajectories. The architecture's Spacecraft segment includes, among other elements, the Crew Exploration Vehicle (CEV), managed by the Johnson Space Flight Center (JSC), which is launched atop the CLV. MSFC is also responsible for CLV and CEV stack integration. This paper provides an overview of the Avionics and Software integration approach (which includes the Integrated System Health Management (ISHM) functions), both within the CLV, and across the CEV interface; it addresses the requirements to be met, logistics of meeting those requirements, and the roles of the various groups. The Avionics Integration and Vehicle Systems Test (ANST) Office was established at the MSFC with system engineering responsibilities for defining and developing the integrated CLV Avionics and Software system. The AIVST Office has defined two Groups, the Avionics and Software Integration Group (AVSIG), and the Integrated System Simulation and Test Integration Group (ISSTIG), and four Panels which will direct trade studies and analyses to ensure the CLV avionics and software meet CLV system and CEV interface requirements. The four panels are: 1) Avionics Integration Panel (AIP), 2) Software Integration Panel, 3) EEE Panel, and 4) Systems Simulation and Test Panel. Membership on the groups and panels includes the MSFC representatives from the requisite engineering disciplines, the First Stage, the Upper Stage, the Upper Stage Engine projects, and key personnel from other NASA centers. The four panels will take the results of trade studies and analyses and develop documentation in support of Design Analysis Cycle Reviews and ultimately the System Requirements Review.

  20. Annual report to the NASA Administrator by the Aerospace Safety Advisory Panel. Part 2: Space shuttle program. Section 2: Summary of information developed in the Panel's fact-finding activities

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The management areas and the individual elements of the shuttle system were investigated. The basic management or design approach including the most obvious limits or hazards that are significant to crew safety was reviewed. Shuttle program elements that were studied included the orbiter, the space shuttle main engine, the external tank project, solid rocket boosters, and the launch and landing elements.

  1. Streamlining Defense Acquisition Laws. Executive Summary: Report of the DoD Acquisition Law Advisory Panel

    DTIC Science & Technology

    1993-03-01

    procurement into a single, 1 The Defense Systems Management College is a DOD educational institution which has, since 1971, trained prgram managers and...greater butis prevented by numerous statutory require- use of commercial items. The Panel has re- ments from buying those products like any other...purchases of an item from one particular source. prevent inadvertent repeal and defines the rela- This is a "lose-lose situation" for commercial tionship of

  2. Space Launch System Panel Discussion

    NASA Image and Video Library

    2013-11-12

    Jim Crocker, Vice President and General Manager, civil space, Lockheed Martin Space Systems, gestures while speaking at a panel discussion on deep space exploration using the Space Launch System and Orion spacecraft at the Newseum in Washington on Tuesday, November 12, 2013. Photo Credit: (NASA/Jay Westcott)

  3. Evaluating reasons for nursing turnover: comparison of exit interview and panel data.

    PubMed

    Weisman, C S; Alexander, C S; Chase, G A

    1981-06-01

    Data from a study of nursing turnover are used to compare findings based on two techniques for evaluating the reasons for resignations within the same population of hospital nurses during one year. The techniques are: (1) exit interviews, in which resigning nurses were asked to report in an open-ended format their major reasons for leaving their jobs; and (2) a prospective panel study, in which nurses who resigned are compared with nurses who remained, and actual turnover is predicted. Results show that due to the absence of a comparison group of remaining nurses and of baseline data, causal inferences based on exit interview data alone are overly simplistic and misleading for management purposes. Results of the panel study are more informative, although implications for hospital management are more complex. Use of the prospective panel design is recommended for hospitals concerned with evaluating nursing job conditions during a period of high turnover and staff nurse shortages.

  4. [The climate debate: the facts].

    PubMed

    van den Broeke, Michiel R

    2009-01-01

    The first report by the Intergovernmental Panel on Climate Change (IPCC) appeared almost 20 years ago. Environmental contamination has a negative effect on the environment in which we live. However, the public at large is confused about the ins and outs of climate change. Managers, politicians, various kinds of advisors, scientists, so-called experts, sceptics and journalists have all taken it upon themselves to lead the debate. Whose task is it to ensure a sound discussion? Surely it is the IPCC's task. However, most politicians and many journalists, and even many scientists, do not take the trouble to read the entire IPCC report or parts of it. As a consequence, much nonsense is published and broadcast. An effective procedure to deal with the climate problem starts with a fair discussion of the scientific evidence. My advice is: just read the free IPCC report: http://www.ipcc.ch/ and click on 'WG I The Physical Science Basis'.

  5. The Pathway to a Safe and Effective Spaceflight Medication Formulary: Expert Review Panel Recommendations

    NASA Technical Reports Server (NTRS)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; McGuire, R. K. M.; Antonsen, E. L.

    2018-01-01

    Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

  6. Information science for the future: an innovative nursing informatics curriculum.

    PubMed

    Travis, L; Flatley Brennan, P

    1998-04-01

    Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.

  7. Chemical, Biological, Radiological, and Nuclear Consequence Management: Ways to Improve Fixed-Site Decontamination Capability

    DTIC Science & Technology

    2007-05-10

    objective is achieved through consequence management and fixed-site decontamination operations. The effectiveness of CBRN consequence management...decontamination operations. The effectiveness of CBRN consequence management and fixed-site decontamination executed in the Joint Security Area can be...when faced with Chemical, Biological, Radiological, or Nuclear (CBRN) contaminated ports of debarkation. The effectiveness of CBRN consequence

  8. 78 FR 34046 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-06

    ... Caribbean Fishery Management Council's Outreach and Education Advisory Panel (OEAP) will hold a meeting... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National..., Puerto Rico. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management Council, 270 Mu[ntilde]oz...

  9. 78 FR 14078 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-04

    ... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... Caribbean Fishery Management Council's (CFMC) Outreach and Education Advisory Panel (OEAP) will hold a.... FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management Council, 270 Mu[ntilde]oz Rivera Avenue...

  10. Patient safety in out-of-hours primary care: a review of patient records.

    PubMed

    Smits, Marleen; Huibers, Linda; Kerssemeijer, Brian; de Feijter, Eimert; Wensing, Michel; Giesen, Paul

    2010-12-10

    Most patients receive healthcare in primary care settings, but relatively little is known about patient safety. Out-of-hours contacts are of particular importance to patient safety. Our aim was to examine the incidence, types, causes, and consequences of patient safety incidents at general practice cooperatives for out-of-hours primary care and to examine which factors were associated with the occurrence of patient safety incidents. A retrospective study of 1,145 medical records concerning patient contacts with four general practice cooperatives. Reviewers identified records with evidence of a potential patient safety incident; a physician panel determined whether a patient safety incident had indeed occurred. In addition, the panel determined the type, causes, and consequences of the incidents. Factors associated with incidents were examined in a random coefficient logistic regression analysis. In 1,145 patient records, 27 patient safety incidents were identified, an incident rate of 2.4% (95% CI: 1.5% to 3.2%). The most frequent incident type was treatment (56%). All incidents had at least partly been caused by failures in clinical reasoning. The majority of incidents did not result in patient harm (70%). Eight incidents had consequences for the patient, such as additional interventions or hospitalisation. The panel assessed that most incidents were unlikely to result in patient harm in the long term (89%). Logistic regression analysis showed that age was significantly related to incident occurrence: the likelihood of an incident increased with 1.03 for each year increase in age (95% CI: 1.01 to 1.04). Patient safety incidents occur in out-of-hours primary care, but most do not result in harm to patients. As clinical reasoning played an important part in these incidents, a better understanding of clinical reasoning and guideline adherence at GP cooperatives could contribute to patient safety.

  11. 77 FR 59901 - Gulf of Mexico Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... Panel in conjunction with the Gulf States Marine Fisheries Commission's Law Enforcement Committee. DATES... Panel (LEAP) along with the Gulf States Marine Fisheries Commission's Law Enforcement Committee (LEC... each of the Gulf States, as well as the National Oceanic and Atmospheric Administration (NOAA) Law...

  12. 32 CFR 1901.41 - Establishment of appeals structure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... HRPB is the Director, Information Management. The Chair may request interested parties to participate... take action when a simple majority of the total membership is present. The Panel shall advise and... interested parties to participate when special equities or expertise are involved. The Panel, functioning as...

  13. 15 CFR 290.8 - Reviews of centers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS REGIONAL CENTERS FOR THE... criteria set out below. There will be regular management interaction with NIST and the other Centers for... involved Center, and Federal officials. An official of NIST shall chair the panel. Each Merit Review Panel...

  14. 15 CFR 290.8 - Reviews of centers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS REGIONAL CENTERS FOR THE... criteria set out below. There will be regular management interaction with NIST and the other Centers for... involved Center, and Federal officials. An official of NIST shall chair the panel. Each Merit Review Panel...

  15. 15 CFR 290.8 - Reviews of centers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS REGIONAL CENTERS FOR THE... criteria set out below. There will be regular management interaction with NIST and the other Centers for... involved Center, and Federal officials. An official of NIST shall chair the panel. Each Merit Review Panel...

  16. 25 CFR 170.170 - How are Indian LTAP centers managed?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Indian Local Technical Assistance... Center Director and staff, with the advice of its technical panel under the Indian LTAP agreements. FHWA... technical panel consisting of one BIA Regional Road Engineer, one FHWA representative, one state DOT...

  17. 75 FR 68688 - Airworthiness Directives; The Boeing Company Model 757 Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

    ...We are adopting a new airworthiness directive (AD) for all Model 757 airplanes. This AD requires changing the lower fixed leading edge panel assemblies immediately outboard of the nacelles at slats 4 and 7. This AD results from reports of Model 757 airplanes in service that have drain holes and unsealed panel assemblies in the fixed leading edge adjacent to the inboard end of slats 4 and 7 that are too close to the hot portion of the engines. We are issuing this AD to prevent fuel leaking onto an engine and a consequent fire.

  18. Coated columbium thermal protection systems: An assessment of technological readiness

    NASA Technical Reports Server (NTRS)

    Levine, S. R.; Grisaffe, S. J.

    1973-01-01

    Evaluation and development to date show that of the coated columbium alloys FS-85 coated with R512E shows significant promise for a reusable thermal protection system (TPS) as judged by environmental resistance and the retention of mechanical properties and structural integrity of panels upon repeated reentry simulation. Production of the alloy, the coating, and full-sized TPS panels is well within current manufacturing technology. Small defects which arise from impact damage or from local coating breakdown do not appear to have serious immediate consequences in the use environment anticipated for the space shuttle orbiter TPS.

  19. 76 FR 77327 - Disciplinary Appeals Board Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    .... FOR FURTHER INFORMATION CONTACT: Larry Ables, Employee Relations and Performance Management Service, Office of Human Resources Management, Department of Veterans Affairs, 810 Vermont Avenue NW., Mailstop...

  20. Occupational mental health promotion: a prevention agenda based on education and treatment. The American Psychological Association/National Institute for Occupational Safety and Health, Health Promotion Panel, 1990 Work and Well-Being Conference.

    PubMed

    1992-01-01

    PURPOSE OF THE REVIEW. Psychological disorders are one of the 10 leading work-related diseases and injuries in the United States according to the National Institute for Occupational Safety and Health. This article addresses occupational metal health and preventive stress management in the workplace. The individual and organizational costs are briefly considered with concern for reducing the burden of suffering associated with these problems. SEARCH METHOD. As an American Psychological Association interdisciplinary panel, we searched the psychological, medical, public health, and organizational literature. We selected articles relevant to the problem of psychological disorders in the workplace and to enhancing occupational mental health and preventive stress management. IMPORTANT FINDINGS. The panel proposed a national agenda of education and treatment, combined with a program of evaluation research, for addressing these issues. Target populations are identified, and the need for collaboration among a variety of national constituencies is considered. Advancing occupational mental health and promoting skills in preventive stress management is considered in the context of comprehensive health promotion. MAJOR CONCLUSIONS. The panel concluded that there is a pressing need to: 1) set a 'gold' standard concerning the current state of knowledge in the domains of occupational mental health and stress management; 2) identify Diagnostically Related Groups (DRGs) which are stress-related; 3) establish assessment standards for stress and mental health; 4) set guidelines for reasonable interventions; and 5) establish acceptable post-outcome criteria.

  1. 78 FR 3923 - Sunshine Act Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-17

    ... impact of tick sizes on small and middle capitalization companies, the economic consequences (including the costs and benefits) of increasing or decreasing minimum tick sizes, and whether other policy... the second panel will address the impact of tick sizes on the securities market in general, including...

  2. Workshop: Market Mechanisms and Incentives: Applications to Environmental Policy (2009-part 3)

    EPA Pesticide Factsheets

    Presentations on the use of market mechanisms and incentives in the areas of fuel economy, water quality, land use and the distributional consequences of using market incentives. There was also a panel discussion on the role of market mechanisms on climate

  3. Safety of folic acid

    PubMed Central

    Field, Martha S.

    2017-01-01

    Abstract There is a large body of literature demonstrating the efficacy of maternal folic acid intake in preventing birth defects, as well as investigations into potential adverse consequences of consuming folic acid above the upper intake level (UL). Recently, two authoritative bodies convened expert panels to assess risks from high intakes of folic acid: the U.S. National Toxicology Program and the UK Scientific Advisory Committee on Nutrition. Overall, the totality of the evidence examined by these panels, as well as studies published since the release of their reports, have not established risks for adverse consequences resulting from existing mandatory folic acid fortification programs that have been implemented in many countries. Current folic acid fortification programs have been shown to support public health in populations, and the exposure levels are informed by and adherent to the precautionary principle. Additional research is needed to assess the health effects of folic acid supplement use when the current upper limit for folic acid is exceeded. PMID:29155442

  4. Implementation of a novel population panel management curriculum among interprofessional health care trainees.

    PubMed

    Kaminetzky, Catherine P; Beste, Lauren A; Poppe, Anne P; Doan, Daniel B; Mun, Howard K; Woods, Nancy Fugate; Wipf, Joyce E

    2017-12-22

    Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees. The curriculum was implemented annually among internal medicine residents, nurse practitioner students and residents, and pharmacy residents co-located in a large, academic primary care site. Small groups of interprofessional trainees participated in supervised quarterly seminars focusing on chronic disease management (e.g., diabetes mellitus, hypertension, or chronic obstructive pulmonary disease) or processes of care (e.g., emergency department utilization for nonacute conditions or chronic opioid management). Following brief didactic presentations, trainees self-assessed their clinic performance using patient-level chart review, presented individual cases to interprofessional staff and faculty, and implemented subsequent feedback with their clinic team. We report data from 2011 to 2015. Program evaluation included post-session participant surveys regarding attitudes, knowledge and confidence towards PPM, ability to identify patients for referral to interprofessional team members, and major learning points from the session. Directed content analysis was performed on an open-ended survey question. Trainees (n = 168) completed 122 evaluation assessments. Trainees overwhelmingly reported increased confidence in using PPM and increased knowledge about managing their patient panel. Trainees reported improved ability to identify patients who would benefit from multidisciplinary care or referral to another team member. Directed content analysis revealed that trainees viewed team members as important system resources (n = 82). Structured interprofessional training in PPM is both feasible and acceptable to trainees across multiple professions. Curriculum participants reported improved panel management skills, increased confidence in using PPM, and increased confidence in identifying candidates for interprofessional care. The curriculum could be readily exported to other programs and contexts.

  5. Pharmacy executives: leadership issues and associated skills, knowledge, and abilities in the U.S. Department of Defense.

    PubMed

    Meadows, Andrew B; Finstuen, Kenn; Hudak, Ronald P

    2003-01-01

    To identify the issues or problems that current and aspiring U.S. Department of Defense (DoD) pharmacy executives will face in the future and to define the skills, knowledge, and abilities (SKAs) required to successfully address these issues. Delphi method for executive decision making. DoD. Ninety-three pharmacists serving in the military grades of lieutenant colonel/commander and colonel/captain, as well as pharmacists selected for promotion to those grades. iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants identified five major issues believed to be of greatest importance to pharmacy executives and reported specific SKAs that might be needed to successfully manage those issues. An expert panel sorted these issues into meaningful domains, then provided an appropriate title for each domain. Round 2--on a 7-point scale, respondents rated the SKA items according to their assessment of how much a future DoD pharmacy executive would need each SKA. Response rates were 44.1% and 46.2% for Delphi rounds 1 and 2, respectively. The first round generated 62 unique issues facing pharmacy executives. The expert panel reviewed and sorted the issues into eight domains and selected an appropriate title for each domain. The domains identified by the panel were human resources, pharmacy operations/business practices, information management and technology, financial resources, formulary management, drug therapy management, pharmacy benefit management, and leadership. During round 2, 73.3% of the top 15 rated SKAs came from the drug therapy management, leadership, and formulary management domains. The three highest-rated SKAs were "ability to see the big picture," "ability to build strong relations with medical staffs," and "skills in both writing and verbal communication." The issues facing future DoD pharmacy executives will require them to expand their clinical abilities as well as their ability to collaborate and communicate with other professionals.

  6. 78 FR 76116 - Establishment of the Secretary of the Navy Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... DEPARTMENT OF DEFENSE Office of the Secretary Establishment of the Secretary of the Navy Advisory Panel AGENCY: DoD. ACTION: Renewal of Federal Advisory Committee. SUMMARY: The Department of Defense... Freeman, Advisory Committee Management Officer for the Department of Defense, 703-692-5952. SUPPLEMENTARY...

  7. 76 FR 13999 - Meeting of the Ocean Research and Resources Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ..., and other current issues in the ocean science and management communities; including, the review and... DEPARTMENT OF DEFENSE Department of the Navy Meeting of the Ocean Research and Resources Advisory Panel AGENCY: Department of the Navy, DoD. ACTION: Notice of open meeting. SUMMARY: The Ocean Research...

  8. 76 FR 22083 - Meeting of the Ocean Research and Resources Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... other current issues in the ocean science and management communities; including, the review and... DEPARTMENT OF DEFENSE Department of the Navy Meeting of the Ocean Research and Resources Advisory Panel AGENCY: Department of the Navy, DoD. ACTION: Notice of open meeting. SUMMARY: The Ocean Research...

  9. Edge-glued panels from Alaska hardwoods: retail manager perspectives

    Treesearch

    David Nicholls; Matthew Bumgardner; Valerie Barber

    2010-01-01

    In Alaska, red alder (Alnus rubra Bong.) and paper birch (Betula papyrifera Marsh.) are both lesser-known hardwoods grown, harvested, and manufactured into appearance products, with potential for increased utilization. The production of edgeglued panels from red alder and paper birch offers one expansion opportunity for wood...

  10. 75 FR 54857 - Meeting of the Chief of Naval Operations Executive Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Operations (CNO) Executive Panel will deliberate on the findings and proposed recommendations of the... Navy strategy, plans, and policies regarding the utilization of technically diverse systems, primarily associated with information management systems. DATES: The meeting will be held on September 30, 2010, from 9...

  11. 76 FR 64073 - New England Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ....m.--Groundfish Advisory Panel The Groundfish Advisory Panel (GAP) will meet to develop advice that... at its November 2011 meeting. The GAP will review draft Framework Adjustment 47 to the Northeast... priorities. The GAP may review information from a sector workshop in October and may prioritize the issues...

  12. 77 FR 71873 - Disciplinary Appeals Board Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... CONTACT: Larry Ables, Employee Relations and Performance Management Service (051), Office of Human Resources Management, Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420. Mr...

  13. 76 FR 22080 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Scallop Advisory Panel...: (508) 747- 8937. Council address: New England Fishery Management Council, 50 Water Street, Mill 2...

  14. 77 FR 25143 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... Management Council's (Council) Recreational Advisory Panel will meet to consider actions affecting New... Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950. FOR FURTHER INFORMATION CONTACT: Paul J...

  15. Delineating managed land for reporting national greenhouse gas emissions and removals to the United Nations framework convention on climate change.

    PubMed

    Ogle, Stephen M; Domke, Grant; Kurz, Werner A; Rocha, Marcelo T; Huffman, Ted; Swan, Amy; Smith, James E; Woodall, Christopher; Krug, Thelma

    2018-05-29

    Land use and management activities have a substantial impact on carbon stocks and associated greenhouse gas emissions and removals. However, it is challenging to discriminate between anthropogenic and non-anthropogenic sources and sinks from land. To address this problem, the Intergovernmental Panel on Climate Change developed a managed land proxy to determine which lands are contributing anthropogenic greenhouse gas emissions and removals. Governments report all emissions and removals from managed land to the United Nations Framework Convention on Climate Change based on this proxy, and policy interventions to reduce emissions from land use are expected to focus on managed lands. Our objective was to review the use of the managed land proxy, and summarize the criteria that governments have applied to classify land as managed and unmanaged. We found that the large majority of governments are not reporting on their application of the managed land proxy. Among the governments that do provide information, most have assigned all area in specific land uses as managed, while designating all remaining lands as unmanaged. This designation as managed land is intuitive for croplands and settlements, which would not exist without management interventions, but a portion of forest land, grassland, and wetlands may not be managed in a country. Consequently, Brazil, Canada and the United States have taken the concept further and delineated managed and unmanaged forest land, grassland and wetlands, using additional criteria such as functional use of the land and accessibility of the land to anthropogenic activity. The managed land proxy is imperfect because reported emissions from any area can include non-anthropogenic sources, such as natural disturbances. However, the managed land proxy does make reporting of GHG emissions and removals from land use more tractable and comparable by excluding fluxes from areas that are not directly influenced by anthropogenic activity. Moreover, application of the managed land proxy can be improved by incorporating additional criteria that allow for further discrimination between managed and unmanaged land.

  16. Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

    PubMed

    Hanekom, Susan D; Brooks, Dina; Denehy, Linda; Fagevik-Olsén, Monika; Hardcastle, Timothy C; Manie, Shamila; Louw, Quinette

    2012-02-06

    Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm. The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

  17. Tether Dynamics Simulation

    NASA Technical Reports Server (NTRS)

    1987-01-01

    The proceedings of the conference are presented. The objective was to provide a forum for the discussion of the structure and status of existing computer programs which are used to simulate the dynamics of a variety of tether applications in space. A major topic was different simulation models and the process of validating them. Guidance on future work in these areas was obtained from a panel discussion; the panel was composed of resource and technical managers and dynamic analysts in the tether field. The conclusions of this panel are also presented.

  18. 78 FR 50037 - Hydrographic Services Review Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... pilotage, coastal and fishery management, and other disciplines as determined appropriate by the... oceanography; coastal resource management, including fisheries management and regional marine planning; and...) Describe your leadership or professional experiences which you believe will contribute to the effectiveness...

  19. Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations.

    PubMed

    Wu, Stephanie; Applewhite, Andrew J; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry

    2017-11-01

    Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. A 2-day panel meeting convened in February 2017. Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.

  20. Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations

    PubMed Central

    Wu, Stephanie; Applewhite, Andrew J.; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry

    2017-01-01

    ABSTRACT OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. SETTING: A 2-day panel meeting convened in February 2017. PARTICIPANTS: Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. RESULTS: The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. CONCLUSIONS: An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed. PMID:29049055

  1. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East.

    PubMed

    Al Sayed, Nasreen; Al Waili, Khalid; Alawadi, Fatheya; Al-Ghamdi, Saeed; Al Mahmeed, Wael; Al-Nouri, Fahad; Al Rukhaimi, Mona; Al-Rasadi, Khalid; Awan, Zuhier; Farghaly, Mohamed; Hassanein, Mohamed; Sabbour, Hani; Zubaid, Mohammad; Barter, Philip

    2016-12-15

    Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines and regional clinical experience to develop recommendations. The panel's recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20years. A scoring system should be used to calculate ASCVD risk that includes known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia. These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  2. Initial Assessment, Surveillance, and Management of Blood Pressure in Patients Receiving Vascular Endothelial Growth Factor Signaling Pathway Inhibitors

    PubMed Central

    Bakris, George L.; Black, Henry R.; Chen, Helen X.; Durand, Jean-Bernard; Elliott, William J.; Ivy, S. Percy; Leier, Carl V.; Lindenfeld, JoAnn; Liu, Glenn; Remick, Scot C.; Steingart, Richard; Tang, W. H. Wilson

    2010-01-01

    Hypertension is a mechanism-based toxic effect of drugs that inhibit the vascular endothelial growth factor signaling pathway (VSP). Substantial evidence exists for managing hypertension as a chronic condition, but there are few prospectively collected data on managing acute hypertension caused by VSP inhibitors. The Investigational Drug Steering Committee of the National Cancer Institute convened an interdisciplinary cardiovascular toxicities expert panel to evaluate this problem, to make recommendations to the Cancer Therapy Evaluation Program on further study, and to structure an approach for safe management by treating physicians. The panel reviewed: the published literature on blood pressure (BP), hypertension, and specific VSP inhibitors; abstracts from major meetings; shared experience with the development of VSP inhibitors; and established principles of hypertension care. The panel generated a consensus report including the recommendations on clinical concerns summarized here. To support the greatest possible number of patients to receive VSP inhibitors safely and effectively, the panel had four recommendations: 1) conduct and document a formal risk assessment for potential cardiovascular complications, 2) recognize that preexisting hypertension will be common in cancer patients and should be identified and addressed before initiation of VSP inhibitor therapy, 3) actively monitor BP throughout treatment with more frequent assessments during the first cycle of treatment, and 4) manage BP with a goal of less than 140/90 mmHg for most patients (and to lower, prespecified goals in patients with specific preexisting cardiovascular risk factors). Proper agent selection, dosing, and scheduling of follow-up should enable maintaining VSP inhibition while avoiding the complications associated with excessive or prolonged elevation in BP. PMID:20351338

  3. Panel: Big Data & Social Media for Empowering Patients with Diabetes.

    PubMed

    Fernandez-Luque, Luis; Mejova, Yelena; Mayer, Miguel-Angel; Hasvold, Per Erlend; Joshi, Surabhi

    2016-01-01

    Millions of people living with diabetes are using mobile phones, Internet and social media to socialize with other patients, share experience or search information relevant for their self-management. This phenomena is leading towards a new paradigm of hyper-connected diabetes digital self-management. This is also leading towards an explosion on data, a large amount of data is collected on populations around the world. This panel will address the opportunities this data presents, discuss the latest research that uses it, and the limitations and other concerns.

  4. Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial.

    PubMed

    Kearns, Patrick

    2017-10-01

    PURPOSE: Health services research evaluates redesign models for primary care. Care management is one alternative. Evaluation includes resource utilization as a criterion. Compare the impact of care-manager teams on resource utilization. The comparison includes entire panes of patients and the subset of patients with diabetes. DESIGN: Randomized, prospective, cohort study comparing change in utilization rates between groups, pre- and post-intervention. METHODOLOGY: Ten primary care physician panels in a safety-net setting. Ten physicians were randomized to either a care-management approach (Group 1) or a traditional approach (Group 2). Care managers focused on diabetes and the cardiovascular cluster of diseases. Analysis compared rates of hospitalization, 30-day readmission, emergency room visits, and urgent care visits. Analysis compared baseline rates to annual rates after a yearlong run-in for entire panels and the subset of patients with diabetes. RESULTS: Resource utilization showed no statistically significant change between baseline and Year 3 (P=.79). Emergency room visits and hospital readmission increased for both groups (P=.90), while hospital admissions and urgent care visits decreased (P=.73). Similarly, utilization was not significantly different for patients with diabetes (P=.69). CONCLUSIONS: A care-management team approach failed to improve resource utilization rates by entire panels and the subset of diabetic patients compared to traditional care. This reinforces the need for further evidentiary support for the care-management model's hypothesis in the safety net.

  5. 78 FR 31519 - Gulf of Mexico Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... Mexico Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS... Advisory Panel meeting. SUMMARY: The Gulf of Mexico Fishery Management Council will convene a meeting of... Mexico Fishery Management Council, 2203 North Lois Avenue, Suite 1100, Tampa, FL 33607. FOR FURTHER...

  6. Transient loads identification for a standoff metallic thermal protection system panel.

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

    Hundhausen, R. J.; Adams, Douglas E.; Derriso, Mark

    2004-01-01

    Standoff thermal protection system (TPS) panels are critical structural components in future aerospace vehicles because they protect the vehicle from the hostile environment encountered during space launch and reentry. Consequently, the panels are exposed to a variety of loads including high temperature thermal stresses, thermal shock, acoustic pressure, and foreign object impacts. Transient impacts are especially detrimental because they can cause immediate and severe degradation of the panel in the form of, for example, debonding and buckling of the face sheet, cracking of the fasteners, or deformation of the standoffs. Loads identification methods for determining the magnitude and location ofmore » impact loads provide an indication of TPS components that may be more susceptible to failure. Furthermore, a historical database of impact loads encountered can be retained for use in the development of statistical models that relate impact loading to panel life. In this work, simulated inservice transient loads are identified experimentally using two methods: a physics-based approach and an inverse Frequency Response Function (FRF) approach. It is shown that by applying the inverse FRF method, the location and magnitude of these simulated impacts can be identified with a high degree of accuracy. The identified force levels vary significantly with impact location due to the differences in panel deformation at the impact site indicating that resultant damage due to impacts would vary with location as well.« less

  7. Assessment of the risk of African swine fever introduction into Finland using NORA-a rapid tool for semiquantitative assessment of the risk.

    PubMed

    Kyyrö, J; Sahlström, L; Lyytikäinen, T

    2017-12-01

    The NORA rapid risk assessment tool was developed for situations where there is a change in the disease status of easily transmissible animal diseases in neighbouring countries or in countries with significant interactions with Finland. The goal was to develop a tool that is quick to use and will provide consistent results to support risk management decisions. The model contains 63 questions that define the potential for entry and exposure by nine different pathways. The magnitude of the consequences is defined by 23 statements. The weight of different pathways is defined according to the properties of the assessed disease. The model was built as an Excel spreadsheet and is intended for use by animal health control administrators. As an outcome, the model gives the possible pathways of disease entry into the country, an overall approximation for the probability of entry and the subsequent exposure, an overall estimate for the consequences and a combined overall risk estimate (probability multiplied by magnitude of consequences). Model validity was assessed by expert panels. Outside Africa, African swine fever is currently established in Russia and Sardinia. In addition, there have been cases in both wild boar and domestic pigs in Latvia, Lithuania, Poland and Estonia. Finland has frequent contacts with Russia and Estonia, especially through passengers. The risk of African swine fever (ASF) introduction into Finland was tested with NORA for the situation in December 2015, when ASF was endemic in many parts of Russia, Africa and Sardinia and was present in Baltic countries and in Poland. African swine fever was assessed to have a high probability of entry into Finland, with high consequences and therefore a high overall risk. © 2017 Blackwell Verlag GmbH.

  8. ASAP Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This is the First Quarterly Report for the newly reconstituted Aerospace Safety Advisory Panel (ASAP). The NASA Administrator rechartered the Panel on November 18,2003, to provide an independent, vigilant, and long-term oversight of NASA's safety policies and programs well beyond Return to Flight of the Space Shuttle. The charter was revised to be consistent with the original intent of Congress in enacting the statute establishing ASAP in 1967 to focus on NASA's safety and quality systems, including industrial and systems safety, risk-management and trend analysis, and the management of these activities.The charter also was revised to provide more timely feedback to NASA by requiring quarterly rather than annual reports, and by requiring ASAP to perform special assessments with immediate feedback to NASA. ASAP was positioned to help institutionalize the safety culture of NASA in the post- Stafford-Covey Return to Flight environment.

  9. Gene panel testing for hereditary breast cancer.

    PubMed

    Winship, Ingrid; Southey, Melissa C

    2016-03-21

    Inherited predisposition to breast cancer is explained only in part by mutations in the BRCA1 and BRCA2 genes. Most families with an apparent familial clustering of breast cancer who are investigated through Australia's network of genetic services and familial cancer centres do not have mutations in either of these genes. More recently, additional breast cancer predisposition genes, such as PALB2, have been identified. New genetic technology allows a panel of multiple genes to be tested for mutations in a single test. This enables more women and their families to have risk assessment and risk management, in a preventive approach to predictable breast cancer. Predictive testing for a known family-specific mutation in a breast cancer predisposition gene provides personalised risk assessment and evidence-based risk management. Breast cancer predisposition gene panel tests have a greater diagnostic yield than conventional testing of only the BRCA1 and BRCA2 genes. The clinical validity and utility of some of the putative breast cancer predisposition genes is not yet clear. Ethical issues warrant consideration, as multiple gene panel testing has the potential to identify secondary findings not originally sought by the test requested. Multiple gene panel tests may provide an affordable and effective way to investigate the heritability of breast cancer.

  10. 49 CFR 195.452 - Pipeline integrity management in high consequence areas.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... by this section must: (1) Develop a written integrity management program that addresses the risks on...

  11. 49 CFR 195.452 - Pipeline integrity management in high consequence areas.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... by this section must: (1) Develop a written integrity management program that addresses the risks on...

  12. 49 CFR 195.452 - Pipeline integrity management in high consequence areas.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... by this section must: (1) Develop a written integrity management program that addresses the risks on...

  13. Initiatives and Challenges in Consequence Management after a WMD Attack

    DTIC Science & Technology

    2004-08-01

    Challenges in Consequence Management people to seek shelter or other protection when possible, to avoid exposure to weapons of mass destruction effects . The...Potential Effects .........................................9 V. Methods for Managing the Consequences of WMD Use.................14 VI. Toward a...mass destruction (WMD). Consequence management1 is a process to mitigate the effects of the use of weapons of mass destruction, including

  14. Homeland Biological Warfare Consequence Management: Capabilities and Needs Assessment

    DTIC Science & Technology

    2001-04-01

    AU/ACSC/105/2001-04 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY HOMELAND BIOLOGICAL WARFARE CONSEQUENCE MANAGEMENT: CAPABILITIES AND NEEDS...Dates Covered (from... to) - Title and Subtitle Homeland biological Warfare Consequence Management: Capabilities and Needs Assessment Contract...FEMA, DoJ, DoD, HHS, etc.) make a comprehensive, organized solution to the problem difficult. Focusing on the consequence management functions

  15. Opening remarks of session moderator

    Treesearch

    Perry J. Brown

    1999-01-01

    It is a pleasure to be in Quebec City to learn about this very important topic of managing research. We have an interesting panel to share ideas about managing science. They will talk about: Research Priorities; Goals and Objectives; Managing Human Resources; Evaluating Research.

  16. Discussion panel: field test design & data analysis

    Treesearch

    Daniel M. Schmitt; William E. Waters; B. Leo Cadogan; Gerald S. Walton

    1985-01-01

    I think it is time to open the panel. On my left respectively are Bill Waters, Professor of Entomology and Forestry, University of California, Berkeley; Gerald S. Walton, Biometrician, Northeastern Forest Experiment Station, Hamden; and Leo Cadogan, Forest Pest Management Institute, Canadian Forestry Service, Sault Ste. Marie, Ontario. My name is Dan Schmitt, Program...

  17. Contemporary Issues in Medicine--Medical Informatics and Population Health: Report II of the Medical School Objectives Project.

    ERIC Educational Resources Information Center

    Academic Medicine, 1999

    1999-01-01

    The report of the Association of American Medical Colleges' Medical School Objectives Program presents the work of two expert panels. One, on medical informatics, identified five important physician roles: lifelong learner, clinician, educator, researcher, and manager. Another panel established a definition for "population health…

  18. Buckling Design and Analysis of a Payload Fairing One-Sixth Cylindrical Arc-Segment Panel

    NASA Technical Reports Server (NTRS)

    Kosareo, Daniel N.; Oliver, Stanley T.; Bednarcyk, Brett A.

    2013-01-01

    Design and analysis results are reported for a panel that is a 16th arc-segment of a full 33-ft diameter cylindrical barrel section of a payload fairing structure. Six such panels could be used to construct the fairing barrel, and, as such, compression buckling testing of a 16th arc-segment panel would serve as a validation test of the buckling analyses used to design the fairing panels. In this report, linear and nonlinear buckling analyses have been performed using finite element software for 16th arc-segment panels composed of aluminum honeycomb core with graphiteepoxy composite facesheets and an alternative fiber reinforced foam (FRF) composite sandwich design. The cross sections of both concepts were sized to represent realistic Space Launch Systems (SLS) Payload Fairing panels. Based on shell-based linear buckling analyses, smaller, more manageable buckling test panel dimensions were determined such that the panel would still be expected to buckle with a circumferential (as opposed to column-like) mode with significant separation between the first and second buckling modes. More detailed nonlinear buckling analyses were then conducted for honeycomb panels of various sizes using both Abaqus and ANSYS finite element codes, and for the smaller size panel, a solid-based finite element analysis was conducted. Finally, for the smaller size FRF panel, nonlinear buckling analysis was performed wherein geometric imperfections measured from an actual manufactured FRF were included. It was found that the measured imperfection did not significantly affect the panel's predicted buckling response

  19. National Institutes of Health State-of-the-Science Conference Statement: Symptom management in cancer: pain, depression, and fatigue, July 15-17, 2002.

    PubMed

    Patrick, Daniel L; Ferketich, Sandra L; Frame, Paul S; Harris, Jesse J; Hendricks, Carolyn B; Levin, Bernard; Link, Michael P; Lustig, Craig; McLaughlin, Joseph; Reid, L Douglas; Turrisi, Andrew T; Unützer, Jürgen; Vernon, Sally W

    2004-01-01

    Despite advances in early detection and effective treatment, cancer remains one of the most feared diseases. Among the most common side effects of cancer and treatments for cancer are pain, depression, and fatigue. Although research is producing increasingly hopeful insights into the causes and cures for cancer, efforts to manage the side effects of the disease and its treatments have not kept pace. The challenge that faces us is how to increase awareness of the importance of recognizing and actively addressing cancer-related distress. The National Institutes of Health (NIH) convened a State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue to examine the current state of knowledge regarding the management of pain, depression, and fatigue in individuals with cancer and to identify directions for future research. Specifically, the conference examined how to identify individuals who are at risk for cancer-related pain, depression, and/or fatigue; what treatments work best to address these symptoms when they occur; and what is the best way to deliver interventions across the continuum of care. STATE-OF-THE-SCIENCE PROCESS: A non-advocate, non-Federal, 14-member panel of experts representing the fields of oncology, radiology, psychology, nursing, public health, social work, and epidemiology prepared the statement. In addition, 24 experts in medical oncology, geriatrics, pharmacology, psychology, and neurology presented data to the panel and to the conference audience during the first 1.5 days of the conference. The panel then prepared its statement, addressing the five predetermined questions and drawing on submitted literature, the speakers' presentations, and discussions held at the conference. The statement was presented to the conference audience, followed by a press conference to allow the panel to respond to questions from the media. After its release at the conference, the draft statement was made available on the Internet. The panel's final statement is available at http://consensus.nih.gov. The panel concluded that the available evidence supports a variety of interventions for treating cancer patients' pain, depression, and fatigue. Clinicians should routinely use brief assessment tools to ask patients about pain, depression, and fatigue and to initiate evidence-based treatments. Assessment should include discussion about common symptoms experienced by cancer patients, and these discussions should continue over the duration of the illness. Impediments to effective symptom management in cancer patients can arise from different sources and interactions among providers, patients and their families, and the health care system. Numerous factors could interfere with adequate symptom management. Among these factors are incomplete effectiveness of some treatments, a lack of sufficient knowledge regarding effective treatment strategies, patient reluctance to report symptoms to caregivers, a belief that such symptoms are simply a part of the cancer experience that must be tolerated, and inadequate coverage and reimbursement for some treatments. Additional research is needed on the definition, occurrence, the treatment of pain, depression, and fatigue, alone and in combination, in adequately funded prospective studies. The panel also concluded that the state of the science in cancer symptom management should be reassessed periodically.

  20. National Institutes of Health State-of-the-Science Conference Statement: Symptom Management in Cancer: Pain, Depression, and Fatigue, July 15-17, 2002.

    PubMed

    Patrick, Donald L; Ferketich, Sandra L; Frame, Paul S; Harris, Jesse J; Hendricks, Carolyn B; Levin, Bernard; Link, Michael P; Lustig, Craig; McLaughlin, Joseph; Ried, L Douglas; Turrisi, Andrew T; Unützer, Jürgen; Vernon, Sally W

    2003-08-06

    Despite advances in early detection and effective treatment, cancer remains one of the most feared diseases. Among the most common side effects of cancer and treatments for cancer are pain, depression, and fatigue. Although research is producing increasingly hopeful insights into the causes and cures for cancer, efforts to manage the side effects of the disease and its treatments have not kept pace. The challenge that faces us is how to increase awareness of the importance of recognizing and actively addressing cancer-related distress. The National Institutes of Health (NIH) convened a State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue to examine the current state of knowledge regarding the management of pain, depression, and fatigue in individuals with cancer and to identify directions for future research. Specifically, the conference examined how to identify individuals who are at risk for cancer-related pain, depression, and/or fatigue; what treatments work best to address these symptoms when they occur; and what is the best way to deliver interventions across the continuum of care. State-of-the-Science Process: A non-advocate, non-Federal, 14-member panel of experts representing the fields of oncology, radiology, psychology, nursing, public health, social work, and epidemiology prepared the statement. In addition, 24 experts in medical oncology, geriatrics, pharmacology, psychology, and neurology presented data to the panel and to the conference audience during the first 1.5 days of the conference. The panel then prepared its statement, addressing the five predetermined questions and drawing on submitted literature, the speakers' presentations, and discussions held at the conference. The statement was presented to the conference audience, followed by a press conference to allow the panel to respond to questions from the media. After its release at the conference, the draft statement was made available on the Internet. The panel's final statement is available at http://consensus.nih.gov. The panel concluded that the available evidence supports a variety of interventions for treating cancer patients' pain, depression, and fatigue. Clinicians should routinely use brief assessment tools to ask patients about pain, depression, and fatigue and to initiate evidence-based treatments. Assessment should include discussion about common symptoms experienced by cancer patients, and these discussions should continue over the duration of the illness. Impediments to effective symptom management in cancer patients can arise from different sources and interactions among providers, patients and their families, and the health care system. Numerous factors could interfere with adequate symptom management. Among these factors are incomplete effectiveness of some treatments, a lack of sufficient knowledge regarding effective treatment strategies, patient reluctance to report symptoms to caregivers, a belief that such symptoms are simply a part of the cancer experience that must be tolerated, and inadequate coverage and reimbursement for some treatments. Additional research is needed on the definition, occurrence, the treatment of pain, depression, and fatigue, alone and in combination, in adequately funded prospective studies. The panel also concluded that the state of the science in cancer symptom management should be reassessed periodically.

  1. Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices.

    PubMed

    Neufeld, E J; Solimeno, L; Quon, D; Walsh, C; Seremetis, S; Cooper, D; Iyer, N N; Hoxer, C S; Giangrande, P

    2017-11-01

    While there is substantial literature addressing the principles of general management of haemophilia, literature on perioperative management of haemostasis is scarce. The aim of this study was to better understand perioperative management among congenital haemophilia B patients (without inhibitors) and to gain insights into real-world surgical practices. A systematic literature review, with an emphasis on haemophilia B, was conducted using EMBASE ® , Medline ® and the Cochrane Library. Studies from 1974 to June 2015 were accessed, and 132 studies were eligible for the full-study review. An international expert panel with five haematologists and one surgeon reviewed the resulting literature and provided further insights. The literature review revealed that documented experience in the perioperative management of bleeding risk in haemophilia B patients is relatively scarce. Therefore, the review was amended to provide a comprehensive overview of the perioperative management for haemophilia A and B patients; the expert panel applied a particular focus to haemophilia B. Several gaps were identified in the literature including the lack of consensus on defining surgery in terms of bleeding risk, optimal factor levels during surgery and lack of robust evidence on surgical outcomes. The ensuing discussions with the expert panel provided validation of some of the results from the systematic literature review and proposed future directions for perioperative management. Suggestions included collaboration with haemophilia treatment centres (HTCs) to collect real-world data on perioperative management, establishing the need for optimal factor level monitoring practice, and the appropriate adoption of extended half-life products in clinical settings. © 2017 John Wiley & Sons Ltd.

  2. 77 FR 22285 - Fisheries of the South Atlantic; South Atlantic Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-13

    ... the South Atlantic; South Atlantic Fishery Management Council; Public Meeting AGENCY: National Marine... of a public meeting of the South Atlantic Fishery Management Council's Technical Shrimp Review Panel. SUMMARY: The South Atlantic Fishery Management Council (SAFMC) will hold a meeting of its Technical Shrimp...

  3. Automated Intelligent Monitoring and the Controlling Software System for Solar Panels

    NASA Astrophysics Data System (ADS)

    Nalamwar, H. S.; Ivanov, M. A.; Baidali, S. A.

    2017-01-01

    The inspection of the solar panels on a periodic basis is important to improve longevity and ensure performance of the solar system. To get the most solar potential of the photovoltaic (PV) system is possible through an intelligent monitoring & controlling system. The monitoring & controlling system has rapidly increased its popularity because of its user-friendly graphical interface for data acquisition, monitoring, controlling and measurements. In order to monitor the performance of the system especially for renewable energy source application such as solar photovoltaic (PV), data-acquisition systems had been used to collect all the data regarding the installed system. In this paper the development of a smart automated monitoring & controlling system for the solar panel is described, the core idea is based on IoT (the Internet of Things). The measurements of data are made using sensors, block management data acquisition modules, and a software system. Then, all the real-time data collection of the electrical output parameters of the PV plant such as voltage, current and generated electricity is displayed and stored in the block management. The proposed system is smart enough to make suggestions if the panel is not working properly, to display errors, to remind about maintenance of the system through email or SMS, and to rotate panels according to a sun position using the Ephemeral table that stored in the system. The advantages of the system are the performance of the solar panel system which can be monitored and analyzed.

  4. A visual analytical approach to rock art panel condition assessment

    NASA Astrophysics Data System (ADS)

    Vogt, Brandon J.

    Rock art is a term for pecked, scratched, or painted symbols found on rock surfaces, most typically joint faces called rock art panels. Because rock art exists on rock at the atmosphere interface, it is highly susceptible to the destructive processes of weathering. Thus, rock weathering scientists, including those that study both natural and cultural surfaces, play a key role towards understanding rock art longevity. The mapping of weathering forms on rock art panels serves as a basis from which to assess overall panel instability. This work examines fissures, case hardened surfaces, crumbly disintegration, and lichen. Knowledge of instability, as measured through these and other weathering forms, provides integral information to land managers and archaeological conservators required to prioritize panels for remedial action. The work is divided into five chapters, three of which are going to be submitted as a peer-reviewed journal manuscript. The second chapter, written as a manuscript for International Newsletter on Rock Art, describes a specific set of criteria that lead to the development of a mapping tool for weathering forms, called 'mapping weathering forms in three dimensions' (MapWeF). The third chapter, written as a manuscript for Remote Sensing of Environment, presents the methodology used to develop MapWeF. The chapter incorporates terrestrial laser scanning, a geographic information system (GIS), geovisualization, image analysis, and exploratory spatial data analysis (ESDA) to identify, map, and quantify weathering features known to cause instability on rock art panels. The methodology implemented in the third chapter satisfies the criteria described in Chapter Two. In the fourth chapter, prepared as a manuscript for Geomorphology, MapWeF is applied to a site management case study, focusing on a region---southeastern Colorado---with notoriously weak and endangered sandstone rock art panels. The final conclusions chapter describes contributions of the work to GIScience and rock weathering, and discusses how MapWeF, as a diagnostic tool, fits into a larger national vision by linking existing rock art stability characterizations to cultural resource management-related conservation action.

  5. Environmental effects of ozone depletion and its interactions with climate change: progress report, 2015.

    PubMed

    2016-02-01

    The Environmental Effects Assessment Panel (EEAP) is one of three Panels that regularly informs the Parties (countries) to the Montreal Protocol on the effects of ozone depletion and the consequences of climate change interactions with respect to human health, animals, plants, biogeochemistry, air quality, and materials. The Panels provide a detailed assessment report every four years. The most recent 2014 Quadrennial Assessment by the EEAP was published as a special issue of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). The next Quadrennial Assessment will be published in 2018/2019. In the interim, the EEAP generally produces an annual update or progress report of the relevant scientific findings. The present progress report for 2015 assesses some of the highlights and new insights with regard to the interactive nature of the effects of UV radiation, atmospheric processes, and climate change.

  6. Sensory profiles for dried fig (Ficus carica L.) cultivars commercially grown and processed in California.

    PubMed

    Haug, Megan T; King, Ellena S; Heymann, Hildegarde; Crisosto, Carlos H

    2013-08-01

    A trained sensory panel evaluated the 6 fig cultivars currently sold in the California dried fig market. The main flavor and aroma attributes determined by the sensory panel were "caramel," "honey," "raisin," and "fig," with additional aroma attributes: "common date," "dried plum," and "molasses." Sensory differences were observed between dried fig cultivars. All figs were processed by 2 commercial handlers. Processing included potassium sorbate as a preservative and SO2 application as an antibrowning agent for white cultivars. As a consequence of SO2 use during processing, high sulfite residues affected the sensory profiles of the white dried fig cultivars. Significant differences between dried fig cultivars and sources demonstrate perceived differences between processing and storage methods. The panel-determined sensory lexicon can help with California fig marketing. © 2013 The Regents of California, Davis Campus Department of Plant Sciences.

  7. Nonstandard Work Schedules and Partnership Quality: Quantitative and Qualitative Findings

    ERIC Educational Resources Information Center

    Mills, Melinda; Taht, Kadri

    2010-01-01

    This article questions existing findings and provides new evidence about the consequences of nonstandard work schedules on partnership quality. Using quantitative couple data from The Netherlands Kinship Panel Study (NKPS) (N = 3,016) and semistructured qualitative interviews (N = 34), we found that, for women, schedules with varying hours…

  8. Social Implications of Biological Education.

    ERIC Educational Resources Information Center

    Grobman, Arnold B.

    Political and social implications of biological research, with particular reference to consequences for education, are discussed in this collection of papers presented at the 1969 convention of the National Association of Biology Teachers. Commentary papers by a panel of three, including at least one high school biology teacher and one expert in…

  9. Script Concordance Testing in Continuing Professional Development: Local or International Reference Panels?

    ERIC Educational Resources Information Center

    Pleguezuelos, E. M.; Hornos, E.; Dory, V.; Gagnon, R.; Malagrino, P.; Brailovsky, C. A.; Charlin, B.

    2013-01-01

    Context: The PRACTICUM Institute has developed large-scale international programs of on-line continuing professional development (CPD) based on self-testing and feedback using the Practicum Script Concordance Test© (PSCT). Aims: To examine the psychometric consequences of pooling the responses of panelists from different countries (composite…

  10. Improving the Pharmacologic Management of Pain in Older Adults: Identifying the Research Gaps and Methods to Address Them

    PubMed Central

    Reid, M. C.; Bennett, David A.; Chen, Wen G.; Eldadah, Basil A.; Farrar, John T.; Ferrell, Bruce; Gallagher, Rollin M.; Hanlon, Joseph T.; Herr, Keela; Horn, Susan D.; Inturrisi, Charles E.; Lemtouni, Salma; Lin, Yu Woody; Michaud, Kaleb; Morrison, R. Sean; Neogi, Tuhina; Porter, Linda L.; Solomon, Daniel H.; Von Korff, Michael; Weiss, Karen; Witter, James; Zacharoff, Kevin L.

    2011-01-01

    Objective There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an “Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults” conference in September, 2010, to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and non-steroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits. Design Eighteen panel members provided oral presentations; each was followed by a multidisciplinary panel discussion. Meeting transcripts and panelists’ slide presentations were reviewed to identify the gaps, and the types of studies and research methods panelists suggested could best address them. Results Fifteen gaps were identified in the areas of treatment(e.g., uncertainty regarding the long-term safety and efficacy of commonly prescribed analgesics), epidemiology (e.g., lack of knowledge regarding the course of common pain syndromes), and implementation(e.g., limited understanding of optimal strategies to translate evidence-based pain treatments into practice). Analyses of data from electronic health care databases, observational cohort studies, and ongoing cohort studies (augmented with pain and other relevant outcomes measures) were felt to be practical methods for building an age-appropriate evidence base to improve the pharmacologic management of pain in later life. Conclusions Addressing the gaps presented in the current report was judged by the panel to have substantial potential to improve the health and well being of older adults with chronic pain. PMID:21834914

  11. 77 FR 57076 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-17

    ... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Groundfish Advisory Panel to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  12. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting...

  13. 78 FR 79402 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ...The New England Fishery Management Council's (Council) Joint VMS/Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ).

  14. 76 FR 63285 - New England Fishery Management Council; Public Meeting; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ...The New England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ).

  15. ACR Appropriateness Criteria® management of locoregionally advanced squamous cell carcinoma of the vulva.

    PubMed

    Kidd, Elizabeth; Moore, David; Varia, Mahesh A; Gaffney, David K; Elshaikh, Mohamed A; Erickson, Beth; Jhingran, Anuja; Lee, Larissa J; Mayr, Nina A; Puthawala, Ajmel A; Rao, Gautam G; Small, William; Wahl, Andrew O; Wolfson, Aaron H; Yashar, Catheryn M; Yuh, William; Cardenes, Higinia Rosa

    2013-08-01

    Locoregionally advanced vulvar cancer (LRAVC) is a rare disease that presents many challenging medical decisions. An expert panel was convened to reach consensus on the most appropriate pretreatment assessment and therapeutic interventions in LRAVC patients. The American College of Radiology Appropriateness Criteria are evidenced-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journal and the application of a well-established consensus methodology (modified Delphi) to rate appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to formulate recommendations. Three clinical variants were developed to address common scenarios in the management of LRAVC. Group members reached consensus on the appropriateness of specific evaluation and treatment approaches, with numerical ratings and descriptive commentary. In combining available medical literature and expert opinion, this manuscript may serve as an aid for other practitioners in the appropriate management of patients with LRAVC.

  16. Recommendations of the Panel on Cost-effectiveness in Health and Medicine.

    PubMed

    Weinstein, M C; Siegel, J E; Gold, M R; Kamlet, M S; Russell, L B

    1996-10-16

    To develop consensus-based recommendations for the conduct of cost-effectiveness analysis (CEA). This article, the second in a 3-part series, describes the basis for recommendations constituting the reference case analysis, the set of practices developed to guide CEAs that inform societal resource allocation decisions, and the content of these recommendations. The Panel on Cost-Effectiveness in Health and Medicine, a nonfederal panel with expertise in CEA, clinical medicine, ethics, and health outcomes measurement, was convened by the US Public Health Service (PHS). The panel reviewed the theoretical foundations of CEA, current practices, and alternative methods used in analyses. Recommendations were developed on the basis of theory where possible, but tempered by ethical and pragmatic considerations, as well as the needs of users. The panel developed recommendations through 2 1/2 years of discussions. Comments on preliminary drafts prepared by panel working groups were solicited from federal government methodologists, health agency officials, and academic methodologists. The panel's methodological recommendations address (1) components belonging in the numerator and denominator of a cost-effectiveness (C/E) ratio; (2) measuring resource use in the numerator of a C/E ratio; (3) valuing health consequences in the denominator of a C/E ratio; (4) estimating effectiveness of interventions; (5) incorporating time preference and discounting; and (6) handling uncertainty. Recommendations are subject to the ¿rule of reason,¿ balancing the burden engendered by a practice with its importance to a study. If researchers follow a standard set of methods in CEA, the quality and comparability of studies, and their ultimate utility, can be much improved.

  17. 2017 TRIAD Small Business Advisory Panel

    DTIC Science & Technology

    2017-10-11

    government service in 2007 as the Science & Technology (S&T) Project Manager for the United States Navy’s Unmanned Maritime Systems Program Office...National Renewable Energy Laboratory (NREL) as a Program Manager for over 110 energy and water projects on military installations. He worked... management , project management , program management , donor relation service, contract and subcontract policy development and implementation, data integrity

  18. Seeing the Elephant -- Consequence Management Policy for the Department of Defense

    DTIC Science & Technology

    2001-05-01

    required for effective Consequence Management. The three response tiers allows the DoD to provide a predesignated level of support to the appropriate Federal...recommendation is the creation of a tiered response capability that balances time and tasks required for effective Consequence Management. The three...the response required for toxic chemical events. The third tier is reserved for the actions required for the Consequence Management for a biological

  19. Annual Report to the NASA Administrator by the Aerospace Safety Advisory Panel on the Space Shuttle Program. Part 2: Summary of Information Developed in the Panel's Fact-Finding Activities

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The panel focused its attention on those areas that are considered most significant for flight success and safety. Elements required for the Approach and Landing Test Program, the Orbital Flight Test Program, and those management systems and their implementation which directly affect safety, reliability, and quality control, were investigated. Ground facilities and the training programs for the ground and flight crews were studied. Of special interest was the orbiter thermal protection subsystems.

  20. CT Scans of NASA BSTRA Balls 5f5, f2, f3, sr2c, nb2a, hb2b

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

    Gross, J; Thompson, R; Perry, R

    2004-01-29

    At the request of Jose Hernandez we performed some feasibility DR/CT scanning of BSTRA Balls of different sizes. To this point we have scanned all the specimens on a single system, HECAT. This particular system employs a 9 meV LINAC as the x-ray source and a THALES 12 x 16 inch 14-bit Amorphous Silicon panel as the detector. In this report we describe the system, detail some of its properties, describe the scans performed and present the data. Figure 1 contains a couple of images of the system as fielded in the 9 MeV bay. The LINAC is in themore » right portion of the picture. The black panels in the blue frame constitute the High Energy collimator developed specifically for High Energy DR/CT scanning (known here as Stonehenge II). The holes in the collimator panels are beveled to match the distribution of the x-rays from the LINAC, and are sized to just subtend the active area of the THALES Amorphous Silicon panel. Consequently the source to detector distance is restricted to a few positions. Nominally our source to detector distance is 6 meters. The part manipulator, part holder fixturing consists of a translate-rotate assembly on a NEWPORT air bearing table. The stages are NEWPORT RV160PP for rotation and NEWPORT IMS400CC for translation. Both are interfaced through an ESP7000 controller, which is connected to our data acquisition computer over USB. The detector holder also resides on this table and includes pitch, roll and yaw adjustments for aligning the panel to the plane of the rotational table and the x-ray beam. The relatively large source to detector distance and LINAC properties (1 mm spot size) conspire to recommend rotation-only scanning. We use a VARIAN LINATRON 3000 with the small spot retrofit implemented. We have measured the source spot size at about 1 mm. Pixel size on the THALES panel is 0.127 um. Consequently we are in a low-cone angle scanning regime which enables rotation-only 3D CT scanning of objects and assemblies with little ''cone-angle'' error.« less

  1. 75 FR 11135 - New England Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... Advisory Panel and its Monkfish Committee on March 24, 2010 and March 25, 2010 to consider actions... Advisory Panel meeting will be held on Wednesday, March 24, 2010 at 9 a.m. and the Committee meeting will be held on Thursday, March 25, 2010 at 9 a.m. ADDRESSES: These meetings will be held at the Holiday...

  2. 76 FR 48073 - Hazardous Waste Management System: Identification and Listing of Hazardous Waste: Carbon Dioxide...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change [Solomon, S., D. Qin, M. Manning, Z. Chen, M. Marquis, K.B. Averyt, M. Tignor... Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel...

  3. Natural resources research and management issues: 2007

    Treesearch

    Christine Vogt; James Absher; Alan Graefe; Bill Hammitt; Linda Kruger; Jerry Vaske

    2008-01-01

    This year (2007) at the Northeastern Recreation Research (NERR) Symposium, we took the opportunity to reflect on the past 15 to 20 years of recreation research and discuss the opportunities and challenges that might face us in the next decade. The session utilized a panel to entertain four primary questions focused on recreation research. Following a panel presentation...

  4. Pennsylvania's Exemplary Special Projects 1976-1990 as Reviewed and Rated by the FOCUS Panel.

    ERIC Educational Resources Information Center

    Royce, Sherry

    This document reviews 117 special projects selected by a panel of literacy experts using three criteria: effectiveness, innovation, and adaptability. Special projects are grouped by the area, or major thrust, of the project and product. The nine areas are as follows: counseling, curriculum, English as a Second Language, management, promotion,…

  5. Parts Color Matching Scanner for Edge Gluing - Research That Works

    Treesearch

    Richard W. Conners; D.Earl Kline; Philip A. Araman

    1996-01-01

    This paper presents an automatic color sorting system for hardwood edge-glued panel parts. The color sorting system simultaneously examines both faces of a panel part and then determines which face has the "best" color given specified color uniformity and priority defined by management. The real-time color sorting system hardware and color matching hardware...

  6. 75 FR 28783 - South Atlantic Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-24

    .... SUMMARY: The South Atlantic Fishery Management Council will hold a meeting of its Spiny Lobster Committee and Advisory Panel jointly with the Gulf of Mexico Fishery Management Council's Spiny Lobster...; email: [email protected] . SUPPLEMENTARY INFORMATION: Meeting Dates: 1. Joint Spiny Lobster...

  7. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a joint public meeting of its Skate Committee and Advisory Panel, in June, 2011, to consider actions affecting New England fisheries in the...

  8. 76 FR 42684 - Mid-Atlantic Fishery Management Council (MAFMC); Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... Fishery Management Council (MAFMC); Public Meeting AGENCY: National Marine Fisheries Service (NMFS.... SUMMARY: The Mid-Atlantic Fishery Management Council Staff will hold a meeting of the Visioning Project Advisory Panel to discuss communications strategies and data gathering tools for the Visioning Project...

  9. STS-114: Discovery Day 6 Post MMT Meeting

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Wayne Hale, Space Shuttle Deputy Program Manager and Steve Poulos, Orbiter Program Manager, discuss the damage assessment from the tiles that came off the Space Shuttle Discovery during launch. Poulos presents charts and discusses in detail the following topics: 1) Composite Tile Damage/Gap Filler Sites Evaluation; 2) Protruding Ceramic Shim Aft of the Nose Landing Gear Door (NLGD); 3) Protruding Chine Gap Filler; 4) RH NLGD Tile Damage; 5) RH NLGD Damage Analysis; 6) Left Wing Tile Damage; 7) Comparison of Ground Test Results vs. FD5 Focused Inspection; 8) Current Status: Focused Inspection 721L07-01 ITVC FD5 Image of Panel 7L Apex 9) Current Status: Focused Inspection Lower Panel 7L721L07-02; 10) Current Status Focused Inspection 721L10-02 Lower Panel 10L Close-up view; and 11) Window 1 Blanket. The presentation ends with a question and answer period from the news media.

  10. The Efficiency of Split Panel Designs in an Analysis of Variance Model

    PubMed Central

    Wang, Wei-Guo; Liu, Hai-Jun

    2016-01-01

    We consider split panel design efficiency in analysis of variance models, that is, the determination of the cross-sections series optimal proportion in all samples, to minimize parametric best linear unbiased estimators of linear combination variances. An orthogonal matrix is constructed to obtain manageable expression of variances. On this basis, we derive a theorem for analyzing split panel design efficiency irrespective of interest and budget parameters. Additionally, relative estimator efficiency based on the split panel to an estimator based on a pure panel or a pure cross-section is present. The analysis shows that the gains from split panel can be quite substantial. We further consider the efficiency of split panel design, given a budget, and transform it to a constrained nonlinear integer programming. Specifically, an efficient algorithm is designed to solve the constrained nonlinear integer programming. Moreover, we combine one at time designs and factorial designs to illustrate the algorithm’s efficiency with an empirical example concerning monthly consumer expenditure on food in 1985, in the Netherlands, and the efficient ranges of the algorithm parameters are given to ensure a good solution. PMID:27163447

  11. Design construction and analysis of solar ridge concentrator photovoltaic (PV) system to improve battery charging performance.

    PubMed

    Narasimman, Kalaiselvan; Selvarasan, Iniyan

    2016-05-01

    A ridge concentrator photovoltaic system for a 10W multi-crystalline solar panel was designed with the concentration ratios of 1X and 2X. The ray tracing model of ridge concentrator photovoltaic system was carried out using Trace-Pro simulation. The optimum tilt angle for the concentrator PV system throughout the year was computed. The electrical parameters of the 3 panels were analyzed. The effect of temperature on the electrical performance of the panel was also studied. The reduction of voltage due to increasing panel temperature was managed by MPES type Charge controller. Glass reflector with reflectivity 0.95 was chosen as the ridge wall for the concentrator system. The maximum power outputs for the 1X and 2X panel reached were 9W and 10.5W with glass reflector. The percentage of power improvement for 1X and 2X concentrations were 22.3% and 45.8% respectively. The 2X concentrated panel connected battery takes lower time to charge compared with normal panel connected battery. Copyright © 2016. Published by Elsevier Inc.

  12. Proceedings of the Symposium on Training of Nuclear Facility Personnel (8th, Gatlinburg, Tennessee, April 24-27, 1989).

    ERIC Educational Resources Information Center

    Oak Ridge National Lab., TN.

    Education-related titles among the 56 papers are "Panel Discussion: Plant Expectation of Training" (Sellman, Zach, Cross); "Managing Training AT&T" (Solomon); "Training Management Systems" (Waylett); "Managing the Training Function" (Wiggin); "Training Management" (Newton); Three Alternative Simulation Systems for Training Nuclear Power Plant…

  13. Wildland fire management futures: insights from a foresight panel

    Treesearch

    Robert L. Olson; David N. Bengston; Leif A. DeVaney; Trevor A.C. Thompson

    2015-01-01

    Wildland fire management faces unprecedented challenges in the 21st century: the increasingly apparent effects of climate change, more people and structures in the wildland-urban interface, growing costs associated with wildfire management, and the rise of high-impact fires, to name a few. Given these significant and growing challenges, conventional fire management...

  14. Evidence and consensus recommendations for the pharmacological management of pain in India

    PubMed Central

    Dureja, Gur Prasad; Iyer, Rajagopalan N; Das, Gautam; Ahdal, Jaishid; Narang, Prashant

    2017-01-01

    Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events – particularly with opioids and surgical methods of analgesia – are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general. Available guidelines suggest that a strategic treatment approach may be helpful for physicians in managing pain in real-world settings. The aim of this manuscript is to propose treatment recommendations for the management of different types of pain, based on the available evidence. Evidence search was performed by using MEDLINE (by PubMed) and Cochrane databases. The types of articles included in this review were based on randomized control studies, case–control or cohort studies, prospective and retrospective studies, systematic reviews, meta-analyses, clinical practice guidelines and evidence-based consensus recommendations. Articles were reviewed by a multidisciplinary expert panel and recommendations were developed. A stepwise treatment algorithm-based approach based on a careful diagnosis and evaluation of the underlying disease, associated comorbidities and type/duration of pain is proposed to assist general practitioners, physicians and pain specialists in clinical decision making. PMID:28435313

  15. Evidence and consensus recommendations for the pharmacological management of pain in India.

    PubMed

    Dureja, Gur Prasad; Iyer, Rajagopalan N; Das, Gautam; Ahdal, Jaishid; Narang, Prashant

    2017-01-01

    Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general. Available guidelines suggest that a strategic treatment approach may be helpful for physicians in managing pain in real-world settings. The aim of this manuscript is to propose treatment recommendations for the management of different types of pain, based on the available evidence. Evidence search was performed by using MEDLINE (by PubMed) and Cochrane databases. The types of articles included in this review were based on randomized control studies, case-control or cohort studies, prospective and retrospective studies, systematic reviews, meta-analyses, clinical practice guidelines and evidence-based consensus recommendations. Articles were reviewed by a multidisciplinary expert panel and recommendations were developed. A stepwise treatment algorithm-based approach based on a careful diagnosis and evaluation of the underlying disease, associated comorbidities and type/duration of pain is proposed to assist general practitioners, physicians and pain specialists in clinical decision making.

  16. Review of Issues Associated with Safe Operation and Management of the Space Shuttle Program

    NASA Technical Reports Server (NTRS)

    Johnstone, Paul M.; Blomberg, Richard D.; Gleghorn, George J.; Krone, Norris J.; Voltz, Richard A.; Dunn, Robert F.; Donlan, Charles J.; Kauderer, Bernard M.; Brill, Yvonne C.; Englar, Kenneth G.; hide

    1996-01-01

    At the request of the President of the United States through the Office of Science and Technology Policy (OSTP), the NASA Administrator tasked the Aerospace Safety Advisory Panel with the responsibility to identify and review issues associated with the safe operation and management of the Space Shuttle program arising from ongoing efforts to improve and streamline operations. These efforts include the consolidation of operations under a single Space Flight Operations Contract (SFOC), downsizing the Space Shuttle workforce and reducing costs of operations and management. The Panel formed five teams to address the potentially significant safety impacts of the seven specific topic areas listed in the study Terms of Reference. These areas were (in the order in which they are presented in this report): Maintenance of independent safety oversight; implementation plan for the transition of Shuttle program management to the Lead Center; communications among NASA Centers and Headquarters; transition plan for downsizing to anticipated workforce levels; implementation of a phased transition to a prime contractor for operations; Shuttle flight rate for Space Station assembly; and planned safety and performance upgrades for Space Station assembly. The study teams collected information through briefings, interviews, telephone conversations and from reviewing applicable documentation. These inputs were distilled by each team into observations and recommendations which were then reviewed by the entire Panel.

  17. KSC-99pp0696

    NASA Image and Video Library

    1999-06-17

    A panel of NASA and contractor senior staff, plus officers from the 45th Space Wing, discuss safetyand health-related concerns in front of an audience of KSC employees, as part of Super Safety and Health Day. Moderating at the podium is Loren Shriver, deputy director for Launch & Payload Processing. Seated left to right are Burt Summerfield, associate director of the Biomedical Office; Colonel William S. Swindling, commander, 45th Medical Group, Patrick Air Force Base, Fla.; Ron Dittemore, manager, Space Shuttle Programs, Johnson Space Center; Roy Bridges, Center Director; Col. Tom Deppe, vice commander, 45th Space Wing, Patrick Air Force Base; Jim Schoefield, program manager, Payload Ground Operations, Boeing; Bill Hickman, program manager, Space Gateway Support; and Ed Adamek, vice president and associate program manager for Ground Operations, United Space Alliance. The panel was one of the presentations during KSC's second annual day-long dedication to safety. Most normal work activities were suspended to allow personnel to attend related activities. The theme, "Safety and Health Go Hand in Hand," emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space-related resources first and foremost. Events also included a keynote address, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television

  18. Consequence Management - Ready or Not?

    DTIC Science & Technology

    2003-04-07

    Defense will have sufficient capability and be ready to respond to a Weapons of Mass Destruction/ Effects attack. An effective consequence management...Defense adopts the National Military Strategy and its consequence management approach, it must identify Weapons of Mass Destruction/ Effects threats...that the Department of Defense: develop Weapons of Mass Destruction/ Effects performance standards for response assets; implement a consequence

  19. 77 FR 50472 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... Region Logbook Family of Forms Federal Register (77 FR 153, 8/8/12). Other business may be discussed. The... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to...

  20. Population Control, Family Planning and Planned Parenthood.

    ERIC Educational Resources Information Center

    Hilmar, Norman A.

    Remarks in this article were made as part of a panel discussion presented at the Planned Parenthood-World Population combined Southeast Council and National Board Meeting, Savannah, Georgia, in May 1970. The problems and consequences of an increasing birth rate are indicated along with the need for reducing present rates of population growth and…

  1. Climate change and the biosphere

    Treesearch

    F. Stuart Chapin

    2008-01-01

    Scientific assessments now clearly demonstrate the ecologic and societal consequences of human induced climate change, as detailed by the most recent Intergovernmental Panel on Climate Change (IPCC) report. Global warming spells danger for Earth's biomes, which in turn play an important role in climate change. On the following pages, you will read about some of...

  2. Changing Policies on Campus. Prevention Update

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2011

    2011-01-01

    "High-Risk Drinking in College: What We Know and What We Need To Learn: Final Report of the Panel on Contexts and Consequences" (2002), a report from the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) Task Force on College Drinking, points out that "federal, state, and local laws help define college administrators' responsibilities…

  3. Unemployment in Families: The Case of Housework

    ERIC Educational Resources Information Center

    Gough, Margaret; Killewald, Alexandra

    2011-01-01

    Unemployment has consequences for individuals, but its impacts also reverberate through families. This paper examines how families adapt to unemployment in one area of life--time in housework. Using 74,881 observations from 10,390 couples in the Panel Study of Income Dynamics, we estimate fixed effects models and find that individuals spend…

  4. The Effect of Widowhood on Mental Health - an Analysis of Anticipation Patterns Surrounding the Death of a Spouse.

    PubMed

    Siflinger, Bettina

    2017-12-01

    This study explores the effects of widowhood on mental health by taking into account the anticipation and adaptation to the partner's death. The empirical analysis uses representative panel data from the USA that are linked to administrative death records of the National Death Index. I estimate static and dynamic specifications of the panel probit model in which unobserved heterogeneity is modeled with correlated random effects. I find strong anticipation effects of the partner's death on the probability of depression, implying that the partner's death event cannot be assumed to be exogenous in econometric models. In the absence of any anticipation effects, the partner's death has long-lasting mental health consequences, leading to a significantly slower adaptation to widowhood. The results suggest that both anticipation effects and adaptation effects can be attributed to a caregiver burden and to the cause of death. The findings of this study have important implications for designing adequate social policies for the elderly US population that alleviate the negative consequences of bereavement. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  5. NAS Panel endorses science center concept

    NASA Astrophysics Data System (ADS)

    Science and technology centers, as proposed by President Ronald Reagan in his January 1987 State of the Union message, could make “significant contributions to science and to the nation's economic competitiveness,” according to a new report by a National Academy of Sciences (NAS) panel. What will be necessary to realize these contributions, the panel cautioned, are proper management, adequate resources, and, “above all, the selection of programs for which the centers are the most effective form of organization.”NSF plans to support science and technology centers, beginning October 1, 1988, which is the start of fiscal year 1988. NSF requested guidance from the NAS panel in implementing the program. Although other government agencies will participate in the program, NSF will play the primary role.

  6. QT Interval Screening in Methadone Maintenance Treatment: Report of a SAMHSA Expert Panel

    PubMed Central

    Martin, Judith A.; Campbell, Anthony; Killip, Thomas; Kotz, Margaret; Krantz, Mori J.; Kreek, Mary Jeanne; McCarroll, Brian A.; Mehta, Davendra; Payte, J. Thomas; Stimmel, Barry; Taylor, Trusandra; Wilford, Bonnie B.

    2014-01-01

    In an effort to enhance patient safety in Opioid Treatment Programs (OTPs), the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members reviewed the literature, regulatory actions, professional guidances, and OTPs’ experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every OTP should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, ECG assessment, risk stratification, and prevention of drug interactions) for all patients, and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining ECGs as indicated by a particular patient’s risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events. The Panel also suggested specific modifications to informed consent documents, patient education, staff education, and methadone protocols. PMID:22026519

  7. Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes.

    PubMed

    Shivaswamy, Vijay; Boerner, Brian; Larsen, Jennifer

    2016-02-01

    Post-transplant diabetes mellitus (PTDM) is a frequent consequence of solid organ transplantation. PTDM has been associated with greater mortality and increased infections in different transplant groups using different diagnostic criteria. An international consensus panel recommended a consistent set of guidelines in 2003 based on American Diabetes Association glucose criteria but did not exclude the immediate post-transplant hospitalization when many patients receive large doses of corticosteroids. Greater glucose monitoring during all hospitalizations has revealed significant glucose intolerance in the majority of recipients immediately after transplant. As a result, the international consensus panel reviewed its earlier guidelines and recommended delaying screening and diagnosis of PTDM until the recipient is on stable doses of immunosuppression after discharge from initial transplant hospitalization. The group cautioned that whereas hemoglobin A1C has been adopted as a diagnostic criterion by many, it is not reliable as the sole diabetes screening method during the first year after transplant. Risk factors for PTDM include many of the immunosuppressant medications themselves as well as those for type 2 diabetes. The provider managing diabetes and associated dyslipidemia and hypertension after transplant must be careful of the greater risk for drug-drug interactions and infections with immunosuppressant medications. Treatment goals and therapies must consider the greater risk for fluctuating and reduced kidney function, which can cause hypoglycemia. Research is actively focused on strategies to prevent PTDM, but until strategies are found, it is imperative that immunosuppression regimens are chosen based on their evidence to prolong graft survival, not to avoid PTDM.

  8. Operating Room Efficiency before and after Entrance in a Benchmarking Program for Surgical Process Data.

    PubMed

    Pedron, Sara; Winter, Vera; Oppel, Eva-Maria; Bialas, Enno

    2017-08-23

    Operating room (OR) efficiency continues to be a high priority for hospitals. In this context the concept of benchmarking has gained increasing importance as a means to improve OR performance. The aim of this study was to investigate whether and how participation in a benchmarking and reporting program for surgical process data was associated with a change in OR efficiency, measured through raw utilization, turnover times, and first-case tardiness. The main analysis is based on panel data from 202 surgical departments in German hospitals, which were derived from the largest database for surgical process data in Germany. Panel regression modelling was applied. Results revealed no clear and univocal trend of participation in a benchmarking and reporting program for surgical process data. The largest trend was observed for first-case tardiness. In contrast to expectations, turnover times showed a generally increasing trend during participation. For raw utilization no clear and statistically significant trend could be evidenced. Subgroup analyses revealed differences in effects across different hospital types and department specialties. Participation in a benchmarking and reporting program and thus the availability of reliable, timely and detailed analysis tools to support the OR management seemed to be correlated especially with an increase in the timeliness of staff members regarding first-case starts. The increasing trend in turnover time revealed the absence of effective strategies to improve this aspect of OR efficiency in German hospitals and could have meaningful consequences for the medium- and long-run capacity planning in the OR.

  9. Impact of the 2014 expert panel recommendations for management of high blood pressure on contemporary cardiovascular practice: insights from the NCDR PINNACLE registry.

    PubMed

    Borden, William B; Maddox, Thomas M; Tang, Fengming; Rumsfeld, John S; Oetgen, William J; Mullen, J Brendan; Spinler, Sarah A; Peterson, Eric D; Masoudi, Frederick A

    2014-12-02

    Since 2003, the Seventh Report of the Joint National Committee (JNC-7) has been the predominant guideline for blood pressure management. A 2014 expert panel recommended increasing the blood pressure targets for patients age 60 years and older, as well as those with diabetes or chronic kidney disease. The purpose of this study was to examine the effect of the 2014 expert panel blood pressure management recommendations on patients managed in U.S. ambulatory cardiovascular practices. Using the National Cardiovascular Data Registry PINNACLE Registry, we assessed the proportion of patients who met the 2003 and 2014 panel recommendations, highlighting the populations of patients for whom the blood pressure goals changed. Of 1,185,253 patients in the study cohort, 706,859 (59.6%) achieved the 2003 JNC-7 goals. Using the 2014 recommendations, 880,378 (74.3%) patients were at goal. Among the 173,519 (14.6%) for whom goal achievement changed, 40,323 (23.2%) had a prior stroke or transient ischemic attack, and 112,174 (64.6%) had coronary artery disease. In addition, the average Framingham risk score in this group was 8.5 ± 3.2%, and the 10-year ASCVD risk score was 28.0 ± 19.5%. Among U.S. ambulatory cardiology patients with hypertension, nearly 1 in 7 who did not meet JNC-7 recommendations would now meet the 2014 treatment goals. If the new recommendations are implemented in clinical practice, blood pressure target achievement and cardiovascular events will need careful monitoring, because many patients for whom the target blood pressure is now more permissive are at high cardiovascular risk. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Depression as a psychosocial consequence of occupational injury in the US working population: findings from the medical expenditure panel survey

    PubMed Central

    2013-01-01

    Background Empirical evidence describing the psychosocial consequences of occupational injury is still limited. The effect of occupational injury on depression might pose unique challenges in workers compared with other kinds of injury. This study aimed to assess the differential impact of workplace injury compared with non-workplace injury on depression over time, and to identify the potential risk factors associated with post-injury depression in the US working population. Methods Using pooled panel data from the Medical Expenditure Panel Survey 2000–2006, a total of 35,155 workers aged 18–64 years who had been followed for about 18 months in each panel were analyzed. Injuries in the 4–5 months before baseline, and subsequent depression incidence during follow-up, were identified using ICD-9 codes for the medical conditions captured in personal interviews. A discrete time-proportional odds model was used. Results A total of 5.5% of workers with occupational injury at baseline reported depression at follow-up, compared with 4.7% of workers with non-occupational injury and 3.1% of workers without injuries. Those with occupational injuries had more severe injuries and required longer treatment, compared with those with non-occupational injuries. Only 39% of workers with workplace injuries were paid Workers’ Compensation (WC). The association between injury and depression appeared to be stronger for workplace injury, and the adjusted odds ratio for depression was 1.72 for those with occupational injury (95% CI: 1.27–2.32), and 1.36 for those with non-occupational injury (95% CI: 1.07–1.65) compared with the no-injury group, after controlling for relevant covariates. Occupational injury was associated with higher odds of developing depression over time. WC as a source of medical payment was associated with 33% higher odds of developing depression (95% CI: 1.01–1.74). Part-time work, shorter job tenure, and long working hours were independently associated with post-injury depression risk. Conclusions Workers with occupational injury were more likely to become depressed than those with non-occupational injury. The psychosocial consequences of occupational injury, including depression, deserve further exploration to adequately support those injured at work. This finding also emphasizes a need for early intervention to reduce the burden of depression associated with occupational injury. PMID:23560685

  11. The social impacts of sudden oak death and other forest diseases: a panel discussion

    Treesearch

    Janice Alexander; Chris Lee

    2010-01-01

    This panel aimed to discuss the intersection of biology and society; specifically, how we balance competing social and biological concerns in regards to forest pests and land management in general. Four panelists began the discussion: Janice Alexander, Sudden Oak Death Outreach Coordinator for the University of California (U.C.) Cooperative Extension, Marin County and...

  12. Intercept™ Panel Trap (INT PT) effective in management of forest Coleoptera

    Treesearch

    D. Czokajlo; J. McLaughlin; L. I. Abu Ayyash; S. Teale; J. Wickham; J. Warren; R. Hoffman; B. Aukema; K. Raffa; P. Kirsch

    2003-01-01

    Trap efficacy in capturing economically important forest Coleoptera was measured in field trials comparing the Intercept Panel Trap (INT PT) with the Multi-Funnel Trap. The INT PT was designed to provide a better option for the monitoring of forest Coleoptera. The trap is made of corrugated plastic and is very robust under rigorous field conditions, but still...

  13. 77 FR 58982 - Fisheries of the South Atlantic; South Atlantic Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-25

    ... joint meeting of its Deepwater Shrimp Advisory Panel (AP) and Coral Advisory Panel in Cape Canaveral, FL. DATES: Members of the Deepwater Shrimp AP and Coral AP will meet jointly from 8:30 a.m. until 5 p.m. on... at the meeting include: An overview of the rock shrimp fishery and of deepwater coral resources...

  14. 77 FR 23130 - Revisions to the California State Implementation Plan, Northern Sierra and Sacramento...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... taking direct final action to approve revisions to the Northern Sierra Air Quality Management District (NSAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD) portions of the California...) Northern Sierra Air Quality Management District. (i) Flexible Package Printing, Flat Wood Paneling Coatings...

  15. 78 FR 35287 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ... areas of leadership, change management, teamwork, panel or population management, competency assessment... Administration (HRSA) has submitted an Information Collection Request (ICR) to the Office of Management and... surveys are Irvine's Leadership Behavior Survey and the Faculty Skill & Program Feasibility Survey. The...

  16. 75 FR 80469 - Gulf of Mexico Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ... Management Council; telephone: (813) 348-1630 x235. SUPPLEMENTARY INFORMATION: The Vessel Monitoring System (VMS) Advisory Panel will meet to discuss operation, design, usage of vessel monitoring systems, and.... SUMMARY: The Gulf of Mexico Fishery Management Council will convene a meeting of the Vessel Monitoring...

  17. Guidelines for locoregional therapy in primary breast cancer in developing countries: The results of an expert panel at the 8th Annual Women's Cancer Initiative – Tata Memorial Hospital (WCI-TMH) Conference

    PubMed Central

    Munshi, Anusheel; Gupta, Sudeep; Anderson, Benjamin; Yarnold, John; Parmar, Vani; Jalali, Rakesh; Sharma, Suresh Chander; Desai, Sangeeta; Thakur, Meenakshi; Baijal, Gunjan; Sarin, Rajiv; Mittra, Indraneel; Ghosh, Jaya; Badwe, Rajendra

    2012-01-01

    Background: Limited guidelines exist for breast cancer management in developing countries. In this context, the Women's Cancer Initiative - Tata Memorial Hospital (WCI-TMH) organised its 8th Annual Conference to update guidelines in breast cancer. Materials and Methods: Appropriately formulated guideline questions on each topic and subtopic in the surgical, radiation and systemic management of primary breast cancer were developed by the scientific committee and shared with the guest faculty of the Conference. Majority of the questions had multiple choice answers. The opinion of the audience, comprising academic and community oncologists, was electronically cumulated, followed by focussed presentations by eminent national and international experts on each topic. The guidelines were finally developed through an expert panel that voted on each guideline question after all talks had been delivered and audience opinion elicited. Separate panels were constituted for locoregional and systemic therapy in primary breast cancer. Results: Based on the voting results of the expert panel, guidelines for locoregional therapy of breast cancer have been formulated. Voting patterns for each question are reported. Conclusions: The updated guidelines on locoregional management of primary breast cancer in the context of developing countries are presented in this article. These recommendations have been designed to allow centers in the developing world to improve the quality of care for breast cancer patients. PMID:22988354

  18. A research to reduce interior noise in general aviation airplanes. General aviation interior noise study

    NASA Technical Reports Server (NTRS)

    Roskam, J.; Muirhead, V. U.; Smith, H. W.; Peschier, T. D.

    1977-01-01

    The construction, calibration, and properties of a facility for measuring sound transmission through aircraft type panels are described along with the theoretical and empirical methods used. Topics discussed include typical noise source, sound transmission path, and acoustic cabin properties and their effect on interior noise. Experimental results show an average sound transmission loss in the mass controlled frequency region comparable to theoretical predictions. The results also verify that transmission losses in the stiffness controlled region directly depend on the fundamental frequency of the panel. Experimental and theoretical results indicate that increases in this frequency, and consequently in transmission loss, can be achieved by applying pressure differentials across the specimen.

  19. Modelling the costs of care of hypertension in patients with metabolic syndrome and its consequences, in Germany, Spain and Italy.

    PubMed

    Wille, Eberhard; Scholze, Jürgen; Alegria, Eduardo; Ferri, Claudio; Langham, Sue; Stevens, Warren; Jeffries, David; Uhl-Hochgraeber, Kerstin

    2011-06-01

    The presence of metabolic syndrome in patients with hypertension significantly increases the risk of cardiovascular disease, type 2 diabetes and mortality. Our aim is to estimate the economic burden to the health service of metabolic syndrome (MetS) in patients with hypertension and its consequences, in three European countries in 2008, and to forecast future economic burden in 2020 using projected demographic estimates and assumptions around the growth of MetS. An age-, sex- and risk group-structured prevalence-based cost of illness model was developed using the United States Adult Treatment Panel III of the National Cholesterol Education Program criteria to define MetS. Data sources included published information and public use databases on disease prevalence, incidence of cardiovascular events, prevalence of type 2 diabetes, treatment patterns and cost of management in Germany, Spain and Italy. The economic burden to the health service of MetS in patients with hypertension has been estimated at 24,427 euro, 1,900 euro and 4,877 euro million in Germany, Spain and Italy, and is forecast to rise by 59, 179 and 157%, respectively, by 2020. The largest components of costs included the management of prevalent type 2 diabetes and incident cardiovascular events. Mean annual costs per hypertensive patient were around three-fold higher in subjects with MetS compared to those without and rose incrementally with the additional number of MetS components present. In conclusion, the presence of MetS in patients with hypertension significantly inflates economic burden, and costs are likely to increase in the future due to an aging population and an increase in the prevalence of components of MetS.

  20. A Conceptual Framework for Quality of Care

    PubMed Central

    Mosadeghrad, Ali Mohammad

    2012-01-01

    Despite extensive research on defining and measuring health care quality, little attention has been given to different stakeholders’ perspectives of high-quality health care services. The main purpose of this study was to explore the attributes of quality healthcare in the Iranian context. Exploratory in-depth individual and focus group interviews were conducted with key healthcare stakeholders including clients, providers, managers, policy makers, payers, suppliers and accreditation panel members to identify the healthcare service quality attributes and dimensions. Data analysis was carried out by content analysis, with the constant comparative method. Over 100 attributes of quality healthcare service were elicited and grouped into five categories. The dimensions were: efficacy, effectiveness, efficiency, empathy, and environment. Consequently, a comprehensive model of service quality was developed for health care context. The findings of the current study led to a conceptual framework of healthcare quality. This model leads to a better understanding of the different aspects of quality in health care and provides a better basis for defining, measuring and controlling quality of health care services. PMID:23922534

  1. Multiplex tests to identify gastrointestinal bacteria, viruses and parasites in people with suspected infectious gastroenteritis: a systematic review and economic analysis.

    PubMed

    Freeman, Karoline; Mistry, Hema; Tsertsvadze, Alexander; Royle, Pam; McCarthy, Noel; Taylor-Phillips, Sian; Manuel, Rohini; Mason, James

    2017-04-01

    Gastroenteritis is a common, transient disorder usually caused by infection and characterised by the acute onset of diarrhoea. Multiplex gastrointestinal pathogen panel (GPP) tests simultaneously identify common bacterial, viral and parasitic pathogens using molecular testing. By providing test results more rapidly than conventional testing methods, GPP tests might positively influence the treatment and management of patients presenting in hospital or in the community. To systematically review the evidence for GPP tests [xTAG ® (Luminex, Toronto, ON, Canada), FilmArray (BioFire Diagnostics, Salt Lake City, UT, USA) and Faecal Pathogens B (AusDiagnostics, Beaconsfield, NSW, Australia)] and to develop a de novo economic model to compare the cost-effectiveness of GPP tests with conventional testing in England and Wales. Multiple electronic databases including MEDLINE, EMBASE, Web of Science and the Cochrane Database were searched from inception to January 2016 (with supplementary searches of other online resources). Eligible studies included patients with acute diarrhoea; comparing GPP tests with standard microbiology techniques; and patient, management, test accuracy or cost-effectiveness outcomes. Quality assessment of eligible studies used tailored Quality Assessment of Diagnostic Accuracy Studies-2, Consolidated Health Economic Evaluation Reporting Standards and Philips checklists. The meta-analysis included positive and negative agreement estimated for each pathogen. A de novo decision tree model compared patients managed with GPP testing or comparable coverage with patients managed using conventional tests, within the Public Health England pathway. Economic models included hospital and community management of patients with suspected gastroenteritis. The model estimated costs (in 2014/15 prices) and quality-adjusted life-year losses from a NHS and Personal Social Services perspective. Twenty-three studies informed the review of clinical evidence (17 xTAG, four FilmArray, two xTAG and FilmArray, 0 Faecal Pathogens B). No study provided an adequate reference standard with which to compare the test accuracy of GPP with conventional tests. A meta-analysis (of 10 studies) found considerable heterogeneity; however, GPP testing produces a greater number of pathogen-positive findings than conventional testing. It is unclear whether or not these additional 'positives' are clinically important. The review identified no robust evidence to inform consequent clinical management of patients. There is considerable uncertainty about the cost-effectiveness of GPP panels used to test for suspected infectious gastroenteritis in hospital and community settings. Uncertainties in the model include length of stay, assumptions about false-positive findings and the costs of tests. Although there is potential for cost-effectiveness in both settings, key modelling assumptions need to be verified and model findings remain tentative. No test-treat trials were retrieved. The economic model reflects one pattern of care, which will vary across the NHS. The systematic review and cost-effectiveness model identify uncertainties about the adoption of GPP tests within the NHS. GPP testing will generally correctly identify pathogens identified by conventional testing; however, these tests also generate considerable additional positive results of uncertain clinical importance. An independent reference standard may not exist to evaluate alternative approaches to testing. A test-treat trial might ascertain whether or not additional GPP 'positives' are clinically important or result in overdiagnoses, whether or not earlier diagnosis leads to earlier discharge in patients and what the health consequences of earlier intervention are. Future work might also consider the public health impact of different testing treatments, as test results form the basis for public health surveillance. This study is registered as PROSPERO CRD2016033320. The National Institute for Health Research Health Technology Assessment programme.

  2. Color quality management in advanced flat panel display engines

    NASA Astrophysics Data System (ADS)

    Lebowsky, Fritz; Neugebauer, Charles F.; Marnatti, David M.

    2003-01-01

    During recent years color reproduction systems for consumer needs have experienced various difficulties. In particular, flat panels and printers could not reach a satisfactory color match. The RGB image stored on an Internet server of a retailer did not show the desired colors on a consumer display device or printer device. STMicroelectronics addresses this important color reproduction issue inside their advanced display engines using novel algorithms targeted for low cost consumer flat panels. Using a new and genuine RGB color space transformation, which combines a gamma correction Look-Up-Table, tetrahedrization, and linear interpolation, we satisfy market demands.

  3. Whole Exome Sequencing of Patients with Steroid-Resistant Nephrotic Syndrome.

    PubMed

    Warejko, Jillian K; Tan, Weizhen; Daga, Ankana; Schapiro, David; Lawson, Jennifer A; Shril, Shirlee; Lovric, Svjetlana; Ashraf, Shazia; Rao, Jia; Hermle, Tobias; Jobst-Schwan, Tilman; Widmeier, Eugen; Majmundar, Amar J; Schneider, Ronen; Gee, Heon Yung; Schmidt, J Magdalena; Vivante, Asaf; van der Ven, Amelie T; Ityel, Hadas; Chen, Jing; Sadowski, Carolin E; Kohl, Stefan; Pabst, Werner L; Nakayama, Makiko; Somers, Michael J G; Rodig, Nancy M; Daouk, Ghaleb; Baum, Michelle; Stein, Deborah R; Ferguson, Michael A; Traum, Avram Z; Soliman, Neveen A; Kari, Jameela A; El Desoky, Sherif; Fathy, Hanan; Zenker, Martin; Bakkaloglu, Sevcan A; Müller, Dominik; Noyan, Aytul; Ozaltin, Fatih; Cadnapaphornchai, Melissa A; Hashmi, Seema; Hopcian, Jeffrey; Kopp, Jeffrey B; Benador, Nadine; Bockenhauer, Detlef; Bogdanovic, Radovan; Stajić, Nataša; Chernin, Gil; Ettenger, Robert; Fehrenbach, Henry; Kemper, Markus; Munarriz, Reyner Loza; Podracka, Ludmila; Büscher, Rainer; Serdaroglu, Erkin; Tasic, Velibor; Mane, Shrikant; Lifton, Richard P; Braun, Daniela A; Hildebrandt, Friedhelm

    2018-01-06

    Steroid-resistant nephrotic syndrome overwhelmingly progresses to ESRD. More than 30 monogenic genes have been identified to cause steroid-resistant nephrotic syndrome. We previously detected causative mutations using targeted panel sequencing in 30% of patients with steroid-resistant nephrotic syndrome. Panel sequencing has a number of limitations when compared with whole exome sequencing. We employed whole exome sequencing to detect monogenic causes of steroid-resistant nephrotic syndrome in an international cohort of 300 families. Three hundred thirty-five individuals with steroid-resistant nephrotic syndrome from 300 families were recruited from April of 1998 to June of 2016. Age of onset was restricted to <25 years of age. Exome data were evaluated for 33 known monogenic steroid-resistant nephrotic syndrome genes. In 74 of 300 families (25%), we identified a causative mutation in one of 20 genes known to cause steroid-resistant nephrotic syndrome. In 11 families (3.7%), we detected a mutation in a gene that causes a phenocopy of steroid-resistant nephrotic syndrome. This is consistent with our previously published identification of mutations using a panel approach. We detected a causative mutation in a known steroid-resistant nephrotic syndrome gene in 38% of consanguineous families and in 13% of nonconsanguineous families, and 48% of children with congenital nephrotic syndrome. A total of 68 different mutations were detected in 20 of 33 steroid-resistant nephrotic syndrome genes. Fifteen of these mutations were novel. NPHS1 , PLCE1 , NPHS2 , and SMARCAL1 were the most common genes in which we detected a mutation. In another 28% of families, we detected mutations in one or more candidate genes for steroid-resistant nephrotic syndrome. Whole exome sequencing is a sensitive approach toward diagnosis of monogenic causes of steroid-resistant nephrotic syndrome. A molecular genetic diagnosis of steroid-resistant nephrotic syndrome may have important consequences for the management of treatment and kidney transplantation in steroid-resistant nephrotic syndrome. Copyright © 2018 by the American Society of Nephrology.

  4. Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid carcinoma.

    PubMed

    Brose, Marcia S; Smit, Johannes; Capdevila, Jaume; Elisei, Rossella; Nutting, Christopher; Pitoia, Fabian; Robinson, Bruce; Schlumberger, Martin; Shong, Young Kee; Takami, Hiroshi

    2012-09-01

    For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and national regulatory policies. Insufficient clinical trial data and variable disease characteristics challenge the creation of universal guidelines, and treatment plans often reflect regional influences. A multidisciplinary, multiregional panel of experts met to discuss regional approaches to managing patients with advanced, radioactive iodine-refractory differentiated thyroid cancer and the potential impact of emerging therapies on current treatment strategies. Despite process-oriented regional differences, the decision-making strategies were similar. Multidisciplinary teams used to manage high-risk patients varied in composition across regions, particularly regarding the responsible physician's specialty. Cytotoxic chemotherapy was viewed as limited in clinical benefit, and targeted agents as attractive, based on promising data. Panel members support clinical trial enrollment as the preferred treatment strategy for managing these patients.

  5. Production of aluminum-lithium near net shape extruded cylinders

    NASA Technical Reports Server (NTRS)

    Hartley, Paula J.

    1995-01-01

    In the late 1980's, under funding from the Advanced Launch System Program, numerous near net shape technologies were investigated as a means for producing high quality, low cost Aluminum-Lithium (Al-Li) hardware. Once such option was to extrude near net shape barrel panels instead of producing panels by machining thick plate into a final tee-stiffened configuration (which produced up to 90% scrap). This method offers a reduction in the volume of scrap and consequently reduces the buy-to-fly cost. Investigation into this technology continued under Shuttle-C funding where four Al alloys 2219, 2195, 2096, and RX 818 were extruded. Presented herein are the results of that program. Each alloy was successfully extruded at Wyman Gordon, opened and flattened at Ticorm, and solution heat treated and stretched at Reynolds Metals Company. The first two processes were quite successful while the stretching process did offer some challenges. Due to the configuration of the panels and the stretch press set-up, it was difficult to induce a consistent percentage of cold work throughout the length and width of each panel. The effects of this variation will be assessed in the test program to be conducted at a future date.

  6. European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics.

    PubMed

    Paschke, Ralf; Cantara, Silvia; Crescenzi, Anna; Jarzab, Barbara; Musholt, Thomas J; Sobrinho Simoes, Manuel

    2017-07-01

    Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF , NRAS , HRAS , KRAS , PAX8/PPARG , RET/PTC ) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation.

  7. European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics

    PubMed Central

    Paschke, Ralf; Cantara, Silvia; Crescenzi, Anna; Jarzab, Barbara; Musholt, Thomas J.; Sobrinho Simoes, Manuel

    2017-01-01

    Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF, NRAS, HRAS, KRAS, PAX8/PPARG, RET/PTC) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation. PMID:28785538

  8. Clinical guidelines for management of dry eye associated with Sjögren disease.

    PubMed

    Foulks, Gary N; Forstot, S Lance; Donshik, Peter C; Forstot, Joseph Z; Goldstein, Michael H; Lemp, Michael A; Nelson, J Daniel; Nichols, Kelly K; Pflugfelder, Stephen C; Tanzer, Jason M; Asbell, Penny; Hammitt, Katherine; Jacobs, Deborah S

    2015-04-01

    To provide a consensus clinical guideline for management of dry eye disease associated with Sjögren disease by evaluating published treatments and recommending management options. Consensus panel evaluation of reported treatments for dry eye disease. Using the 2007 Report of the International Workshop on Dry Eye (DEWS) as a starting point, a panel of eye care providers and consultants evaluated peer-reviewed publications and developed recommendations for evaluation and management of dry eye disease associated with Sjögren disease. Publications were graded according to the American Academy of Ophthalmology Preferred Practice Pattern guidelines for level of evidence. Strength of recommendation was according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. The recommendations of the panel are briefly summarized herein. Evaluation should include symptoms of both discomfort and visual disturbance as well as determination of the relative contribution of aqueous production deficiency and evaporative loss of tear volume. Objective parameters of tear film stability, tear osmolarity, degree of lid margin disease, and ocular surface damage should be used to stage severity of dry eye disease to assist in selecting appropriate treatment options. Patient education with regard to the nature of the problem, aggravating factors, and goals of treatment is critical to successful management. Tear supplementation and stabilization, control of inflammation of the lacrimal glands and ocular surface, and possible stimulation of tear production are treatment options that are used according to the character and severity of dry eye disease. Management guidelines for dry eye associated with Sjögren's disease are presented. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative

    PubMed Central

    Sivera, Francisca; Andrés, Mariano; Carmona, Loreto; Kydd, Alison S R; Moi, John; Seth, Rakhi; Sriranganathan, Melonie; van Durme, Caroline; van Echteld, Irene; Vinik, Ophir; Wechalekar, Mihir D; Aletaha, Daniel; Bombardier, Claire; Buchbinder, Rachelle; Edwards, Christopher J; Landewé, Robert B; Bijlsma, Johannes W; Branco, Jaime C; Burgos-Vargas, Rubén; Catrina, Anca I; Elewaut, Dirk; Ferrari, Antonio J L; Kiely, Patrick; Leeb, Burkhard F; Montecucco, Carlomaurizio; Müller-Ladner, Ulf; Østergaard, Mikkel; Zochling, Jane; Falzon, Louise; van der Heijde, Désirée M

    2014-01-01

    We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated with a systematic literature review. Medline, Embase, Cochrane CENTRAL and abstracts from 2010–2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, rheumatologists from 14 countries (Europe, South America and Australasia) developed national recommendations. After rounds of discussion and voting, multinational recommendations were formulated. Each recommendation was graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. Combining evidence and clinical expertise, 10 recommendations were produced. One recommendation referred to the diagnosis of gout, two referred to cardiovascular and renal comorbidities, six focused on different aspects of the management of gout (including drug treatment and monitoring), and the last recommendation referred to the management of asymptomatic hyperuricaemia. The level of agreement with the recommendations ranged from 8.1 to 9.2 (mean 8.7) on a 1–10 scale, with 10 representing full agreement. Ten recommendations on the diagnosis and management of gout were established. They are evidence-based and supported by a large panel of rheumatologists from 14 countries, enhancing their utility in clinical practice. PMID:23868909

  10. 75 FR 25208 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ...The New England Fishery Management Council (Council) has cancelled the public meeting of its Joint Skate Committee and Advisory Panel that was scheduled for Tuesday, May 18, 2010 beginning at 9:30 a.m., in Peabody, MA.

  11. Measuring Engagement with the Potential Consequences of Climate Change

    NASA Astrophysics Data System (ADS)

    Young, N.; Danielson, R. W.; Lombardi, D.

    2015-12-01

    Across three studies, we investigated engagement with the consequences of climate change. We drew from the conceptual change and risk analysis literatures to find the factors that determine how much people will care about future risks. Questions derived from these factors were then asked about many hypothesized consequences of climate change. These consequences were drawn from an Intergovernmental Panel on Climate Change special report (IPCC, 2012) and, in the third study, additionally from the IPCC AR5 (IPCC, 2014). The first two studies, using undergraduate students, demonstrated that some consequences were indeed considerably more engaging than others. The third study used a more representative sample of American adults, drawn from Amazon Mechanical Turk and used the Global Warming's Six Americas Screening Tool (Maibach, Leiserowitz, Roser-Renouf, Mertz, & Akerlof, 2011) in a large screening survey to find 20 participants in each of the six audiences defined by this tool. These participants were then asked about the potential consequences of climate change. Results again showed that some consequences are considered more engaging than others, and also showed the ways in which members of these six audiences perceive the consequences of climate change differently.

  12. The coordination of plural logics of action and its consequences: Evidence from plural medical systems

    PubMed Central

    Shim, Jae-Mahn

    2017-01-01

    Drawing on the theory of social action in organizational and institutional sociology, this paper examines the behavioral consequences of plural logics of action. It addresses the question based on the empirical case of plural medical systems that are composed of both biomedicine and alternative medicine. Applying mixed methods of a cross-national panel data analysis and a content analysis of medical journal articles, it finds that plural systems affect health outcomes negatively when tensions between biomedicine and alternative medicine are unaddressed. In contrast, plural systems produce tangible health benefits when biomedicine and alternative medicine are coordinated through government policies or by health care organizations/professionals. This paper proposes plurality coordination as an important mechanism that modifies the behavioral consequences of plural logics. This proposition contributes to providing theoretical answers to the sociological puzzle that plural logics of action produce inconsistent behavioral consequences. PMID:29253867

  13. U.S. Army Aeromedical Research Laboratory Annual Progress Report, Calendar Year 1999

    DTIC Science & Technology

    2000-03-01

    has continued basic flat panel research with the intent of transitioning the approach to applied, in-flight examination of flat panel technology...Department of Psychology was executed in CY99 for cooperative investigation of hierarchically ordered information in intelligent multifunction displays...1999 Instructional courses on fatigue management were given at the Aviation Precommand Course, the Aviation Psychology Course, the Flight Surgeon’s

  14. The Management of Information and Knowledge; a Compilation of Papers Prepared for the Eleventh Meeting of the Panel on Science and Technology.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Science and Technology.

    A special document, published separately from the complete proceedings of the eleventh meeting of the Panel on Science and Technology, is justified because the papers presented discuss the impact of the rapid development of the computer and the revolution in communication technology upon our society. This impact is critically examined by 10…

  15. 9. View southeast corner of perimeter acquisition radar power plant ...

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

    9. View southeast corner of perimeter acquisition radar power plant room #214, control room; showing central monitoring station console in foreground. Well and booster control panel in left background and electric power management panel on far right - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Power Plant, In Limited Access Area, Southwest of PARB at end of Service Road B, Nekoma, Cavalier County, ND

  16. Effective Utilization and Management of Emerging Information Technologies. Information Resources Management Association International Conference (Boston, Massachusetts, May 17-20, 1998).

    ERIC Educational Resources Information Center

    Khosrowpour, Mehdi, Ed.

    This proceeding of the 1998 Information Resources Management Association International Conference contains 80 full papers, 87 research in progress papers, 33 abstracts, and 15 panel, workshop, and tutorial summaries. The papers focus on issues of managing information technology (IT) in organizations around the world. Issues covered include:…

  17. Early-Childhood Poverty and Adult Attainment, Behavior, and Health

    ERIC Educational Resources Information Center

    Duncan, Greg J.; Ziol-Guest, Kathleen M.; Kalil, Ariel

    2010-01-01

    This article assesses the consequences of poverty between a child's prenatal year and 5th birthday for several adult achievement, health, and behavior outcomes, measured as late as age 37. Using data from the Panel Study of Income Dynamics (1,589) and controlling for economic conditions in middle childhood and adolescence, as well as demographic…

  18. Educational Mismatch and the Careers of Scientists

    ERIC Educational Resources Information Center

    Bender, Keith A.; Heywood, John S.

    2011-01-01

    Previous research confirms that many employees work in jobs not well matched to their skills and education, resulting in lower pay and job satisfaction. While this literature typically uses cross-sectional data, we examine the evolution of mismatch and its consequences over a career, by using a panel data set of scientists in the USA. The results…

  19. Short vs. Long: Cognitive Load, Retention and Changing Class Structures

    ERIC Educational Resources Information Center

    Sheridan, Brandon; Smith, Ben; Pleggenkuhle-Miles, Erin

    2017-01-01

    University class structure is changing. To accommodate working students, programmes are increasing their offerings of long night classes--some lasting as long as six hours. While these long classes may be more convenient for students, they have unintended consequences as a result of cognitive load. Using a panel of 124 students (372 observations)…

  20. The Gendered Consequences of Unemployment Insurance Reforms

    ERIC Educational Resources Information Center

    Mooi-Reci, Irma; Mills, Melinda

    2012-01-01

    This study examines whether a series of unemployment insurance benefit reforms that took place over a 20-year period in the Netherlands had a gendered effect on the duration of unemployment and labor market outcomes. Using longitudinal data from the Dutch Labor Supply Panel (OSA) over the period 1980-2000, and adopting a quasi-experimental design,…

  1. 78 FR 60660 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ... compound (CIC) Boeing Material Specification (BMS) 3-23 to the surfaces of the repaired area. As an option... fracture and failure of the skin panels of the fuselage, and consequent rapid decompression of the airplane... availability of this material at the FAA, call 425-227-1221. Examining the AD Docket You may examine the AD...

  2. Family Formation and Men's and Women's Attainment of Workplace Authority

    ERIC Educational Resources Information Center

    Bygren, Magnus; Gahler, Michael

    2012-01-01

    Using Swedish panel data, we assess whether the gender gap in supervisory authority has changed during the period 1968-2000, and investigate to what extent the gap can be attributed to gender-specific consequences of family formation. The results indicate that the gap has narrowed modestly during the period, and that the life-event of parenthood…

  3. The Social and Psychological Consequences of Intragenerational Mobility. Working Paper 73.4.

    ERIC Educational Resources Information Center

    Rojek, Dean G.

    The relationship between prior and present socioeconomic status and 10 symptoms of social and psychological stress were examined for mobility effects. The analysis was confined to a 5-year, intragenerational mobility panel from 2 Illinois regions--Putnam County and segments of 3 other adjacent counties in north-central Illinois, and a portion of…

  4. 75 FR 6674 - Center for Scientific Review; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review... Scientific Review Special Emphasis Panel, Microvascular Interactions. Date: March 3, 2010. Time: 3 p.m. to 5... Social Consequences of HIV/AIDS Study Section. Date: March 15-16, 2010. Time: 8 a.m. to 5 p.m. Agenda: To...

  5. Modeling and simulation of the shading effect on the performance of a photovoltaic module in the presence of the bypass diode.

    NASA Astrophysics Data System (ADS)

    Zebiri, Mohamed; Mediouni, Mohamed; Idadoub, Hicham

    2018-05-01

    In photovoltaic renewable energy production systems where production is dependent on weather conditions, maintaining production at a suitable level is more than essential. The shading effect in photovoltaic panels affects the production of electrical energy by reducing it or even causing the destruction of some or all of the panels. To circumvent this problem, among the solutions proposed in the literature we find the use of by-pass diode and anti-return diode to minimize these consequences.In this paper we present a simulation under Matlab-Simulink of the shading effect and we compare the current voltages characteristics (I-V) and power voltage (P-V) of a photovoltaic system for different irradiations in the presence and absence of diode by -pass. For modeling, we will use the diode model and the Lambert W-function to solve the implicit equation of the output current. This method allows you to analyze the performance of a panel at different shading levels.

  6. Inland water resources

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The work is reported of the panel concerning the application of space technology to the improved management of the nation's inland resources. The progress since the 1967-68 study is briefly reviewed. The data needed for the management of inlet water ways, and the potential benefits of better management are discussed along with 16 proposed demonstration projects.

  7. 75 FR 74008 - Gulf of Mexico Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    .... SUMMARY: The Gulf of Mexico Fishery Management Council will convene a public meeting of the Florida.... Council address: Gulf of Mexico Fishery Management Council, 2203 North Lois Avenue, Suite 1100, Tampa, FL... Florida/Alabama group is part of a three unit Habitat Protection Advisory Panel (AP) of the Gulf of Mexico...

  8. 76 FR 9020 - Disease, Disability, and Injury Prevention and Control; Special Emphasis Panel (SEP): Ability of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-16

    ... Integrated Tick Management (ITM) Technologies To Reduce the Entomological Risk of Lyme Disease, Funding... Tick Management (ITM) Technologies To Reduce the Entomological Risk of Lyme Disease, FOA CK11-005...), Title 5 U.S.C., and the Determination of the Director, Management Analysis and Services Office, CDC...

  9. Managing Senegalese water resources: Definition and relative importance of information needs

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

    Engi, D.

    1998-09-01

    This report provides an overview of the results of the Vital Issues process as implemented for the Senegal Water Resources Management Initiative, a collaborative effort between the Senegalese Ministry of Water Resources and Sandia National Laboratories. This Initiative is being developed to assist in the development of an efficient and sustainable water resources management system for Senegal. The Vital Issues process was used to provide information for the development of a proposal that will recommend actions to address the key management issues and establish a state-of-the-art decision support system (DSS) for managing Senegal`s water resources. Three Vital Issues panel meetingsmore » were convened to (1) develop a goal statement and criteria for identifying and ranking the issues vital to water resources management in Senegal; (2) define and rank the issues, and (3) identify and prioritize a preliminary list of information needed to address the vital issues. The selection of panelists from the four basic institutional perspectives (government, industry, academe, and citizens` interest groups) ensured a high level of stakeholder representation on the panels.« less

  10. THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE

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

    Pemberton, Wendy; Mena, RaJah; Beal, William

    The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phasemore » efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.« less

  11. Robust Power Management Control for Stand-Alone Hybrid Power Generation System

    NASA Astrophysics Data System (ADS)

    Kamal, Elkhatib; Adouane, Lounis; Aitouche, Abdel; Mohammed, Walaa

    2017-01-01

    This paper presents a new robust fuzzy control of energy management strategy for the stand-alone hybrid power systems. It consists of two levels named centralized fuzzy supervisory control which generates the power references for each decentralized robust fuzzy control. Hybrid power systems comprises: a photovoltaic panel and wind turbine as renewable sources, a micro turbine generator and a battery storage system. The proposed control strategy is able to satisfy the load requirements based on a fuzzy supervisor controller and manage power flows between the different energy sources and the storage unit by respecting the state of charge and the variation of wind speed and irradiance. Centralized controller is designed based on If-Then fuzzy rules to manage and optimize the hybrid power system production by generating the reference power for photovoltaic panel and wind turbine. Decentralized controller is based on the Takagi-Sugeno fuzzy model and permits us to stabilize each photovoltaic panel and wind turbine in presence of disturbances and parametric uncertainties and to optimize the tracking reference which is given by the centralized controller level. The sufficient conditions stability are formulated in the format of linear matrix inequalities using the Lyapunov stability theory. The effectiveness of the proposed Strategy is finally demonstrated through a SAHPS (stand-alone hybrid power systems) to illustrate the effectiveness of the overall proposed method.

  12. KSC-99pp0697

    NASA Image and Video Library

    1999-06-17

    A panel of NASA and contractor senior staff, plus officers from the 45th Space Wing, discuss safetyand health-related concerns in front of an audience of KSC employees as part of Super Safety and Health Day. Moderating at the podium is Loren Shriver, deputy director for Launch & Payload Processing. Seated left to right are Burt Summerfield, associate director of the Biomedical Office; Colonel William S. Swindling, commander, 45th Medical Group, Patrick Air Force Base, Fla.; Ron Dittemore, manager, Space Shuttle Programs, Johnson Space Center; Roy Bridges, Center Director; Col. Tom Deppe, vice commander, 45th Space Wing, Patrick Air Force Base; Jim Schoefield, program manager, Payload Ground Operations, Boeing; Bill Hickman, program manager, Space Gateway Support; and Ed Adamek, vice president and associate program manager for Ground Operations, United Space Alliance. Answering a question at the microphone on the floor is Dave King, director, Shuttle Processing. The panel was one of the presentations during KSC's second annual day-long dedication to safety. Most normal work activities were suspended to allow personnel to attend related activities. The theme, "Safety and Health Go Hand in Hand," emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space-related resources first and foremost. Events also included a keynote address, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television

  13. Tailored Panel Management: A Theory-Based Approach to Building and Maintaining Participant Commitment to a Longitudinal Study.

    PubMed

    Estrada, Mica; Woodcock, Anna; Schultz, P Wesley

    2014-02-01

    Many psychological processes unfold over time, necessitating longitudinal research designs. Longitudinal research poses a host of methodological challenges, foremost of which is participant attrition. Building on Dillman's work, we provide a review of how social influence and relationship research informs retention strategies in longitudinal studies. Objective: We introduce the tailored panel management (TPM) approach, which is designed to establish communal norms that increase commitment to a longitudinal study, and this commitment, in turn, increases response rates and buffers against attrition. Specifically, we discuss practices regarding compensation, communication, consistency, and credibility that increase longer term commitment to panel participation. Research design: Throughout the article, we describe how TPM is being used in a national longitudinal study of undergraduate minority science students. TheScienceStudy is a continuing panel, which has 12 waves of data collected across 6 academic years, with response rates ranging from 70% to 92%. Although more than 90% of participants have either left or graduated from their undergraduate degree program, this highly mobile group of people remains engaged in the study. TheScienceStudy has usable longitudinal data from 96% of the original panel. Conclusion: This article combines social psychological theory, current best practice, and a detailed case study to illustrate the TPM approach to longitudinal data collection. The approach provides guidance for other longitudinal researchers, and advocates for empirical research into longitudinal research methodologies. © The Author(s) 2014.

  14. Novel efficient genome-wide SNP panels for the conservation of the highly endangered Iberian lynx.

    PubMed

    Kleinman-Ruiz, Daniel; Martínez-Cruz, Begoña; Soriano, Laura; Lucena-Perez, Maria; Cruz, Fernando; Villanueva, Beatriz; Fernández, Jesús; Godoy, José A

    2017-07-21

    The Iberian lynx (Lynx pardinus) has been acknowledged as the most endangered felid species in the world. An intense contraction and fragmentation during the twentieth century left less than 100 individuals split in two isolated and genetically eroded populations by 2002. Genetic monitoring and management so far have been based on 36 STRs, but their limited variability and the more complex situation of current populations demand more efficient molecular markers. The recent characterization of the Iberian lynx genome identified more than 1.6 million SNPs, of which 1536 were selected and genotyped in an extended Iberian lynx sample. We validated 1492 SNPs and analysed their heterozygosity, Hardy-Weinberg equilibrium, and linkage disequilibrium. We then selected a panel of 343 minimally linked autosomal SNPs from which we extracted subsets optimized for four different typical tasks in conservation applications: individual identification, parentage assignment, relatedness estimation, and admixture classification, and compared their power to currently used STR panels. We ascribed 21 SNPs to chromosome X based on their segregation patterns, and identified one additional marker that showed significant differentiation between sexes. For all applications considered, panels of autosomal SNPs showed higher power than the currently used STR set with only a very modest increase in the number of markers. These novel panels of highly informative genome-wide SNPs provide more powerful, efficient, and flexible tools for the genetic management and non-invasive monitoring of Iberian lynx populations. This example highlights an important outcome of whole-genome studies in genetically threatened species.

  15. Installed Base Registration of Decentralised Solar Panels with Applications in Crisis Management

    NASA Astrophysics Data System (ADS)

    Aarsen, R.; Janssen, M.; Ramkisoen, M.; Biljecki, F.; Quak, W.; Verbree, E.

    2015-08-01

    In case of a calamity in the Netherlands - e.g. a dike breach - parts of the nationwide electric network can fall out. In these occasions it would be useful if decentralised energy sources of the Smart Grid would contribute to balance out the fluctuations of the energy network. Decentralised energy sources include: solar energy, wind energy, combined heat and power, and biogas. In this manner, parts of the built environment - e.g. hospitals - that are in need of a continuous power flow, could be secured of this power. When a calamity happens, information about the Smart Grid is necessary to control the crisis and to ensure a shared view on the energy networks for both the crisis managers and network operators. The current situation of publishing, storing and sharing data of solar energy has been shown a lack of reliability about the current number, physical location, and capacity of installed decentralised photovoltaic (PV) panels in the Netherlands. This study focuses on decentralised solar energy in the form of electricity via PV panels in the Netherlands and addresses this challenge by proposing a new, reliable and up-to-date database. The study reveals the requirements for a registration of the installed base of PV panels in the Netherlands. This new database should serve as a replenishment for the current national voluntary registration, called Production Installation Register of Energy Data Services Netherland (EDSN-PIR), of installed decentralised PV panel installations in the Smart Grid, and provide important information in case of a calamity.

  16. Preselection statistics and Random Forest classification identify population informative single nucleotide polymorphisms in cosmopolitan and autochthonous cattle breeds.

    PubMed

    Bertolini, F; Galimberti, G; Schiavo, G; Mastrangelo, S; Di Gerlando, R; Strillacci, M G; Bagnato, A; Portolano, B; Fontanesi, L

    2018-01-01

    Commercial single nucleotide polymorphism (SNP) arrays have been recently developed for several species and can be used to identify informative markers to differentiate breeds or populations for several downstream applications. To identify the most discriminating genetic markers among thousands of genotyped SNPs, a few statistical approaches have been proposed. In this work, we compared several methods of SNPs preselection (Delta, F st and principal component analyses (PCA)) in addition to Random Forest classifications to analyse SNP data from six dairy cattle breeds, including cosmopolitan (Holstein, Brown and Simmental) and autochthonous Italian breeds raised in two different regions and subjected to limited or no breeding programmes (Cinisara, Modicana, raised only in Sicily and Reggiana, raised only in Emilia Romagna). From these classifications, two panels of 96 and 48 SNPs that contain the most discriminant SNPs were created for each preselection method. These panels were evaluated in terms of the ability to discriminate as a whole and breed-by-breed, as well as linkage disequilibrium within each panel. The obtained results showed that for the 48-SNP panel, the error rate increased mainly for autochthonous breeds, probably as a consequence of their admixed origin lower selection pressure and by ascertaining bias in the construction of the SNP chip. The 96-SNP panels were generally more able to discriminate all breeds. The panel derived by PCA-chrom (obtained by a preselection chromosome by chromosome) could identify informative SNPs that were particularly useful for the assignment of minor breeds that reached the lowest value of Out Of Bag error even in the Cinisara, whose value was quite high in all other panels. Moreover, this panel contained also the lowest number of SNPs in linkage disequilibrium. Several selected SNPs are located nearby genes affecting breed-specific phenotypic traits (coat colour and stature) or associated with production traits. In general, our results demonstrated the usefulness of Random Forest in combination to other reduction techniques to identify population informative SNPs.

  17. 78 FR 67127 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-08

    ... Caribbean Fishery Management Council's Outreach and Education Advisory Panel (OEAP) will meet. DATES: The... Verguilla Issue --USVI Activities: ``Marine Outreach & Education USVI Style'' --Caribbean Fisheries Teacher... Commercial and Recreational Fishing Regulations for the US Caribbean Exclusive Economic Zone --Other Business...

  18. Practice Management Skills for the Nurse Practitioner.

    ERIC Educational Resources Information Center

    Sportsman, Susan; Hawley, Linda J.; Pollock, Susan; Varnell, Gayle

    2001-01-01

    An expert panel identified 20 business concepts important for a family nurse practitioner curriculum. A focus group of practitioners verified the concepts and clarified relevant information to be taught. The business concepts center on management and operations of a clinical practice. (SK)

  19. 41 CFR 302-15.13 - What are the income tax consequences when my agency pays for my property management services?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the income tax consequences when my agency pays for my property management services? 302-15.13 Section 302-15.13 Public....13 What are the income tax consequences when my agency pays for my property management services? When...

  20. 41 CFR 302-3.421 - What are the income tax consequences when my agency pays for property management services?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the income tax consequences when my agency pays for property management services? 302-3.421 Section 302-3.421 Public Contracts... § 302-3.421 What are the income tax consequences when my agency pays for property management services...

  1. Situational Strength Cues from Social Sources at Work: Relative Importance and Mediated Effects

    PubMed Central

    Alaybek, Balca; Dalal, Reeshad S.; Sheng, Zitong; Morris, Alexander G.; Tomassetti, Alan J.; Holland, Samantha J.

    2017-01-01

    Situational strength is considered one of the most important situational forces at work because it can attenuate the personality–performance relationship. Although organizational scholars have studied the consequences of situational strength, they have paid little attention to its antecedents. To address this gap, the current study focused on situational strength cues from different social sources as antecedents of overall situational strength at work. Specifically, we examined how employees combine situational strength cues emanating from three social sources (i.e., coworkers, the immediate supervisor, and top management). Based on field theory, we hypothesized that the effect of situational strength from coworkers and immediate supervisors (i.e., proximal sources of situational strength) on employees' perceptions of overall situational strength on the job would be greater than the effect of situational strength from the top management (i.e., the distal source of situational strength). We also hypothesized that the effect of situational strength from the distal source would be mediated by the effects of situational strength from the proximal sources. Data from 363 full-time employees were collected at two time points with a cross-lagged panel design. The former hypothesis was supported for one of the two situational strength facets studied. The latter hypothesis was fully supported. PMID:28928698

  2. Effects of Cancer Genetic Panel Testing on at-Risk Individuals.

    PubMed

    Frost, Anja S; Toaff, Miriam; Biagi, Tara; Stark, Elizabeth; McHenry, Allison; Kaltman, Rebecca

    2018-06-01

    To evaluate the role of screening patients at increased risk for hereditary cancer syndromes with an extended panel of cancer predisposition genes to identify actionable genetic mutations. A retrospective chart review was conducted of all patients presenting to a multidisciplinary cancer program for genetic counseling and testing from January 2015 to December 2016. Individuals presenting to the program were identified as at-risk by a personal or family history of cancer, by their health care provider, or by self-referral. All participants met current National Comprehensive Cancer Network criteria for genetic risk evaluation for hereditary cancer. The results of testing and its implications for management, based on National Comprehensive Cancer Network guidelines, were recorded. Of 670 at-risk patients who underwent genetic testing, 66 (9.9%) had BRCA-limited testing; of these, 26 of 670 (3.9%) had a deleterious or likely pathogenic mutation. Expanded panel testing was done for 560 of the 670 patients (83.4%), and abnormal results were found in 65 of 670 (9.7%); non-BRCA mutations (predominantly CHEK2) were found in 49 of the 65 (75%). Abnormal genetic testing was associated with increased surveillance in 96% of those with deleterious mutations, whereas negative testing for a known familial mutation in 45 patients was associated with a downgrade of their risk and reduction of subsequent surveillance and management. Guideline-based management is frequently altered by genetic testing, including panel testing, in patients at risk for cancer. We recommend that obstetrics and gynecology providers routinely refer at-risk patients for genetic counseling and testing when clinically appropriate.

  3. Coastal zone management

    NASA Technical Reports Server (NTRS)

    Tilton, E. L., III

    1975-01-01

    A panel of federal and state representatives concerned with coastal zone affairs discussed their problems in this area. In addition, several demonstrations of the application of remote sensing technology to coastal zone management were described. These demonstrations were performed by several agencies in a variety of geographical areas.

  4. Research Gaps in Practice Guidelines for Acute Postoperative Pain Management in Adults: Findings From a Review of the Evidence for an American Pain Society Clinical Practice Guideline.

    PubMed

    Gordon, Debra B; de Leon-Casasola, Oscar A; Wu, Christopher L; Sluka, Kathleen A; Brennan, Timothy J; Chou, Roger

    2016-02-01

    Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  5. Air Force Personalized Medicine Program Panel: Representative Research at the 59th Medical Wing San Antonio Military Medical Center

    DTIC Science & Technology

    2016-05-18

    and treatment strategies at the San Antonio Military Health System. Panel members will describe studies in Disease Management providing evidence for...Application in a Clinical CBA: AFMSand MAJCOM Needs (Research Knowledge) Setti g Optimization of Pharmacologic Cardiovascular Personalized Care...Medicine Research Program Development of Human Mesenchymal Stem Cells for Treatment of Immune System Dysregulation in Neurological & other Diseases

  6. [Guidelines for wise utilization of knee imaging].

    PubMed

    Finestone, Aharon S; Eshed, Iris; Freedman, Yehuda; Beer, Yiftah; Bar-Sever, Zvi; Kots, Yavvgeni; Adar, Eliyahu; Mann, Gideon

    2012-02-01

    The knee is a complex structure afflicted with diverse pathologies. Correct management of knee complaints demands wise utilization of imaging modalities, considering their accuracy in the specific clinical situation, the patient's safety and availability and financial issues. Some of these considerations are universal, while others are local, depending on medical and insurance systems. There is controversy and unclearness regarding the best imaging modality in different clinical situations. To develop clinical guidelines for utilizing knee imaging. Leading physicians in specialties associated with knee disease and imaging were invited to participate in a panel on the guidelines. Controversies were settled in the main panel or in sub-panels. The panel agreed on the principles in choosing from the various modalities, primarily medical accuracy, followed by patient safety, availability and cost. There was agreement that the physician is responsible to choose the most appropriate diagnostic tool, consulting, when necessary, on the advantages, limitations and risks of the various imaging modalities. A comprehensive table was compiled with the importance of the different imaging modalities in various clinical situations. For the first time, Israeli guidelines on wise utilization of knee imaging are presented. They take into consideration the clinical situations and also availability and financial issues specific to Israel. These guidelines will serve physicians of several disciplines and medical insurers to improve patient management efficiently.

  7. Pharmacokinetics and Pharmacodynamics in Space

    NASA Technical Reports Server (NTRS)

    Putcha, Lakshmi; Cintron, Nitza M.

    1990-01-01

    The Pharmacokinetics and Pharmacodynamics Panel met on 29-30 Aug. 1988 at the Lunar and Planetary Institute in Houston, Texas to discuss pharmacokinetic and pharmacodynamic implications of space flight and make recommendations for operational and research strategies. Based on the knowledge available on the physiological changes that occur during space flight, the dependence of pharmacokinetics on physiological factors, and the therapeutic requirements for future space missions, the panel made several recommendations for research. It was suggested that using medications available with a large (wide) therapeutic window will avoid unforeseen therapeutic consequences during flight. The sequence for conducting research was outlined as follows: (1) identify ground-based simulation models (e.g., antiorthostatic bed rest) for conducting pharmacokinetic and pharmacodynamic research; (2) estimate parametric changes in these models using pharmacologic agents that have different pharmacokinetic characteristics and a narrow therapeutic index; (3) verify these findings during flight; and (4) develop and identify appropriate and effective drug delivery systems, dosage forms, and regimens. The panel recommended gaining a thorough understanding of the pharmacokinetic deviations of medications that have a narrow therapeutic index (e.g. cardiovascular drugs and sedative hypnotics) in order to ensure safe and effective treatment during flight with these agents. It was also suggested that basic information on physiological factors such as organ blood flow, protein composition and binding, tissue distribution, and metabolism by hepatic enzymes must be accumulated by conducting ground-based animal and human studies using models of weightlessness. This information will be useful to construct and identify physiologically based pharmacokinetic models that can provide valuable information on the pharmacodynamic consequences of space flight and aid in identifying appropriate therapeutic regimens.

  8. Changes in federal agencies panel: human dimensions research and ecosystem management: policy and research implications for recreation research efforts

    Treesearch

    Alan Ewert

    1995-01-01

    With an increased emphasis being placed on ecosystem management, the importance of Human Dimension Research (HDR) efforts in management and policy formulation are becoming more important. Developing an understanding of the type of management questions and policy needs that can be addressed by human dimension research is becoming increasingly important and timely. This...

  9. Warming will alter water resources

    NASA Astrophysics Data System (ADS)

    Maggs, William Ward

    Drastic changes in water resources in all regions of the United States will be the most severe effect of global warming, according to a study reported January 16 at the meeting of the American Association for the Advancement of Science in San Francisco. However, said the scientists on the AAAS panel on climate and U.S. water resources, strong governmental involvement can greatly reduce the water supply problems climate change will bring.The natural variability of present and future climate was the starting point for the AAAS study. The panel pointed out that it is difficult to identify the direction of potential change for many of the possible consequences of the greenhouse effect, partly because recent history provides little evidence of strong responses to such changes.

  10. A multinational, multidisciplinary consensus for the diagnosis and management of spinal cord compression among patients with mucopolysaccharidosis VI.

    PubMed

    Solanki, Guirish A; Alden, Tord D; Burton, Barbara K; Giugliani, Roberto; Horovitz, Dafne D G; Jones, Simon A; Lampe, Christina; Martin, Kenneth W; Ryan, Maura E; Schaefer, Matthias K; Siddiqui, Aisha; White, Klane K; Harmatz, Paul

    2012-09-01

    Cervical cord compression is a sequela of mucopolysaccharidosis VI, a rare lysosomal storage disorder, and has devastating consequences. An international panel of orthopedic surgeons, neurosurgeons, anesthesiologists, neuroradiologists, metabolic pediatricians, and geneticists pooled their clinical expertise to codify recommendations for diagnosing, monitoring, and managing cervical cord compression; for surgical intervention criteria; and for best airway management practices during imaging or anesthesia. The recommendations offer ideal best practices but also attempt to recognize the worldwide spectrum of resource availability. Functional assessments and clinical neurological examinations remain the cornerstone for identification of early signs of myelopathy, but magnetic resonance imaging is the gold standard for identification of cervical cord compression. Difficult airways of MPS VI patients complicate the anesthetic and, thus, the surgical management of cervical cord compression. All patients with MPS VI require expert airway management during any surgical procedure. Neurophysiological monitoring of the MPS VI patient during complex spine or head and neck surgery is considered standard practice but should also be considered for other procedures performed with the patient under general anesthesia, depending on the length and type of the procedure. Surgical interventions may include cervical decompression, stabilization, or both. Specific techniques vary widely among surgeons. The onset, presentation, and rate of progression of cervical cord compression vary among patients with MPS VI. The availability of medical resources, the expertise and experience of members of the treatment team, and the standard treatment practices vary among centers of expertise. Referral to specialized, experienced MPS treatment centers should be considered for high-risk patients and those requiring complex procedures. Therefore, the key to optimal patient care is to implement best practices through meaningful communication among treatment team members at each center and among MPS VI specialists worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Safety and Mission Assurance Knowledge Management Retention: Managing Knowledge for Successful Mission Operations

    NASA Technical Reports Server (NTRS)

    Johnson, Teresa A.

    2006-01-01

    Knowledge Management is a proactive pursuit for the future success of any large organization faced with the imminent possibility that their senior managers/engineers with gained experiences and lessons learned plan to retire in the near term. Safety and Mission Assurance (S&MA) is proactively pursuing unique mechanism to ensure knowledge learned is retained and lessons learned captured and documented. Knowledge Capture Event/Activities/Management helps to provide a gateway between future retirees and our next generation of managers/engineers. S&MA hosted two Knowledge Capture Events during 2005 featuring three of its retiring fellows (Axel Larsen, Dave Whittle and Gary Johnson). The first Knowledge Capture Event February 24, 2005 focused on two Safety and Mission Assurance Safety Panels (Space Shuttle System Safety Review Panel (SSRP); Payload Safety Review Panel (PSRP) and the latter event December 15, 2005 featured lessons learned during Apollo, Skylab, and Space Shuttle which could be applicable in the newly created Crew Exploration Vehicle (CEV)/Constellation development program. Gemini, Apollo, Skylab and the Space Shuttle promised and delivered exciting human advances in space and benefits of space in people s everyday lives on earth. Johnson Space Center's Safety & Mission Assurance team work over the last 20 years has been mostly focused on operations we are now beginning the Exploration development program. S&MA will promote an atmosphere of knowledge sharing in its formal and informal cultures and work processes, and reward the open dissemination and sharing of information; we are asking "Why embrace relearning the "lessons learned" in the past?" On the Exploration program the focus will be on Design, Development, Test, & Evaluation (DDT&E); therefore, it is critical to understand the lessons from these past programs during the DDT&E phase.

  12. Development and Implementation of Team-Based Panel Management Tools: Filling the Gap between Patient and Population Information Systems.

    PubMed

    Watts, Brook; Lawrence, Renée H; Drawz, Paul; Carter, Cameron; Shumaker, Amy Hirsch; Kern, Elizabeth F

    2016-08-01

    Effective team-based models of care, such as the Patient-Centered Medical Home, require electronic tools to support proactive population management strategies that emphasize care coordination and quality improvement. Despite the spread of electronic health records (EHRs) and vendors marketing population health tools, clinical practices still may lack the ability to have: (1) local control over types of data collected/reports generated, (2) timely data (eg, up-to-date data, not several months old), and accordingly (3) the ability to efficiently monitor and improve patient outcomes. This article describes a quality improvement project at the hospital system level to develop and implement a flexible panel management (PM) tool to improve care of subpopulations of patients (eg, panels of patients with diabetes) by clinical teams. An in-depth case analysis approach is used to explore barriers and facilitators in building a PM registry tool for team-based management needs using standard data elements (eg, laboratory values, pharmacy records) found in EHRs. Also described are factors that may contribute to sustainability; to date the tool has been adapted to 6 disease-focused subpopulations encompassing more than 200,000 patients. Two key lessons emerged from this initiative: (1) though challenging, team-based clinical end users and information technology needed to work together consistently to refine the product, and (2) locally developed population management tools can provide efficient data tracking for frontline clinical teams and leadership. The preliminary work identified critical gaps that were successfully addressed by building local PM registry tools from EHR-derived data and offers lessons learned for others engaged in similar work. (Population Health Management 2016;19:232-239).

  13. Relationships between Electronic Information Media and Records Management Practices: Results of a Survey of United Nations Organizations. A Rand Note.

    ERIC Educational Resources Information Center

    Bikson, T. K.; Schieber, L.

    A Technical Panel on Electronic Records Management (TP/REM), which was established by the Advisory Committee for the Co-ordination of Information Systems (ACCIS), conducted a survey of existing electronic records management practices and standards related to new information and communication technologies and their interrelationships within the…

  14. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Patient Education Programmes in the Management of Osteoarthritis

    ERIC Educational Resources Information Center

    Health Education Journal, 2011

    2011-01-01

    Objective: The purpose of this study was to develop guidelines and recommendations on patient education programmes of any type, targeted specially to individuals with OA and which were designed to improve the clinical effectiveness of managing OA. Methods: The Ottawa Methods Group contacted specialized organizations that focus on management for…

  15. Managed care innovation and new product development.

    PubMed

    Clark, C S; Schuster, T B

    1994-01-01

    This article explores recent innovative activity by managed care payor plans nationwide with particular emphasis on emerging, new relationships between the plans and their purchasers, enrollees, provider panels, and competitors. Because they already practice what advocates of health care reform are now preaching, many managed care plans are leading the charge to transform our health care delivery and financing systems.

  16. Laboratory study of PCB transport from primary sources to ...

    EPA Pesticide Factsheets

    Transport of house dust and Arizona Test Dust on polychlorinated biphenyl (PCB)-containing panels and PCB-free panels was investigated in a 30-m3 stainless steel chamber. The PCB-containing panels were aluminum sheets coated with a PCB-spiked, oil-based primer or two-part polysulfide caulk. The PCB-free panels were coated with the same materials but they were not spiked with PCBs. The dust was weighed and spread on the panels as evenly as possible. The dust on each panel was collected at different times to determine its PCB content. The dust data collected from the PCB panels were used to evaluate the PCB migration from the source to the dust through direct contact, and the data from the PCB-free panels were used to evaluate the sorption of PCBs through the dust/air partition. Settled dust can adsorb PCBs from air. The sorption concentration was dependent on the congener concentration in the air and favored less volatile congeners. When the house dust was in direct contact with a primary source, PCBs migrated into the dust at a much faster rate than the PCB transfer rate due to the dust/air partition. Unlike the dust/air partition, the dust/source partition was not significantly affected by the volatility of the congener. This research is important to decision makers, environmental engineers, and researchers who are concerned with risk assessment and risk management for PCB contamination.

  17. Data Base Management Systems Panel. Third workshop summary

    NASA Technical Reports Server (NTRS)

    Urena, J. L. (Editor)

    1981-01-01

    The discussions and results of a review by a panel of data base management system (DRMS) experts of various aspects of the use of DBMSs within NASA/Office of Space and Terrestrial Applications (OSTA) and related organizations are summarized. The topics discussed included the present status of the use of DBMS technology and of the various ongoing DBMS-related efforts within NASA. The report drafts of a study that seeks to determine the functional requirements for a generalized DBMS for the NASA/OSTA and related data bases are examined. Future problems and possibilities with the use of DBMS technology are also considered. A list of recommendations for NASA/OSTA data systems is included.

  18. COTS Initiative Panel Discussion

    NASA Image and Video Library

    2013-11-13

    L-R: Alan Lindenmoyer, Manager of Commercial Crew and Cargo Program, NASA; Gwynne Shotwell, President, SpaceX; Frank Culbertson, Executive Vice President and General Manager, Orbital Sciences Advanced Programs Group; Frank Slazer, Vice President of Space Systems, Aerospace Industries Association and Phil McAlister, Director of Commercial Spaceflight Development at NASA, participate in a panel discussion on the Commercial Orbital Transportation Services (COTS) initiative at NASA Headquarters in Washington on Wednesday, November 13, 2013. Through COTS, NASA's partners Space Exploration Technologies Corp. (SpaceX) and Orbital Sciences Corp., developed new U.S. rockets and spacecraft, launched from U.S. soil, capable of transporting cargo to low-Earth orbit and the International Space Station. Photo Credit: (NASA/Jay Westcott)

  19. Effective self-management strategies for bipolar disorder: A community-engaged Delphi Consensus Consultation study.

    PubMed

    Michalak, Erin E; Suto, Melinda J; Barnes, Steven J; Hou, Sharon; Lapsley, Sara; Scott, Mike W; Murray, Greg; Austin, Jehannine; Elliott, Nusha Balram; Berk, Lesley; Crest Bd

    2016-12-01

    Self-management represents an important complement to psychosocial treatments for bipolar disorder (BD), but research is limited. Specifically, little is known about self-management approaches for elevated mood states; this study investigated self-management strategies for: (1) maintaining balance in mood, and (2) stopping progression into hypomania/mania. To identify the common components of BD self-management, Delphi Consensus Consultation methods were combined with a Community-Based Participatory Research (CBPR) approach across five study phases: (1) Qualitative dataset content analysis; (2) Academic/grey literature reviews; (3) Content analysis; (4) Two Delphi rounds (rating strategies on a 5-point Likert scale, Very Unhelpful-Very Helpful), and; (5) Quantitative analysis and interpretation. Participants were people with BD and healthcare providers. Phases 1 and 2 identified 262 and 3940 candidate strategies, respectively; 3709 were discarded as duplicates/unintelligible. The remaining 493 were assessed via Delphi methods in Phase 4: 101 people with BD and 52 healthcare providers participated in Round 1; 83 of the BD panel (82%) and 43 of the healthcare provider panel (83%) participated in Round 2-exploratory factor analysis (EFA) was conducted on Round 2 results. EFA was underpowered and sample was not ethnically diverse, limiting generalizability. High concordance was observed in ratings of strategy effectiveness between the two panels. Future research could usefully investigate the provisional discovery here of underlying factors which link individual strategies. For example, 'maintaining hope' underpinned strategies for maintaining balance, and 'decreasing use of stimulants' underpinned strategies to interrupt hypo/manic ascent. There is merit in combining CBPR and Delphi methods. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. 12 CFR 225.83 - What are the consequences of failing to continue to meet applicable capital and management...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 3 2012-01-01 2012-01-01 false What are the consequences of failing to continue to meet applicable capital and management requirements? 225.83 Section 225.83 Banks and Banking... the consequences of failing to continue to meet applicable capital and management requirements? (a...

  1. 12 CFR 225.83 - What are the consequences of failing to continue to meet applicable capital and management...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false What are the consequences of failing to continue to meet applicable capital and management requirements? 225.83 Section 225.83 Banks and Banking... the consequences of failing to continue to meet applicable capital and management requirements? (a...

  2. Defense Science Board 2006 Summer Study of Information Management for Net-Centric Operations. Volume 2. Operations Panel Report

    DTIC Science & Technology

    2007-04-01

    and/or time de-confliction to insure safe separation of component forces. For example, in the Vietnam era, Air Force units were employed in the Hanoi...systems and people to exploit it. For example, Accenture (Accenture.com), a $15 billion global management consulting and technology services company ...information managers (called knowledge managers) to functional specialties, such as oil, gas, insurance , and pharmaceuticals. Information managers collect

  3. The Quality of Doctoral Education in South Africa: A Question of Significance

    ERIC Educational Resources Information Center

    Jansen, Jonathan D.

    2011-01-01

    One of the underlying concerns in the Study Panel on the South African PhD, a large-scale, overview investigation of the Academy of Science of South Africa (ASSAf), was the negative consequences of signalling the need for more doctoral graduates to boost the presumed link to national competitiveness within a global knowledge economy. There was…

  4. The Socioeconomic Consequences of "In-Work" Benefit Reform for British Lone Mothers

    ERIC Educational Resources Information Center

    Francesconi, Marco; van der Klaauw, Wilbert

    2007-01-01

    In October 1999, the British government enacted the Working Families' Tax Credit, which aimed at encouraging work among low-income families with children. This paper uses panel data collected between 1991 and 2001 to evaluate the effect of this reform on single mothers. We find that the reform led to a substantial increase in their employment rate…

  5. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1999-01-01

    This report covers the activities of the Aerospace Safety Advisory Panel (ASAP) for calendar year 1998-a year of sharp contrasts and significant successes at NASA. The year opened with the announcement of large workforce cutbacks. The slip in the schedule for launching the International Space Station (ISS) created a five-month hiatus in Space Shuttle launches. This slack period ended with the successful and highly publicized launch of the STS-95 mission. As the year closed, ISS assembly began with the successful orbiting and joining of the Functional Cargo Block (FGB), Zarya, from Russia and the Unity Node from the United States. Throughout the year, the Panel maintained its scrutiny of NASA's safety processes. Of particular interest were the potential effects on safety of workforce reductions and the continued transition of functions to the Space Flight Operations Contractor. Attention was also given to the risk management plans of the Aero-Space Technology programs, including the X-33, X-34, and X-38. Overall, the Panel concluded that safety is well served for the present. The picture is not as clear for the future. Cutbacks have limited the depth of talent available. In many cases, technical specialties are 'one deep.' The extended hiring freeze has resulted in an older workforce that will inevitably suffer significant departures from retirements in the near future. The resulting 'brain drain' could represent a future safety risk unless appropriate succession planning is started expeditiously. This and other topics are covered in the section addressing workforce. The major NASA programs are also limited in their ability to plan property for the future. This is of particular concern for the Space Shuttle and ISS because these programs are scheduled to operate well into the next century. In the case of the Space Shuttle, beneficial and mandatory safety and operational upgrades are being delayed because of a lack of sufficient present funding. Likewise, the ISS has little flexibility to begin long lead-time items for upgrades or contingency planning. For example, the section on computer hardware and software contains specific findings related to required longer range safety-related actions. NASA can be proud of its accomplishments this past year, but must remain ever vigilant, particularly as ISS assembly begins to accelerate. The Panel will continue to focus on both the short- and long-term aspects of risk management and safety planning. This task continues to be made manageable and productive by the excellent cooperation the Panel receives from both NASA and its contractors. Particular emphasis will continue to be directed to longer term workforce and program planning issues as well as the immediate risks associated with ISS assembly and the initial flights of the X-33 and X-34. Section 2 of this report presents specific findings and recommendations generated by ASAP activities during 1998. Section 3 contains more detailed information in support of these findings and recommendations. Appendix A is a current roster of Panel members, consultants, and staff. Appendix B contains NASA's response to the findings and recommendations from the 1997 ASAP Annual Report. Appendix C details the fact-finding activities of the Panel in 1998. During the year, Mr. Richard D. Blomberg was elected chair of the Panel and Vice Admiral (VADM) Robert F Dunn was elected deputy chair. VADM Bernard M. Kauderer moved from consultant to member. Mr. Charles J. Donlan retired from the Panel after many years of meritorious service. Ms. Shirley C. McCarty and Mr. Robert L. ('Hoot') Gibson joined the Panel as consultants.

  6. 78 FR 11237 - Public Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... management of human error in its operations and system safety programs, and the status of PTC implementation... UP's safety management policies and programs associated with human error, operational accident and... Chairman of the Board of Inquiry 2. Introduction of the Board of Inquiry and Technical Panel 3...

  7. 78 FR 42807 - SES Performance Review Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ... the Office of Personnel Management, one or more SES Performance Review Boards. The Board shall review... Management and Budget Sunil Iyengar--Director, Research & Analysis William O'Brien--Senior Advisor for Program Innovation Kathy Plowitz-Worden, Panel Coordinator, National Endowment for the Arts. [FR Doc. 2013...

  8. 76 FR 71515 - South Atlantic Fishery Management Council Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... Lobster Committee; Law Enforcement Committee; Ecosystem-Based Management Committee; Advisory Panel... . SUPPLEMENTARY INFORMATION: Meeting Dates 1. Spiny Lobster Committee Meeting: December 5, 2011, 1:30 p.m. until 3 p.m. The Spiny Lobster Committee will: Receive a presentation on the process for preparing...

  9. 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...

  10. 77 FR 68735 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... Committee will continue to develop options and alternatives for Omnibus Essential Fish Habitat Amendment 2 (OA2). Specifically, the Committee will review Habitat Advisory Panel and Plan Development Team... England Fishery Management Council (Council) is scheduling a public meeting of its Habitat Oversight...

  11. 10 CFR 1.19 - Other committees, boards, and panels.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of Nuclear Regulatory Research on important management matters in the direction of the Commission's... science, waste disposal and seismic and structural engineering. In performing its activities, the... information science and in managing records of the Commission's licensing process for the HLW repository. [52...

  12. 10 CFR 1.19 - Other committees, boards, and panels.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of Nuclear Regulatory Research on important management matters in the direction of the Commission's... science, waste disposal and seismic and structural engineering. In performing its activities, the... information science and in managing records of the Commission's licensing process for the HLW repository. [52...

  13. 10 CFR 1.19 - Other committees, boards, and panels.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of Nuclear Regulatory Research on important management matters in the direction of the Commission's... science, waste disposal and seismic and structural engineering. In performing its activities, the... information science and in managing records of the Commission's licensing process for the HLW repository. [52...

  14. 10 CFR 1.19 - Other committees, boards, and panels.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of Nuclear Regulatory Research on important management matters in the direction of the Commission's... science, waste disposal and seismic and structural engineering. In performing its activities, the... information science and in managing records of the Commission's licensing process for the HLW repository. [52...

  15. 10 CFR 1.19 - Other committees, boards, and panels.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of Nuclear Regulatory Research on important management matters in the direction of the Commission's... science, waste disposal and seismic and structural engineering. In performing its activities, the... information science and in managing records of the Commission's licensing process for the HLW repository. [52...

  16. 78 FR 23685 - Airworthiness Directives; The Boeing Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-22

    ... installing new operational software for the electrical load management system and configuration database. The..., installing a new electrical power control panel, and installing new operational software for the electrical load management system and configuration database. Since the proposed AD was issued, we have received...

  17. Managing overweight and obesity in adults to reduce cardiovascular disease risk.

    PubMed

    Ebbert, Jon O; Elrashidi, Muhamad Y; Jensen, Michael D

    2014-10-01

    Obesity is a leading preventable cause of death and disability worldwide. Obesity increases the risk for clinically identifiable risk factors for cardiovascular disease (CVD) as well as a host of other metabolic, sleep, and orthopedic disorders. Coordinated and systematic interventions are needed to manage obesity and reduce these risks. The Obesity 2 Expert Panel updated the previous guidelines and produced the "Guideline for the Management of Overweight and Obesity in Adults." The Panel used data from publications from years 1999 to 2011 to address five critical questions, provide evidence statements, and recommend creation of a treatment algorithm to guide decision making about clinical care. The current review discusses the evidence statements pertaining to CVD risk in the assessment and management of patients who are overweight and obese. We summarize the FDA-approved medications for the treatment of overweight and obesity and their impact on CVD risk and risk factors, as well as ongoing clinical trials which will further inform clinical practice.

  18. Diagnosis and management of acute myeloid leukemia in children and adolescents: recommendations from an international expert panel.

    PubMed

    Creutzig, Ursula; van den Heuvel-Eibrink, Marry M; Gibson, Brenda; Dworzak, Michael N; Adachi, Souichi; de Bont, Eveline; Harbott, Jochen; Hasle, Henrik; Johnston, Donna; Kinoshita, Akitoshi; Lehrnbecher, Thomas; Leverger, Guy; Mejstrikova, Ester; Meshinchi, Soheil; Pession, Andrea; Raimondi, Susana C; Sung, Lillian; Stary, Jan; Zwaan, Christian M; Kaspers, Gertjan J L; Reinhardt, Dirk

    2012-10-18

    Despite major improvements in outcome over the past decades, acute myeloid leukemia (AML) remains a life-threatening malignancy in children, with current survival rates of ∼70%. State-of-the-art recommendations in adult AML have recently been published in this journal by Döhner et al. The primary goal of an international expert panel of the International BFM Study Group AML Committee was to set standards for the management, diagnosis, response assessment, and treatment in childhood AML. This paper aims to discuss differences between childhood and adult AML, and to highlight recommendations that are specific to children. The particular relevance of new diagnostic and prognostic molecular markers in pediatric AML is presented. The general management of pediatric AML, the management of specific pediatric AML cohorts (such as infants) or subtypes of the disease occurring in children (such as Down syndrome related AML), as well as new therapeutic approaches, and the role of supportive care are discussed.

  19. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria.

    PubMed

    Zuberbier, T; Asero, R; Bindslev-Jensen, C; Walter Canonica, G; Church, M K; Giménez-Arnau, A; Grattan, C E H; Kapp, A; Merk, H F; Rogala, B; Saini, S; Sánchez-Borges, M; Schmid-Grendelmeier, P; Schünemann, H; Staubach, P; Vena, G A; Wedi, B; Maurer, M

    2009-10-01

    This guideline, together with its sister guideline on the management of urticaria [Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM et al. EAACI/GA(2)LEN/EDF/WAO Guideline: Management of urticaria. Allergy, 2009; 64:1427-1443] is the result of a consensus reached during a panel discussion at the 3rd International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2)LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO). Urticaria is a frequent disease. The life-time prevalence for any subtype of urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors, and pathomechanisms. In addition, it outlines evidence-based diagnostic approaches for different subtypes of urticaria. The correct management of urticaria, which is of paramount importance for patients, is very complex and is consequently covered in a separate guideline developed during the same consensus meeting. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).

  20. High-Resolution Maps of Mouse Reference Populations

    PubMed Central

    Simecek, Petr; Forejt, Jiri; Williams, Robert W.; Shiroishi, Toshihiko; Takada, Toyoyuki; Lu, Lu; Johnson, Thomas E.; Bennett, Beth; Deschepper, Christian F.; Scott-Boyer, Marie-Pier; Pardo-Manuel de Villena, Fernando; Churchill, Gary A.

    2017-01-01

    Genetic reference panels are widely used to map complex, quantitative traits in model organisms. We have generated new high-resolution genetic maps of 259 mouse inbred strains from recombinant inbred strain panels (C57BL/6J × DBA/2J, ILS/IbgTejJ × ISS/IbgTejJ, and C57BL/6J × A/J) and chromosome substitution strain panels (C57BL/6J-Chr#, C57BL/6J-Chr#, and C57BL/6J-Chr#). We genotyped all samples using the Affymetrix Mouse Diversity Array with an average intermarker spacing of 4.3 kb. The new genetic maps provide increased precision in the localization of recombination breakpoints compared to the previous maps. Although the strains were presumed to be fully inbred, we found residual heterozygosity in 40% of individual mice from five of the six panels. We also identified de novo deletions and duplications, in homozygous or heterozygous state, ranging in size from 21 kb to 8.4 Mb. Almost two-thirds (46 out of 76) of these deletions overlap exons of protein coding genes and may have phenotypic consequences. Twenty-nine putative gene conversions were identified in the chromosome substitution strains. We find that gene conversions are more likely to occur in regions where the homologous chromosomes are more similar. The raw genotyping data and genetic maps of these strain panels are available at http://churchill-lab.jax.org/website/MDA. PMID:28839117

  1. High-Resolution Maps of Mouse Reference Populations.

    PubMed

    Simecek, Petr; Forejt, Jiri; Williams, Robert W; Shiroishi, Toshihiko; Takada, Toyoyuki; Lu, Lu; Johnson, Thomas E; Bennett, Beth; Deschepper, Christian F; Scott-Boyer, Marie-Pier; Pardo-Manuel de Villena, Fernando; Churchill, Gary A

    2017-10-05

    Genetic reference panels are widely used to map complex, quantitative traits in model organisms. We have generated new high-resolution genetic maps of 259 mouse inbred strains from recombinant inbred strain panels (C57BL/6J × DBA/2J, ILS/IbgTejJ × ISS/IbgTejJ, and C57BL/6J × A/J) and chromosome substitution strain panels (C57BL/6J-Chr#, C57BL/6J-Chr#, and C57BL/6J-Chr#). We genotyped all samples using the Affymetrix Mouse Diversity Array with an average intermarker spacing of 4.3 kb. The new genetic maps provide increased precision in the localization of recombination breakpoints compared to the previous maps. Although the strains were presumed to be fully inbred, we found residual heterozygosity in 40% of individual mice from five of the six panels. We also identified de novo deletions and duplications, in homozygous or heterozygous state, ranging in size from 21 kb to 8.4 Mb. Almost two-thirds (46 out of 76) of these deletions overlap exons of protein coding genes and may have phenotypic consequences. Twenty-nine putative gene conversions were identified in the chromosome substitution strains. We find that gene conversions are more likely to occur in regions where the homologous chromosomes are more similar. The raw genotyping data and genetic maps of these strain panels are available at http://churchill-lab.jax.org/website/MDA. Copyright © 2017 Simecek et al.

  2. Performance of active feedforward control systems in non-ideal, synthesized diffuse sound fields.

    PubMed

    Misol, Malte; Bloch, Christian; Monner, Hans Peter; Sinapius, Michael

    2014-04-01

    The acoustic performance of passive or active panel structures is usually tested in sound transmission loss facilities. A reverberant sending room, equipped with one or a number of independent sound sources, is used to generate a diffuse sound field excitation which acts as a disturbance source on the structure under investigation. The spatial correlation and coherence of such a synthesized non-ideal diffuse-sound-field excitation, however, might deviate significantly from the ideal case. This has consequences for the operation of an active feedforward control system which heavily relies on the acquisition of coherent disturbance source information. This work, therefore, evaluates the spatial correlation and coherence of ideal and non-ideal diffuse sound fields and considers the implications on the performance of a feedforward control system. The system under consideration is an aircraft-typical double panel system, equipped with an active sidewall panel (lining), which is realized in a transmission loss facility. Experimental results for different numbers of sound sources in the reverberation room are compared to simulation results of a comparable generic double panel system excited by an ideal diffuse sound field. It is shown that the number of statistically independent noise sources acting on the primary structure of the double panel system depends not only on the type of diffuse sound field but also on the sample lengths of the processed signals. The experimental results show that the number of reference sensors required for a defined control performance exhibits an inverse relationship to control filter length.

  3. Managing the risks of extreme events and disasters to advance climate change adaptation. Special report of the Intergovernmental Panel on Climate Change (IPCC)

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

    Field, C.B.; Barros, V.; Stocker, T.F.

    2012-07-01

    This Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX) has been jointly coordinated by Working Groups I (WGI) and II (WGII) of the Intergovernmental Panel on Climate Change (IPCC). The report focuses on the relationship between climate change and extreme weather and climate events, the impacts of such events, and the strategies to manage the associated risks. This Special Report, in particular, contributes to frame the challenge of dealing with extreme weather and climate events as an issue in decision making under uncertainty, analyzing response in the context of risk management.more » The report consists of nine chapters, covering risk management; observed and projected changes in extreme weather and climate events; exposure and vulnerability to as well as losses resulting from such events; adaptation options from the local to the international scale; the role of sustainable development in modulating risks; and insights from specific case studies. (LN)« less

  4. MO-E-BRB-03: Panel Member

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

    Salter, B.

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms ofmore » (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.« less

  5. MO-E-BRB-01: Panel Member

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

    Benedict, S.

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms ofmore » (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.« less

  6. Healthcare Quality Indicators for Physiotherapy Management in Hip and Knee Osteoarthritis and Rheumatoid Arthritis: A Delphi Study.

    PubMed

    Peter, W F; Hurkmans, E J; van der Wees, P J; Hendriks, E J M; van Bodegom-Vos, L; Vliet Vlieland, T P M

    2016-12-01

    The aim of the present study was to develop healthcare quality indicators (HCQIs) for the physiotherapy (PT) management of patients with hip or knee osteoarthritis (HKOA) or rheumatoid arthritis (RA) in the Netherlands. Two multidisciplinary expert panels, including patients, were instituted. A draft HCQI set was derived from recommendations included in two existing Dutch PT guidelines for HKOA and RA. The panels suggested additional topics, after which a Delphi procedure was performed. All propositions were scored for their potential to represent good-quality PT care (score range 0-9). Based on predefined rules, the Delphi panel HCQIs were discussed and selected. Lastly, every indicator was rephrased, resulting in its output consisting of a numerator and denominator, to facilitate comparisons within and among practices. After two Delphi rounds, two final sets of 17 HCQI - one for HKOA and one for RA - were composed, both containing 16 process indicators (regarding initial assessment, treatment and evaluation) and one outcome indicator. Two sets of HCQIs for PT management in HKOA and RA were developed for measuring the quality of PT care in daily clinical practice. Each indicator was formulated in a measurable way. Future research should focus on the feasibility of both indicator sets for daily clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

  7. MO-E-BRB-00: PANEL DISCUSSION: SBRT/SRS Case Studies - Lung

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

    NONE

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms ofmore » (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.« less

  8. Prospects of Fine-Mapping Trait-Associated Genomic Regions by Using Summary Statistics from Genome-wide Association Studies.

    PubMed

    Benner, Christian; Havulinna, Aki S; Järvelin, Marjo-Riitta; Salomaa, Veikko; Ripatti, Samuli; Pirinen, Matti

    2017-10-05

    During the past few years, various novel statistical methods have been developed for fine-mapping with the use of summary statistics from genome-wide association studies (GWASs). Although these approaches require information about the linkage disequilibrium (LD) between variants, there has not been a comprehensive evaluation of how estimation of the LD structure from reference genotype panels performs in comparison with that from the original individual-level GWAS data. Using population genotype data from Finland and the UK Biobank, we show here that a reference panel of 1,000 individuals from the target population is adequate for a GWAS cohort of up to 10,000 individuals, whereas smaller panels, such as those from the 1000 Genomes Project, should be avoided. We also show, both theoretically and empirically, that the size of the reference panel needs to scale with the GWAS sample size; this has important consequences for the application of these methods in ongoing GWAS meta-analyses and large biobank studies. We conclude by providing software tools and by recommending practices for sharing LD information to more efficiently exploit summary statistics in genetics research. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  9. Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

    PubMed Central

    Shivaswamy, Vijay; Boerner, Brian

    2016-01-01

    Post-transplant diabetes mellitus (PTDM) is a frequent consequence of solid organ transplantation. PTDM has been associated with greater mortality and increased infections in different transplant groups using different diagnostic criteria. An international consensus panel recommended a consistent set of guidelines in 2003 based on American Diabetes Association glucose criteria but did not exclude the immediate post-transplant hospitalization when many patients receive large doses of corticosteroids. Greater glucose monitoring during all hospitalizations has revealed significant glucose intolerance in the majority of recipients immediately after transplant. As a result, the international consensus panel reviewed its earlier guidelines and recommended delaying screening and diagnosis of PTDM until the recipient is on stable doses of immunosuppression after discharge from initial transplant hospitalization. The group cautioned that whereas hemoglobin A1C has been adopted as a diagnostic criterion by many, it is not reliable as the sole diabetes screening method during the first year after transplant. Risk factors for PTDM include many of the immunosuppressant medications themselves as well as those for type 2 diabetes. The provider managing diabetes and associated dyslipidemia and hypertension after transplant must be careful of the greater risk for drug-drug interactions and infections with immunosuppressant medications. Treatment goals and therapies must consider the greater risk for fluctuating and reduced kidney function, which can cause hypoglycemia. Research is actively focused on strategies to prevent PTDM, but until strategies are found, it is imperative that immunosuppression regimens are chosen based on their evidence to prolong graft survival, not to avoid PTDM. PMID:26650437

  10. COTS Initiative Panel Discussion

    NASA Image and Video Library

    2013-11-13

    Alan Lindenmoyer, Manager of Commercial Crew and Cargo Program at NASA, delivers remarks panel discussion on the Commercial Orbital Transportation Services (COTS) initiative at NASA Headquarters in Washington on Wednesday, November 13, 2013. Through COTS, NASA's partners Space Exploration Technologies Corp. (SpaceX) and Orbital Sciences Corp., developed new U.S. rockets and spacecraft, launched from U.S. soil, capable of transporting cargo to low-Earth orbit and the International Space Station. Photo Credit: (NASA/Jay Westcott)

  11. Annual report to the NASA Administrator by the Aerospace Safety Advisory Panel on the space shuttle program. Part 2: Summary of information developed in the panel's fact-finding activities

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Safety management areas of concern include the space shuttle main engine, shuttle avionics, orbiter thermal protection system, the external tank program, and the solid rocket booster program. The ground test program and ground support equipment system were reviewed. Systems integration and technical 'conscience' were of major priorities for the investigating teams.

  12. 12 CFR 225.83 - What are the consequences of failing to continue to meet applicable capital and management...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 3 2014-01-01 2014-01-01 false What are the consequences of failing to continue to meet applicable capital and management requirements? 225.83 Section 225.83 Banks and Banking....83 What are the consequences of failing to continue to meet applicable capital and management...

  13. Counter-Chemical, Biological, Radiological, and Nuclear Operations

    DTIC Science & Technology

    2007-01-26

    environment. (Page 10) Consequence management activities serve to reduce the effects of a CBRN attack or event, and assist in the restoration of...can be used quite effectively as attack agents. Toxic Industrial Chemicals (TICs), Toxic Industrial Materials (TIMs), and other potentially...CBRN pillars. Consequence Management Consequence management (CM) activities serve to reduce the effects of a CBRN attack or event, and assist in

  14. An exploration of Bureau of Reclamation approaches for managing conflict over diverging science

    USGS Publications Warehouse

    Burkardt, Nina; Ruell, Emily; Clark, Douglas

    2008-01-01

    As a major institutional agent supplying Western water resources, the Bureau of Reclamation (Reclamation) provides important leadership, technical, and financial resources in water management, serving as the West's "water broker" (Bowersox 2000; Pisani 2003). In recent years, growing numbers of constituencies using water and the over-allocation of water resources have contributed to conflict over the resource in the American West (National Research Council 2004). Although the conflicts arise from many sources, one common theme is that Reclamation managers often must make decisions about water use and allocation when scientific studies provide uncertain or competing recommendations. We conducted a preliminary study of Reclamation water managers and water scientists to try to understand the approaches or techniques they use or consider useful for dealing with scientific conflicts over water allocation and how these compare to techniques found in the relevant literature. We report the results of (1) an electronic survey of Reclamation senior managers and (2) a panel discussion amongst Reclamation senior managers as to the current institutional capabilities for managing diverging scientific findings in water dispute resolution processes. We conclude with a discussion of the strengths and weaknesses of the different tools and techniques managers reported in the survey and in the panel discussion.

  15. Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices.

    PubMed

    Dulay, Maya; Bowen, Judith L; Weppner, William G; Eastburn, Abigail; Poppe, Anne P; Spanos, Pete; Wojtaszek, Danielle; Printz, Destiny; Kaminetzky, Catherine P

    2018-05-10

    Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort. Five VA Centers of Excellence in Primary Care Education collaborated to identify a common set of interprofessionally relevant desired learning outcomes (DLOs) for the PM and to develop assessment instruments for monitoring trainees' PM learning. Authors cataloged teaching and learning activities across sites. Results from pilot testing were systematically discussed leading to iterative revisions of curricular elements. Authors completed a retrospective self-assessment of curriculum implementation for the academic year 2015-16 using a 5-point scale: contemplation (score = 0), pilot (1), action (2), maintenance (3), and embedded (4). Implementation scores were analyzed using descriptive statistics. DLOs were organized into five categories (individual patients, populations, guidelines/measures, teamwork, and improvement) along with a developmental continuum and mapped to program competencies. Instruction and implementation varied across sites based on resources and priorities. Between 2015 and 2016, 159 trainees (internal medicine residents, nurse practitioner students and residents, pharmacy residents, and psychology post-doctoral fellows) participated in the PM curriculum. Curriculum implementation scores for guidelines/measures and improvement DLOs were similar for all trainees; scores for individual patients, populations, and teamwork DLOs were more advanced for nurse practitioner and physician trainees. In conclusion, collaboratively identified DLOs for PM guided development of assessment instruments and instructional approaches for panel management activities in interprofessional teams. This PM curriculum and associated tools provide resources for educators in other settings.

  16. Pfiesteria: review of the science and identification of research gaps. Report for the National Center for Environmental Health, Centers for Disease Control and Prevention.

    PubMed Central

    Samet, J; Bignami, G S; Feldman, R; Hawkins, W; Neff, J; Smayda, T

    2001-01-01

    In connection with the CDC National Conference on Pfiesteria, a multidisciplinary panel evaluated Pfiesteria-related research. The panel set out what was known and what was not known about adverse effects of the organism on estuarine ecology, fish, and human health; assessed the methods used in Pfiesteria research; and offered suggestions to address data gaps. The panel's expertise covered dinoflagellate ecology; fish pathology and toxicology; laboratory measurement of toxins, epidemiology, and neurology. The panel evaluated peer-reviewed and non-peer-reviewed literature available through June 2000 in a systematic conceptual framework that moved from the source of exposure, through exposure research and dose, to human health effects. Substantial uncertainties remain throughout the conceptual framework the panel used to guide its evaluation. Firm evidence demonstrates that Pfiesteria is toxic to fish, but the specific toxin has not been isolated or characterized. Laboratory and field evidence indicate that the organism has a complex life cycle. The consequences of human exposure to Pfiesteria toxin and the magnitude of the human health problem remain obscure. The patchwork of approaches used in clinical evaluation and surrogate measures of exposure to the toxin are major limitations of this work. To protect public health, the panel suggests that priority be given research that will provide better insight into the effects of Pfiesteria on human health. Key gaps include the identity and mechanism of action of the toxin(s), the incomplete description of effects of exposure in invertebrates, fish, and humans, and the nature and extent of exposures that place people at risk. PMID:11687383

  17. Demographic and Psychological Predictors of Panel Attrition: Evidence from the New Zealand Attitudes and Values Study

    PubMed Central

    Satherley, Nicole; Milojev, Petar; Greaves, Lara M.; Huang, Yanshu; Osborne, Danny; Bulbulia, Joseph; Sibley, Chris G.

    2015-01-01

    This study examines attrition rates over the first four years of the New Zealand Attitudes and Values Study, a longitudinal national panel sample of New Zealand adults. We report the base rate and covariates for the following four distinct classes of respondents: explicit withdrawals, lost respondents, intermittent respondents and constant respondents. A multinomial logistic regression examined an extensive range of demographic and socio-psychological covariates (among them the Big-Six personality traits) associated with membership in these classes (N = 5,814). Results indicated that men, Māori and Asian peoples were less likely to be constant respondents. Conscientiousness and Honesty-Humility were also positively associated with membership in the constant respondent class. Notably, the effect sizes for the socio-psychological covariates of panel attrition tended to match or exceed those of standard demographic covariates. This investigation broadens the focus of research on panel attrition beyond demographics by including a comprehensive set of socio-psychological covariates. Our findings show that core psychological covariates convey important information about panel attrition, and are practically important to the management of longitudinal panel samples like the New Zealand Attitudes and Values Study. PMID:25793746

  18. Quality Indicators for Continuous Monitoring to Improve Maternal and Infant Health in Maternity Departments: A Modified Delphi Survey of an International Multidisciplinary Panel

    PubMed Central

    Boulkedid, Rym; Sibony, Olivier; Goffinet, François; Fauconnier, Arnaud; Branger, Bernard; Alberti, Corinne

    2013-01-01

    Objective Measuring the quality of inpatient obstetrical care using quality indicators is becoming increasingly important for both patients and healthcare providers. However, there is no consensus about which measures are optimal. We describe a modified Delphi method to identify a set of indicators for continuously monitoring the quality of maternity care by healthcare professionals. Methodology and Main Findings An international French-speaking multidisciplinary panel comprising 22 obstetricians-gynaecologists, 12 midwives, and 1 paediatrician assessed potential indicators extracted from a medical literature search, using a two-round Delphi procedure followed by a physical meeting. Each panellist rated each indicator based on validity and feasibility. In the first round, 35 panellists from 5 countries and 20 maternity units evaluated 26 indicators including 15 related to the management of the overall population of pregnant women, 3 to the management of women followed from the first trimester of pregnancy, 2 to the management of low-risk pregnant women, and 6 to the management of neonates. 25 quality indicators were kept for next step. In the second round, 27 (27/35: 77%) panellists selected 17 indicators; the remaining 8 indicators were discussed during a physical meeting. The final set comprised 18 indicators. Conclusion A multidisciplinary panel selected indicators that reflect the quality of obstetrical care. This set of indicators could be used to assess and monitor obstetrical care, with the goal of improving the quality of care in maternity units. PMID:23577143

  19. Healthy Coping: Issues and Implications in Diabetes Education and Care

    PubMed Central

    Kent, Dan; Haas, Linda; Randal, David; Lin, Elizabeth; Thorpe, Carolyn T.; Boren, Suzanne A.; Fisher, Jan; Heins, Joan; Lustman, Patrick; Nelson, Joe; Ruggiero, Laurie; Wysocki, Tim; Sherr, Dawn; Martin, Annette Lenzi

    2010-01-01

    Abstract Psychological, emotional, and social factors not only impact quality of life, but also often play a role in chronic illness outcomes. Diabetes care, in particular, is greatly influenced by psychosocial factors when they hinder a person's ability to manage the disease and achieve metabolic control. Healthy coping, defined as responding to a psychological and physical challenge by recruiting available resources to increase the probability of favorable outcomes in the future, is essential to effective self-management by people with diabetes. In June 2009, the American Association of Diabetes Educators convened a multidisciplinary expert panel to discuss healthy coping in diabetes. The panel included diabetes educators and behavioral science and mental health professionals. Drawing on their knowledge and experiences, as well as information presented at the symposium, the panel probed several aspects of healthy coping including what it entails, common barriers, assessment, population diversity, and clinical applications. A team approach to addressing the patient's coping is critical. Team involvement relieves the diabetes educator of the entire burden of supporting the patient in this regard. The team should be broadly defined and include those who are formally and informally involved. Healthy coping is a complex, qualitative behavior that cannot be easily quantified. Future efforts to address the issue of healthy coping should add to the body of literature regarding diabetes self-management at the individual and population-based levels. (Population Health Management 2010;13:227–233) PMID:20879903

  20. Future leisure environments

    Treesearch

    Elwood L. Shafer; George H. Moeller; Russell E. Getty

    1974-01-01

    As an aid to policy- and decision-making about future environmental problems, a panel of experts was asked to predict the probabilities of future events associated with natural-resource management, wildland-recreation management, environmental pollution, population-workforce-leisure, and urban environments. Though some of the predictions projected to the year 2050 may...

  1. 5 CFR 9901.103 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and bonuses. Pay Pool Panel means management officials of the organizations or functions represented... employee, either employee-initiated or management-directed, to a different position or set of duties in the... of the bands. When moving from a non-NSPS position to NSPS, the band of the NSPS position is...

  2. 5 CFR 9901.103 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and bonuses. Pay Pool Panel means management officials of the organizations or functions represented... employee, either employee-initiated or management-directed, to a different position or set of duties in the... of the bands. When moving from a non-NSPS position to NSPS, the band of the NSPS position is...

  3. 32 CFR 1900.41 - Establishment of appeals structure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... denial. The Executive Secretary of the HRPB is the Director, Information Management. The Chair may... subordinate Agency Release Panel. (1) Membership. The ARP is composed of the Director, Information Management... AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Cia Action on Foia...

  4. 32 CFR 1900.41 - Establishment of appeals structure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... denial. The Executive Secretary of the HRPB is the Director, Information Management. The Chair may... subordinate Agency Release Panel. (1) Membership. The ARP is composed of the Director, Information Management... AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Cia Action on Foia...

  5. 32 CFR 1900.41 - Establishment of appeals structure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... denial. The Executive Secretary of the HRPB is the Director, Information Management. The Chair may... subordinate Agency Release Panel. (1) Membership. The ARP is composed of the Director, Information Management... AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Cia Action on Foia...

  6. 32 CFR 1900.41 - Establishment of appeals structure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... denial. The Executive Secretary of the HRPB is the Director, Information Management. The Chair may... subordinate Agency Release Panel. (1) Membership. The ARP is composed of the Director, Information Management... AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Cia Action on Foia...

  7. Osteoporosis prevention, diagnosis, and therapy.

    PubMed

    The objective of this NIH Consensus Statement is to inform the biomedical research and clinical practice communities of the results of the NIH Consensus Development Conference on Osteoporosis Prevention, Diagnosis, and Therapy. The statement provides state-of-the-art information and presents the conclusions and recommendations of the consensus panel regarding these issues. In addition, the statement identifies those areas of study that deserve further investigation. The target audience of clinicians for this statement includes, but is not limited to, family practitioners, internists, gerontologists, orthopaedic surgeons, rheumatologists, obstetricians and gynecologists, and preventive medicine specialisits. A nonfederal, nonadvocate, 13-member panel representing the fields of internal medicine, family and community medicine, endocrinology, epidemiology, orthopaedic surgery, gerontology, rheumatology, obstetrics and gynecology, preventive medicine, and cell biology. In addition, 32 experts from these same fields presented data to the panel and a conference audience of approximately 700. The literature was searched using MEDLINE and an extensive bibliography of references was provided to the panel. Experts prepared abstracts for their conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions. Osteoporosis occurs in all populations and at all ages. Though more prevalent in white postmenopausal females, it often goes unrecognized in other populations. Osteoporosis is a devastating disorder with significant physical, psychosocial, and financial consequences. The risks for osteoporosis, as reflected by low bone density, and the risks for fracture overlap but are not identical. More attention should be paid to skeletal health in persons with conditions known to be associated with secondary osteoporosis. Clinical risk factors have an important, but as yet poorly validated, role in determining who should have BMD measurement, in assessing risk of fracture, and in determining who should be treated. Adequate calcium and vitamin D intake are crucial to develop optimal peak bone mass and to preserve bone mass throughout life. Supplementation of these two components in bioavailable forms may be necessary in individuals who do not achieve recommended intake from dietary sources. Gonadal steroids are important determinants of peak and lifetime bone mass in men, women, and children. Regular exercise, especially resistance and high-impact activities, contributes to development of high peak bone mass and may reduce the risk of falls in older individuals. Assessment of bone mass, identification of fracture risk, and determination of who should be treated are the optimal goals when evaluating patients for osteoporosis. Fracture prevention is the primary goal in the treatment of patients with osteoporosis. Several treatments have been shown to reduce the risk of osteoporotic fractures. These include therapies that enhance bone mass and reduce risk or consequences of falls. Adults with vertebral, rib, hip, or distal forearm fractures should be evaluated for the presence of osteoporosis and given appropriate therapy.

  8. Identifying Training Needs to Improve Indigenous Community Representatives Input into Environmental Resource Management Consultative Processes: A Case Study of the Bundjalung Nation

    ERIC Educational Resources Information Center

    Lloyd, David; Norrie, Fiona

    2004-01-01

    Despite increased engagement of Indigenous representatives as participants on consultative panels charged with processes of natural resource management, concerns have been raised by both Indigenous representatives and management agencies regarding the ability of Indigenous people to have quality input into the decisions these processes produce. In…

  9. Rotorcraft Dynamics 1984

    NASA Technical Reports Server (NTRS)

    1985-01-01

    In the conference proceedings are 24 presented papers, their discussions, and material given in two panels. The presented papers address the general areas of the dynamics of rotorcraft or helicopters. Specific topics include the stability of rotors in hover and forward flight, the stability of coupled rotor-fuselage systems in hover, the loads on a rotor in forward flight including new developments in rotor loads calculations, and the calculation of rotorcraft vibration and means for its control or suppression. Material in the first panel deals with the successful application of dynamics technology to engineering development of flight vehicles. Material in the second panel is concerned with large data bases in the area of rotorocraft dynamics and how they are developed, managed, and used.

  10. The first object oriented monitor for intravenous anesthesia.

    PubMed

    Cantraine, F R; Coussaert, E J

    2000-01-01

    To describe the design and implementation of "INFUSION TOOLBOX," a software tool to control and monitor multiple intravenous drug infusions simultaneously using pharmacokinetic and pharmacodynamic principles. INFUSION TOOLBOX has been designed to present a graphical interface. Object Oriented design was used and the software was implemented using Smalltalk, to run on a PC. Basic tools are available to manage patient, drugs, pumps and reports. These tools are the PatientPanel, the DrugPanel, the PumpPanel and the HistoryPanel. The screen is built dynamically. The panels may be collapsed or closed to avoid a crowded display. We also built control panels such as the Target ControlPanel which calculates the best infusion sequence to bring the drug concentration in the plasma compartment to a preset value. Before drug delivery, the user enters the patient's data, selects a drug, enters its dilution factor and chooses a pharmacokinetic model. The calculated plasma concentration is continually displayed and updated. The anesthetist may ask for the history of the delivery to obtain a graphic report or to add events to the logbook. A panel targeting the effect is used when a pharmacodynamic model is known. Data files for drugs, pumps and surgery are upgradable. By creating a resizeable ControlPanel we enable the anesthetist to display the information he wishes, when he wishes it. The available panels are diverse enough to meet the anesthetist needs; they may be adapted to the drug used, pumps used and surgery. It is the anesthetist who builds dynamically its different control screens. By adopting an evolutionary solution model we have achieved considerable success in building our drug delivery monitor. In addition we have gained valuable insight into the anesthesia information domain that will allow us to further enhance and expand the system.

  11. REASONS AND CONSEQUENCES OF APPLIED LEADERSHIP STYLES IN ETHICAL DILEMMAS WHEN NURSE MANAGERS MAKE DECISIONS.

    PubMed

    Zydziunaite, V; Suominen, T

    2014-09-21

    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.

  12. Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences.

    PubMed

    Zydziunaite, Vilma; Suominen, Tarja

    2014-01-01

    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.

  13. The impact of case mix on timely access to appointments in a primary care group practice.

    PubMed

    Ozen, Asli; Balasubramanian, Hari

    2013-06-01

    At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the impact of the size and case-mix on the ability of a multi-provider practice to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician practice as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a practice: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test practices created using patient level data from the primary care practice at Mayo Clinic, Rochester, Minnesota. An important advantage of our approach is that it can be implemented in an Excel Spreadsheet and used for aggregate level planning and panel management decisions.

  14. Probabilistic accident consequence uncertainty analysis -- Late health effects uncertain assessment. Volume 2: Appendices

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

    Little, M.P.; Muirhead, C.R.; Goossens, L.H.J.

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library ofmore » uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA late health effects models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the expert panel on late health effects, (4) short biographies of the experts, and (5) the aggregated results of their responses.« less

  15. Probabilistic accident consequence uncertainty analysis -- Uncertainty assessment for internal dosimetry. Volume 2: Appendices

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

    Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M.

    1998-04-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library ofmore » uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA internal dosimetry models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the panel on internal dosimetry, (4) short biographies of the experts, and (5) the aggregated results of their responses.« less

  16. Global health resource utilization associated with pacemaker complications.

    PubMed

    Waweru, Catherine; Steenrod, Anna; Wolff, Claudia; Eggington, Simon; Wright, David Jay; Wyrwich, Kathleen W

    2017-07-01

    To estimate health resource utilization (HRU) associated with the management of pacemaker complications in various healthcare systems. Electrophysiologists (EPs) from four geographical regions (Western Europe, Australia, Japan, and North America) were invited to participate. Survey questions focused on HRU in the management of three chronic pacemaker complications (i.e. pacemaker infections requiring extraction, lead fractures/insulation breaches requiring replacement, and upper extremity deep venous thrombosis [DVT]). Panelists completed a maximum of two web-based surveys (iterative rounds). Mean, median values, and interquartile ranges were calculated and used to establish consensus. Overall, 32 and 29 panelists participated in the first and second rounds of the Delphi panel, respectively. Consensus was reached on treatment and HRU associated with a typical pacemaker implantation and complications. HRU was similar across regions, except for Japan, where panelists reported the longest duration of hospital stay in all scenarios. Infections were the most resource-intensive complications and were characterized by intravenous antibiotics days of 9.6?13.5 days and 21.3?29.2 days for pocket and lead infections respectively; laboratory and diagnostic tests, and system extraction and replacement procedures. DVT, on the other hand, was the least resource intensive complication. The results of the panel represent the views of the respondents who participated and may not be generalizable outside of this panel. The surveys were limited in scope and, therefore, did not include questions on management of acute complications (e.g. hematoma, pneumothorax). The Delphi technique provided a reliable and efficient approach to estimating resource utilization associated with chronic pacemaker complications. Estimates from the Delphi panel can be used to generate costs of pacemaker complications in various regions.

  17. Antiretroviral treatment of adult HIV infection: 2008 recommendations of the International AIDS Society-USA panel.

    PubMed

    Hammer, Scott M; Eron, Joseph J; Reiss, Peter; Schooley, Robert T; Thompson, Melanie A; Walmsley, Sharon; Cahn, Pedro; Fischl, Margaret A; Gatell, Jose M; Hirsch, Martin S; Jacobsen, Donna M; Montaner, Julio S G; Richman, Douglas D; Yeni, Patrick G; Volberding, Paul A

    2008-08-06

    The availability of new antiretroviral drugs and formulations, including drugs in new classes, and recent data on treatment choices for antiretroviral-naive and -experienced patients warrant an update of the International AIDS Society-USA guidelines for the use of antiretroviral therapy in adult human immunodeficiency virus (HIV) infection. To summarize new data in the field and to provide current recommendations for the antiretroviral management and laboratory monitoring of HIV infection. This report provides guidelines in key areas of antiretroviral management: when to initiate therapy, choice of initial regimens, patient monitoring, when to change therapy, and how best to approach treatment options, including optimal use of recently approved drugs (maraviroc, raltegravir, and etravirine) in treatment-experienced patients. A 14-member panel with expertise in HIV research and clinical care was appointed. Data published or presented at selected scientific conferences since the last panel report (August 2006) through June 2008 were identified. Data that changed the previous guidelines were reviewed by the panel (according to section). Guidelines were drafted by section writing committees and were then reviewed and edited by the entire panel. Recommendations were made by panel consensus. New data and considerations support initiating therapy before CD4 cell count declines to less than 350/microL. In patients with 350 CD4 cells/microL or more, the decision to begin therapy should be individualized based on the presence of comorbidities, risk factors for progression to AIDS and non-AIDS diseases, and patient readiness for treatment. In addition to the prior recommendation that a high plasma viral load (eg, >100,000 copies/mL) and rapidly declining CD4 cell count (>100/microL per year) should prompt treatment initiation, active hepatitis B or C virus coinfection, cardiovascular disease risk, and HIV-associated nephropathy increasingly prompt earlier therapy. The initial regimen must be individualized, particularly in the presence of comorbid conditions, but usually will include efavirenz or a ritonavir-boosted protease inhibitor plus 2 nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine or abacavir/lamivudine). Treatment failure should be identified and managed promptly, with the goal of therapy, even in heavily pretreated patients, being an HIV-1 RNA level below assay detection limits.

  18. Developing a patient and family research advisory panel to include people with significant disease, multimorbidity and advanced age.

    PubMed

    Portalupi, Laura B; Lewis, Carmen L; Miller, Carl D; Whiteman-Jones, Kerry L; Sather, Kay A; Nease, Donald E; Matlock, Daniel D

    2017-06-01

    People who have experienced illness due to significant disease, multimorbidity and/or advanced age are high utilizers of the health care system. Yet this population has had little formal opportunity to participate in guiding the health care research agenda, and few mechanisms exist for researchers to engage this population in an efficient way. We describe the process of developing a standing patient and family advisory panel to incorporate this population's voice into research in the USA. The panel was created at the University of Colorado. Preliminary panel development consisted of a needs assessment, information gathering and participant recruitment. We collected feedback from researchers who consulted with the panel and from panel members in order to better understand the experience from the patient and family member perspective. The patient and family research advisory panel consists of eight advisors who have experience with significant disease, multimorbidity and/or advanced age, two physicians and a program manager. The panel meets every other month for 2 hours with the main purpose of advising diverse researchers on health care studies. People with significant disease, multimorbidity and/or advanced age represent a growing demographic in the USA, and their engagement in research is essential as the model of health care delivery moves from volume to value. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. 76 FR 64329 - Meeting of the Ocean Research and Resources Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... for Ocean Leadership, 1201 New York Avenue, NW., 4th Floor, Washington DC 20005. FOR FURTHER... discussions on ocean research, resource management, and other current issues in the ocean science and management communities. Dated: October 11, 2011. J.M. Beal, Lieutenant Commander, Office of the Judge...

  20. 78 FR 79672 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ...The New England Fishery Management Council (Council) is scheduling a public meeting of its Herring Advisory Panel to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will be brought to the full Council for formal consideration and action, if appropriate.

  1. Information Management: Considering Adolescents' Regulation of Parental Knowledge

    ERIC Educational Resources Information Center

    Marshall, Sheila K.; Tilton-Weaver, Lauree C.; Bosdet, Lara

    2005-01-01

    Employing Goffman's [(1959). "The presentation of self in everyday life." New York: Doubleday and Company] notion of impression management, adolescents' conveyance of information about their whereabouts and activities to parents was assessed employing two methodologies. First, a two-wave panel design with a sample of 121 adolescents was used to…

  2. 77 FR 65536 - Fisheries of the South Atlantic; South Atlantic Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... to ecosystem-based management; and consideration of updates to essential fish habitat policy... meeting of its Habitat and Environmental Protection Advisory Panel (AP) in Charleston, SC. DATES: The...) 769-4520; email: [email protected] . SUPPLEMENTARY INFORMATION: Members of the Habitat and...

  3. 32 CFR 1900.33 - Allocation of resources; agreed extensions of time.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Information and Privacy Coordinator is responsible for management of the Agency-wide program defined by this..., Information Management through the Agency Release Panel shall provide policy and resource direction as... INTELLIGENCE AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Additional...

  4. 32 CFR 1900.33 - Allocation of resources; agreed extensions of time.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Information and Privacy Coordinator is responsible for management of the Agency-wide program defined by this..., Information Management through the Agency Release Panel shall provide policy and resource direction as... INTELLIGENCE AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Additional...

  5. 32 CFR 1900.33 - Allocation of resources; agreed extensions of time.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Information and Privacy Coordinator is responsible for management of the Agency-wide program defined by this..., Information Management through the Agency Release Panel shall provide policy and resource direction as... INTELLIGENCE AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Additional...

  6. 78 FR 4129 - Fisheries of the South Atlantic; South Atlantic Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... regulatory and law enforcement issues with officers and field offices. Information & Education AP Agenda... of the South Atlantic Fishery Management Council's Information & Education Advisory Panel (AP); Law Enforcement AP; Joint Meeting of the Information & Education AP and Law Enforcement AP; and meeting of the...

  7. Agriculture, forest, and range

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The findings and recommendations of the panel for developing a satellite remote-sensing global information system in the next decade are reported. User requirements were identified in five categories: (1) cultivated crops, (2) land resources, (3)water resources, (4)forest management, and (5) range management. The benefits from the applications of satellite data are discussed.

  8. 75 FR 43148 - Gulf of Mexico Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ...; telephone: (813) 348-1630 x235. SUPPLEMENTARY INFORMATION: The Vessel Monitoring System Advisory Panel will meet to discuss operation, design, agency usage of vessel monitoring systems (VMS), and resulting data.... SUMMARY: The Gulf of Mexico Fishery Management Council will convene a meeting of the Vessel Monitoring...

  9. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

    PubMed Central

    Estey, Elihu; Grimwade, David; Amadori, Sergio; Appelbaum, Frederick R.; Büchner, Thomas; Dombret, Hervé; Ebert, Benjamin L.; Fenaux, Pierre; Larson, Richard A.; Levine, Ross L.; Lo-Coco, Francesco; Naoe, Tomoki; Niederwieser, Dietger; Ossenkoppele, Gert J.; Sanz, Miguel; Sierra, Jorge; Tallman, Martin S.; Tien, Hwei-Fang; Wei, Andrew H.; Löwenberg, Bob; Bloomfield, Clara D.

    2017-01-01

    The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease. PMID:27895058

  10. Panel 2.18: logistics, information technology (IT), and telecommunications in crisis management.

    PubMed

    De Silva, Terrence; Chikersal, Jyotsna; Snoad, Nigel; Woodworth, Brent; Ghaly, Cherif; Catterall, Martin

    2005-01-01

    This is a summary of the presentations and discussion of Panel 2.18, Logistics, Information Technology, and Telecommunications in Crisis Management of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to logistics, information technology (IT), and crisis communication pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) issues; (2) lessons learned; (3) what was done well; (4) what could have been done better; and (5) conclusions and recommendations. Each major section is presented in four sub-sections: (1) needs assessments; (2) coordination; (3) filling the gaps; and (4) capacity building.

  11. Meet Your Future: An Interactive Panel on Industry Careers

    NASA Astrophysics Data System (ADS)

    Lambert, Steven

    There will be a brief presentation showing some statistics about careers in physics followed by a panel discussion. The panelists are: Pavel Kornilovich, HP Inc., Senior Technologist Erik Lucero, Google Santa Barbara, Hardware Engineer Raja Rajasekaran, Toptica-USA, Western Regional Sales & Application Manager Tiffany Santos, Western Digital, Principal Research Engineer Krysta Svore, Microsoft, Principal Researcher & Research Manager Each panelist will introduce themselves and give a brief overview of their career path. We'll then open it up to audience participation. Bring your questions about working in the private sector: daily responsibilities, work environment, how to prepare for this path, making contacts, and anything else you'd like to hear about. We look forward to an interactive and lively session.

  12. Lessons Learned from the Great Recession: Layoffs and the RIF-Induced Teacher Shuffle

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Strunk, Katharine O.; Brown, Nate; Knight, David S.

    2016-01-01

    One consequence of the Great Recession is that teacher layoffs occurred at a scale previously unseen. In this article, we assess the effects of receiving a layoff notice on teacher mobility using data from Los Angeles and Washington State. Our analyses are based on 6-year panels of data in each site, including 4 years of layoffs. We find that the…

  13. Marital Processes, Arranged Marriage, and Contraception to Limit Fertility

    PubMed Central

    Ghimire, Dirgha J.; Axinn, William G.

    2013-01-01

    An international transition away from familially-arranged marriages toward participation in spouse choice has endured for decades and continues to spread through rural Asia today. Though we know this transformation has important consequences for childbearing early in marriage, we know much less about longer-term consequences of this marital revolution. This study draws upon theories of family and fertility change and a rural Asian panel study designed to investigate changes in both marital and childbearing behaviors to investigate these long-term consequences. Controlling for social changes that shape both marital practices and childbearing behaviors, and explicitly considering multiple dimensions of marital processes, we find evidence consistent with an independent, long-standing association of participation in spouse choice with higher rates of contraception to terminate childbearing. These results add a new dimension to the evidence linking revolutions in marital behavior to long-term declines in fertility, but also motivate new research to consider a broader range of long-term consequences of changing marital processes. PMID:23709184

  14. Toward a framework linkage map of the canine genome.

    PubMed

    Langston, A A; Mellersh, C S; Wiegand, N A; Acland, G M; Ray, K; Aguirre, G D; Ostrander, E A

    1999-01-01

    Selective breeding to maintain specific physical and behavioral traits has made the modern dog one of the most physically diverse species on earth. One unfortunate consequence of the common breeding practices used to develop lines of dogs with the desired traits is amplification and propagation of genetic diseases within distinct breeds. To map disease loci we have constructed a first-generation framework map of the canine genome. We developed large numbers of highly polymorphic markers, constructed a panel of canine-rodent hybrid cell lines, and assigned those markers to chromosome groups using the hybrid cell lines. Finally, we determined the order and spacing of markers on individual canine chromosomes by linkage analysis using a reference panel of 17 outbred pedigrees. This article describes approaches and strategies to accomplish these goals.

  15. Noncontacting Laser Inspection System for Dimensional Profiling of Space Application Thermal Barriers

    NASA Technical Reports Server (NTRS)

    Taylor, Shawn C.

    2011-01-01

    A noncontacting, two-dimensional (2-D) laser inspection system has been designed and implemented to dimensionally profile thermal barriers being developed for space vehicle applications. In a vehicle as-installed state, thermal barriers are commonly compressed between load sensitive thermal protection system (TPS) panels to prevent hot gas ingestion through the panel interface during flight. Loads required to compress the thermal barriers are functions of their construction, as well as their dimensional characteristics relative to the gaps in which they are installed. Excessive loads during a mission could damage surrounding TPS panels and have catastrophic consequences. As such, accurate dimensional profiling of thermal barriers prior to use is important. Due to the compliant nature of the thermal barriers, traditional contact measurement techniques (e.g., calipers and micrometers) are subjective and introduce significant error and variability into collected dimensional data. Implementation of a laser inspection system significantly enhanced the method by which thermal barriers are dimensionally profiled, and improved the accuracy and repeatability of collected data. A statistical design of experiments study comparing laser inspection and manual caliper measurement techniques verified these findings.

  16. Annual report to the NASA Administrator by the Aerospace Safety Advisory Panel on the space shuttle program. Part 1: Observations and conclusions

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The panel reviewed the following areas of major significance for the Approach and Landing Test program: mission planning and crew training, flight-readiness of the Carrier Aircraft and the Orbiter, including its flight control and avionics system, facilities, and communications and ground support equipment. The management system for risk assessment was investigated. The Orbital Flight Test Program was also reviewed. Observations and recommendations are presented.

  17. Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.

    PubMed

    Boodhwani, Munir; Andelfinger, Gregor; Leipsic, Jonathon; Lindsay, Thomas; McMurtry, M Sean; Therrien, Judith; Siu, Samuel C

    2014-06-01

    This Canadian Cardiovascular Society position statement aims to provide succinct perspectives on key issues in the management of thoracic aortic disease (TAD). This document is not a comprehensive overview of TAD and important elements of the epidemiology, presentation, diagnosis, and management of acute aortic syndromes are deliberately not discussed; readers are referred to the 2010 guidelines published by the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery, and other stakeholders. Rather, this document is a practical guide for clinicians managing adult patients with TAD. Topics covered include size thresholds for surgical intervention, emerging therapies, imaging modalities, medical and lifestyle management, and genetics of TAD. The primary panel consisted of experts from a variety of disciplines that are essential for comprehensive management of TAD patients. The methodology involved a focused literature review with an emphasis on updates since 2010 and the use of Grading of Recommendations Assessment, Development, and Evaluation methodology to arrive at specific recommendations. The final document then underwent review by a secondary panel. This document aims to provide recommendations for most patients and situations. However, the ultimate judgement regarding the management of any individual patients should be made by their health care team. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  18. Advanced consequence management program: challenges and recent real-world implementations

    NASA Astrophysics Data System (ADS)

    Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

    2002-08-01

    The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

  19. Patterns of cannabis use and prospective associations with health issues among young males.

    PubMed

    Baggio, Stéphanie; N'Goran, Alexandra A; Deline, Stéphane; Studer, Joseph; Dupuis, Marc; Henchoz, Yves; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard

    2014-06-01

    To test prospective associations between cannabis disorder symptoms/frequency of cannabis use and health issues and to investigate stability versus transience in cannabis use trajectories. Two waves of data collection from the longitudinal Cohort Study on Substance Use Risk Factors (C-SURF). A representative sample of young Swiss men in their early 20s from the general population. A total of 5084 young men (mean age 19.98 ± 1.19 years at time 1). Cannabis use (life-time use, frequency of use, cannabis disorder symptoms) and self-reported measures of health issues (depression, mental/physical health, health consequences) were assessed. Significant changes in cannabis use were tested using t-test/Wilcoxon's rank test for paired data. Cross-lagged panel models provided evidence regarding longitudinal associations between cannabis use and health issues. Most of the participants (84.5%) remained in the same use category and cannabis use kept to similar levels at times 1 and 2 (P = 0.114 and P = 0.755; average of 15 ± 2.8 months between times 1 and 2). Cross-lagged panel models showed that cannabis disorder symptoms predicted later health issues (e.g. depression, β = 0.087, P < 0.001; health consequences, β = 0.045, P < 0.05). The reverse paths from health issues to cannabis disorder symptoms and the cross-lagged panel model between frequency of cannabis use and health issues were non-significant. Patterns of cannabis use showed substantial continuity among young Swiss men in their early 20s. The number of symptoms of cannabis use disorder, rather than the frequency of cannabis use, is a clinically important measure of cannabis use among young Swiss men. © 2014 Society for the Study of Addiction.

  20. Delineating managed land for reporting national greenhouse gas emissions and removals to the United Nations framework convention on climate change

    Treesearch

    Stephen M. Ogle; Grant Domke; Werner A. Kurz; Marcelo T. Rocha; Ted Huffman; Amy Swan; James E. Smith; Christopher Woodall; Thelma Krug

    2018-01-01

    Land use and management activities have a substantial impact on carbon stocks and associated greenhouse gas emissions and removals. However, it is challenging to discriminate between anthropogenic and non-anthropogenic sources and sinks from land. To address this problem, the Intergovernmental Panel on Climate Change developed a managed land proxy to determine which...

  1. Sexual health after breast cancer: Recommendations from the Spanish Menopause Society, Federación Española de Sociedades de Sexología, Sociedad Española de Médicos de Atención Primaria and Sociedad Española de Oncología Médica.

    PubMed

    Mendoza, Nicolás; Molero, Francisca; Criado, Fermín; Cornellana, Mª Jesús; González, Encarna

    2017-11-01

    Breast cancer is the most common cancer in women. As survival rates are increasing, the long-term health problems of survivors now need attention. Many survivors develop sexual disorders as a consequence of either the side-effects of treatment or induced menopause. A panel of experts from various Spanish scientific societies (Spanish Menopause Society, SMS; Federación Española de Sociedades de Sexología, FESS; Sociedad Española de Médicos de Atención Primaria, SEMERGEN; and Sociedad Española de Oncología Médica) met to develop recommendations for the management of sexual health in breast cancer survivors based on the best evidence available. The main recommendation is that sexuality must be considered by a multidisciplinary team as an integral part of treatment, to improve the quality of life of breast cancer survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Canadian Cardiovascular Society guidelines on the use of cardiac resynchronization therapy: implementation.

    PubMed

    Parkash, Ratika; Philippon, François; Shanks, Miriam; Thibault, Bernard; Cox, Jafna; Low, Aaron; Essebag, Vidal; Bashir, Jamil; Moe, Gordon; Birnie, David H; Larose, Eric; Yee, Raymond; Swiggum, Elizabeth; Kaul, Padma; Redfearn, Damian; Tang, Anthony S; Exner, Derek V

    2013-11-01

    Recent studies have provided the impetus to update the recommendations for cardiac resynchronization therapy (CRT). This article provides guidance on the implementation of CRT and is intended to serve as a framework for the implementation of CRT within the Canadian health care system and beyond. These guidelines were developed through a critical evaluation of the existing literature, and expert consensus. The panel unanimously adopted each recommendation. The 9 recommendations relate to patient selection in the presence of comorbidities, delivery and optimization of CRT, and resources required to deliver this therapy. The strength of evidence was weighed, taking full consideration of any risk of bias, and any imprecision, inconsistency, and indirectness of the available data. The strength of each recommendation and the quality of evidence were adjudicated. Trade-offs between desirable and undesirable consequences of alternative management strategies were considered, as were values, preferences, and resource availability. These guidelines were externally reviewed by experts, modified based on those reviews, and will be updated as new knowledge is acquired. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. Information Security Pmp Report: August 23, 2013

    NASA Astrophysics Data System (ADS)

    Wegener, Henning

    2014-07-01

    I have to start this brief report with a rueful confession: the PMP did not manage over the last months to complete the work program it had ambitiously laid out in its report of last year. Due to unforeseen circumstances, mainly professional reasons of some long-term members, the Group lost a number of them as active participants, and as a consequence failed to maintain the critical mass required for successful work as a group. However, thanks to the vision and generosity of Professor Zichichi, we were given the opportunity to draw in a number of new high-level cybersecurity experts from a number of countries which not only broadened our collective expertise, but also enhanced geographical distribution. Commensurate with the global nature of cyber affairs, we are now ourselves more global. A panel discussion in this year's plenary on topical issues of cybersecurity under the title "Cybersecurity at the Crossroads: Are We Losing the Battle" allowed some of our new members to display their prowess and expertise. At the same time, we have attempted to weld this new revitalized team into an effective work unit...

  4. Misstaging in nephroblastoma. Causes and consequences. A report of the Sixth Nephroblastoma Trial and Study of the International Society of Paediatric Oncology.

    PubMed

    de Kraker, J; Delemarre, J F; Lilien, M R; Tournade, M F

    1999-06-01

    In the Wilms tumour trials and studies of the International Society of Paediatric Oncology (SIOP), the postoperative treatment is based on the extension (stage) and the histological type. Incorrect staging results in under- or overtreatment. The authors studied the causes and consequences of misstaging in SIOP 6. In this study, the final stage was defined by a central panel of pathologists after review of the surgical and histopathological forms and study of representative microscopical sections. In 46 out of 509 trial patients there was a discrepancy between the final stage and the stage determined at the participating centres: 33 patients were understaged of whom 27 survived more than 5 years (18% died) and 13 patients were overstaged of whom 11 survived more than 5 years (15.3% died). All children with tumour extension into the renal pelvis and treated as stage I instead of stage II survived without evidence of disease. Therefore, it was decided to treat these children in the next study as a stage I. In 17 cases the treatment was based on the surgical stage before the pathological stage was known or the treatment was given according to the stage determined by the local pathologist without waiting for the panel review. The numbers are too small to conclude on the consequences of overtreatment on late effects. For all clinicians the main and most important conclusion of this study is: wait for the final pathology report before initiating postoperative therapy.

  5. Statin-associated muscle symptoms: impact on statin therapy—European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management

    PubMed Central

    Stroes, Erik S.; Thompson, Paul D.; Corsini, Alberto; Vladutiu, Georgirene D.; Raal, Frederick J.; Ray, Kausik K.; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G.; Bruckert, Eric; De Backer, Guy; Krauss, Ronald M.; Laufs, Ulrich; Santos, Raul D.; Hegele, Robert A.; Hovingh, G. Kees; Leiter, Lawrence A.; Mach, Francois; März, Winfried; Newman, Connie B.; Wiklund, Olov; Jacobson, Terry A.; Catapano, Alberico L.; Chapman, M. John; Ginsberg, Henry N.; Stroes, Erik; Thompson, Paul D.; Corsini, Alberto; Vladutiu, Georgirene D.; Raal, Frederick J.; Ray, Kausik K.; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G.; Bruckert, Eric; Krauss, Ronald M.; Laufs, Ulrich; Santos, Raul D.; März, Winfried; Newman, Connie B.; John Chapman, M.; Ginsberg, Henry N.; John Chapman, M.; Ginsberg, Henry N.; de Backer, Guy; Catapano, Alberico L.; Hegele, Robert A.; Kees Hovingh, G.; Jacobson, Terry A.; Leiter, Lawrence; Mach, Francois; Wiklund, Olov

    2015-01-01

    Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS. Statin-associated myopathy, with significant elevation of serum creatine kinase (CK), is a rare but serious side effect of statins, affecting 1 per 1000 to 1 per 10 000 people on standard statin doses. Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels, with a prevalence of 7–29% in registries and observational studies. Preclinical studies show that statins decrease mitochondrial function, attenuate energy production, and alter muscle protein degradation, thereby providing a potential link between statins and muscle symptoms; controlled mechanistic and genetic studies in humans are necessary to further understanding. The Panel proposes to identify SAMS by symptoms typical of statin myalgia (i.e. muscle pain or aching) and their temporal association with discontinuation and response to repetitive statin re-challenge. In people with SAMS, the Panel recommends the use of a maximally tolerated statin dose combined with non-statin lipid-lowering therapies to attain recommended low-density lipoprotein cholesterol targets. The Panel recommends a structured work-up to identify individuals with clinically relevant SAMS generally to at least three different statins, so that they can be offered therapeutic regimens to satisfactorily address their cardiovascular risk. Further research into the underlying pathophysiological mechanisms may offer future therapeutic potential. PMID:25694464

  6. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management.

    PubMed

    Stroes, Erik S; Thompson, Paul D; Corsini, Alberto; Vladutiu, Georgirene D; Raal, Frederick J; Ray, Kausik K; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G; Bruckert, Eric; De Backer, Guy; Krauss, Ronald M; Laufs, Ulrich; Santos, Raul D; Hegele, Robert A; Hovingh, G Kees; Leiter, Lawrence A; Mach, Francois; März, Winfried; Newman, Connie B; Wiklund, Olov; Jacobson, Terry A; Catapano, Alberico L; Chapman, M John; Ginsberg, Henry N

    2015-05-01

    Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS. Statin-associated myopathy, with significant elevation of serum creatine kinase (CK), is a rare but serious side effect of statins, affecting 1 per 1000 to 1 per 10 000 people on standard statin doses. Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels, with a prevalence of 7-29% in registries and observational studies. Preclinical studies show that statins decrease mitochondrial function, attenuate energy production, and alter muscle protein degradation, thereby providing a potential link between statins and muscle symptoms; controlled mechanistic and genetic studies in humans are necessary to further understanding. The Panel proposes to identify SAMS by symptoms typical of statin myalgia (i.e. muscle pain or aching) and their temporal association with discontinuation and response to repetitive statin re-challenge. In people with SAMS, the Panel recommends the use of a maximally tolerated statin dose combined with non-statin lipid-lowering therapies to attain recommended low-density lipoprotein cholesterol targets. The Panel recommends a structured work-up to identify individuals with clinically relevant SAMS generally to at least three different statins, so that they can be offered therapeutic regimens to satisfactorily address their cardiovascular risk. Further research into the underlying pathophysiological mechanisms may offer future therapeutic potential. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  7. Best practices recommendations for chiropractic care for infants, children, and adolescents: results of a consensus process.

    PubMed

    Hawk, Cheryl; Schneider, Michael; Ferrance, Randy J; Hewitt, Elise; Van Loon, Meghan; Tanis, Lora

    2009-10-01

    There has been much discussion about the role of chiropractic care in the evaluation, management, and treatment of pediatric patients. To date, no specific guidelines have been adopted that address this issue from an evidence based perspective. Previous systematic reviews of the chiropractic literature concluded that there is not yet a substantial body of high quality evidence from which to develop standard clinical guidelines. The purpose of this project was to develop recommendations on "best practices" related primarily to the evaluation and spinal manipulation aspects of pediatric chiropractic care; nonmanipulative therapies were not addressed in detail. Based on both clinical experience and the results of an extensive literature search, a set of seed documents was compiled to inform development of the seed statements. These were circulated electronically to the Delphi panel until consensus was reached, which was considered to be present when there was agreement by at least 80% of the panelists. A multidisciplinary panel of 37 was made up primarily of doctors of chiropractic with a mean of 18 years in practice, many with post-graduate training in pediatrics. The panel represented 5 countries and 17 states; there were members of the American Chiropractic Association, the International Chiropractors Association, and the International Chiropractic Pediatric Association. The panel reached a minimum of 80% consensus on the 51 seed statements after 4 rounds. A broad-based panel of experienced chiropractors was able to reach a high level (80%) of consensus regarding specific aspects of the chiropractic approach to clinical evaluation, management, and manual treatment for pediatric patients, based on both scientific evidence and clinical experience.

  8. Impact of expanded newborn screening--United States, 2006.

    PubMed

    2008-09-19

    Universal newborn screening for selected metabolic, endocrine, hematologic, and functional disorders is a well-established practice of state public health programs. Recent developments in tandem mass spectrometry (MS/MS), which is now capable of multi-analyte analysis in a high throughput capacity, has enabled newborn screening to include many more disorders detectable from a newborn blood spot. In 2006, to address the substantial variation that existed from state to state in the number of disorders included in newborn screening panels, the American College of Medical Genetics (ACMG), under guidance from the Health Resources and Services Administration, recommended a uniform panel of 29 disorders, which was subsequently endorsed by the federal Advisory Committee on Heritable Disorders in Newborns and Children. After 2006, most states began to expand their panels to include all 29 disorders; currently, 21 states and the District of Columbia have fully implemented the ACMG panel. To estimate the burden to state newborn screening programs resulting from this expansion, CDC used 2001-2006 data from those states with well-established MS/MS screening programs to estimate the number of children in the United States who would have been identified with disorders in 2006 if all 50 states and the District of Columbia had been using the ACMG panel. This report describes the results of that analysis, which indicated that, although such an expansion would have increased the number of children identified by only 32% (from 4,370 to 6,439), these children would have had many rare disorders that require local or regional capacity to deliver expertise in screening, diagnosis, and management. The findings underscore the need for public health and health-care delivery systems to build or expand the programs required to manage the rare disorders detected through expanded newborn screening, while also continuing programs to address more common disorders.

  9. Combating Terrorism: Issues in Managing Counterterrorist Programs

    DTIC Science & Technology

    2000-04-06

    major effort to develop a national strategy, to date the strategy does not include a clear desired outcome to be achieved. Resources to combat...Federal exercises, in contrast to earlier years, are now practicing crisis and consequence management simultaneously and including state and local...categories—crisis management and consequence management. Crisis management includes efforts to stop a terrorist attack, arrest terrorists, and gather

  10. Environmental Security Cooperation USARPAC’s: Defense Environmental and International Cooperation (DEIC) Conference (Center of Strategic Leadeship Issue Paper, Volume 07-03, September 2003)

    DTIC Science & Technology

    2003-09-01

    infrastructure, and providing consequence management and mitigation of man-made and natural disasters. The United States Army, Pacifi c (USARPAC), the Offi...Terrorism, Disaster Response and Consequence Management , and Medical Aspects of Environmental Security. The conference brought together military and...consequence management in maintaining governmental legitimacy, and examine salient military roles in preventing, responding to, and mitigating natural

  11. Outreach Opportunities for Early Career Scientists at the Phoenix ComiCon

    NASA Astrophysics Data System (ADS)

    Horodyskyj, L.; Walker, S. I.; Forrester, J. H.

    2014-12-01

    The Phoenix ComiCon (PCC) is a rapidly growing annual four-day pop culture event, featuring guests, costuming, exhibits, and discussion panels for popular sci-fi, fantasy, horror, and anime franchises. In 2013, PCC began experimenting with science discussion panels. The popularity of the science programming resulted in an expansion of the track for 2014, which Horodyskyj was responsible for coordinating. Thirty hours of programming were scheduled, including 25 discussion panels, NASA's FameLab, and a Mars room. Panelists included industry specialists, established scientists, STEM outreach enthusiasts, and early career scientists. The majority of the panelists were early career scientists recruited from planetary sciences and biology departments at ASU and UA. Panel topics included cosmology, biotechnology, artificial intelligence, space exploration, astrobiology, and the cross-linkages of each with pop culture. Formats consisted of Q&A, presentations, and interactive game shows. Although most panels were aimed at the general audience, some panels were more specialized. PCC 2014 attracted 77,818 attendees. The science programming received rave reviews from the audience, the PCC management, and the panelists themselves. Many panel rooms were filled to capacity and required crowd control to limit attendance. We observed the formation of science "groupies" who sought out the science panels exclusively and requested more information on other science public events in the Phoenix area. We distributed surveys to several select sessions to evaluate audience reasons for attending the science panels and their opinion of the scientists they observed. We will present the results of these surveys. As the PCC continues to grow at an exponential rate, the science programming will continue to expand. We will discuss ideas for continued expansion of the PCC science programming both to serve the public and as a unique public outreach opportunity for early career scientists.

  12. Diuretics

    MedlinePlus

    ... 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee. Journal of the American Medical Association. 2014;311:507. ...

  13. Experimental investigation to evaluate the potential environmental hazards of photovoltaic panels.

    PubMed

    Tammaro, Marco; Salluzzo, Antonio; Rimauro, Juri; Schiavo, Simona; Manzo, Sonia

    2016-04-05

    Recently the potential environmental hazard of photovoltaic modules together with their management as waste has attracted the attention of scientists. Particular concern is aroused by the several metals contained in photovoltaic panels whose potential release in the environment were scarcely investigated. Here, for the first time, the potential environmental hazard of panels produced in the last 30 years was investigated through the assessment of up to 18 releasable metals. Besides, the corresponding ecotoxicological effects were also evaluated. Experimental data were compared with the current European and Italian law limits for drinking water, discharge on soil and landfill inert disposal in order to understand the actual pollution load. Results showed that less than 3% of the samples respected all law limits and around 21% was not ecotoxic. By considering the technological evolutions in manufacturing, we have shown that during the years crystalline silicon panels have lower tendency to release hazardous metals with respect to thin film panels. In addition, a prediction of the amounts of lead, chromium, cadmium and nickel releasable from next photovoltaic waste was performed. The prevision up to 2050 showed high amounts of lead (30t) and cadmium (2.9t) releasable from crystalline and thin film panels respectively. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Analysis of Wind Forces on Roof-Top Solar Panel

    NASA Astrophysics Data System (ADS)

    Panta, Yogendra; Kudav, Ganesh

    2011-03-01

    Structural loads on solar panels include forces due to high wind, gravity, thermal expansion, and earthquakes. International Building Code (IBC) and the American Society of Civil Engineers are two commonly used approaches in solar industries to address wind loads. Minimum Design Loads for Buildings and Other Structures (ASCE 7-02) can be used to calculate wind uplift loads on roof-mounted solar panels. The present study is primarily focused on 2D and 3D modeling with steady, and turbulent flow over an inclined solar panel on the flat based roof to predict the wind forces for designing wind management system. For the numerical simulation, 3-D incompressible flow with the standard k- ɛ was adopted and commercial CFD software ANSYS FLUENT was used. Results were then validated with wind tunnel experiments with a good agreement. Solar panels with various aspect ratios for various high wind speeds and angle of attacks were modeled and simulated in order to predict the wind loads in various scenarios. The present study concluded to reduce the strong wind uplift by designing a guide plate or a deflector before the panel. Acknowledgments to Northern States Metal Inc., OH (GK & YP) and School of Graduate Studies of YSU for RP & URC 2009-2010 (YP).

  15. Pollution Permanent Monitoring PANEL--2013 Annual Report

    NASA Astrophysics Data System (ADS)

    Everett, Lorne G.

    2014-07-01

    The following sections are included: * POLLUTION PANEL ACTIVITIES 2013 * NATIONAL ACADEMY OF SCIENCES 2013 * MTBE NEW HAMPSHIRE LITIGATION--APRIL 12, 2013 * ALTERNATIVES FOR MANAGING THE NATION's COMPLEX CONTAMINATED GROUNDWATER SITES--NATIONAL ACADEMY OF SCIENCES, 2013 * HUMAN HEALTH EFFECTS OF TRICHLOROETHYLENE: KEY FINDINGS AND SCIENTIFIC ISSUES. MARCH 1, 2013 REVIEWS * BAROMETRIC PRESSURE DRIVES SOIL-GAS CONCENTRATIONS * WATER RESOURCES--TERRORISM TARGETS * WITH A LITTLE INGENUITY THE PROBLEM IS NOT INSOLUBLE * HIGH RISE BUILDINGS * TERRORIST MATERIAL MAY DESTROY WATER TRANSMISSION INFRASTRUCTURE * WATER THREAT CONCLUSIONS * MULTINATIONAL REPOSITORIES

  16. An Analysis of an R&D Program Selection Process at the Aeronautical Systems Division.

    DTIC Science & Technology

    1980-09-01

    Without the help of the Defense Wide Management and Support panel members, this research effort would have been impossible. They provided valuable personal ...decision packages. Next, the DWMS panel members were interviewed in order to obtain their personal interpretation of the evaluation cri- teria used by...packages (McCandless, 1978:46). The state of Georgia had over 11,000 packages to evaluate, and it would be impossible for one person to evaluate all the

  17. Chicago’s O’Hare Runway Configuration Management System (RCMS). Volume 1. Description of the Operational Software,

    DTIC Science & Technology

    1987-07-01

    9 ...Glossary D-i E- Distribution List E-I D. tSl ’S I hec 3 tttt ,"t!<_-Z. :,,’ e ’: :’ :.,", : - ’,,"/ . .>" ",;’ 9 ’ ’:/’,"" ’,,-’¢’..’:, : ,’-.’ ,.-;.;.;- 4...2 Sheets) 23 6 Foreground Program Flowchart (2 Sheets) 25 7 PF-1 Master Auto Panel 27 8 PF-2 Master Panel 28 9 PF-3 Eligible Current

  18. ISASS Policy Statement – Lumbar Artificial Disc

    PubMed Central

    Garcia, Rolando

    2015-01-01

    Purpose The primary goal of this Policy Statement is to educate patients, physicians, medical providers, reviewers, adjustors, case managers, insurers, and all others involved or affected by insurance coverage decisions regarding lumbar disc replacement surgery. Procedures This Policy Statement was developed by a panel of physicians selected by the Board of Directors of ISASS for their expertise and experience with lumbar TDR. The panel's recommendation was entirely based on the best evidence-based scientific research available regarding the safety and effectiveness of lumbar TDR. PMID:25785243

  19. Trustees Are Playing a Greater Role in Managing Colleges' Risks

    ERIC Educational Resources Information Center

    Wolverton, Brad

    2008-01-01

    College trustees are stepping up their oversight as institutions seek new revenue sources and as government scrutiny of higher education continues to increase, a panel of management experts said last week at the annual conference of the Association of Governing Boards of Universities and Colleges. Across the country, board members are hiring…

  20. 77 FR 72831 - Meeting of the Ocean Research Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-06

    ... commentary. ADDRESSES: The meeting will be held at the Consortium for Ocean Leadership, 1201 New York Avenue... Committee Act (5 U.S.C. App. 2). The meeting will include discussions on ocean research, resource management, and other current issues in the ocean science and management communities. Dated: November 29, 2012. L...

  1. 76 FR 12088 - Meeting of the Ocean Research and Resources Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ...: The meeting will be held at the Consortium for Ocean Leadership, 1201 New York Avenue, NW., 4th Floor... U.S.C. App. 2). The meeting will include discussions on ocean research, resource management, and other current issues in the ocean science and management communities; including, the review and...

  2. The Total Quality Management Model Department of Personnel State of Colorado,

    DTIC Science & Technology

    A panel of three members will present the Total Quality Management model recently designed for the Department of Personnel, State of Colorado. This model was selected to increase work quality and productivity of the Department and to exemplify Governor Romer’s commitment to quality work within state government.

  3. Report of the Army Scientific Advisory Panel AD HOC Group for Logistics and Research and Development

    DTIC Science & Technology

    1975-01-01

    where the Group met with the commanding officers and staff of the Army Logistics Management Center (ALMC) and the Army Logistics Center (ALOGC...has been completad; i.e., retrospectively, and a new program being con- sidered . It is our understanding that the Army Logistics Management Center

  4. 75 FR 1754 - Gulf of Mexico Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-13

    ...; Spiny Lobster/ Stone Crab Management; Red Drum; Habitat Protection; Coastal Migratory Pelagics (Mackerel... the SEDAR meetings for Spiny Lobster, Yellowedge Grouper and Tilefish and Greater Amberjack. 9:20 a.m... Panel meeting. 4:45 p.m. - 5:45 p.m. - The Spiny Lobster/Stone Crab Committee will discuss the Options...

  5. American Council on Consumer Interests Annual Conference (45th, Chicago, Illinois, March 24-27, 1999).

    ERIC Educational Resources Information Center

    Leech, Irene E., Ed.

    1999-01-01

    This document contains 4 invited papers, 21 refereed papers, 15 reports accompanying refereed posters, 8 reports from invited paper sessions, and 4 reports from invited panel sessions. Selected papers are as follows: "Managed Care Benefits Consumers" (Smith); "The Paradox of Managed Care" (Lieberman); "How Much Is Enough:…

  6. 78 FR 7418 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-01

    ...; Submission to the Office of Management and Budget for Review and Approval; Comment Request; High School... Maintenance AGENCY: Department of Education (ED), Institute of Education Sciences. ACTION: Notice. SUMMARY: In... (HSLS:09) High School Transcript and 2013 Update Full Scale Study and Panel Maintenance. OMB Control...

  7. Integrating Science and Management to Assess Forest Ecosystem Vulnerability to Climate Change

    Treesearch

    Leslie A. Brandt; Patricia R. Butler; Stephen D. Handler; Maria K. Janowiak; P. Danielle Shannon; Christopher W. Swanston

    2017-01-01

    We developed the ecosystem vulnerability assessment approach (EVAA) to help inform potential adaptation actions in response to a changing climate. EVAA combines multiple quantitative models and expert elicitation from scientists and land managers. In each of eight assessment areas, a panel of local experts determined potential vulnerability of forest ecosystems to...

  8. 76 FR 57958 - Fisheries of the South Atlantic and Gulf of Mexico; South Atlantic Fishery Management Council...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ...) will hold meetings of its Scientific and Statistical Committee (SSC) and Socio-Economic Sub-Panel (SEP) to review fishery management plan (FMP) amendments under development, ABC control rule approaches... process. The SSC will discuss FMP amendments under development, assessments of black sea bass and tilefish...

  9. Panel Discussion: Weed Management

    Treesearch

    Don Stringfield

    2005-01-01

    Successful weed management must be an incorporation of techniques and ideas. Habitual practices of cleaning equipment, using the proper cover crop, spraying small amounts of herbicides early and more often, timing of applications, and the use of the correct mulch/resin are all important lines of attack in keeping the nursery free of competing vegetation. The methods...

  10. Starting from Scratch: Greening Your Game Day--The Collegiate Football Sustainable Materials Management Toolkit. Version 1.0

    ERIC Educational Resources Information Center

    Association for the Advancement of Sustainability in Higher Education, 2011

    2011-01-01

    The "Collegiate Football Sustainable Materials Management Toolkit" was researched by student interns in the Virginia Tech Office of Energy & Sustainability, developed in collaboration with the US EPA (US Environmental Protection Agency) and a national panel of technical experts from universities across the nation, and driven forward…

  11. 77 FR 42297 - Meeting of the Ocean Research and Resources Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... Consortium for Ocean Leadership, 1201 New York Avenue NW., 4th Floor, Washington, DC 2005. FOR FURTHER... discussions on ocean research, resource management, and other current issues in the ocean science and management communities. J.M. Beal, Lieutenant Commander, Office of the Judge Advocate General, U.S. Navy...

  12. Residents' values and fuels management approaches

    Treesearch

    Gwo-Bao Liou; Christine Vogt; Greg Winter; Sarah McCaffrey

    2008-01-01

    The research utilizes the Forest Value and Salient Value Similarity Scales to examine homeowners' value orientations and relate them to attitudes toward and support for fuels management approaches. Data were collected from homeowners living in the wildland-urban interface of the Huron- Manistee National Forest at two time periods, in 2002 and 2006. The panel data...

  13. Quality of Disease Management and Risk of Mortality in English Primary Care Practices.

    PubMed

    Dusheiko, Mark; Gravelle, Hugh; Martin, Stephen; Smith, Peter C

    2015-10-01

    To investigate whether better management of chronic conditions by family practices reduces mortality risk. Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions. © Health Research and Educational Trust.

  14. Issues and challenges in resource management and its interaction with levels 2/3 fusion with applications to real-world problems: an annotated perspective

    NASA Astrophysics Data System (ADS)

    Blasch, Erik; Kadar, Ivan; Hintz, Kenneth; Biermann, Joachim; Chong, Chee-Yee; Salerno, John; Das, Subrata

    2007-04-01

    Resource management (or process refinement) is critical for information fusion operations in that users, sensors, and platforms need to be informed, based on mission needs, on how to collect, process, and exploit data. To meet these growing concerns, a panel session was conducted at the International Society of Information Fusion Conference in 2006 to discuss the various issues surrounding the interaction of Resource Management with Level 2/3 Situation and Threat Assessment. This paper briefly consolidates the discussion of the invited panel panelists. The common themes include: (1) Addressing the user in system management, sensor control, and knowledge based information collection (2) Determining a standard set of fusion metrics for optimization and evaluation based on the application (3) Allowing dynamic and adaptive updating to deliver timely information needs and information rates (4) Optimizing the joint objective functions at all information fusion levels based on decision-theoretic analysis (5) Providing constraints from distributed resource mission planning and scheduling; and (6) Defining L2/3 situation entity definitions for knowledge discovery, modeling, and information projection

  15. Empire's recent history, as seen from the Special Advisory Review Panel on Blue Cross.

    PubMed

    Barba, J J

    1997-01-01

    Empire is a smaller and more financially stable company that no longer has an externally imposed social mission. The board and management of Empire have decided to convert to a for-profit company, to compete in the marketplace. In light of this decision, they also decided to turn over the company's charitable value to a new foundation. Because Empire's board has chosen not to maintain a social mission, the Panel strongly supports its proposal to turn over the full value of the charitable asset. This will allow the asset to be used for purposes that are in keeping with Empire's original social mission. Exactly how this asset should be valued, what form it should take, when it should be turned over, who should control the assets, and what activities it should support are just a few of the many important issues that must be resolved during the next few months. Empire will not and should not remain stagnant during the next few months. Given the rapidly evolving health-care market, Empire's board and management must continue to pursue a market strategy that strengthens the company. However, given the factors discussed earlier--hospital deregulation, the increasingly competitive managed-care market, and other pressures in the health-care environment--it is clear that the road ahead for Empire will not be a smooth one and that the company's financial resurgence is no guarantee of continued stability. Much hard work remains. I am confident that Empire's board and its management will continue to do its part, that the Panel will continue to do likewise.

  16. Empire's recent history, as seen from the Special Advisory Review Panel on Blue Cross.

    PubMed Central

    Barba, J. J.

    1997-01-01

    Empire is a smaller and more financially stable company that no longer has an externally imposed social mission. The board and management of Empire have decided to convert to a for-profit company, to compete in the marketplace. In light of this decision, they also decided to turn over the company's charitable value to a new foundation. Because Empire's board has chosen not to maintain a social mission, the Panel strongly supports its proposal to turn over the full value of the charitable asset. This will allow the asset to be used for purposes that are in keeping with Empire's original social mission. Exactly how this asset should be valued, what form it should take, when it should be turned over, who should control the assets, and what activities it should support are just a few of the many important issues that must be resolved during the next few months. Empire will not and should not remain stagnant during the next few months. Given the rapidly evolving health-care market, Empire's board and management must continue to pursue a market strategy that strengthens the company. However, given the factors discussed earlier--hospital deregulation, the increasingly competitive managed-care market, and other pressures in the health-care environment--it is clear that the road ahead for Empire will not be a smooth one and that the company's financial resurgence is no guarantee of continued stability. Much hard work remains. I am confident that Empire's board and its management will continue to do its part, that the Panel will continue to do likewise. PMID:9439862

  17. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain

    PubMed Central

    Chou, Roger; Fanciullo, Gilbert J.; Fine, Perry G.; Adler, Jeremy A.; Ballantyne, Jane C.; Davies, Pamela; Donovan, Marilee I.; Fishbain, David A.; Foley, Kathy M.; Fudin, Jeffrey; Gilson, Aaron M.; Kelter, Alexander; Mauskop, Alexander; O'Connor, Patrick G.; Passik, Steven D.; Pasternak, Gavril W.; Portenoy, Russell K.; Rich, Ben A.; Roberts, Richard G.; Todd, Knox H.; Miaskowski, Christine

    2014-01-01

    Use of chronic opioid therapy for chronic noncancer pain has increased substantially. The American Pain Society and the American Academy of Pain Medicine commissioned a systematic review of the evidence on chronic opioid therapy for chronic noncancer pain and convened a multidisciplinary expert panel to review the evidence and formulate recommendations. Although evidence is limited, the expert panel concluded that chronic opioid therapy can be an effective therapy for carefully selected and monitored patients with chronic noncancer pain. However, opioids are also associated with potentially serious harms, including opioid-related adverse effects and outcomes related to the abuse potential of opioids. The recommendations presented in this document provide guidance on patient selection and risk stratification; informed consent and opioid management plans; initiation and titration of chronic opioid therapy; use of methadone; monitoring of patients on chronic opioid therapy; dose escalations, high-dose opioid therapy, opioid rotation, and indications for discontinuation of therapy; prevention and management of opioid-related adverse effects; driving and work safety; identifying a medical home and when to obtain consultation; management of breakthrough pain; chronic opioid therapy in pregnancy; and opioid-related polices. Perspective: Safe and effective chronic opioid therapy for chronic noncancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and on the assessment and management of risks associated with opioid abuse, addiction, and diversion. Although evidence is limited in many areas related to use of opioids for chronic noncancer pain, this guideline provides recommendations developed by a multidisciplinary expert panel following a systematic review of the evidence. PMID:19187889

  18. Identification and management of comorbidity in psoriatic arthritis: evidence- and expert-based recommendations from a multidisciplinary panel from Spain.

    PubMed

    Torre-Alonso, Juan Carlos; Carmona, Loreto; Moreno, Mireia; Galíndez, Eva; Babío, Jesús; Zarco, Pedro; Linares, Luis; Collantes-Estevez, Eduardo; Barrial, Manuel Fernández; Hermosa, Juan Carlos; Coto, Pablo; Suárez, Carmen; Almodóvar, Raquel; Luelmo, Jesús; Castañeda, Santos; Gratacós, Jordi

    2017-08-01

    The objective is to establish recommendations, based on evidence and expert opinion, for the identification and management of comorbidities in patients with psoriatic arthritis (PsA). The following techniques were applied: discussion group, systematic review, and Delphi survey for agreement. A panel of professionals from four specialties defined the users, the sections of the document, possible recommendations, and what systematic reviews should be performed. A second discussion was held with the results of the systematic reviews. Recommendations were formulated in the second meeting and voted online from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation were assigned using the Oxford Centre for Evidence-Based Medicine guidance. The full document was critically appraised by the experts, and the project was supervised at all times by a methodologist. In a final step, the document was reviewed and commented by a patient and a health management specialist. Fourteen recommendations were produced, together with a checklist to facilitate the implementation. The items with the largest support from evidence were those related to cardiovascular disease and risk factors. The panel recommends paying special attention to obesity, smoking, and alcohol consumption, as they are all modifiable factors with an impact on treatment response or complications of PsA. Psychological and organizational aspects were also deemed important. We herein suggest practical recommendations for the management of comorbidities in PsA based on evidence and expert opinion.

  19. Communicating Uncertainty about Climate Change for Application to Security Risk Management

    NASA Astrophysics Data System (ADS)

    Gulledge, J. M.

    2011-12-01

    The science of climate change has convincingly demonstrated that human activities, including the release of greenhouse gases, land-surface changes, particle emissions, and redistribution of water, are changing global and regional climates. Consequently, key institutions are now concerned about the potential social impacts of climate change. For example, the 2010 Quadrennial Defense Review Report from the U.S. Department of Defense states that "climate change, energy security, and economic stability are inextricably linked." Meanwhile, insured losses from climate and weather-related natural disasters have risen dramatically over the past thirty years. Although these losses stem largely from socioeconomic trends, insurers are concerned that climate change could exacerbate this trend and render certain types of climate risk non-diversifiable. Meanwhile, the climate science community-broadly defined as physical, biological, and social scientists focused on some aspect of climate change-remains largely focused scholarly activities that are valued in the academy but not especially useful to decision makers. On the other hand, climate scientists who engage in policy discussions have generally permitted vested interests who support or oppose climate policies to frame the discussion of climate science within the policy arena. Such discussions focus on whether scientific uncertainties are sufficiently resolved to justify policy and the vested interests overstate or understate key uncertainties to support their own agendas. Consequently, the scientific community has become absorbed defending scientific findings to the near exclusion of developing novel tools to aid in risk-based decision-making. For example, the Intergovernmental Panel on Climate Change (IPCC), established expressly for the purpose of informing governments, has largely been engaged in attempts to reduce unavoidable uncertainties rather than helping the world's governments define a science-based risk-management framework for climate security. The IPCC's Fourth Assessment Report concluded that "Responding to climate change involves an iterative risk management process that includes both adaptation and mitigation and takes into account climate change damages, co-benefits, sustainability, equity and attitudes to risk." In risk management, key uncertainties guide action aimed at reducing risk and cannot be ignored or used to justify inaction. Security policies such as arms control and counter-terrorism demonstrate that high-impact outcomes matter to decision makers even if they are likely to be rare events. In spite of this fact, the long tail on the probability distribution of climate sensitivity was largely ignored by the climate science community until recently and its implications for decision making are still not receiving adequate attention. Informing risk management requires scientists to shift from a singular aversion to type I statistical error (i.e. false positive) to a balanced presentation of both type I error and type II error (i.e. false negative) when the latter may have serious consequences. Examples from national security, extreme weather, and economics illustrate these concepts.

  20. Double-Lap Shear Test For Honeycomb Core

    NASA Technical Reports Server (NTRS)

    Nettles, Alan T.; Hodge, Andrew J.

    1992-01-01

    Double-lap test measures shear strength of panel made of honeycomb core with 8-ply carbon-fiber/epoxy face sheets. Developed to overcome three principal disadvantages of prior standard single-lap shear test: specimen had to be more than 17 in. long; metal face sheets had to be used; and test introduced torque, with consequent bending and peeling of face sheets and spurious tensile or compressive loading of honeycomb.

  1. Managing Risk for Thermal Vacuum Testing of the International Space Station Radiators

    NASA Technical Reports Server (NTRS)

    Carek, Jerry A.; Beach, Duane E.; Remp, Kerry L.

    2000-01-01

    The International Space Station (ISS) is designed with large deployable radiator panels that are used to reject waste heat from the habitation modules. Qualification testing of the Heat Rejection System (HRS) radiators was performed using qualification hardware only. As a result of those tests, over 30 design changes were made to the actual flight hardware. Consequently, a system level test of the flight hardware was needed to validate its performance in the final configuration. A full thermal vacuum test was performed on the flight hardware in order to demonstrate its ability to deploy on-orbit. Since there is an increased level of risk associated with testing flight hardware, because of cost and schedule limitations, special risk mitigation procedures were developed and implemented for the test program, This paper introduces the Continuous Risk Management process that was utilized for the ISS HRS test program. Testing was performed in the Space Power Facility at the NASA Glenn Research Center, Plum Brook Station located in Sandusky, Ohio. The radiator system was installed in the 100-foot diameter by 122-foot tall vacuum chamber on a special deployment track. Radiator deployments were performed at several thermal conditions similar to those expected on-orbit using both the primary deployment mechanism and the back-up deployment mechanism. The tests were highly successful and were completed without incident.

  2. Priorities for the professional development of registered nurses in nursing homes: a Delphi study.

    PubMed

    Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara

    2017-01-08

    To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.

  3. Consultative Committee on Road Traffic Fatalities: trauma audit methodology.

    PubMed

    McDermott, F T; Cordner, S M; Tremayne, A B

    2000-10-01

    Since 1992 the Consultative Committee on Road Traffic Fatalities in Victoria has identified deficiencies and errors in the management of 559 road traffic fatalities in which the patients were alive on arrival of ambulance services. The Committee also assessed the preventability of deaths. Reproducibility of results using its methodology has been shown to be statistically significant. The Committee's findings and recommendations, the latter made in association with the learned Colleges and specialist Societies, led to the establishment of a Ministerial Taskforce on Trauma and Emergency Services. As a consequence, in 2000, a new trauma care system will be implemented in Victoria. This paper presents a case example demonstrating the Committee's methodology. The Committee has two 12 member multidisciplinary evaluative panels. A retrospective evaluation was made of the complete ambulance, hospital and autopsy records of eligible fatalities. The clinical and pathological findings were analysed using a comprehensive data proforma, a narrative summary and the complete records. Resulting multidisciplinary discussion problems were identified and the potential preventability of death was assessed. In the present case example the Committee identified 16 management deficiencies of which 11 were assessed as having contributed to the patient's death; the death, however, was judged to be non-preventable. The presentation of this example demonstrating the Committee's methodology may be of assistance to hospital medical staff undertaking their own major trauma audit.

  4. Risk factors perceived predictive of ISA spread in Chile: applications to decision support.

    PubMed

    Gustafson, L; Antognoli, M; Lara Fica, M; Ibarra, R; Mancilla, J; Sandoval Del Valle, O; Enriquez Sais, R; Perez, A; Aguilar, D; Madrid, E; Bustos, P; Clement, A; Godoy, M G; Johnson, C; Remmenga, M

    2014-11-01

    Aquaculture is anticipated to be a critical element in future solutions to global food shortage. However, diseases can impede industry efficiency and sustainability. Consequently, diseases can and have led to dramatic re-structuring in industry or regulatory practices. The emergence of infectious salmon anemia (ISA) in Chile is one such example. As in other countries, many mitigations were instituted universally, and many incurred considerable costs as they introduced a new layer of coordination of farming activities of marine sites within common geographic areas (termed 'neighborhoods' or 'barrios'). The aggregate response led to a strong reduction in ISA incidence and impact. However, the relative value of individual mitigations is less clear, especially where response policies were universally applied and retrospective analyses are missing 'controls' (i.e., areas where a mitigation was not applied). Further, re-focusing policies around disease prevention following resolution of an outbreak is important to renew sustainable production; though, again, field data to guide this shift in purpose are often lacking. Expert panels can offer timely decision support in the absence of empirical data. We convened a panel of fish health experts to weight risk factors predictive of ISA virus (ISAV) introduction or spread between Atlantic salmon barrios in Chile. Barrios, rather than sites, were the unit of interest because many of the new mitigations operate at this level and few available studies examine their efficacy. Panelists identified barrio processing plant biosecurity, fallowing strategies, adult live fish transfers, fish and site density, smolt quality, hydrographic connection with other neighborhoods, presence of sea lice (Caligus rogercresseyi), and harvest vessel biosecurity as factors with the greatest predictive strength for ISAV virulent genotype ('HPR-deleted') occurrence. Fewer factors were considered predictive of ISAV HPR0 genotype ('HPR0') occurrence, with greatest strengths assigned to fish and site density, adult live fish transfers, and smolt facility HPR0 status. Field validation based on ISAV and risk factor occurrence after panel completion generally supports expert estimates, and highlights a few factors (e.g., broodstock HPR0 status) less conclusive in the original study. Results inform legislation, industry best management practices and surveillance design. Published by Elsevier B.V.

  5. Using a Fuzzy Light Sensor to Improve the Efficiency of Solar Panels

    NASA Astrophysics Data System (ADS)

    Suryono; Suseno, Jatmiko Endro; Sulistiati, Ainie Khuriati Riza; Prahara, Tahan

    2018-02-01

    Solar panel efficiency can be increased by improving the quality of photovoltaic material, the effectiveness of electronic circuit, and the light source tracking model. This research is aimed at improving the quality of solar panels by tracking light source using a fuzzy logic sensor. A fuzzy light sensor property is obtained from two LDR (light dependent resistor) light sensors installed in parallel to each other and is given a light separator in between them. Both sensors are mounted on a solar panel. Sensor output is acquired using a 12 bit ADC from an ATSAM3XE microcontroller and is then sent to a computer using WIFI radio. A PID (Proportional-Integral-Derivative) control algorithm is used to manage the position of the solar panel in line with the input given by the fuzzy light sensor. This control mechanism works based on the margin of fuzzy membership from both sensors that is used to move a motor DC that in turn moves the solar panel. Experimental results show a characteristically symmetrical fuzzy membership of both sensors with a reflected correlation of R=0.9981 after gains from both sensors are arranged with a program. Upon being tested in the field, this system was capable of improving the performance of solar panels in gaining power compared to their original fixed position. The discrepancy was evident when the angle of incoming sunlight approached both 0° and 180°. Further calculations of data acquired by the fuzzy light sensor show increased solar panel power efficiency by up to 5.6%.

  6. Public acceptance for centralized storage and repositories of low-level waste session (Panel)

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

    Lutz, H.R.

    1995-12-31

    Participants from various parts of the world will provide a summary of their particular country`s approach to low-level waste management and the cost of public acceptance for low-level waste management facilities. Participants will discuss the number, geographic location, and type of low-level waste repositories and centralized storage facilities located in their countries. Each will discuss the amount, distribution, and duration of funds to gain public acceptance of these facilities. Participants will provide an estimated $/meter for centralized storage facilities and repositories. The panel will include a brief discussion about the ethical aspects of public acceptance costs, approaches for negotiating acceptance,more » and lessons learned in each country. The audience is invited to participate in the discussion.« less

  7. Molecular Approaches to Thyroid Cancer Diagnosis

    PubMed Central

    Hsiao, Susan J.; Nikiforov, Yuri E.

    2014-01-01

    Thyroid nodules are common, and the accurate diagnosis of cancer or benign disease is important for the effective clinical management of these patients. Molecular markers are a helpful diagnostic tool, particularly for cytologically indeterminate thyroid nodules. In the past few years, significant progress has been made in developing molecular markers for clinical use in fine needle aspiration (FNA) specimens, including gene mutation panels and gene expression classifiers. With the availability of next generation sequencing technology, gene mutation panels can be expanded to interrogate multiple genes simultaneously and to provide yet more accurate diagnostic information. In addition, recently several new molecular markers in thyroid cancer have been identified that offer diagnostic, prognostic, and therapeutic information that could potentially be of value in guiding individualized management of patients with thyroid nodules. PMID:24829266

  8. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel.

    PubMed

    Döhner, Hartmut; Estey, Elihu; Grimwade, David; Amadori, Sergio; Appelbaum, Frederick R; Büchner, Thomas; Dombret, Hervé; Ebert, Benjamin L; Fenaux, Pierre; Larson, Richard A; Levine, Ross L; Lo-Coco, Francesco; Naoe, Tomoki; Niederwieser, Dietger; Ossenkoppele, Gert J; Sanz, Miguel; Sierra, Jorge; Tallman, Martin S; Tien, Hwei-Fang; Wei, Andrew H; Löwenberg, Bob; Bloomfield, Clara D

    2017-01-26

    The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease. © 2017 by The American Society of Hematology.

  9. EAGLEView: A surface and grid generation program and its data management

    NASA Technical Reports Server (NTRS)

    Remotigue, M. G.; Hart, E. T.; Stokes, M. L.

    1992-01-01

    An old and proven grid generation code, the EAGLE grid generation package, is given an added dimension of a graphical interface and a real time data base manager. The Numerical Aerodynamic Simulation (NAS) Panel Library is used for the graphical user interface. Through the panels, EAGLEView constructs the EAGLE script command and sends it to EAGLE to be processed. After the object is created, the script is saved in a mini-buffer which can be edited and/or saved and reinterpreted. The graphical objects are set-up in a linked-list and can be selected or queried by pointing and clicking the mouse. The added graphical enhancement to the EAGLE system emphasizes the unique capability to construct field points around complex geometry and visualize the construction every step of the way.

  10. Career Anchors and Career Paths: A Panel Study of Management School Graduates. Technical Report No. 1.

    ERIC Educational Resources Information Center

    Schein, Edgar H.

    The first of a series, this report describes a 10-year followup study of a sample of 44 graduates of the Sloan School of Management, analyzing the interaction of personal values and career events in the lives of managers in organizations. All 44 participants were located, interviewed, and given the same attitude surveys as in the early 1960's.…

  11. Styles of Success: Research on Gender Differences in Management Styles [and] What Is the Most Important Difference in Management Styles between Men and Women?

    ERIC Educational Resources Information Center

    Small Business Forum, 1995

    1995-01-01

    Responses to the Success Style Profile from 127 men and women businessowners and reactions from an 8-member panel found that male and female entrepreneurs resemble each other more than they resemble nonentrepreneurs in thinking and management styles. Women favor right-brain, intuitive styles. One conclusion is that both ways have strengths. (JOW)

  12. Cognitive Learning Theory Takes a Backseat: Consequences of a Management Development Program for Work Practice

    ERIC Educational Resources Information Center

    Moesby-Jensen, Cecilie K.

    2008-01-01

    This paper describes the consequences of a cognitive management development program for middle managers in a public organization. The objective was to teach transformational leadership and teamwork but it occasioned a very limited improved articulation of transformational leadership and teamwork and only a modest change in the managers' actions in…

  13. 77 FR 59686 - Sunshine Act Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... prevention of errors through robust system design, deployment, and operation. The second panel will focus on the responses to errors and malfunctions and managing crises in real-time. For further information...

  14. 75 FR 74004 - Atlantic Highly Migratory Species; Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... Organization, Practices, and Procedures by any of the following methods: E-mail: [email protected] . Mail... in the fisheries, related industries, research, teaching, writing, conservation, or management of...

  15. Clinical management algorithm of uveitis associated with juvenile idiopathic arthritis: interdisciplinary panel consensus.

    PubMed

    Bou, Rosa; Adán, Alfredo; Borrás, Fátima; Bravo, Beatriz; Calvo, Inmaculada; De Inocencio, Jaime; Díaz, Jesús; Escudero, Julia; Fonollosa, Alex; de Vicuña, Carmen García; Hernández, Victoria; Merino, Rosa; Peralta, Jesús; Rúa, María-Jesús; Tejada, Pilar; Antón, Jordi

    2015-05-01

    Uveitis associated with juvenile idiopathic arthritis (JIA) typically involves the anterior chamber segment, follows an indolent chronic course, and presents a high rate of uveitic complications and a worse outcome as compared to other aetiologies of uveitis. Disease assessment, treatment, and outcome measures have not been standardized. Collaboration between pediatric rheumatologists and ophthalmologists is critical for effective management and prevention of morbidity, impaired vision, and irreparable visual loss. Although the Standardization of Uveitis Nomenclature Working Group recommendations have been a great advance to help clinicians to improve consistency in grading and reporting data, difficulties arise at the time of deciding the best treatment approach in the individual patient in routine daily practice. For this reason, recommendations for a systematized control and treatment strategies according to clinical characteristics and disease severity in children with JIA-related uveitis were developed by a panel of experts with special interest in uveitis associated with JIA. A clinical management algorithm organized in a stepwise regimen is here presented.

  16. A novel dual-marker expression panel for easy and accurate risk stratification of patients with gastric cancer.

    PubMed

    Kanda, Mitsuro; Murotani, Kenta; Tanaka, Haruyoshi; Miwa, Takashi; Umeda, Shinichi; Tanaka, Chie; Kobayashi, Daisuke; Hayashi, Masamichi; Hattori, Norifumi; Suenaga, Masaya; Yamada, Suguru; Nakayama, Goro; Fujiwara, Michitaka; Kodera, Yasuhiro

    2018-05-07

    Development of specific biomarkers is necessary for individualized management of patients with gastric cancer. The aim of this study was to design a simple expression panel comprising novel molecular markers for precise risk stratification. Patients (n = 200) who underwent gastrectomy for gastric cancer were randomly assigned into learning and validation sets. Tissue mRNA expression levels of 15 candidate molecular markers were determined using quantitative PCR analysis. A dual-marker expression panel was created according to concordance index (C-index) values of overall survival for all 105 combinations of two markers in the learning set. The reproducibility and clinical significance of the dual-marker expression panel were evaluated in the validation set. The patient characteristics of the learning and validation sets were well balanced. The C-index values of combinations were significantly higher compared with those of single markers. The panel with the highest C-index (0.718) of the learning set comprised SYT8 and MAGED2, which clearly stratified patients into low-, intermediate-, and high-risk groups. The reproducibility of the panel was demonstrated in the validation set. High expression scores were significantly associated with larger tumor size, vascular invasion, lymph node metastasis, peritoneal metastasis, and advanced disease. The dual-marker expression panel provides a simple tool that clearly stratifies patients with gastric cancer into low-, intermediate-, and high risk after gastrectomy. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  17. Primer Modification Improves Rapid and Sensitive In Vitro and Field-Deployable Assays for Detection of High Plains Virus Variants

    PubMed Central

    Arif, M.; Aguilar-Moreno, G. S.; Wayadande, A.; Fletcher, J.

    2014-01-01

    A high consequence pathogen, High plains virus (HPV) causes considerable damage to wheat if the crop is infected during early stages of development. Methods for the early, accurate, and sensitive detection of HPV in plant tissues are needed for the management of disease outbreaks and reservoir hosts. In this study, the effectiveness of five methods—real-time SYBR green and TaqMan reverse transcription-quantitative PCR (RT-qPCR), endpoint RT-PCR, RT-helicase dependent amplification (RT-HDA) and the Razor Ex BioDetection System (Razor Ex)—for the broad-range detection of HPV variants was evaluated. Specific PCR primer sets and probes were designed to target the HPV nucleoprotein gene. Primer set HPV6F and HPV4R, which amplifies a product of 96 bp, was validated in silico against published sequences and in vitro against an inclusivity panel of infected plant samples and an exclusivity panel of near-neighbor viruses. The primers were modified by adding a customized 22 nucleotide long tail at the 5′ terminus, raising the primers' melting temperature (Tm; ca. 10°C) to make them compatible with RT-HDA (required optimal Tm = 68°C), in which the use of primers lacking such tails gave no amplification. All of the methods allowed the detection of as little as 1 fg of either plasmid DNA carrying the target gene sequence or of infected plant samples. The described in vitro and in-field assays are accurate, rapid, sensitive, and useful for pathogen detection and disease diagnosis, microbial quantification, and certification and breeding programs, as well as for biosecurity and microbial forensics applications. PMID:24162574

  18. "Population and poverty: major barriers to food accessibility" -- a panel discussion on civil society and people's participation.

    PubMed

    1996-01-01

    This paper summarizes conference statements on poverty and food policies that were made by parliamentary members from Malaysia, the Philippines, and India. These presentations were made after the main panel discussion on barriers to food accessibility. In Malaysia the government adopted a National Agricultural Policy in 1984. This policy encouraged increased productivity, effective use of resources, agricultural credit and incentives, and integrated pest management. Strong support was given to the food processing industry. Poverty was the main reason for food inaccessibility. Through government efforts, poverty was reduced from 16.5% in 1990 to 8.9% in 1995. The Filipino member reported that government efforts had focused on national campaigns to combat hunger and to encourage community participation. The government was forced to implement a national Plan of Action for Food Security due to increased population, environmental degradation, closing land frontiers, and the global economy. The Plan encouraged increases in productivity, price and supply stabilization, maintenance of stocks, and rice subsidies for the poor. Gender concerns were being incorporated into development programs. The Indian member linked food insecurity to world resource problems. He stated that food problems included imbalances between supply and demand, but more importantly inequalities in access to food and differences in nutritional content of food. Populations in developing countries spent a larger proportion of income on food of lesser quality and variety that contributed to nutritional deficiencies, particularly among women and children. Food insecurity was part of the cycle of poverty, hunger, low productivity, and high mortality. Poverty was the primary cause and a major consequence of hunger and chronic food insecurity. Although India increased food productivity, food insecurity remained. Multidisciplinary approaches are needed.

  19. How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

    PubMed

    Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin

    Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  20. Psychometric Evaluation of a Turkish Version of the Diabetes Fear of Self-injecting and Self-testing Questionnaire (D-FISQ).

    PubMed

    Celik, Selda; Pinar, Rukiye

    2016-09-01

    To examine the psychometric properties of a Turkish version of the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ). Forward-backward translation of the D-FISQ from English into Turkish was conducted. Original English and translated forms were examined by a panel group. Validity was investigated using content, confirmatory factor analysis, and divergent validity. Reliability was assessed using Cronbach α values, item-total correlations, and intraclass correlations. The sample comprised 350 patients with diabetes. Data were analyzed using SPSS 15.0 for Windows and LISREL 8. The content validity index for the panel members was .90, which indicated perfect content validity; items in D-FISQ were clear, concise, readable, and distinct. Confirmatory factor analysis confirmed the original construct of the D-FISQ. All items had factor loadings higher than the recommended level of .40. The D-FISQ scores were discriminated by the level of anxiety. Reliability results were also satisfactory. Cronbach α values were within ideal limits. Item-total correlation coefficient ranged from .72 to .86. In terms of test-retest reliability, intraclass correlation coefficient was found to be over .90. D-FISQ is a valid and reliable questionnaire in assessing needle-prick fear among Turkish patients with diabetes. We recommend performing the Turkish D-FISQ in determining and screening patients with diabetes who have fear related to self-insulin injection and finger-prick test. Thus, health care professionals should be aware of the potential consequences of injection fear such as insulin misuse and poor self-monitoring of blood glucose, which may have unfavorable effects on optimal diabetes management. Copyright © 2016. Published by Elsevier B.V.

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