Monitoring Coastal Marshes for Persistent Flooding and Salinity Stress

NASA Technical Reports Server (NTRS)

Kalcic, Maria

2010-01-01

Our objective is to provide NASA remote sensing products that provide inundation and salinity information on an ecosystem level to support habitat switching models. Project born out of need by the Coastal Restoration Monitoring System (CRMS), joint effort by Louisiana Department of Natural Resources and the U.S. Geological Survey, for information on persistence of flooding by storm surge and other flood waters. The results of the this work support the habitat-switching modules in the Coastal Louisiana Ecosystem Assessment and Restoration (CLEAR) model, which provides scientific evaluation for restoration management. CLEAR is a collaborative effort between the Louisiana Board of Regents, the Louisiana Department of Natural Resources (LDNR), the U.S. Geological Survey (USGS), and the U.S. Army Corps of Engineers (USACE). Anticipated results will use: a) Resolution enhanced time series data combining spatial resolution of Landsat with temporal resolution of MODIS for inundation estimates. b) Potential salinity products from radar and multispectral modeling. c) Combined inundation and salinity inputs to habitat switching module to produce habitat switching maps (shown at left)

Access Services Are Human Services: Collaborating to Provide Textbook Access to Students

ERIC Educational Resources Information Center

McElroy, Kelly; Moore, Dan; Hilterbrand, Lori; Hindes, Nicole

2017-01-01

Despite the clear negative impact of high textbook costs on students, limits--including space, funding, and policies--prevent many academic libraries from fully supporting textbook collections. Partnering with other campus units on textbook lending requires creative thinking but can provide students access to other services in addition to the…

Aspects of decision support in water management--example Berlin and Potsdam (Germany) I--spatially differentiated evaluation.

PubMed

Simon, Ute; Brüggemann, Rainer; Pudenz, Stefan

2004-04-01

Decisions about sustainable development demand spatially differentiated evaluations. As an example, we demonstrate the evaluation of water management strategies in the cities of Berlin and Potsdam (Germany) with respect to their ecological effects in 14 sections of the surface water system. Two decision support systems were compared, namely PROMETHEE, which is designed to obtain a clear decision (linear ranking), and Hasse Diagram Technique (HDT), normally providing more than one favourable solution (partial order). By PROMETHEE, the spatial differentiation had unwanted effects on the result, negating the stakeholders determined weighting of indicators. Therefore, the stakeholder can barely benefit from the convenience of obtaining a clear decision (linear ranking). In contrast, the result obtained by HDT was not influenced by spatial differentiation. Furthermore, HDT provided helpful tools to analyse the evaluation result, such as the concept of antagonistic indicators to discover conflicts in the evaluation process.

Attachment-Based Family Therapy: A Review of the Empirical Support.

PubMed

Diamond, Guy; Russon, Jody; Levy, Suzanne

2016-09-01

Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biological desire for meaningful and secure relationships. The therapy is grounded in attachment theory and provides an interpersonal, process-oriented, trauma-focused approach to treating adolescent depression, suicidality, and trauma. Although a process-oriented therapy, ABFT offers a clear structure and road map to help therapists quickly address attachment ruptures that lie at the core of family conflict. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanism of change. This article provides an overview of the clinical model and the existing empirical support for ABFT. © 2016 Family Process Institute.

Strategies for Teaching Regional Climate Modeling: Online Professional Development for Scientists and Decision Makers

NASA Astrophysics Data System (ADS)

Walton, P.; Yarker, M. B.; Mesquita, M. D. S.; Otto, F. E. L.

2014-12-01

There is a clear role for climate science in supporting decision making at a range of scales and in a range of contexts: from Global to local, from Policy to Industry. However, clear a role climate science can play, there is also a clear discrepancy in the understanding of how to use the science and associated tools (such as climate models). Despite there being a large body of literature on the science there is clearly a need to provide greater support in how to apply appropriately. However, access to high quality professional development courses can be problematic, due to geographic, financial and time constraints. In attempt to address this gap we independently developed two online professional courses that focused on helping participants use and apply two regional climate models, WRF and PRECIS. Both courses were designed to support participants' learning through tutor led programs that covered the basic climate scientific principles of regional climate modeling and how to apply model outputs. The fundamental differences between the two courses are: 1) the WRF modeling course expected participants to design their own research question that was then run on a version of the model, whereas 2) the PRECIS course concentrated on the principles of regional modeling and how the climate science informed the modeling process. The two courses were developed to utilise the cost and time management benefits associated with eLearning, with the recognition that this mode of teaching can also be accessed internationally, providing professional development courses in countries that may not be able to provide their own. The development teams saw it as critical that the courses reflected sound educational theory, to ensure that participants had the maximum opportunity to learn successfully. In particular, the role of reflection is central to both course structures to help participants make sense of the science in relation to their own situation. This paper details the different structures of both courses, evaluating the advantages and disadvantages of each, along with the educational approaches used. We conclude by proposing a framework for the develop of educationally robust online professional development programs that actively supports decision makers in understanding, developing and applying regional climate models.

China’s Military Support Facility in Djibouti: The Economic and Security Dimensions of China’s First Overseas Base

DTIC Science & Technology

2017-07-01

Cleared for Public Release China’s Military Support Facility in Djibouti: The Economic and Security Dimensions of China’s...paper provides a preliminary look at the origins of China’s military support facility in Djibouti. It explores the evolution of the economic and security...military facilities abroad. It also assesses the implications of the growing economic and military ties between the two countries for the United

Getting a Clear Focus on Roof Replacement and Management.

ERIC Educational Resources Information Center

Patterson, Valerie B.

2002-01-01

Describes how a new generation of X-ray-like vision--the patented INFRARED2k--provides roof-condition reports that help extend roof life, conserve energy, and survey for mold-supporting environments, thereby improving indoor air quality. (EV)

Statistical field theory of futures commodity prices

NASA Astrophysics Data System (ADS)

Baaquie, Belal E.; Yu, Miao

2018-02-01

The statistical theory of commodity prices has been formulated by Baaquie (2013). Further empirical studies of single (Baaquie et al., 2015) and multiple commodity prices (Baaquie et al., 2016) have provided strong evidence in support the primary assumptions of the statistical formulation. In this paper, the model for spot prices (Baaquie, 2013) is extended to model futures commodity prices using a statistical field theory of futures commodity prices. The futures prices are modeled as a two dimensional statistical field and a nonlinear Lagrangian is postulated. Empirical studies provide clear evidence in support of the model, with many nontrivial features of the model finding unexpected support from market data.

Building Cultures of Integrity: The Small Choices Education Leaders Make Can Advance Districtwide Ethics Powerfully and Positively

ERIC Educational Resources Information Center

Mirk, Paula

2011-01-01

Today's superintendents must play a critical role in building a district culture of integrity that maximizes students' ethical development. They must provide an educational environment that clearly supports the broadest aims of public education, which must include strong academic preparation. But it also includes providing students with an…

Students Seeking Help for Mental Health Problems: Do Australian University Websites Provide Clear Pathways?

ERIC Educational Resources Information Center

Laws, Thomas A.; Fiedler, Brenton A.

2013-01-01

Mental health problems in young Australians continue to be a major public health issue. Studying at university can generate social pressures particularly for youth, which have been associated with the onset of a mental illness or a worsening of an existing condition. Many universities provide health services to support students with health…

Reflections on providing sport science support for athletes with learning difficulties.

PubMed

Hills, Laura; Utley, Andrea

2010-01-01

To highlight the benefits and the need for sport science support for athletes with learning difficulties, and to reflect on our experience of working with the GB squad for athletes with learning difficulties. A review of key and relevant literature is presented, followed by a discussion of the sport science support provision and the issues that emerged in working with athletes with learning difficulties. Pre- and post- physiological tests along with evaluations of athletes' potential to benefit from sport psychology support were conducted. The aim of these tests was to provide information for the athletes and the coaches on fitness levels, to use this information to plan future training, and to identify how well the performance could be enhanced. A case study is presented for one athlete, who had competed in distance events. The focus is the psychological support that was provided. It is clear that athletes with learning difficulties require the same type of sports science support as their mainstream peers. However, sport scientists will need to consider ways to extend their practice in order to provide the appropriate level of support.

Instilling hope for a brighter future: A mixed-method mentoring support programme for individuals with and recovered from anorexia nervosa.

PubMed

Ramjan, Lucie M; Fogarty, Sarah; Nicholls, Daniel; Hay, Phillipa

2018-03-01

To investigate the feasibility of a 13-week mentoring programme in providing social support to promote hope for recovery in anorexia nervosa. With no clear first-line psychological treatment for people with anorexia nervosa, mentoring support programmes, as an adjunct to treatment, may provide the social support necessary to promote hope for recovery. A mixed-method study; participatory action research. Women (n = 11), recovering and who had recovered from anorexia nervosa, participated in the programme and completed self-report questionnaires related to quality of life, distress and the mentoring relationship at different time points. Qualitative feedback from logbooks, workshop evaluation questionnaires, interviews and focus groups was also collected to assess the programme's acceptability. General compliance for completing most study outcome questionnaires was 90%; however, the mentoring relationship questionnaires were not completed to the same degree. Five key themes emerged from the focus group/interview data: (i) she understands me and could relate to me; (ii) reconnecting with the world-asking questions and being challenged; (iii) mentors' altruistic motivations and the transformation and discovery of self; (iv) instilling hope-recovery is possible; and (v) effective communication-the key to successful mentoring. Further research is needed; however, the results provide preliminary support for the mentoring programme's feasibility as an adjunct to treatment. We found that having someone who understands, to talk and share with, met a clear need for people with anorexia nervosa. While further research is warranted mentoring support or recovered mentors, may play a potentially valuable role in supporting those in community settings. © 2017 John Wiley & Sons Ltd.

Monitoring Coastal Marshes for Persistent Saltwater Intrusion

NASA Technical Reports Server (NTRS)

Kalcic, Maria; Hall, Callie; Fletcher, Rose; Russell, Jeff

2009-01-01

Primary goal: Provide resource managers with remote sensing products that support ecosystem forecasting models requiring salinity and inundation data. Work supports the habitat-switching modules in the Coastal Louisiana Ecosystem Assessment and Restoration (CLEAR) model, which provides scientific evaluation for restoration management (Visser et al., 2008). Ongoing work to validate flooding with radar (NWRC/USGS) and enhance persistence estimates through "fusion" of MODIS and Landsat time series (ROSES A.28 Gulf of Mexico). Additional work will also investigate relationship between saltwater dielectric constant and radar returns (Radarsat) (ROSES A.28 Gulf of Mexico).

Naval Construction Force Readiness Training, Peacetime Construction and the War Mission: A Question of Congruency.

DTIC Science & Technology

1983-09-01

8217:-" . Cc.,h~,b 2 ¢ nstruct.ilon ..1 ,. 1._ An Amphibious Construction Battalion (P1!3CB) provides engineering support to a Naval Beach Group during the...PHIBCB’s. The top priority requirements in an amphibious opez- ation are to render beaches trafficable and to establish lines of communication and...tactical air support. After ther landing beach is cleared, establishment and support of Marine tactical aircraft ashore is the first priority. The9

Nutrition support teams: how they work, are set up and maintained

PubMed Central

Nightingale, Jeremy

2010-01-01

Safe cost effective nutritional support is provided by a multidisciplinary team whose activity is overseen by a Nutrition Steering Group that reports directly to the Hospital Trust Board. When a nutrition support team (NST) is first formed, a nutrition nurse specialist enables parenteral nutrition to be given safely. An NST needs to have a clearly agreed scope of practice and needs to be able to justify its presence in terms of quality and cost savings. PMID:28839571

Preventing maternal and early childhood obesity: the fetal flaw in Australian perinatal care.

PubMed

Miller, Margaret; Hearn, Lydia; van der Pligt, Paige; Wilcox, Jane; Campbell, Karen J

2014-01-01

Almost half of Australian women of child-bearing age are overweight or obese, with a rate of 30-50% reported in early pregnancy. Maternal adiposity is a costly challenge for Australian obstetric care, with associated serious maternal and neonatal complications. Excess gestational weight gain is an important predictor of offspring adiposity into adulthood and higher maternal weight later in life. Current public health and perinatal care approaches in Australia do not adequately address excess perinatal maternal weight or gestational weight gain. This paper argues that the failure of primary health-care providers to offer systematic advice and support regarding women's weight and related lifestyle behaviours in child-bearing years is an outstanding 'missed opportunity' for prevention of inter-generational overweight and obesity. Barriers to action could be addressed through greater attention to: clinical guidelines for maternal weight management for the perinatal period, training and support of maternal health-care providers to develop skills and confidence in raising weight issues with women, a variety of weight management programs provided by state maternal health services, and clear referral pathways to them. Attention is also required to service systems that clearly define roles in maternal weight management and ensure consistency and continuity of support across the perinatal period.

Use of mobile phones and cancer risk.

PubMed

Ayanda, Olushola S; Baba, Alafara A; Ayanda, Omolola T

2012-01-01

Mobile phones work by transmitting and receiving radio frequency microwave radiation. The radio frequency (RF) emitted by mobile phones is stronger than FM radio signal which are known to cause cancer. Though research and evidence available on the risk of cancer by mobile phones does not provide a clear and direct support that mobile phones cause cancers. Evidence does not also support an association between exposure to radio frequency and microwave radiation from mobile phones and direct effects on health. It is however clear that lack of available evidence of cancer as regards the use of mobile phone should not be interpreted as proof of absence of cancer risk, so that excessive use of mobile phones should be taken very seriously and with caution to prevent cancer.

A system to improve medication safety in the setting of acute kidney injury: initial provider response.

PubMed

McCoy, Allison B; McCoy, Allison Beck; Peterson, Josh F; Gadd, Cynthia S; Gadd, Cindy; Danciu, Ioana; Waitman, Lemuel R

2008-11-06

Clinical decision support systems can decrease common errors related to inappropriate or excessive dosing for nephrotoxic or renally cleared drugs. We developed a comprehensive medication safety intervention with varying levels of workflow intrusiveness within computerized provider order entry to continuously monitor for and alert providers about early-onset acute kidney injury. Initial provider response to the interventions shows potential success in improving medication safety and suggests future enhancements to increase effectiveness.

Astrology and Astronomy.

ERIC Educational Resources Information Center

Astronomical Society of the Pacific, San Francisco, CA.

One of a series of information packets, the document provides clear, specific information about the controversial subject of astrology. The packet includes six articles explaining the dozens of careful scientific tests which have concluded that there is no scientific evidence supporting astrology. The packet includes an interview with astronomer…

State Funding Mechanisms for English Language Learners

ERIC Educational Resources Information Center

Millard, Maria

2015-01-01

Research is clear that English language learners (ELLs) perform better academically and achieve greater language proficiency when they have high-quality English language instruction.1 Like all supplemental services, these necessary supports require additional funding above the average per-student amount. The federal government provides grant…

Glycerol dehydration of native and diabetic animal tissues studied by THz-TDS and NMR methods

PubMed Central

Smolyanskaya, O. A.; Schelkanova, I. J.; Kulya, M. S.; Odlyanitskiy, E. L.; Goryachev, I. S.; Tcypkin, A. N.; Grachev, Ya. V.; Toropova, Ya. G.; Tuchin, V. V.

2018-01-01

The optical clearing method has been widely used for different spectral ranges where it provides tissue transparency. In this work, we observed the enhanced penetration of the terahertz waves inside biological samples (skin, kidney, and cornea) treated with glycerol solutions inducing changes of optical and dielectric properties. It was supported by the observed trend of free-to-bound water ratio measured by the nuclear magnetic resonance (NMR) method. The terahertz clearing efficiency was found to be less for diabetic samples than for normal ones. Results of the numerical simulation proved that pulse deformation is due to bigger penetration depth caused by the reduction of absorption and refraction at optical clearing. PMID:29541513

In-situ materials processing systems and bioregenerative life support systems interrelationships

NASA Technical Reports Server (NTRS)

Mignon, George V.; Frye, Robert J.

1992-01-01

The synergy and linkages between bioregenerative life support systems and the materials produced by in-situ materials processing systems was investigated. Such systems produce a broad spectrum of byproducts such as oxygen, hydrogen, processed soil material, ceramics, refractory, and other materials. Some of these materials may be utilized by bioregenerative systems either directly or with minor modifications. The main focus of this project was to investigate how these materials can be utilized to assist a bioregenerative life support system. Clearly the need to provide a sustainable bioregenerative life support system for long term human habitation of space is significant.

Cyclone: A close air support aircraft for tomorrow

NASA Technical Reports Server (NTRS)

Cox, George; Croulet, Donald; Dunn, James; Graham, Michael; Ip, Phillip; Low, Scott; Vance, Gregg; Volckaert, Eric

1991-01-01

To meet the threat of the battlefield of the future, the U.S. ground forces will require reliable air support. To provide this support, future aircrews demand a versatile close air support aircraft capable of delivering ordinance during the day, night, or in adverse weather with pin-point accuracy. The Cyclone aircraft meets these requirements, packing the 'punch' necessary to clear the way for effective ground operations. Possessing anti-armor, missile, and precision bombing capability, the Cyclone will counter the threat into the 21st Century. Here, it is shown that the Cyclone is a realistic, economical answer to the demand for a capable close air support aircraft.

The Impact of Supported Employment Versus Standard Vocational Rehabilitation in Veterans with PTSD

DTIC Science & Technology

2014-08-01

Compensated Work Therapy/Veterans Industries ( CWT ) and provides a work regimen with monetary incentives derived from contracts whereby participants are...Compensated Work Therapy ( CWT ) programs, found that the rate of competitive employment at discharge was only 30% for Veterans with PTSD and 36% for...adaptation to CWT programming and personnel, and so clear substantial evidence is needed to support such a dramatic change. Such modifications in the VA

42 CFR 85.7 - Conduct of investigations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... investigation, the employer should precisely identify information which can be obtained in the workplace or workplaces to be inspected as trade secrets. If the NIOSH officer has no clear reason to question such... provide additional information in support of the trade secret designation. The Director, NIOSH, shall...

29 CFR 1917.117 - Manlifts.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Warning signs and lights; (12) Illumination; (13) Drive pulley; (14) Bottom (boot) pulley and clearance... manlift. (j) Landings. (1) Clear and unobstructed landing spaces shall be provided at each level. Manlifts... strength to support 250 pounds (1,112 N). (k) Floor opening guards. The ascending sides of manlift floor...

29 CFR 1917.117 - Manlifts.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Warning signs and lights; (12) Illumination; (13) Drive pulley; (14) Bottom (boot) pulley and clearance... manlift. (j) Landings. (1) Clear and unobstructed landing spaces shall be provided at each level. Manlifts... strength to support 250 pounds (1,112 N). (k) Floor opening guards. The ascending sides of manlift floor...

29 CFR 1917.117 - Manlifts.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Warning signs and lights; (12) Illumination; (13) Drive pulley; (14) Bottom (boot) pulley and clearance... manlift. (j) Landings. (1) Clear and unobstructed landing spaces shall be provided at each level. Manlifts... strength to support 250 pounds (1,112 N). (k) Floor opening guards. The ascending sides of manlift floor...

29 CFR 1917.117 - Manlifts.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Warning signs and lights; (12) Illumination; (13) Drive pulley; (14) Bottom (boot) pulley and clearance... manlift. (j) Landings. (1) Clear and unobstructed landing spaces shall be provided at each level. Manlifts... strength to support 250 pounds (1,112 N). (k) Floor opening guards. The ascending sides of manlift floor...

Try a Videotape for Communicating with District Patrons.

ERIC Educational Resources Information Center

DiazGrandox, Frederick

1991-01-01

A small Idaho school district gained public support for a school levy by producing and distributing a videotape of school activities and district needs. The videotape provided a clear, concise presentation of information while avoiding confrontations that often occur with other methods of communication. (Author/SV)

Mars inflatable greenhouse analog.

PubMed

Sadler, Philip D; Giacomelli, Gene A

2002-01-01

Light intensities on the Martian surface can possibly support a bioregenerative life support system (BLSS) utilizing natural sunlight for hydroponic crop production, if a suitable controlled environment can be provided. Inflatable clear membrane structures offer low mass, are more easily transported than a rigid structure, and are good candidates for providing a suitable controlled environment for crop production. Cable culture is one hydroponic growing system that can take advantage of the beneficial attributes of the inflatable structure. An analog of a Mars inflatable greenhouse can provide researchers data on issues such as crew time requirements for operation, productivity for BLSS, human factors, and much more at a reasonable cost. This is a description of one such design.

SUPPORT Tools for evidence-informed health Policymaking (STP) 3: Setting priorities for supporting evidence-informed policymaking

PubMed Central

2009-01-01

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing – or supporting the development of – evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact. Examples of undesirable practices in a priority-setting approach include timelines to support evidence-informed policymaking being negotiated on a case-by-case basis (instead of having clear norms about the level of support that can be provided for each timeline), implicit (rather than explicit) criteria for setting priorities, ad hoc (rather than systematic and explicit) priority-setting process, and the absence of both a communications plan and a monitoring and evaluation plan. In this article, we suggest questions that can guide those setting priorities for finding and using research evidence to support evidence-informed policymaking. These are: 1. Does the approach to prioritisation make clear the timelines that have been set for addressing high-priority issues in different ways? 2. Does the approach incorporate explicit criteria for determining priorities? 3. Does the approach incorporate an explicit process for determining priorities? 4. Does the approach incorporate a communications strategy and a monitoring and evaluation plan? PMID:20018110

SUPPORT Tools for evidence-informed health Policymaking (STP) 3: Setting priorities for supporting evidence-informed policymaking.

PubMed

Lavis, John N; Oxman, Andrew D; Lewin, Simon; Fretheim, Atle

2009-12-16

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing--or supporting the development of--evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact. Examples of undesirable practices in a priority-setting approach include timelines to support evidence-informed policymaking being negotiated on a case-by-case basis (instead of having clear norms about the level of support that can be provided for each timeline), implicit (rather than explicit) criteria for setting priorities, ad hoc (rather than systematic and explicit) priority-setting process, and the absence of both a communications plan and a monitoring and evaluation plan. In this article, we suggest questions that can guide those setting priorities for finding and using research evidence to support evidence-informed policymaking. These are: 1. Does the approach to prioritisation make clear the timelines that have been set for addressing high-priority issues in different ways? 2. Does the approach incorporate explicit criteria for determining priorities? 3. Does the approach incorporate an explicit process for determining priorities? 4. Does the approach incorporate a communications strategy and a monitoring and evaluation plan?

2010 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Volume 2, Main Findings

DTIC Science & Technology

2011-05-01

characteristics and student engagement , namely that students have clear roles and expectations, that instructors provide support for autonomy (a previously...C. J. (2009) Facilitators and outcomes of student engagement in a college setting. Journal of Psychology, 143, 5-27. USAREUR. (2007). Modular

Districts Create Community Connections with Social Media

ERIC Educational Resources Information Center

Gordon, Dan

2012-01-01

More districts realize that communicating in a clear and engaging way with stakeholders about everything from the district's overall education vision to scholastic and extracurricular success stories can go a long way toward enlisting broad community support. And although face-to-face communications are still important, technology provides a…

The Impact of Superintendent Support for Curriculum Mapping on Principals' Efficacious Use of Maps

ERIC Educational Resources Information Center

Danna, Stephen; Spatt, Spatt

2013-01-01

Pressures on school leaders to reform are pervasive within the United States. Prior studies show that superintendents who provide clear expectations and goals, collaborate, ensure quality professional development, and attend to curriculum alignment develop effective building leaders (Marzano & Waters, 2009; Wahlstrom, Louis, Leithwood, &…

Youth Unemployment and Localized Impact: A Career Studies Teacher's Story

ERIC Educational Resources Information Center

Godden, Lorraine

2015-01-01

The global economic downturn and high youth unemployment have created a challenging context for Ontario secondary-school teachers to meet the compulsory half-credit career studies course objectives intended to support school-to-work (STW) transition. Bronfenbrener's (1979) ecological systems theory provided a clear framework to examine influences…

Sexual Health Promotion for Men Who Have Sex with Other Men.

ERIC Educational Resources Information Center

Keeling, Richard P.; Engstrom, Eric L.

1996-01-01

Asserts that the challenge in developing effective campus health-promotion strategies for homosexual men is to provide clear information, opportunities for skill building, enhancement of self-esteem, and community support for those who may not even realize they need interventions. Discusses intimacy, sexual behavior, prejudice, and violence as…

Final Radiological Assessment of External Exposure for CLEAR-Line Americium Recovery Operations

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

Davis, Adam C.; Belooussova, Olga N.; Hetrick, Lucas Duane

2014-11-12

Los Alamos National Laboratory is currently planning to implement an americium recovery program. The americium, ordinarily isotopically pure 241Am, would be extracted from existing Pu materials, converted to an oxide and shipped to support fabrication of americium oxide-beryllium neutron sources. These operations would occur in the currently proposed Chloride Extraction and Actinide Recovery (CLEAR) line of glove boxes. This glove box line would be collocated with the currently-operational Experimental Chloride Extraction Line (EXCEL). The focus of this document is to provide an in-depth assessment of the currently planned radiation protection measures and to determine whether or not further design workmore » is required to satisfy design-goal and ALARA requirements. Further, this document presents a history of americium recovery operations in the Department of Energy and high-level descriptions of the CLEAR line operations to provide a basis of comparison. Under the working assumptions adopted by this study, it was found that the evaluated design appears to mitigate doses to a level that satisfies the ALARA-in-design requirements of 10 CFR 835 as implemented by the Los Alamos National Laboratory procedure P121. The analyses indicate that extremity doses would also meet design requirements. Dose-rate calculations were performed using the radiation transport code MCNP5 and doses were estimated using a time-motion study developed in consort with the subject matter expert. A copy of this report and all supporting documentation are located on the Radiological Engineering server at Y:\\Rad Engineering\\2013 PROJECTS\\TA-55 Clear Line.« less

34 CFR 367.22 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2012 CFR

2012-07-01

... to support the overall mission of the IL program, as stated in section 701 of the Act. (b) Plan of... otherwise eligible to participate are selected without regard to race, color, national origin, gender, age, or disability; (6) A clear description of how the applicant will provide equal access to services for...

34 CFR 367.22 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2014 CFR

2014-07-01

... to support the overall mission of the IL program, as stated in section 701 of the Act. (b) Plan of... otherwise eligible to participate are selected without regard to race, color, national origin, gender, age, or disability; (6) A clear description of how the applicant will provide equal access to services for...

34 CFR 367.22 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2013 CFR

2013-07-01

... to support the overall mission of the IL program, as stated in section 701 of the Act. (b) Plan of... otherwise eligible to participate are selected without regard to race, color, national origin, gender, age, or disability; (6) A clear description of how the applicant will provide equal access to services for...

34 CFR 367.22 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2011 CFR

2011-07-01

... to support the overall mission of the IL program, as stated in section 701 of the Act. (b) Plan of... otherwise eligible to participate are selected without regard to race, color, national origin, gender, age, or disability; (6) A clear description of how the applicant will provide equal access to services for...

Levinas and an Ethics for Science Education

ERIC Educational Resources Information Center

Blades, David W.

2006-01-01

Despite claims that STS(E) science education promotes ethical responsibility, this approach is not supported by a clear philosophy of ethics. This paper argues that the work of Emmanuel Levinas provides an ethics suitable for an STS(E) science education. His concept of the face of the Other redefines education as learning from the other, rather…

Preparation for College and Careers. Research Summary

ERIC Educational Resources Information Center

Philadelphia Youth Network, 2009

2009-01-01

The financial benefits of a college degree are clear. Philadelphians with 1-3 years of college earn a third more than high school graduates over a working lifetime, and four-year degree-holders earn twice as much. Furthermore, college-goers contribute substantially more in tax revenues to support services provided through local, state and federal…

Information Fuels Support for School Reform

ERIC Educational Resources Information Center

Henderson, Michael B.; Howell, William G.; Peterson, Paul E.

2014-01-01

The Common Core State Standards initiative (CCSS) seeks to "provide a consistent, clear understanding of what students are expected to learn" at various grade levels. For some education observers, CCSS will finally clarify for students, parents, and educators what students need to know and be able to do if they are to be prepared for…

Using Word Clouds in Online Discussions to Support Critical Thinking and Engagement

ERIC Educational Resources Information Center

deNoyelles, Aimee; Reyes-Foster, Beatriz

2015-01-01

Being actively engaged in a task is often associated with critical thinking. Cultivating critical thinking skills, such as purposefully reflecting and analyzing one's own thinking, is a major goal of higher education. However, there is a challenge in providing college students opportunities to clearly demonstrate these skills in online courses.…

America's Clear Choices.

ERIC Educational Resources Information Center

Reich, Robert B.

1992-01-01

For U.S. workers to have jobs that add value to world economy, resulting in higher living standard, they need to learn problem-solving skills while in school. This will require larger federal financial roles; consolidation of some school districts; and more support from the private sector in working with schools to provide a school-to-work…

77 FR 27214 - Applications for New Awards; Ronald E. McNair Postbaccalaureate Achievement Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-09

... educational support for qualified individuals from disadvantaged backgrounds. The McNair Program is a... provide disadvantaged college students with effective preparation for doctoral study. The President has set a clear goal for our education system: By 2020, the United States will once again lead the world...

76 FR 20659 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... visitor log. All visitor bags are processed through an X-ray machine and subject to search. Visitors will... your comments: 1. Explain your views as clearly as possible and provide specific examples. 2. Describe... that support your views. 4. If you estimate potential burden or costs, explain how you arrived at the...

76 FR 49471 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... visitor log. All visitor bags are processed through an X-ray machine and subject to search. Visitors will... your comments: 1. Explain your views as clearly as possible and provide specific examples. 2. Describe... that support your views. 4. If you estimate potential burden or costs, explain how you arrived at the...

Kawasaki disease and toxic shock syndrome--at last the etiology is clear?

PubMed

Curtis, Nigel

2004-01-01

A decade after the superantigen hypothesis for KD was first suggested, it has still not been either proven or refuted conclusively. Although initial optimism for the hypothesis was quashed by a series of published papers apparently refuting the idea, in the last few years there have been a number of good studies providing evidence in support of the superantigen hypothesis. Whether this renewed enthusiasm is justified will hopefully become clear in the near future. Ultimately, accurate diagnosis, more targeted treatment, and preventative strategies depend on the unraveling of the immunopathogenesis of this disease.

Clear cell hidradenocarcinoma--a case report with unusual in situ malignant changes.

PubMed

Al-Irhayim, B

1984-05-01

Clear cell hidradenocarcinoma is a rare tumour, the histogenesis of which has been much debated in the past. However, it is now considered a tumour of sweat gland origin. Presented herewith is a report of a case with unusual histological features of in situ malignant changes within sweat glands. These changes very closely simulate lobular cancerisation of the breast. On reviewing the English literature on the histopathology of sweat gland tumours, we have not found similar histological findings. These histological findings provide supportive evidence of the sweat gland origin of these tumours.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Detect and Avoid Display Evaluations in Support of SC-228 Minimum Operational Performance Standards Development

NASA Technical Reports Server (NTRS)

Fern, Lisa Carolynn

2017-01-01

The primary activity for the UAS-NAS Human Systems Integration (HSI) sub-project in Phase 1 was support of RTCA Special Committee 228 Minimum Operational Performance Standards (MOPS). We provide data on the effect of various Detect and Avoid (DAA) display features with respect to pilot performance of the remain well clear function in order to determine the minimum requirements for DAA displays.

Guiding Principles for Implementing School-Based Management Programs: An Online Toolkit Providing General Principles That Can Be Applied to the Implementation of School-Based Management Reforms

ERIC Educational Resources Information Center

Patrinos, Harry Anthony; Fasih, Tazeen; Barrera, Felipe; Garcia-Moreno, Vicente A.; Bentaouet-Kattan, Raja; Baksh, Shaista; Wickramasekera, Inosha

2007-01-01

School-based management (SBM) has become a very popular movement over the past decade. The World Bank Education Team's SBM work program emerged out of a need to define the concept more clearly, review the evidence, support impact assessments in various countries, and provide some initial feedback to teams preparing education projects. During the…

Age Differences in the Complexity of Emotion Perception.

PubMed

Kim, Seungyoun; Geren, Jennifer L; Knight, Bob G

2015-01-01

The current study examined age differences in the number of emotion components used in the judgment of emotion from facial expressions. Fifty-eight younger and 58 older adults were compared on the complexity of perception of emotion from standardized facial expressions that were either clear or ambiguous exemplars of emotion. Using an intra-individual factor analytic approach, results showed that older adults used more emotion components in perceiving emotion in faces than younger adults. Both age groups reported greater emotional complexity for the clear and prototypical emotional stimuli. Age differences in emotional complexity were more pronounced for the ambiguous expressions compared with the clear expressions. These findings demonstrate that older adults showed increased elaboration of emotion, particularly when emotion cues were subtle and provide support for greater emotion differentiation in older adulthood.

The 5As team patient study: patient perspectives on the role of primary care in obesity management.

PubMed

Torti, Jacqueline; Luig, Thea; Borowitz, Michelle; Johnson, Jeffrey A; Sharma, Arya M; Campbell-Scherer, Denise L

2017-02-08

Over 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients' perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies. Qualitative study employing semi-structured interviews and thematic analysis, with a sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices in Alberta. Four illustrative themes emerged: (1) the patient-physician relationship plays an important role in the adequacy of obesity management; (2) patients have clear expectations of substantive conversations with their primary care team; (3) complex conditions affect weight and patients require assistance tailored to individual obesity drivers; (4) current services provide support in important ways (accessibility, availability, accountability, affordability, consistency of messaging), but are not yet meeting patient needs for individual plans, advanced education, and follow-up opportunities. Patients have clear expectations that their primary care physician asks them about weight within a supportive therapeutic relationship. They see obesity as a complex phenomenon with multiple drivers. They want their healthcare providers to assess and address their root causes - not simplistic advice to "eat less, move more". Patients felt that the current services were positive resources, but expressed needs for tailored weight management plans, and longer-term follow-up.

Lipid resuscitation in acute poisoning: after a decade of publications, what have we really learned?

PubMed

Hoegberg, Lotte C G; Gosselin, Sophie

2017-08-01

The decision to provide intravenous lipid emulsion (ILE) therapy as a treatment modality for the reversal of various drug toxicity was discovered in the last decade. Numerous publications, in both humans and animals attest to its clinical use, but current supporting evidence is inconsistent. A recent systematic review reported evidence for benefit of ILE in bupivacaine toxicity. Human randomized trials, large observational studies as well as animal models of orogastric poisoning failed to report a clear benefit of ILE for nonlocal anesthetics poisoning. ILE can be used to resuscitate local anesthetics especially bupivacaine. The impact of ILE on oral overdoses is controversial and clear evidence on benefit is lacking. A thorough risk benefit assessment with consideration of alternative options is warranted to minimize the risk of adverse effects. Evidence supports using bolus doses of ILE, while infusion rates are still debatable.

Relationship between mathematics teacher subject matter knowledge, pedagogical content knowledge and professional development needs

NASA Astrophysics Data System (ADS)

Tajudin, Nor'ain Mohd; Chinnappan, Mohan; Saad, Noor Shah

2017-05-01

Two key variables emerged from the literature review is that Specific Matter Knowledge [SMK] and Pedagogical Content Knowledge [PCK] can influence the mathematics teachers' Professional Development [PD] needs. However, the key variables of SMK and PCK that were being investigated were not defined clearly. Empirical evidence that support relationship between SMK and PD and PCK and PD were not verified. In addition, how does PCK mediate SMK and PD is not clear and somewhat lacking. Therefore, the purpose of this paper was to examine the relationship between primary mathematics teacher's SMK, PCK and PD needs. Results of path analysis with SmartPLS indicated that the direct effect of SMK on PD was mediated via PCK. This data provide support for the claim that PD programs for future teachers of primary mathematics should be driven by a more nuanced understanding of the link between SMK and PCK.

Feasibility study on the use of groupware support for NASA source evaluation boards

NASA Technical Reports Server (NTRS)

Bishop, Peter C.; Yoes, Cissy

1991-01-01

Groupware is a class of computer based systems that support groups engaged in a common task (or goal) and that provide an interface to a shared environment. A potential application for groupware is the source evaluation board (SEB) process used in the procurement of government contracts. This study was undertaken to (1) identify parts of the SEB process which are candidates for groupware supports; and (2) identify tools which could be used to support the candidate process. Two processes of the SEB were identified as good candidates for groupware support: (1) document generation - a coordination and communication process required to present and document the findings of an SEB; and (2) group decision making - a highly analytical and integrative decision process requiring a clear and supportable outcome.

30 CFR 75.1403-5 - Criteria-Belt conveyors.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (g) A clear travelway at least 24 inches wide should be provided on both sides of all belt conveyors installed after March 30, 1970. Where roof supports are installed within 24 inches of a belt conveyor, a... is less than 24 inches, and should not exceed 350 feet per minute when the vertical clearance is 24...

77 FR 11175 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... support the Request. In order to facilitate this automation, DTC will create a function that will provide... automation, DTC will be able to reduce the notification time frame on full call MMIs so that effective April... automation input mechanism. Additionally, at the request of the Options Clearing Corporation (``OCC''), DTC...

California Report Card 2008: The State of the State's Children

ERIC Educational Resources Information Center

Children Now, 2008

2008-01-01

The California Report Card provides a clear, complete and concise picture of the state of the state's children along with recommendations for how we can better support our children through new and improved public policies. It assigns letter grades to such key indicators as health insurance, oral health, asthma, mental health, infant health,…

78 FR 30300 - Agency Information Collection Activities; Proposed Collection; Comment Request; Implementation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

....regulations.gov to obtain a copy of the draft collection of information, submit or view public comments... helpful for preparing your comments: (i) Explain your views as clearly as possible and provide specific... and/or data you used that support your views. (iv) If you estimate potential burden or costs, explain...

ARRA and New Jersey's Preschool Expansion Initiative: "Not Perfect Together." ACNJ Policy Brief

ERIC Educational Resources Information Center

Rice, Cynthia

2009-01-01

The American Recovery and Reinvestment Act of 2009 (ARRA), the federal stimulus package, will over the next two years provide all states with federal funding to support early learning opportunities for 3- and 4-year-olds. This investment clearly reflects Washington's acknowledgement of the link between high-quality early education and the nation's…

Children in Need of Protection: Reporting Policies in Ontario School Boards

ERIC Educational Resources Information Center

Shewchuk, Samantha

2014-01-01

A clear, well defined policy can help empower school personnel to make informed decisions on how to handle cases of suspected child abuse. This article presents an analysis of (N = 64) school board child abuse reporting policies and procedures in Ontario and explored what training, resources, and support school boards state they will provide to…

17 CFR 229.1114 - (Item 1114) Credit enhancement and other support, except for certain derivatives instruments.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., describe the following, including a clear discussion of the manner in which each potential item is designed... enhancement designed to ensure that the asset-backed securities or pool assets will pay in accordance with... purpose is to provide credit enhancement related to pool assets or the asset-backed securities. (4) Any...

17 CFR 229.1114 - (Item 1114) Credit enhancement and other support, except for certain derivatives instruments.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., describe the following, including a clear discussion of the manner in which each potential item is designed... enhancement designed to ensure that the asset-backed securities or pool assets will pay in accordance with... purpose is to provide credit enhancement related to pool assets or the asset-backed securities. (4) Any...

17 CFR 229.1114 - (Item 1114) Credit enhancement and other support, except for certain derivatives instruments.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., describe the following, including a clear discussion of the manner in which each potential item is designed... enhancement designed to ensure that the asset-backed securities or pool assets will pay in accordance with... purpose is to provide credit enhancement related to pool assets or the asset-backed securities. (4) Any...

Designing Adult Learning Strategies: The Case of South Eastern Europe

ERIC Educational Resources Information Center

Gunny, Madeleine; Viertel, Evelyn

2006-01-01

The importance of lifelong learning is generally well understood and few people today would query the need for adults to regularly update their skills in line with labour market needs, and for governments and social partners to provide an environment that supports skills acquisition and updating. However, it is clear when we look at data from the…

75 FR 82007 - Agency Information Collection Activities; Proposed Collection; Comment Request; PCBs...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... visitor log. All visitor bags are processed through an X-ray machine and subject to search. Visitors will... your comments: 1. Explain your views as clearly as possible and provide specific examples. 2. Describe... that support your views. 4. If you estimate potential burden or costs, explain how you arrived at the...

76 FR 4657 - Agency Information Collection Activities; Proposed Collection; Comment Request; TSCA Section 402...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... visitor log. All visitor bags are processed through an X-ray machine and subject to search. Visitors will... your comments: 1. Explain your views as clearly as possible and provide specific examples. 2. Describe... that support your views. 4. If you estimate potential burden or costs, explain how you arrived at the...

75 FR 66087 - Agency Information Collection Activities; Proposed Collection; Comment Request; Residential Lead...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... visitor log. All visitor bags are processed through an X-ray machine and subject to search. Visitors will... your comments: 1. Explain your views as clearly as possible and provide specific examples. 2. Describe... that support your views. 4. If you estimate potential burden or costs, explain how you arrived at the...

The Role of Postural Support in Young Adults' Control of Stationary Kicking

ERIC Educational Resources Information Center

Sidaway, Ben; Bouchard, Matthew; Chasse, Julie; Dunn, Jonathan; Govoni, Andrea; McPherson, Breanne; Roy, Katherine; Anderson, David I.

2017-01-01

Purpose: The requirement for postural stability during the performance of motor skills has been clearly demonstrated in infants, but the necessity for such a postural substrate is not well documented in adults. The present study investigated the role of postural stability during a ballistic ball-kicking task in adults by providing varying degrees…

How can a competency framework for advanced practice support care?

PubMed

Stanford, Pamela Elizabeth

2016-11-10

Aim To explore whether perception of nurse practitioners in relation to whether a competency framework for advanced practice can support their work. Method A qualitative cross-sectional design was used, embedded in an interpretative paradigm of research. A non-probability sample of eight experienced nurse practitioners took part in focus groups and answered questionnaires. A mixture of phenomenological and grounded theory approaches were used to collect the data. Findings Four major themes were identified: competency frameworks can identify individual strengths and weaknesses, they can be used to set clear goals and targets, they can improve how practice is organised, and they have the potential to limit practice in terms of narrowing boundaries. The study also found competency frameworks could provide an structure to guide the development and evaluation of educational programmes. Conclusion Competency frameworks can be used so to target the development of new advanced nurse practitioners. They can address workforce development and governance by ensuring nurse practitioners have the competencies to provide safe, autonomous practice. Competency frameworks have been shown to ensure consistency in clinical practice skills underpinned with nurse practitioners' theoretical knowledge. They provide a clear development structure for career development and advanced practice. However, internationally, there is still a lack of definition of advanced practice and its core competencies.

The elusive importance effect: more failure for the Jamesian perspective on the importance of importance in shaping self-esteem.

PubMed

Marsh, Herbert W

2008-10-01

Following William James (1890/1963), many leading self-esteem researchers continue to support the Individual-importance hypothesis-that the relation between specific facets of self-concept and global self-esteem depends on the importance an individual places on each specific facet. However, empirical support for the hypothesis is surprisingly elusive, whether evaluated in terms of an importance-weighted average model, a generalized multiple regression approach for testing self-concept-by-importance interactions, or idiographic approaches. How can actual empirical support for such an intuitively appealing and widely cited psychological principle be so elusive? Hardy and Moriarty (2006), acknowledging this previous failure of the Individual-importance hypothesis, claim to have solved the conundrum, demonstrating an innovative idiographic approach that provides clear support for it. However, a critical evaluation of their new approach, coupled with a reanalysis of their data, undermines their claims. Indeed, their data provide compelling support against the Individual-importance hypothesis, which remains as elusive as ever.

Fairness heuristics and substitutability effects: inferring the fairness of outcomes, procedures, and interpersonal treatment when employees lack clear information.

PubMed

Qin, Xin; Ren, Run; Zhang, Zhi-Xue; Johnson, Russell E

2015-05-01

Employees routinely make judgments of 3 kinds of justice (i.e., distributive, procedural, and interactional), yet they may lack clear information to do so. This research examines how justice judgments are formed when clear information about certain types of justice is unavailable or ambiguous. Drawing from fairness heuristic theory, as well as more general theories of cognitive heuristics, we predict that when information for 1 type of justice is unclear (i.e., low in justice clarity), people infer its fairness based on other types of justice with clear information (i.e., high in justice clarity). Results across 3 studies employing different designs (correlational vs. experimental), samples (employees vs. students), and measures (proxy vs. direct) provided support for the proposed substitutability effects, especially when inferences were based on clear interactional justice information. Moreover, we found that substitutability effects were more likely to occur when employees had high (vs. low) need for cognitive closure. We conclude by discussing the theoretical contributions and practical implications of our findings. (c) 2015 APA, all rights reserved).

Post Cold War transformation of the medical function in support of the deployed soldier.

PubMed

Vekerdi, Zoltan

2013-12-01

This article summarises the changes that resulted in, and still act towards, final implementation of a separate medical function in operational medical support. This article is not intended to represent an historical account, but to provide concise supplemental material for decision makers to position medical under the commander, which enables medical staff to support and care for the troops and which can be used in the best possible way as an image forming factor for the force. The aim of this article is to clearly articulate the necessity for independence of the medical and logistic functions, while recognising the need for continued close coordination.

Information and support from dietary consultation for mothers of children with food allergies.

PubMed

MacKenzie, Heather; Grundy, Jane; Glasbey, Gillian; Dean, Taraneh; Venter, Carina

2015-01-01

Professional dietetic input is essential to ensure that children with diagnosed food allergies have an individualized avoidance plan and nutritionally adequate diet. However, it is not clear what dietary information and support parents require. To explore what information and support parents of children with food allergies require from a dietary consultation. Focus groups were conducted with 17 mothers who attend an allergy center for dietary advice for their food allergic child. A number of issues around food allergy dietary advice needs were explored and analyzed using thematic analysis. Six themes were identified. The mothers described how they sought to protect their child from harm, to maintain normality for their child, and to promote child independence. They described needing to become an expert in their child's food allergy and fight their corner when needed. The dietitian supported their needs by ensuring their child's diet was safe and nutritionally adequate and giving information and support to help them provide a normal life for their child. Dietitians also taught mothers about food allergy and provided advocacy and emotional support. Mothers of children with food allergies want to understand how to provide a nutritionally adequate, allergen-safe diet while maintaining a normal life. Hence, mothers value a range of support from dietitians, including monitoring their child's health and providing information, practical advice and support, and emotional support. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Coastal Marsh Monitoring for Persistent Saltwater Intrusion

NASA Technical Reports Server (NTRS)

Hall, Callie M.

2008-01-01

This viewgraph presentation reviews NASA's work on the project that supports the Gulf of Mexico Alliance (GOMA) Governors Action Plan to monitor the coastal wetlands for saltwater intrusion. The action items that relate to the task are: (1) Obtain information on projected relative sea level rise, subsidence, and storm vulnerability to help prioritize conservation projects, including restoration, enhancement, and acquisition, and (2) Develop and apply ecosystem models to forecast the habitat structure and succession following hurricane disturbance and changes in ecological functions and services that impact vital socio-economic aspects of coastal systems. The objectives of the program are to provide resource managers with remote sensing products that support ecosystem forecasting models requiring salinity and inundation data. Specifically, the proposed work supports the habitat-switching modules in the Coastal Louisiana Ecosystem Assessment and Restoration (CLEAR) model, which provides scientific evaluation for restoration management.

Alpha and Beta Oscillations Index Semantic Congruency between Speech and Gestures in Clear and Degraded Speech.

PubMed

Drijvers, Linda; Özyürek, Asli; Jensen, Ole

2018-06-19

Previous work revealed that visual semantic information conveyed by gestures can enhance degraded speech comprehension, but the mechanisms underlying these integration processes under adverse listening conditions remain poorly understood. We used MEG to investigate how oscillatory dynamics support speech-gesture integration when integration load is manipulated by auditory (e.g., speech degradation) and visual semantic (e.g., gesture congruency) factors. Participants were presented with videos of an actress uttering an action verb in clear or degraded speech, accompanied by a matching (mixing gesture + "mixing") or mismatching (drinking gesture + "walking") gesture. In clear speech, alpha/beta power was more suppressed in the left inferior frontal gyrus and motor and visual cortices when integration load increased in response to mismatching versus matching gestures. In degraded speech, beta power was less suppressed over posterior STS and medial temporal lobe for mismatching compared with matching gestures, showing that integration load was lowest when speech was degraded and mismatching gestures could not be integrated and disambiguate the degraded signal. Our results thus provide novel insights on how low-frequency oscillatory modulations in different parts of the cortex support the semantic audiovisual integration of gestures in clear and degraded speech: When speech is clear, the left inferior frontal gyrus and motor and visual cortices engage because higher-level semantic information increases semantic integration load. When speech is degraded, posterior STS/middle temporal gyrus and medial temporal lobe are less engaged because integration load is lowest when visual semantic information does not aid lexical retrieval and speech and gestures cannot be integrated.

Secretary | Center for Cancer Research

Cancer.gov

The Basic Science Program (BSP) pursues independent, multidisciplinary research programs in basic or applied molecular biology, immunology, retrovirology, cancer biology, or human genetics. Research efforts and support are an integral part of the Center for Cancer Research (CCR) at the Frederick national Laboratory for Cancer Research (FNLCR). The BSP Office provides procurement and logistical assistance in support of the research activities of the Center for Cancer Research.KEY ROLES/RESPONSIBILITIES The Secretary III will: Provide heavy-volume procurement support to a large customer base of laboratory staff, both Leidos Biomed and CCR (gov’t), using blanket orders, purchase requisitions, credit card, and online warehouse system Data entry into appropriate financial system component (CostPoint, Cor360), status checks on orders, maintenance of orders log, reconciliation of credit card transactions, maintenance of electronic filing systems Providing logistical support for the facilitation of travel packages (both pre-travel and post travel) for Leidos Biomed employees, as well as the coordination of seminar speakers and subsequent reimbursements Composing and answering emails/correspondence Communicating with all levels of personnel, both verbally and in writing, to gather and clearly convey information

Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group.

PubMed

Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

2016-03-01

The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a group of peers who also have a sibling with an intellectual disability, though no specific method for running this type of group has yet been fully explored. This article reports the views of 39 children taking part in such a group, analysing their perspective through a proposed model for the operation of sibling groups: social pedagogy. It was found that the closer the group's activities were to social pedagogy, the more supported the children and young people felt. © The Author(s) 2015.

Building Fire Behavior Analyst (FBAN) capability and capacity: Lessons learned From Victoria, Australia's Bushfire Behavior Predictive Services Strategy

Treesearch

K. E. Gibos; A. Slijepcevic; T. Wells; L. Fogarty

2015-01-01

Wildland fire managers must frequently make meaning from chaos in order to protect communities and infrastructure from the negative impacts of fire. Fire management personnel are increasingly turning to science to support their experience-based decision-making processes and to provide clear, confident leadership for communities frequently exposed to risk from wildfire...

Providing High-Quality Support Services to Home-Based Child Care: A Conceptual Model and Literature Review

ERIC Educational Resources Information Center

Bromer, Juliet; Korfmacher, Jon

2017-01-01

Research Findings: Home-based child care accounts for a significant proportion of nonparental child care arrangements for young children in the United States. Yet the early care and education field lacks clear models or pathways for how to improve quality in these settings. The conceptual model presented here articulates the components of…

New Research into General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

ERIC Educational Resources Information Center

Chaplin, R.

2009-01-01

Background: There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either…

Subnanometer and nanometer catalysts, method for preparing size-selected catalysts

DOEpatents

Vajda, Stefan , Pellin, Michael J.; Elam, Jeffrey W [Elmhurst, IL; Marshall, Christopher L [Naperville, IL; Winans, Randall A [Downers Grove, IL; Meiwes-Broer, Karl-Heinz [Roggentin, GR

2012-04-03

Highly uniform cluster based nanocatalysts supported on technologically relevant supports were synthesized for reactions of top industrial relevance. The Pt-cluster based catalysts outperformed the very best reported ODHP catalyst in both activity (by up to two orders of magnitude higher turn-over frequencies) and in selectivity. The results clearly demonstrate that highly dispersed ultra-small Pt clusters precisely localized on high-surface area supports can lead to affordable new catalysts for highly efficient and economic propene production, including considerably simplified separation of the final product. The combined GISAXS-mass spectrometry provides an excellent tool to monitor the evolution of size and shape of nanocatalyst at action under realistic conditions. Also provided are sub-nanometer gold and sub-nanometer to few nm size-selected silver catalysts which possess size dependent tunable catalytic properties in the epoxidation of alkenes. Invented size-selected cluster deposition provides a unique tool to tune material properties by atom-by-atom fashion, which can be stabilized by protective overcoats.

Subnanometer and nanometer catalysts, method for preparing size-selected catalysts

DOEpatents

Vajda, Stefan [Lisle, IL; Pellin, Michael J [Naperville, IL; Elam, Jeffrey W [Elmhurst, IL; Marshall, Christopher L [Naperville, IL; Winans, Randall A [Downers Grove, IL; Meiwes-Broer, Karl-Heinz [Roggentin, GR

2012-03-27

Highly uniform cluster based nanocatalysts supported on technologically relevant supports were synthesized for reactions of top industrial relevance. The Pt-cluster based catalysts outperformed the very best reported ODHP catalyst in both activity (by up to two orders of magnitude higher turn-over frequencies) and in selectivity. The results clearly demonstrate that highly dispersed ultra-small Pt clusters precisely localized on high-surface area supports can lead to affordable new catalysts for highly efficient and economic propene production, including considerably simplified separation of the final product. The combined GISAXS-mass spectrometry provides an excellent tool to monitor the evolution of size and shape of nanocatalyst at action under realistic conditions. Also provided are sub-nanometer gold and sub-nanometer to few nm size-selected silver catalysts which possess size dependent tunable catalytic properties in the epoxidation of alkenes. Invented size-selected cluster deposition provides a unique tool to tune material properties by atom-by-atom fashion, which can be stabilized by protective overcoats.

Confirmatory factor analysis of posttraumatic stress symptoms in sexually harassed women.

PubMed

Palmieri, Patrick A; Fitzgerald, Louise F

2005-12-01

Posttraumatic stress disorder (PTSD) factor analytic research to date has not provided a clear consensus on the structure of posttraumatic stress symptoms. Seven hypothesized factor structures were evaluated using confirmatory factor analysis of the Posttraumatic Stress Disorder Checklist, a paper-and-pencil measure of posttraumatic stress symptom severity, in a sample of 1,218 women who experienced a broad range of workplace sexual harassment. The model specifying correlated re-experiencing, effortful avoidance, emotional numbing, and hyperarousal factors provided the best fit to the data. Virtually no support was obtained for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) three-factor model of re-experiencing, avoidance, and hyperarousal factors. Different patterns of correlations with external variables were found for the avoidance and emotional numbing factors, providing further validation of the supported model.

What Is Asked in Clinical Data Request Forms? A Multi-site Thematic Analysis of Forms Towards Better Data Access Support

PubMed Central

Hanauer, David A; Hruby, Gregory W.; Fort, Daniel G.; Rasmussen, Luke V.; Mendonça, Eneida A.; Weng, Chunhua

2014-01-01

Many academic medical centers have aggregated data from multiple clinical systems into centralized repositories. These repositories can then be queried by skilled data analysts who act as intermediaries between the data stores and the research teams. To obtain data, researchers are often expected to complete a data request form. Such forms are meant to support record-keeping and, most importantly, provide a means for conveying complex data needs in a clear and understandable manner. Yet little is known about how data request forms are constructed and how effective they are likely to be. We conducted a content analysis of ten data request forms from CTSA-supported institutions. We found that most of the forms over-emphasized the collection of metadata that were not considered germane to the actual data needs. Based on our findings, we provide recommendations to improve the quality of data request forms in support of clinical and translational research. PMID:25954367

Clear-Sky Probability for the August 21, 2017, Total Solar Eclipse Using the NREL National Solar Radiation Database

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

Habte, Aron M; Roberts, Billy J; Kutchenreiter, Mark C

The National Renewable Energy Laboratory (NREL) and collaborators have created a clear-sky probability analysis to help guide viewers of the August 21, 2017, total solar eclipse, the first continent-spanning eclipse in nearly 100 years in the United States. Using cloud and solar data from NREL's National Solar Radiation Database (NSRDB), the analysis provides cloudless sky probabilities specific to the date and time of the eclipse. Although this paper is not intended to be an eclipse weather forecast, the detailed maps can help guide eclipse enthusiasts to likely optimal viewing locations. Additionally, high-resolution data are presented for the centerline of themore » path of totality, representing the likelihood for cloudless skies and atmospheric clarity. The NSRDB provides industry, academia, and other stakeholders with high-resolution solar irradiance data to support feasibility analyses for photovoltaic and concentrating solar power generation projects.« less

Joint Refugee Information Clearing Office (JRICO)

DTIC Science & Technology

1976-03-02

A. JRICO Documentation 42 B. DA Documentation 62 C. DOD Documentation 75 D. IATF Documentation 83 E. Operating Procedures 103 F. Data...Indochina ( IATF ) and maintain access to the IATF computer data files on refugees, as well as coordinating with OSD, refugee resettlement centers...providing facilities and administrative support as requir- ed and negotiating with IATF for on-line computer access to the refugee records in the

Using Shared Online Blogs to Structure and Support Informal Coach Learning--Part 1: A Tool to Promote Reflection and Communities of Practice

ERIC Educational Resources Information Center

Stoszkowski, John; Collins, Dave

2017-01-01

Coaches' apparent preferences for informal and self-directed modes of learning have been highlighted in the literature. Consequently, there is a need for innovative coach education approaches that complement these clearly preferred, informal routes and better provide coaches with the professional skills they need to deal with the complex nature of…

Steps and Tools to Guide Planning and Implementation of a Comprehensive System to Address Barriers to Learning and Teaching

ERIC Educational Resources Information Center

Center for Mental Health in Schools at UCLA, 2007

2007-01-01

The data are clear: Too many students are not doing well in school. Too many are experiencing interfering barriers, most of which are not internal dysfunctions but are associated with neighborhood, family, school, and peer factors. If the situation is to change, schools must play a greater role in providing supports for students experiencing…

Determining the Optimal Design for a New ADR Mechanical Support

NASA Astrophysics Data System (ADS)

Waldvogel, Kelly; Stacey, Gordon; Nikola, Thomas; Parshley, Stephen

2018-01-01

ZEUS-2 is a grating spectrometer that is used to observe emission lines in submillimeter wavelengths. It is capable of detecting redshifted fine structure lines of galaxies over a wide redshift range. ZEUS-2 can observe carbon, nitrogen, and oxygen lines, which will in turn allow for modeling of optically thick molecular clouds, provide information about star temperatures, and help gain insight about the interstellar medium and gases from which stars form. The detections collected by ZEUS-2 can provide a glimpse into star formation in the early universe and improve the current understanding of the star formation process.ZEUS-2 utilizes an Adiabatic Demagnetization Refrigerator (ADR) to cool its detectors to around 100 mK. Copper rods connect the salt pills within the ADR and the mechanical supports. These supports are comprised of three main pieces: a base member, an inner member, and a guard member. On two separate mechanical supports, the Kevlar strands have broken. This led to thermal contact between the three members, preventing the detector from reaching its final operating temperature. It is clear that a replacement mechanical support system is necessary for operation.

More than a device: today's medical technology companies provide value through service.

PubMed

McCoy, Fred

2003-01-01

When physicians implant cardiac rhythm management devices, they establish a long-term relationship with those devices and with the manufacturers of those devices. The therapeutic value that each device will provide to its patient is enhanced throughout the life of the device by the services that the manufacturer provides. Services are provided prior to, during and long after implantation. Services include physician and allied health professional training, quality assurance programs, therapy outreach initiatives, on site technical support during device implantation and follow-up, technical service expertise and customer service support. The costs of these services are substantial. When assessed on a per device basis, the service costs may actually exceed the costs of manufacture. Further, the costs of these services are rising. Over the past five years, the number of implanted cardiac rhythm management devices has doubled. Industry field forces have tripled in size. Clearly, industry is dedicated to providing service as a critical element in achieving excellent patient outcomes.

Word identification in reading and the promise of subsymbolic psycholinguistics.

PubMed

Van Orden, G C; Pennington, B F; Stone, G O

1990-10-01

The vast literature concerning printed word identification either contradicts or provides ambiguous support for each of the central hypotheses of dual-process theory, the most widely accepted theory of printed word identification. In contrast, clear, positive support exists for an alternative subsymbolic approach that includes a central role for the process of phonologic coding. This subsymbolic account is developed around a covariant learning hypothesis, derived from a design principle common to current learning algorithms within the subsymbolic paradigm. Where this hypothesis applies, and it may apply broadly, it predicts a common empirical profile of development.

What is the need for comparative effectiveness studies in IBD?

PubMed

Flasar, Mark H; Cross, Raymond K

2014-11-01

Unlike traditional clinical trial research, Comparative Effectiveness Research seeks to determine what is 'best' for a typical patient when deciding between effective options used in daily practice - a therapy, diagnostic test, or course of action. There is a clear need for Comparative Effectiveness Research in Inflammatory Bowel Disease, a point emphasized by the Institute of Medicine and supported by governmental agencies and escalating funding. This review highlights the rationale and support for Comparative Effectiveness Research, provides examples of Comparative Effectiveness Research in Inflammatory Bowel Disease, and outlines current and future focus for Comparative Effectiveness Research in Inflammatory Bowel Disease.

The process of developing and implementing a telephone-based peer support program for postpartum depression: evidence from two randomized controlled trials

PubMed Central

2014-01-01

Background A randomized controlled trial evaluated the effect of telephone-based peer support on preventing postpartum depression (PPD) among high-risk mothers. The results indicated that support provided by peer volunteers may be an effective preventative strategy. The purpose of this paper is to outline the process of developing, implementing, maintaining, and evaluating the peer support program that we used in this PPD prevention trial. Methods The peer support program had been used successfully in a pilot trial and a previous breastfeeding peer support trial. Based on our experience and lessons learned, we developed a 4-phase, 12-step approach so that the peer support model could be copied and used by different health providers in various settings. We will use the PPD prevention trial to demonstrate the suggested steps. Results The trial aim to prevent the onset of PPD was established. Peer volunteers who previously experienced and recovered from self-reported PPD were recruited and attended a four-hour training session. Volunteers were screened and those identified as appropriate to provide support to postpartum mothers were selected. Women who scored more than 9 on the Edinburgh Postnatal Depression Scale within the first two weeks after childbirth were recruited to participate in the trial and proactive, individualized, telephone-based peer support (mother-to-mother) was provided to those randomized to the intervention group. Peer volunteers maintained the intervention, supported other volunteers, and evaluated the telephone-based support program. Possible negative effects of the intervention were assessed. An in-depth assessment of maternal perspectives of the program at 12 weeks postpartum was performed. Conclusions The 4-phase, 12-step approach delineated in this paper provides clear and concise guidelines for health professionals to follow in creating and implementing community-based, peer-support interventions with the potential to prevent PPD. Trial registration Current Controlled Trials ISRCTN68337727. PMID:24742217

Engineering Microvascularized 3D Tissue Using Alginate-Chitosan Microcapsules.

PubMed

Zhang, Wujie; Choi, Jung K; He, Xiaoming

2017-02-01

Construction of vascularized tissues is one of the major challenges of tissue engineering. The goal of this study was to engineer 3D microvascular tissues by incorporating the HUVEC-CS cells with a collagen/alginate-chitosan (AC) microcapsule scaffold. In the presence of AC microcapsules, a 3D vascular-like network was clearly observable. The results indicated the importance of AC microcapsules in engineering microvascular tissues -- providing support and guiding alignment of HUVEC-CS cells. This approach provides an alternative and promising method for constructing vascularized tissues.

Social Media: Gateway to Public Preparedness and Understanding of GeoHazards

NASA Astrophysics Data System (ADS)

Ballmann, J. E.; Bohon, W.; Bartel, B. A.

2016-12-01

The clear, timely communication of natural hazards information is critical to providing the public with the tools and information they need to make informed decisions before, during, and after events such as earthquakes, tsunamis, and volcanic eruptions. For the geohazards community, this is a multi-sector collaboration involving partners from national, state, and local governments, businesses, educational organizations, non-profit groups, and scientific institutions, for the benefit and participation of the whole community. Communications channels must be clear, consistent, and unified for the sake of maximum reach. One method of public communication that has proven to be particularly effective in disseminating hazards-related information is social media. The broad social and geographic reach of social media coupled with its ubiquitous use in all age groups makes it a powerful way to reach large segments of the population. Social media is already widely used by mass media and scientific organizations to communicate science and hazards. However, it is important that science organizations present a united and clear message, particularly about hazards preparation and response. The Southern California Earthquake Center (SCEC), UNAVCO, and the Incorporated Research Institutions for Seismology (IRIS) have created a Joint Social Media Task Force. The objective of this collaboration is 1) to build social media communities and improve the reach of science messaging, 2) to create and present consistent and clear messaging across social media platforms and regional facilities, 3) to promote outstanding products and educational information , 4) to assist and collaborate in regional, national and international efforts (TweetChats, Reddit fora, ShakeOut, etc.) and 5) to assist and support the efforts of FEMA, the USGS and other partner organizations during crisis situations. Here, we outline the difficulties and successes of creating such an alliance and provide a road map forward showing ways that diverse organizations can collaborate to improve and support science and hazards-related social media dissemination.

Capturing information needs of care providers to support knowledge sharing and distributed decision making.

PubMed

Rogers, M; Zach, L; An, Y; Dalrymple, P

2012-01-01

This paper reports on work carried out to elicit information needs at a trans-disciplinary, nurse-managed health care clinic that serves a medically disadvantaged urban population. The trans-disciplinary model provides a "one-stop shop" for patients who can receive a wide range of services beyond traditional primary care. However, this model of health care presents knowledge sharing challenges because little is known about how data collected from the non-traditional services can be integrated into the traditional electronic medical record (EMR) and shared with other care providers. There is also little known about how health information technology (HIT) can be used to support the workflow in such a practice. The objective of this case study was to identify the information needs of care providers in order to inform the design of HIT to support knowledge sharing and distributed decision making. A participatory design approach is presented as a successful technique to specify requirements for HIT applications that can support a trans-disciplinary model of care. Using this design approach, the researchers identified the information needs of care providers working at the clinic and suggested HIT improvements to integrate non-traditional information into the EMR. These modifications allow knowledge sharing among care providers and support better health decisions. We have identified information needs of care providers as they are relevant to the design of health information systems. As new technology is designed and integrated into various workflows it is clear that understanding information needs is crucial to acceptance of that technology.

Use of PRA in Shuttle Decision Making Process

NASA Technical Reports Server (NTRS)

Boyer, Roger L.; Hamlin, Teri L.

2010-01-01

How do you use PRA to support an operating program? This presentation will explore how the Shuttle Program Management has used the Shuttle PRA in its decision making process. It will reveal how the PRA has evolved from a tool used to evaluate Shuttle upgrades like Electric Auxiliary Power Unit (EAPU) to a tool that supports Flight Readiness Reviews (FRR) and real-time flight decisions. Specific examples of Shuttle Program decisions that have used the Shuttle PRA as input will be provided including how it was used in the Hubble Space Telescope (HST) manifest decision. It will discuss the importance of providing management with a clear presentation of the analysis, applicable assumptions and limitations, along with estimates of the uncertainty. This presentation will show how the use of PRA by the Shuttle Program has evolved overtime and how it has been used in the decision making process providing specific examples.

Test, Control and Monitor System (TCMS) operations plan

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

How Business Leaders Can Support College and Career-Readiness: Staying the Course on Common Core. White Paper

ERIC Educational Resources Information Center

Meyer, Lori

2014-01-01

For the first time in the nation's history, a majority of students in the United States are learning based on a common set of standards for mathematics and English language arts (ELA) that will prepare them for the demands of the 21st century. The Common Core State Standards (CCSS) provide a clear, consistent framework for what students should…

Finite temperature grand canonical ensemble study of the minimum electrophilicity principle.

PubMed

Miranda-Quintana, Ramón Alain; Chattaraj, Pratim K; Ayers, Paul W

2017-09-28

We analyze the minimum electrophilicity principle of conceptual density functional theory using the framework of the finite temperature grand canonical ensemble. We provide support for this principle, both for the cases of systems evolving from a non-equilibrium to an equilibrium state and for the change from one equilibrium state to another. In doing so, we clearly delineate the cases where this principle can, or cannot, be used.

Process and implementation of participatory ergonomic interventions: a systematic review.

PubMed

van Eerd, Dwayne; Cole, Donald; Irvin, Emma; Mahood, Quenby; Keown, Kiera; Theberge, Nancy; Village, Judy; St Vincent, Marie; Cullen, Kim

2010-10-01

Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount. STATEMENT OF RELEVANCE: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.

A new barrier-free burn center.

PubMed

Edlich, R F; Neal, J G; Suber, F; Kirby, D; Woods, J A; Bentram, D; McGawen, J

1998-01-01

This article describes a barrier-free burn center that is accessible to persons with disabilities and that complies with Title III of the Americans with Disabilities Act. The burn center has 3 separate components: patient rooms, patient support facilities, and staff support facilities. Thirteen rooms are used to care for 16 patients. Two of the 13 rooms are accessible to people with disabilities. These 2 rooms have wide doors that permit a wheelchair to pass through, and they have enough clear floor space for a wheelchair to make a 180 degrees turn. The rooms have a sink that is accessible from a wheelchair. The bathrooms have large, clear floor spaces that allow for the turning of a wheelchair, elevated toilets, grab bars, and showers that permit wheelchair access. Special wheelchairs that provide easier shower and commode access are available. The patient support services feature a large hydrotherapy room that contains a table-shower system that allows a person in a wheelchair to gain access to both sides of the shower table. A tub room has been constructed to provide compact patient bathing and hydromassage, and it is also accessible to people in wheelchairs. The staff support services include a locker room that has a shower accessible to people with disabilities so that staff members with mobility disorders can work in the burn center. Grade II braille writing marks all of the signs that designate the permanent rooms and spacing in the burn center and in the contiguous common use areas. The common use area has a restroom accessible to people with disabilities and a waiting room with a telephone communications system for people with mobility disorders or mobility impairment.

Recruitment and retention of Native American graduate students in school psychology.

PubMed

Goforth, Anisa N; Brown, Jacqueline A; Machek, Greg R; Swaney, Gyda

2016-09-01

There is a clear underrepresentation of Native Americans in the field of school psychology. There are a number of factors that have led to this underrepresentation, including cultural and historical variables, barriers to accessing higher educational opportunities, and lack of financial support. Given the importance of having diverse perspectives in the field, as well as the need for mental health services and academic supports for Native American children and their families, school psychology trainers should consider actively recruiting and retaining Native American graduate students to doctoral and specialist programs. This article provides specific research-based recommendations for recruiting Native American students and strategies for supporting their success and matriculation in the program. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Natural history of idiopathic normal-pressure hydrocephalus.

PubMed

Toma, Ahmed K; Stapleton, Simon; Papadopoulos, Marios C; Kitchen, Neil D; Watkins, Laurence D

2011-10-01

Natural history of idiopathic normal-pressure hydrocephalus (INPH) is not clear. We performed a literature search for studies that looked into the outcome of unshunted INPH patients trying to answer the following questions: Do all INPH patients deteriorate without shunt? If yes, at what rate? Do some NPH patients improve without shunt? If yes, to what extent? Six studies objectively described the outcome of 102 INPH patients. Result shows that without surgery, most INPH patients had measurable deterioration as early as 3 months following initial assessment. A small number of patients might improve without shunt, however the extent of improvement is not clear. The homogeneity of the findings of the cohort studies provided high evidence supporting the rule of shunt surgery in INPH patients.

Partnerships: One Strategy for Meeting Big Data Challenges

NASA Astrophysics Data System (ADS)

Chandler, C. L.; Groman, R. C.; Kinkade, D.; Shepherd, A.; Allison, M. D.; Rauch, S.; Wiebe, P. H.; Glover, D. M.

2014-12-01

In late 2006 staff members from the previously independent US Joint Global Ocean Flux Study (US JGOFS) and US GLOBal Ocean ECosystems Dynamics (US GLOBEC) data management offices joined forces and received funding from the US National Science Foundation to provide data management support to ocean science researchers. The transition from providing dedicated, project-specific data management services to supporting a broader research community data facility has necessitated understanding of and adaptation to evolving needs. One of the strategies that has proven to be very effective is the formation of partnerships with other groups doing complementary work. Staff members at BCO-DMO have formed collaborative partnerships with others to support our primary research community efficiently and in a way that covers the full research data life cycle. Examples will be provided that highlight ways in which such partnerships have enhanced the work done by BCO-DMO, and also ways in which BCO-DMO activities have contributed to broader national and global initiatives. One of the clear benefits of collaboration with other groups is the opportunity for identification of shared challenges, strategies and solutions and the increased likelihood of developing interoperable systems.

Retaining the next generation of nurses: the Wisconsin nurse residency program provides a continuum of support.

PubMed

Bratt, Marilyn Meyer

2009-09-01

Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits. Copyright 2009, SLACK Incorporated.

Healthcare providers balancing norms and practice: challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study.

PubMed

Paul, Mandira; Näsström, Sara B; Klingberg-Allvin, Marie; Kiggundu, Charles; Larsson, Elin C

2016-01-01

Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Self-management support in chronic illness care: a concept analysis.

PubMed

Kawi, Jennifer

2012-01-01

This article reports on the concept analysis of self-management support (SMS) to provide clarity for systematic implementation in practice. SMS is a concept in its early phase of development. It is increasingly evident in literature on chronic illness care. However, the definition has been simplified or vague leading to variable SMS programs and inconsistent outcomes. Elucidation of SMS is necessary in chronic illness care to facilitate clear understanding and implementation. Rodgers' evolutionary concept analysis method was used to examine SMS. Data sources included systematic multidisciplinary searches of multiple search engines. SMS refers to comprehensive sustaining approaches toward improving chronic illness outcomes consisting of patient-centered attributes (involving patients as partners; providing diverse, innovative educational modalities specific to patients' needs; individualizing patient care), provider attributes (possessing adequate knowledge, skills, attitudes in providing care), and organizational attributes (putting an organized system of care in place, having multidisciplinary team approach, using tangible and social support). A well-clarified SMS concept is important in theory development. The attributes offer necessary components in SMS programs for systematic implementation, evaluation, and research. There is great potential that SMS can help improve outcomes of chronic illness care.

[Structure of Relationships Formed by Occupational Health Nurses for Co-operating with Managers to Support Workers with Mental Health Concerns].

PubMed

Hatanaka, Junko; Takasaki, Masako; Hatanaka, Michiyo

2018-05-31

Occupational health staff and managers play important roles in supporting workers with mental health concerns and mutual co-operation among them is a necessary element. However, when co-operating with other professionals, several problems arise that often make such co-operation a challenge. Effective mutual actions are needed to promote such co-operation, and relationships must be formed for this purpose. Therefore, in this study, we aimed to clarify how occupational health nurses form relationships for facilitating co-operation with managers to provide support to workers with mental health concerns. Data were collected using semi-structured interviews with 11 occupational health nurses who provide individualized mental health support and who have at least 5 years of experience as occupational health nurses. Analysis of the recorded interviews was performed using a qualitative statistical method (KJ method). Six elements that constitute the formation of relationships were identified. When occupational health nurses form relationships for facilitating co-operation with a manager to provide support to workers, they "form relationships through strategic communication" with them and when co-operation is required, they form a relationship by "acting in a manner that suits the manager," such as his/her character and the situation. To support this relationship, occupational health nurses "provide mental support to the manager" by listening to his/her anxiety or real intention about supporting the subordinate with mental health concerns and provide relief while understanding their burdens during the co-operation. Occupational health nurses even "provide support to the manager in their activities," which assessed the situation at the workplace as the specialist and advised the manager to understand how to concern to the subordinate specifically. In addition, they "indirectly support the manager" which included coordinating with the concerned persons so as to not excessively burden the manager. Such support promoted the "creation of systems for clear roles" of managers in supporting the subordinate with mental health concerns. Relationships that occupational health nurses form with their managers were the structure which formed emotional human relationships from the front or back necessity of co-operation causes and developing confidence in relationships with the foundation of emotional human relationships.

Implementation of Medical Assistance in Dying: A Scoping Review of Health Care Providers' Perspectives.

PubMed

Fujioka, Jamie K; Mirza, Raza M; McDonald, P Lynn; Klinger, Christopher A

2018-06-01

With the growing interest in Medical Assistance in Dying (MAiD), understanding health care professionals' roles and experiences in handling requests is necessary to evaluate the quality, consistency, and efficacy of current practices. This scoping review sought to map the existing literature on health care providers' perspectives of their involvement in MAiD. A scoping review was conducted to address the following: 1) What are the roles of diverse health care professionals in the provision of MAiD? and 2) What professional challenges arise when confronted with MAiD requests? A literature search in electronic databases and gray literature sources was performed. Articles were screened, and a thematic content analysis synthesized key findings. After evaluating 1715 citations and 148 full-text papers, 33 articles were included. Perspectives of nurses (n = 10), physicians (n = 7), mental health providers (n = 7), pharmacists (n = 4), social workers (n = 3), and medical examiners (n = 1) were explored. Professional roles included consulting/supporting patients and/or other staff members with requests, assessing eligibility, administering/dispensing the lethal drugs, providing aftercare to bereaved relatives, and regulatory oversight. Challenges included lack of clear guidelines/protocols, role ambiguity, evaluating capacity/consent, conscientious objection, and lack of interprofessional collaboration. Evidence from various jurisdictions highlighted a need for clear guidelines and protocols that define each profession's role, scope of practice, and legal boundaries for MAiD. Comprehensive models of care that incorporate multidisciplinary teams alongside improved clinician education may be effective to support MAiD implementation. Little is known about health care providers' perspectives in handling requests, especially outside physician practice and nursing. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Component-Level Electronic-Assembly Repair (CLEAR) Operational Concept

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

2011-01-01

This Component-Level Electronic-Assembly Repair (CLEAR) Operational Concept document was developed as a first step in developing the Component-Level Electronic-Assembly Repair (CLEAR) System Architecture (NASA/TM-2011-216956). The CLEAR operational concept defines how the system will be used by the Constellation Program and what needs it meets. The document creates scenarios for major elements of the CLEAR architecture. These scenarios are generic enough to apply to near-Earth, Moon, and Mars missions. The CLEAR operational concept involves basic assumptions about the overall program architecture and interactions with the CLEAR system architecture. The assumptions include spacecraft and operational constraints for near-Earth orbit, Moon, and Mars missions. This document addresses an incremental development strategy where capabilities evolve over time, but it is structured to prevent obsolescence. The approach minimizes flight hardware by exploiting Internet-like telecommunications that enables CLEAR capabilities to remain on Earth and to be uplinked as needed. To minimize crew time and operational cost, CLEAR exploits offline development and validation to support online teleoperations. Operational concept scenarios are developed for diagnostics, repair, and functional test operations. Many of the supporting functions defined in these operational scenarios are further defined as technologies in NASA/TM-2011-216956.

Confronting data requirements and data provision in Space Weather: The Contribution of Long Term Archives. Part 1.

NASA Astrophysics Data System (ADS)

Heynderickx, Daniel; Glover, Alexi

Operational space weather services rely heavily on reliable data streams from spacecraft and ground-based facilities, as well as from services providing processed data products. This event focuses on an unusual solar maximum viewed from several different perspectives, and as such highlights the important contribution of long term archives in supporting space weather studies and services. We invite the space weather community to contribute to a discussion on the key topics listed below, with the aim of formulating recommendations and guidelines for policy makers, stakeholders, data and service providers: - facilitating access to and awareness of existing data resources - establishing clear guidelines for space weather data archives including data quality, interoperability and metadata standards - ensuring data ownership and terms of (re)use are clearly identified such that this information can be taken into account when (potentially commercial) services are developed based on data provided without charge for scientific purposes only All participants are invited to submit input for the discussion to the authors ahead of the Assembly. The outcome of the session will be formulated as a set of proposed panel recommendations.

Confronting data requirements and data provision in Space Weather: The Contribution of Long Term Archives. Part 2.

NASA Astrophysics Data System (ADS)

Glover, Alexi; Heynderickx, Daniel

Operational space weather services rely heavily on reliable data streams from spacecraft and ground-based facilities, as well as from services providing processed data products. This event focuses on an unusual solar maximum viewed from several different perspectives, and as such highlights the important contribution of long term archives in supporting space weather studies and services. We invite the space weather community to contribute to a discussion on the key topics listed below, with the aim of formulating recommendations and guidelines for policy makers, stakeholders, data and service providers: - facilitating access to and awareness of existing data resources - establishing clear guidelines for space weather data archives including data quality, interoperability and metadata standards - ensuring data ownership and terms of (re)use are clearly identified such that this information can be taken into account when (potentially commercial) services are developed based on data provided without charge for scientific purposes only All participants are invited to submit input for the discussion to the authors ahead of the Assembly. The outcome of the session will be formulated as a set of proposed panel recommendations.

Approach to In Situ Component Level Electronics Assembly Repair (CLEAR) for Constellation

NASA Technical Reports Server (NTRS)

Struk, Peter M.; Oeftering, Richard C.

2010-01-01

Maintenance resupply is a significant issue for long duration space missions. Currently, the International Space Station (ISS) approaches maintenance primarily around replaceable modules called Orbital Replacement Units (ORU). While swapping out ORUs has served the ISS well keeping crew time for maintenance to a minimum, this approach assumes a substantial logistics capacity to provide replacement ORUs and return ORUs to Earth for repair. The ORUs used for ISS require relatively large blocks of replacement hardware even though the actual failed component may be several orders of magnitude smaller. The Component Level Electronics Assembly Repair (CLEAR) task was created to explore electronics repair down to the component level for future space missions. From 2006 to 2009, CLEAR was an activity under the Supportability project of the Exploration Technology Development Program. This paper describes the activities of CLEAR including making a case for component-level electronics repair, examination of current terrestrial repair hardware, and potential repair needs. Based on those needs, the CLEAR team proposes an architecture for an in-situ repair capability aboard a spacecraft or habitat. Additionally, this paper discusses recent progress toward developing in-space repair capabilities--including two spaceflight experiments-- and presents technology concepts which could help enable or benefit the same.

A Clinical Decision Support System to Assist Pediatric Oncofertility: A Short Report.

PubMed

Hand, Meredith; Kemertzis, Matthew A; Peate, Michelle; Gillam, Lynn; McCarthy, Maria; Orme, Lisa; Heloury, Yves; Sullivan, Michael; Zacharin, Margaret; Jayasinghe, Yasmin

2018-05-07

Fertility preservation discussions with pediatric and adolescent cancer patients can be difficult for clinicians. This study describes the acceptability of a fertility clinician decision support system (CDSS). A cross-sectional study of clinicians at The Royal Children's Hospital, Melbourne. Participants were trained on CDSS purpose, contents, and use. A survey captured the perceived benefits and weaknesses of the CDSS. Thirty-nine clinicians participated. Over 90% felt the CDSS aims and format were clear, and understood the components. Over 80% felt it would enable adherence to clinical pathways, policy, and standards of care. The CDSS provided significant perceived benefits to oncofertility care.

Assessing the Rationale and Effectiveness of Frozen Plasma Transfusions: An Evidence-based Review.

PubMed

Tinmouth, Alan

2016-06-01

Frozen plasma is a commonly used blood product. The primary indications for frozen plasma are the treatment and prevention of bleeding in patients with prolonged coagulation tests. However, there is a lack of well-conducted clinical trials to determine the appropriate indications for frozen plasma. The rationale and evidence for frozen plasma transfusions are reviewed, including the evidence or lack of evidence supporting common indications. Targeting indications in which frozen plasma transfusions are clearly not beneficial as supported by the current evidence provides an opportunity to improve the current use of frozen plasma and reduce adverse transfusion events. Copyright © 2016 Elsevier Inc. All rights reserved.

Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review.

PubMed

Gardiner, Clare; Gott, Merryn; Ingleton, Christine

2012-05-01

The care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, district nurses and others who have not undertaken specialist training in palliative care. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to suggest factors which support collaborative working between specialist and generalist palliative care providers. To explore factors that support partnership working between specialist and generalist palliative care providers. Systematic review. A systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until January 2011. Of the 159 articles initially identified, 22 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; and coordinated care. Multiple examples exist of good partnership working between specialist and generalist providers; however, there is little consistency regarding how models of collaborative working are developed, and which models are most effective. Little is known about the direct impact of collaborative working on patient outcomes. Further research is required to gain the direct perspectives of health professionals and patients regarding collaborative working in palliative care, and to develop appropriate and cost-effective models for partnership working.

Critical care in the surgical global period.

PubMed

Painter, Julie R

2013-03-01

This article explores the rules and regulations from Current Procedural Terminology (CPT) code set and US Medicare and Medicaid Services (Medicare) regarding multiple physicians reporting critical care services during the global period. The article takes into account the critical care definitions, regulations, documentation requirements, and services each provider can report to Medicare. A clinical scenario based on literature supporting the types of complications and care that might typically be included in the post-operative period for a patient who is surgically treated for a type A aortic dissection was analyzed. It was determined that multiple physicians may provide critical care services to a single patient during the global period. The physician who performed the primary procedure cannot report critical care separately unless documentation supporting use of modifier 25 (significant, separately identifiable services) or 24 (unrelated services) supports that critical care is unrelated to the global period. Other physicians may report critical care services separately if specific criteria are met. To report critical care services to Medicare, the patient's condition must meet the Medicare definition of critical care and the physicians should generally represent different specialties providing different aspects of care to the critically ill or injured patient as defined by Medicare. There should be no overlap in time of services provided by each physician. Each physician's documentation should clearly support medical necessity with the diagnosis demonstrating the critical nature of the patients' illness, the total time spent providing critical care, the critical care service provided, and other contributing factors.

Photooxidative degradation of clear ultraviolet absorbing acrylic copolymer surfaces

NASA Technical Reports Server (NTRS)

Gupta, A.; Liang, R. H.; Vogl, O.; Pradellok, W.; Huston, A. L.; Scott, G. W.

1983-01-01

Photodegradation of copolymer of methyl methacrylate and 2(2'-hydroxy 5'vinyl-phenyl) 2H-benzotriazole has been investigated in order to determine the changes in the chemical composition of the surface of the copolymer on photooxidation. An electronic energy transfer mechanism has been postulated in order to interpret the observed photochemical changes in the polymer. Preliminary examination of the photophysical properties of the chromophore provides support for such a mechanism.

A Study to Determine the Most Feasible Sign System for Improving the Flow of Patients in the Interior Hospital

DTIC Science & Technology

1985-08-01

29 E. NEW GRAPHICS DESIGNED BY AUTHOR ....... ................ .37 F. COST-BENEFIT ANALYSIS ........ ..................... ... 44 G. IMPLEMENTATION OF...Cornett, and Catherine Tillotson were invaluable in designing new hospital graphics . Finally, a big thanks for the faith and typing support of...February 1975): 25. "Careful Design Provides Outpatient Facility with Simple, Clear, Attractive Signage and Graphics ." Hospitals, Vol 53 (16 April 1979): 40

Meeting Air Training Command’s Future Airspace Needs.

DTIC Science & Technology

1982-08-01

Fekke Lieutenant Colonel, USAF I!. ..... .... .a T B DTIG 3Air University (ATC) Air War College -j Maxwell Air Force Base, Alabama ,9 83 11 03 04...Commandant, Air War College, Maxwell Air Force Base, Alabama. It has been cleared for public release. -ii BIOGRAPHICAL SKETCH Upon entering the Air...efficiently provide the type of terminal support required by ATC. viii 0%.- KINTRODUCTION This monograph documents a long-range planning effort which exam

Volumetric measurement of rock movement using photogrammetry

PubMed Central

Benton, Donovan J.; Iverson, Stephen R.; Martin, Lewis A.; Johnson, Jeffrey C.; Raffaldi, Michael J.

2016-01-01

NIOSH ground control safety research program at Spokane, Washington, is exploring applications of photogrammetry to rock mass and support monitoring. This paper describes two ways photogrammetric techniques are being used. First, photogrammetric data of laboratory testing is being used to correlate energy input and support deformation. This information can be used to infer remaining support toughness after ground deformation events. This technique is also demonstrated in a field application. Second, field photogrammetric data is compared to crackmeter data from a deep underground mine. Accuracies were found to average 8 mm, but have produced results within 0.2 mm of true displacement, as measured by crackmeters. Application of these techniques consists of monitoring overall fault activity by monitoring multiple points around the crackmeter. A case study is provided in which a crackmeter is clearly shown to have provided insufficient information regarding overall fault ground deformation. Photogrammetry is proving to be a useful ground monitoring tool due to its unobtrusiveness and ease of use. PMID:27110429

Woman focused smoking cessation programming: a qualitative study.

PubMed

Minian, Nadia; Penner, Jessica; Voci, Sabrina; Selby, Peter

2016-03-12

Several studies of smoking cessation programs in clinical settings have revealed poorer outcomes for women compared to men, including counselling alone or in combination with pharmacotherapy. The objective of the current study was to explore treatment and program structure needs and preferences among female clients in a specialized smoking cessation clinic in an academic mental health and addiction health science centre in order to inform program design so that it meets the needs of female clients. Four focus groups were conducted with current and former female clients (n = 23, mode age range = 50-59 years old, 56.5% were still smoking and 43.5% had quit) who had registered for outpatient smoking cessation treatment. Questions were designed to examine what aspects of the services were helpful and what changes they would like to see to better assist them and other women with quitting smoking. A thematic analysis of the raw data (audio recordings and notes taken during the focus groups) was conducted using a phenomenological theoretical framework. Themes that emerged indicated that females trying to quit smoking are best supported if they have choice from a variety of services so that treatment can be individualized to meet their specific needs; psychosocial support is provided both one-one-one with health care professionals and by peers in support groups; free pharmacotherapy is available to eliminate financial barriers to use; women-specific educational topics and support groups are offered; the clinic is accessible with evening/weekend hours, options to attend a local clinic, and childcare availability; and communication about clinic services and operation are clear, readily available, and regularly updated. An ideal smoking cessation program for women includes a women's centred approach with sufficient variety and choice, free pharmacotherapy, non-judgmental support, accessible services and clear communication of program options and changes. Findings may suggest an actionable list of adaptations that can be adopted by other clinics providing smoking cessation services to women.

Cooperation in social dilemmas: free riding may be thwarted by second-order reward rather than by punishment.

PubMed

Kiyonari, Toko; Barclay, Pat

2008-10-01

Cooperation among nonrelatives can be puzzling because cooperation often involves incurring costs to confer benefits on unrelated others. Punishment of noncooperators can sustain otherwise fragile cooperation, but the provision of punishment suffers from a "second-order" free-riding problem because nonpunishers can free ride on the benefits from costly punishment provided by others. One suggested solution to this problem is second-order punishment of nonpunishers; more generally, the threat or promise of higher order sanctions might maintain the lower order sanctions that enforce cooperation in collective action problems. Here the authors report on 3 experiments testing people's willingness to provide second-order sanctions by having participants play a cooperative game with opportunities to punish and reward each other. The authors found that people supported those who rewarded cooperators either by rewarding them or by punishing nonrewarders, but people did not support those who punished noncooperators--they did not reward punishers or punish nonpunishers. Furthermore, people did not approve of punishers more than they did nonpunishers, even when nonpunishers were clearly unwilling to use sanctions to support cooperation. The results suggest that people will much more readily support positive sanctions than they will support negative sanctions.

Selective control of gait subtasks in robotic gait training: foot clearance support in stroke survivors with a powered exoskeleton

PubMed Central

2013-01-01

Background Robot-aided gait training is an emerging clinical tool for gait rehabilitation of neurological patients. This paper deals with a novel method of offering gait assistance, using an impedance controlled exoskeleton (LOPES). The provided assistance is based on a recent finding that, in the control of walking, different modules can be discerned that are associated with different subtasks. In this study, a Virtual Model Controller (VMC) for supporting one of these subtasks, namely the foot clearance, is presented and evaluated. Methods The developed VMC provides virtual support at the ankle, to increase foot clearance. Therefore, we first developed a new method to derive reference trajectories of the ankle position. These trajectories consist of splines between key events, which are dependent on walking speed and body height. Subsequently, the VMC was evaluated in twelve healthy subjects and six chronic stroke survivors. The impedance levels, of the support, were altered between trials to investigate whether the controller allowed gradual and selective support. Additionally, an adaptive algorithm was tested, that automatically shaped the amount of support to the subjects’ needs. Catch trials were introduced to determine whether the subjects tended to rely on the support. We also assessed the additional value of providing visual feedback. Results With the VMC, the step height could be selectively and gradually influenced. The adaptive algorithm clearly shaped the support level to the specific needs of every stroke survivor. The provided support did not result in reliance on the support for both groups. All healthy subjects and most patients were able to utilize the visual feedback to increase their active participation. Conclusion The presented approach can provide selective control on one of the essential subtasks of walking. This module is the first in a set of modules to control all subtasks. This enables the therapist to focus the support on the subtasks that are impaired, and leave the other subtasks up to the patient, encouraging him to participate more actively in the training. Additionally, the speed-dependent reference patterns provide the therapist with the tools to easily adapt the treadmill speed to the capabilities and progress of the patient. PMID:23336754

75 FR 37864 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... and Rules To Establish a Clearing Fund Amount Intended To Support Losses Under a Defined Set of... intended to support losses under a defined set of default scenarios. II. Self-Regulatory Organization's... discussed any comments it received on the proposed rule change. The text of these statements may be examined...

17 CFR 39.5 - Review of swaps for Commission determination on clearing requirement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... publicly; (vi) Risk management procedures, including measurement and monitoring of credit exposures... derivative clearing organization's ability to manage the risks associated with clearing the swap, especially... of rule framework, capacity, operational expertise and resources, and credit support infrastructure...

17 CFR 39.5 - Review of swaps for Commission determination on clearing requirement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... publicly; (vi) Risk management procedures, including measurement and monitoring of credit exposures... derivative clearing organization's ability to manage the risks associated with clearing the swap, especially... of rule framework, capacity, operational expertise and resources, and credit support infrastructure...

The role of steroid hormone supplementation in non-assisted reproductive technology treatments for unexplained infertility.

PubMed

Quaas, Alexander M; Hansen, Karl R

2016-12-01

Fertility treatment strategies are evolving, with a more rapid transition to assisted reproductive technology (ART) treatments after unsuccessful non-ART treatments. This trend increases the potential importance of adjuvant treatments in non-ART cycles, such as steroid hormone supplementation. It has been established that success rates of ART treatments are increased with the use of luteal support with progesterone. In the setting of non-ART cycles, however, the evidence is less clear, and clinical practices vary widely between providers and clinics. In this review, we aimed to provide an overview of the current evidence for the use of steroid hormone supplementation, including progesterone for luteal support, estrogens, androgens, and mineralocorticoids, in the setting of non-ART treatments for ovulatory women. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Data Mining of Network Logs

NASA Technical Reports Server (NTRS)

Collazo, Carlimar

2011-01-01

The statement of purpose is to analyze network monitoring logs to support the computer incident response team. Specifically, gain a clear understanding of the Uniform Resource Locator (URL) and its structure, and provide a way to breakdown a URL based on protocol, host name domain name, path, and other attributes. Finally, provide a method to perform data reduction by identifying the different types of advertisements shown on a webpage for incident data analysis. The procedures used for analysis and data reduction will be a computer program which would analyze the URL and identify and advertisement links from the actual content links.

Performance of gigabit FDDI

NASA Technical Reports Server (NTRS)

Game, David; Maly, Kurt J.

1990-01-01

Great interest exists in developing high speed protocols which will be able to support data rates at gigabit speeds. Hardware currently exists which can experimentally transmit at data rates exceeding a gigabit per second, but it is not clear as to what types of protocols will provide the best performance. One possibility is to examine current protocols and their extensibility to these speeds. Scaling of Fiber Distributed Data Interface (FDDI) to gigabit speeds is studied. More specifically, delay statistics are included to provide insight as to which parameters (network length, packet length or number of nodes) have the greatest effect on performance.

Formal ontologies in biomedical knowledge representation.

PubMed

Schulz, S; Jansen, L

2013-01-01

Medical decision support and other intelligent applications in the life sciences depend on increasing amounts of digital information. Knowledge bases as well as formal ontologies are being used to organize biomedical knowledge and data. However, these two kinds of artefacts are not always clearly distinguished. Whereas the popular RDF(S) standard provides an intuitive triple-based representation, it is semantically weak. Description logics based ontology languages like OWL-DL carry a clear-cut semantics, but they are computationally expensive, and they are often misinterpreted to encode all kinds of statements, including those which are not ontological. We distinguish four kinds of statements needed to comprehensively represent domain knowledge: universal statements, terminological statements, statements about particulars and contingent statements. We argue that the task of formal ontologies is solely to represent universal statements, while the non-ontological kinds of statements can nevertheless be connected with ontological representations. To illustrate these four types of representations, we use a running example from parasitology. We finally formulate recommendations for semantically adequate ontologies that can efficiently be used as a stable framework for more context-dependent biomedical knowledge representation and reasoning applications like clinical decision support systems.

Therapeutic interventions in cerebral palsy.

PubMed

Patel, Dilip R

2005-11-01

Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

How students' achievement goals shape their beliefs about effective teaching: a 'build-a-professor' study.

PubMed

Senko, Corwin; Belmonte, Kimberly; Yakhkind, Anastasyia

2012-09-01

Which instructor qualities do students consider most important? The answer likely depends on the student. This study attempted to trace beliefs about the most essential instructor qualities to students' academic achievement goals. The present study tested the hypothesis that students pursuing mastery goals favour instructors who stimulate and challenge them intellectually, whereas those pursuing performance goals favour instructors who present material clearly and provide clear cues about how to succeed. Participants were 157 students at a 4-year public university. Participants designed the ideal professor through a hypothetical combination of nine widely valued instructor qualities, such as enthusiasm, presentation clarity, and an interactive teaching style. The more they acquired of any one instructor quality, the less they could acquire of the others, thus compelling students to distinguish necessary qualities from desirable luxury qualities. Students' achievement goals corresponded to their views about the most essential instructor qualities. Mastery goals predicted greater demand for professors who intellectually challenge students and possess topic expertise, whereas performance goals predicted high demand for professors who present material clearly and provide cues about how to succeed in the course. The findings support emerging theorizing about how mastery and performance goals nudge students to pursue different learning agendas, with distinct consequences to their learning experience. ©2011 The British Psychological Society.

An IT Architecture for Systems Medicine.

PubMed

Ganzinger, Matthias; Gietzelt, Matthias; Karmen, Christian; Firnkorn, Daniel; Knaup, Petra

2015-01-01

Systems medicine aims to support treatment of complex diseases like cancer by integrating all available data for the disease. To provide such a decision support in clinical practice, a suitable IT architecture is necessary. We suggest a generic architecture comprised of the following three layers: data representation, decision support, and user interface. For the systems medicine research project "Clinically-applicable, omics-based assessment of survival, side effects, and targets in multiple myeloma" (CLIOMMICS) we developed a concrete instance of the generic architecture. We use i2b2 for representing the harmonized data. Since no deterministic model exists for multiple myeloma we use case-based reasoning for decision support. For clinical practice, visualizations of the results must be intuitive and clear. At the same time, they must communicate the uncertainty immanent in stochastic processes. Thus, we develop a specific user interface for systems medicine based on the web portal software Liferay.

Clear Self, Better Relationships: Adolescents' Self-Concept Clarity and Relationship Quality With Parents and Peers Across 5 Years.

PubMed

Becht, Andrik I; Nelemans, Stefanie A; van Dijk, Marloes P A; Branje, Susan J T; Van Lier, Pol A C; Denissen, Jaap J A; Meeus, Wim H J

2017-11-01

This study examined reciprocal associations between adolescents' self-concept clarity (SCC) and their relationship quality with parents and best friends in a five-wave longitudinal study from age 13 to 18 years. In all, 497 adolescents (57% boys) reported on their SCC and all informants (i.e., adolescents, both parents, and adolescents' best friends) reported on support and negative interaction. Within-person cross-lagged analyses provided systematic evidence for both parent effects and child effects, with the direction of effects being strongly dependent on the relational context. For example, higher maternal support predicted higher adolescent SCC, supporting a parent effects perspective, whereas higher SCC predicted lower paternal negative interaction, supporting a child effects perspective. Peer effects on adolescent SCC were not consistently found across adolescent and best friend reports. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Definition of supportive care: does the semantic matter?

PubMed

Hui, David

2014-07-01

'Supportive care' is a commonly used term in oncology; however, no consensus definition exists. This represents a barrier to communication in both the clinical and research settings. In this review, we propose a unifying conceptual framework for supportive care and discuss the proper use of this term in the clinical and research settings. A recent systematic review revealed several themes for supportive care: a focus on symptom management and improvement of quality of life, and care for patients on treatments and those with advanced stage disease. These findings are consistent with a broad definition for supportive care: 'the provision of the necessary services for those living with or affected by cancer to meet their informational, emotional, spiritual, social, or physical needs during their diagnostic, treatment, or follow-up phases encompassing issues of health promotion and prevention, survivorship, palliation, and bereavement.' Supportive care can be classified as primary, secondary, and tertiary based on the level of specialization. For example, palliative care teams provide secondary supportive care for patients with advanced cancer. Until a consensus definition is available for supportive care, this term should be clearly defined or cited whenever it is used.

Technology as Teammate: Examining the Role of External Cognition in Support of Team Cognitive Processes

PubMed Central

Fiore, Stephen M.; Wiltshire, Travis J.

2016-01-01

In this paper we advance team theory by describing how cognition occurs across the distribution of members and the artifacts and technology that support their efforts. We draw from complementary theorizing coming out of cognitive engineering and cognitive science that views forms of cognition as external and extended and integrate this with theorizing on macrocognition in teams. Two frameworks are described that provide the groundwork for advancing theory and aid in the development of more precise measures for understanding team cognition via focus on artifacts and the technologies supporting their development and use. This includes distinctions between teamwork and taskwork and the notion of general and specific competencies from the organizational sciences along with the concepts of offloading and scaffolding from the cognitive sciences. This paper contributes to the team cognition literature along multiple lines. First, it aids theory development by synthesizing a broad set of perspectives on the varied forms of cognition emerging in complex collaborative contexts. Second, it supports research by providing diagnostic guidelines to study how artifacts are related to team cognition. Finally, it supports information systems designers by more precisely describing how to conceptualize team-supporting technology and artifacts. As such, it provides a means to more richly understand process and performance as it occurs within sociotechnical systems. Our overarching objective is to show how team cognition can both be more clearly conceptualized and more precisely measured by integrating theory from cognitive engineering and the cognitive and organizational sciences. PMID:27774074

Technology as Teammate: Examining the Role of External Cognition in Support of Team Cognitive Processes.

PubMed

Fiore, Stephen M; Wiltshire, Travis J

2016-01-01

In this paper we advance team theory by describing how cognition occurs across the distribution of members and the artifacts and technology that support their efforts. We draw from complementary theorizing coming out of cognitive engineering and cognitive science that views forms of cognition as external and extended and integrate this with theorizing on macrocognition in teams. Two frameworks are described that provide the groundwork for advancing theory and aid in the development of more precise measures for understanding team cognition via focus on artifacts and the technologies supporting their development and use. This includes distinctions between teamwork and taskwork and the notion of general and specific competencies from the organizational sciences along with the concepts of offloading and scaffolding from the cognitive sciences. This paper contributes to the team cognition literature along multiple lines. First, it aids theory development by synthesizing a broad set of perspectives on the varied forms of cognition emerging in complex collaborative contexts. Second, it supports research by providing diagnostic guidelines to study how artifacts are related to team cognition. Finally, it supports information systems designers by more precisely describing how to conceptualize team-supporting technology and artifacts. As such, it provides a means to more richly understand process and performance as it occurs within sociotechnical systems. Our overarching objective is to show how team cognition can both be more clearly conceptualized and more precisely measured by integrating theory from cognitive engineering and the cognitive and organizational sciences.

Adequate Facilities for All: Reforming New York State's System for Providing Building Aid to School Districts and for Meeting Schools' Urgent Capital Needs. Part II. [Sound Basic Education Task Force Proposal

ERIC Educational Resources Information Center

Campaign for Fiscal Equity, Inc., 2004

2004-01-01

In recent years, court mandates in education adequacy cases have resulted in substantial increases in state-level support for local building needs in a number of states. The Court of Appeals' decision in "CFE v. State of New York" has made clear that extensive facilities deficiencies in New York City constitute a major constitutional…

Plain Language Summary: Earwax (Cerumen Impaction)

PubMed

Krouse, Helene J; Magit, Anthony E; O'Connor, Sarah; Schwarz, Seth R; Walsh, Sandra A

2017-01-01

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.

Valuation of pollinator forage services provided by Eucalyptus cladocalyx.

PubMed

de Lange, Willem J; Veldtman, Ruan; Allsopp, Mike H

2013-08-15

We assess the monetary value of forage provisioning services for honeybees as provided by an alien tree species in the Western Cape province of South Africa. Although Eucalyptus cladocalyx is not an officially declared invader, it is cleared on a regular basis along with other invasive Eucalyptus species such as Eucalyptus camaldulensis, and Eucalyptus conferruminata (which have been prioritised for eradication in South Africa). We present some of the trade-offs associated with the clearing of E. cladocalyx by means of a practical example that illustrates a situation where the benefits of the species to certain stakeholders could support the containment of the species in demarcated areas, while allowing clearing outside such areas. Given the absence of market prices for such forage provisioning services, the replacement cost is used to present the value of the loss in forage as provided by E. cladocalyx if the alien tree species is cleared along with invasive alien tree species. Two replacement scenarios formed the basis for our calculations. The first scenario was an artificial diet as replacement for the forage provisioning service, which yielded a direct cost estimate of US$7.5 m per year. The second was based on a Fynbos cultivation/restoration initiative aimed at substituting the forage provisioning service of E. cladocalyx, which yielded a direct cost of US$20.2 m per year. These figures provide estimates of the potential additional cost burden on the beekeeping industry if E. cladocalyx is completely eradicated from the Western Cape. The cost estimates should be balanced against the negative impacts of E. cladocalyx on ecosystem services in order to make an informed decision with regard to appropriate management strategies for this species. The findings therefore serve as useful inputs to balance trade-offs for alien species that are considered as beneficial to some, but harmful to other. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Highly conserved gonadotropin-releasing hormone-2 form acts as a melatonin-releasing factor in the pineal of a teleost fish, the european sea bass Dicentrarchus labrax.

PubMed

Servili, Arianna; Lethimonier, Christèle; Lareyre, Jean-Jacques; López-Olmeda, José Fernando; Sánchez-Vázquez, Francisco Javier; Kah, Olivier; Muñoz-Cueto, José Antonio

2010-05-01

With the exception of modern mammals, most vertebrate species possess two GnRH genes, GnRH-1 and GnRH-2. In addition, in many teleost fish, there is a third gene called GnRH-3. If the main function of GnRH-1 is unambiguously to stimulate gonadotropin release, the other two GnRH forms still lack clear functions. This is particularly true for the highly conserved GnRH-2 that encodes chicken GnRH-II. This GnRH variant is consistently expressed in neurons of the dorsal synencephalon in most vertebrate groups but still has no clear functions supported by anatomical, pharmacological, and physiological data. In this study performed on a perciform fish, the European sea bass, we show for the first time that the pineal organ receives GnRH-2-immunoreactive fibers originating from the synencephalic GnRH-2 neurons. This was shown through a combination of retrograde tracing and immunohistochemistry, using highly specific antibodies. Supporting the presence of GnRH-2 functional targets, RT-PCR data together with the in situ hybridization studies showed that the sea bass pineal gland strongly expressed a GnRH receptor (dlGnRHR-II-2b) with clear selectivity for GnRH-2 and, to a lesser extent, the dlGnRHR-II-1a subtype. Finally, in vitro and in vivo experiments demonstrate stimulatory effects of GnRH-2 on nocturnal melatonin secretion by the sea bass pineal organ. Altogether, these data provide, for the first time in a vertebrate species, converging evidence supporting a role of GnRH-2 in the modulation of fish pineal functions.

Genital Chlamydia trachomatis Infections Clear More Slowly in Men Than Women, but Are Less Likely to Become Established.

PubMed

Lewis, Joanna; Price, Malcolm J; Horner, Paddy J; White, Peter J

2017-07-15

Rigorous estimates for clearance rates of untreated chlamydia infections are important for understanding chlamydia epidemiology and designing control interventions, but were previously only available for women. We used data from published studies of chlamydia-infected men who were retested at a later date without having received treatment. Our analysis allowed new infections to take one of 1, 2, or 3 courses, each clearing at a different rate. We determined which of these 3 models had the most empirical support. The best-fitting model had 2 courses of infection in men, as was previously found for women: "slow-clearing" and "fast-clearing." Only 68% (57%-78%) (posterior median and 95% credible interval [CrI]) of incident infections in men were slow-clearing, vs 77% (69%-84%) in women. The slow clearance rate in men (based on 6 months' follow-up) was 0.35 (.05-1.15) year-1 (posterior median and 95% CrI), corresponding to mean infection duration 2.84 (.87-18.79) years. This compares to 1.35 (1.13-1.63) years in women. Our estimated clearance rate is slower than previously assumed. Fewer infections become established in men than women but once established, they clear more slowly. This study provides an improved description of chlamydia's natural history to inform public health decision making. We describe how further data collection could reduce uncertainty in estimates. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Health impact assessment in Australia: A review and directions for progress

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

Harris, Patrick, E-mail: patrick.harris@unsw.edu.a; Spickett, Jeff, E-mail: J.Spickett@curtin.edu.a

2011-07-15

This article provides an overview of Health Impact Assessment (HIA) within Australia. We discuss the development and current position of HIA and offer some directions for HIA's progression. Since the early 1990s HIA activity in Australia has increased and diversified in application and practice. This article first highlights the emergent streams of HIA practice across environmental, policy and health equity foci, and how these have developed within Australia. The article then provides summaries of current practice provided by each Australian state and territory. We then offer some insight into current issues that require further progression or resolution if HIA ismore » to progress effectively in Australia. This progress rests both on developing broad system support for HIA across government, led by the health sector, and developing system capacity to undertake, commission or review HIAs. We argue that a unified and clear HIA approach is required as a prerequisite to gaining the understanding and support for HIA in the public and private sectors and the wider community.« less

Component-Level Electronic-Assembly Repair (CLEAR) Analysis of the Problem Reporting and Corrective Action (PRACA) Database of the International Space Station On-Orbit Electrical Systems

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.

2011-01-01

The NASA Constellation Program is investigating and developing technologies to support human exploration of the Moon and Mars. The Component-Level Electronic-Assembly Repair (CLEAR) task is part of the Supportability Project managed by the Exploration Technology Development Program. CLEAR is aimed at enabling a flight crew to diagnose and repair electronic circuits in space yet minimize logistics spares, equipment, and crew time and training. For insight into actual space repair needs, in early 2008 the project examined the operational experience of the International Space Station (ISS) program. CLEAR examined the ISS on-orbit Problem Reporting and Corrective Action database for electrical and electronic system problems. The ISS has higher than predicted reliability yet, as expected, it has persistent problems. A goal was to identify which on-orbit electrical problems could be resolved by a component-level replacement. A further goal was to identify problems that could benefit from the additional diagnostic and test capability that a component-level repair capability could provide. The study indicated that many problems stem from a small set of root causes that also represent distinct component problems. The study also determined that there are certain recurring problems where the current telemetry instrumentation and built-in tests are unable to completely resolve the problem. As a result, the root cause is listed as unknown. Overall, roughly 42 percent of on-orbit electrical problems on ISS could be addressed with a component-level repair. Furthermore, 63 percent of on-orbit electrical problems on ISS could benefit from additional external diagnostic and test capability. These results indicate that in situ component-level repair in combination with diagnostic and test capability can be expected to increase system availability and reduce logistics. The CLEAR approach can increase the flight crew s ability to act decisively to resolve problems while reducing dependency on Earth-supplied logistics for future Constellation Program missions.

Workplace Social Support and Behavioral Health Prior to Long-Duration Spaceflight.

PubMed

Deming, Charlene A; Vasterling, Jennifer J

2017-06-01

Preparation and training for long-duration spaceflight bring with them psychosocial stressors potentially affecting the well-being and performance of astronauts, before and during spaceflight. Social support from within the workplace may mitigate behavioral health concerns arising during the preflight period and enhance resiliency before and during extended missions. The purpose of this review was to evaluate evidence addressing the viability of workplace social support as a pre-mission countermeasure, specifically addressing: 1) the observed relationships between workplace social support and behavioral health; 2) perceived need, acceptability, and format preference for workplace social support among high-achievers; 3) potential barriers to delivery/receipt of workplace social support; 4) workplace social support interventions; and 5) delivery timeframe and anticipated duration of workplace social support countermeasure benefits. We conducted an evidence review examining workplace social support in professional contexts sharing one or more characteristics with astronauts and spaceflight. Terms included populations of interest, social support constructs, and behavioral health outcomes. Abstracts of matches were subsequently reviewed for relevance and quality. Research findings demonstrate clear associations between workplace social support and behavioral health, especially following exposure to stress. Further, studies indicate strong need for support and acceptability of support countermeasures, despite barriers. Our review revealed two general formats for providing support (i.e., direct provision of support and training to optimize skills in provision and receipt of support) with potential differentiation of expected duration of benefits, according to format. Workplace social support countermeasures hold promise for effective application during pre-mission phases of long-duration spaceflight. Specific recommendations are provided.Deming CA, Vasterling JJ. Workplace social support and behavioral health prior to long-duration spaceflight. Aerosp Med Hum Perform. 2017; 88(6):565-573.

Functional requirements regarding medical registries--preliminary results.

PubMed

Oberbichler, Stefan; Hörbst, Alexander

2013-01-01

The term medical registry is used to reference tools and processes to support clinical or epidemiologic research or provide a data basis for decisions regarding health care policies. In spite of this wide range of applications the term registry and the functional requirements which a registry should support are not clearly defined. This work presents preliminary results of a literature review to discover functional requirements which form a registry. To extract these requirements a set of peer reviewed articles was collected. These set of articles was screened by using methods from qualitative research. Up to now most discovered functional requirements focus on data quality (e. g. prevent transcription error by conducting automatic domain checks).

Mission Control Center (MCC) system specification for the shuttle Orbital Flight Test (OFT) timeframe

NASA Technical Reports Server (NTRS)

1978-01-01

The Mission Control Center Shuttle (MCC) Shuttle Orbital Flight Test (OFT) Data System (OFTDS) provides facilities for flight control and data systems personnel to monitor and control the Shuttle flights from launch (tower clear) to rollout (wheels stopped on runway). It also supports the preparation for flight (flight planning, flight controller and crew training, and integrated vehicle and network testing activities). The MCC Shuttle OFTDS is described in detail. Three major support systems of the OFTDS and the data types and sources of data entering or exiting the MCC were illustrated. These systems are the communication interface system, the data computation complex, and the display and control system.

An Exploration of Factors that Effect the Implementation of Peer Support Services in Community Mental Health Settings.

PubMed

Mancini, Michael A

2018-02-01

This study explored the integration of peer services into community mental health settings through qualitative interviews with peer-providers and non-peer mental health workers. Results show peer job satisfaction was contingent upon role clarity, autonomy, and acceptance by non-peer coworkers. Mental health workers reported the need for organizational support for peer services and guidance about how to utilize peers, negotiate their professional boundaries and accommodate their mental health needs. Effective peer integration requires organizational readiness, staff preparation and clear policies and procedures. Consultation from consumer-based organizations, enhanced professional competencies, and professional development and career advancement opportunities for peers represent important resources.

[Human rights. Right to health. Right to health information. The Venezuelan biomedical journals].

PubMed

Stegemann, Herbert

2013-06-01

Venezuelan Biomedical journals have been confronting, for several years, a gradual decline both, from the standpoint of their management and in the quality of their editorial content. At its highest level, Venezuela had about sixty different titles. But irregular financial support, as well as the lack of a clear official policy, regarding these scientific activities, were some of the reasons that have contributed to this decline. Several recent Venezuelan and international documents provide an important legal support for the design of new official policies and government responsibilities. There is now a valid opportunity to profit from new tools to evaluate and improve the quality of our scientific and editorial activities.

Development of CO2 laser Doppler instrumentation for detection of clear air turbulence, volume 2: Appendices

NASA Technical Reports Server (NTRS)

Harris, C. E.; Jelalian, A. V.

1979-01-01

Analyses of the mounting and mount support systems of the clear air turbulence transmitters verify that satisfactory shock and vibration isolation are attained. The mount support structure conforms to flight crash safety requirements with high margins of safety. Restraint cables reinforce the mounts in the critical loaded forward direction limiting maximum forward system deflection to 1 1/4 inches.

Ceramic capacitor exhibiting graceful failure by self-clearing, method for fabricating self-clearing capacitor

DOEpatents

Kaufman, David Y [Chicago, IL; Saha, Sanjib [Santa Clara, CA

2006-08-29

A short-resistant capacitor comprises an electrically conductive planar support substrate having a first thickness, a ceramic film deposited over the support substrate, thereby defining a ceramic surface; and a metallic film deposited over the ceramic surface, said film having a second thickness which is less than the first thickness and which is between 0.01 and 0.1 microns.

The evolving role of the personal support worker in home care in Ontario, Canada.

PubMed

Saari, Margaret; Patterson, Erin; Kelly, Shawna; Tourangeau, Ann E

2018-03-01

To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home-care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home-care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team-based approach to the delivery of home-care services be considered. Utilisation of a team-based model can help establish positive relationships among home-care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills. © 2017 John Wiley & Sons Ltd.

A Rab-centric perspective of bacterial pathogen-occupied vacuoles.

PubMed

Sherwood, Racquel Kim; Roy, Craig R

2013-09-11

The ability to create and maintain a specialized organelle that supports bacterial replication is an important virulence property for many intracellular pathogens. Living in a membrane-bound vacuole presents inherent challenges, including the need to remodel a plasma membrane-derived organelle into a novel structure that will expand and provide essential nutrients to support replication, while also having the vacuole avoid membrane transport pathways that target bacteria for destruction in lysosomes. It is clear that pathogenic bacteria use different strategies to accomplish these tasks. The dynamics by which host Rab GTPases associate with pathogen-occupied vacuoles provide insight into the mechanisms used by different bacteria to manipulate host membrane transport. In this review we highlight some of the strategies bacteria use to maintain a pathogen-occupied vacuole by focusing on the Rab proteins involved in biogenesis and maintenance of these novel organelles. Copyright © 2013 Elsevier Inc. All rights reserved.

A Systematic Review of Strategies for Implementing Empirically Supported Mental Health Interventions

PubMed Central

Powell, Byron J.; Proctor, Enola K.; Glass, Joseph E.

2013-01-01

Objective This systematic review examines experimental studies that test the effectiveness of strategies intended to integrate empirically supported mental health interventions into routine care settings. Our goal was to characterize the state of the literature and to provide direction for future implementation studies. Methods A literature search was conducted using electronic databases and a manual search. Results Eleven studies were identified that tested implementation strategies with a randomized (n = 10) or controlled clinical trial design (n = 1). The wide range of clinical interventions, implementation strategies, and outcomes evaluated precluded meta-analysis. However, the majority of studies (n = 7; 64%) found a statistically significant effect in the hypothesized direction for at least one implementation or clinical outcome. Conclusions There is a clear need for more rigorous research on the effectiveness of implementation strategies, and we provide several suggestions that could improve this research area. PMID:24791131

Financial support of graduate programs in Brazil: quo vadis?

PubMed

Helene, A F; Xavier, G F

2006-07-01

Graduate programs provide the highest level of formal education and thus are crucial for the development of any country. However, official Brazilian data clearly show a dramatic decrease in the number and values of scholarships available to graduate programs in Brazil over the last few years, despite the importance and growth of such programs. Between 1995 and 2004, investment by the Coordenadoria de Aperfeiçoamento de Pessoal do Ensino Superior (CAPES, subordinate to the Ministry of Education and Culture) in funding scholarships, corrected for inflation in the period, actually decreased by 51%. In addition, during the period between 1994 and 2004, there was a loss of about 60% in the purchasing power of the graduate scholarships provided by CAPES and the National Council for Science and Technology (CNPq). To reverse this trend, we propose the development of sectorial funding for Brazilian graduate programs to guarantee the availability and continuity of financial support for this strategic activity.

Population structure and group composition of western lowland gorillas in north-western Republic of Congo.

PubMed

Magliocca, F; Querouil, S; Gautier-Hion, A

1999-01-01

Population studies are an essential part of conservation actions. Under exceptional observation conditions we studied a western lowland gorilla population visiting the Maya salt-clearing (north of the Parc national d'Odzala, P.N.O., Congo) over an 8 month period; 36 groups and 18 solitary individuals (a total of 420 individuals) have been identified visiting the clearing, which suggests a high gorilla density in the region. Ninety-six percent of the gorillas entered the clearing in groups. One-male groups had a mean size of 11.2. Ninety percent of solitary individuals were silver-back males. Compared with other populations of both lowland gorillas and mountain gorillas, the Maya population had the highest immature rate and the highest number of infants per female. Ecological correlates that could explain the attractiveness of the Maya clearing are discussed. The present status and the renewal rate of the Maya population indicate the need for further studies and confirm the importance of developing eco-tourism in this region as part of the sustainable park management activities developed by the ECOFAC programme (European Union). The results also provide arguments to support the proposal for extending the P.N.O. to include this region, which is rich in salt-clearings and attracts many other key-species of mammal such as forest elephants.

Characterizing the Preturbulence Environment for Sensor Development, New Hazard Algorithms and NASA Experimental Flight Planning

NASA Technical Reports Server (NTRS)

Kaplan, Michael L.; Lin, Yuh-Lang

2004-01-01

During the grant period, several tasks were performed in support of the NASA Turbulence Prediction and Warning Systems (TPAWS) program. The primary focus of the research was on characterizing the preturbulence environment by developing predictive tools and simulating atmospheric conditions that preceded severe turbulence. The goal of the research being to provide both dynamical understanding of conditions that preceded turbulence as well as providing predictive tools in support of operational NASA B-757 turbulence research flights. The advancements in characterizing the preturbulence environment will be applied by NASA to sensor development for predicting turbulence onboard commercial aircraft. Numerical simulations with atmospheric models as well as multi-scale observational analyses provided insights into the environment organizing turbulence in a total of forty-eight specific case studies of severe accident producing turbulence on commercial aircraft. These accidents exclusively affected commercial aircraft. A paradigm was developed which diagnosed specific atmospheric circulation systems from the synoptic scale down to the meso-y scale that preceded turbulence in both clear air and in proximity to convection. The emphasis was primarily on convective turbulence as that is what the TPAWS program is most focused on in terms of developing improved sensors for turbulence warning and avoidance. However, the dynamical paradigm also has applicability to clear air and mountain turbulence. This dynamical sequence of events was then employed to formulate and test new hazard prediction indices that were first tested in research simulation studies and then ultimately were further tested in support of the NASA B-757 turbulence research flights. The new hazard characterization algorithms were utilized in a Real Time Turbulence Model (RTTM) that was operationally employed to support the NASA B-757 turbulence research flights. Improvements in the RTTM were implemented in an effort to increase the accuracy of the operational characterization of the preturbulence environment. Additionally, the initial research necessary to create a statistical evaluation scheme for the characterization indices utilized in the RTTM was undertaken. Results of all components of this research were then published in NASA contractor reports and scientific journal papers.

Improving the Nation's Climate Literacy through the Next Generation Science Standards

NASA Astrophysics Data System (ADS)

Grogan, M.; Niepold, F.; Ledley, T. S.; Gold, A. U.; Breslyn, W. G.; Carley, S.

2013-12-01

Climate Literacy: The Essential Principles of Climate Science (2009) presented the information that is deemed important for individuals and communities to know and understand about Earth's climate, impacts of climate change, and approaches to adaptation or mitigation by a group of federal agencies, science and educational partners. These principles guided the development of the NRC Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas (2012) and the Next Generation Science Standards (NGSS, 2013). National Science Foundation recently funded two partnership projects which support the implementation of the climate component of the NGSS using the Climate Literacy framework. The first project, the Climate Literacy and Energy Awareness Network (CLEAN), was launched in 2010 as a National Science Digital Library (NSDL) Pathways project. CLEAN's primary effort is to steward a collection of educational resources around energy and climate topics and foster a community that supports learning about climate and energy topics. CLEAN's focus has been to integrate the effective use of the educational resources across all grade levels - with a particular focus on the middle-school through undergraduate levels (grades 6-16) and align the resources with educational standards. The second project, the Maryland and Delaware Climate Change Education, Assessment and Research (MADE-CLEAR) program is supported by a Phase II Climate Change Education Partnership (CCEP) grant awarded to the University System of Maryland (USM) by the National Science Foundation. The MADE-CLEAR project's related goals are to support innovations in interdisciplinary P-20 (preschool through graduate school) climate change education, and develop new pathways for teacher education and professional development leading to expertise in climate change content and pedagogy. Work in Maryland, Delaware (MADE-CLEAR) and other states on the implementation of the NGSS, that will utilize the years of work, the efforts of hundreds of community members and tens of millions of dollars of investment and to increase the nations climate literacy, will be highlighted. We will particularly focus on the partnerships among MADE-CLEAR, NOAA and CLEAN. Climate science and energy are complex topics, with rapidly developing science and technology and the potential for controversy. The NGSS offer educators an opportunity to effectively bring these important subjects into their classrooms across a learning progression spanning K-12 and well beyond. Yet regardless of the pedagogic setting, using a literacy-based approach can provide a sound foundation for building learners' understanding of these topics. In this presentation, we will describe contributions by a group of collaborative projects and organizations to support the NGSS implementation through an integrated Earth system science approach in K-12 education.

Impact on perceived postnatal support, maternal anxiety and symptoms of depression in new mothers in Nepal when their husbands provide continuous support during labour.

PubMed

Sapkota, Sabitri; Kobayashi, Toshio; Takase, Miyuki

2013-11-01

when a husband provides continuous support during his wife's labour, his presence is considered effective in reducing her dissatisfaction with the childbirth process. The impact of this on the postnatal well-being of a new mother, however, is not clear. to examine the impact on postnatal support, maternal anxiety and symptoms of depression experienced by new mothers in Nepal when their husband supported them continuously during labour. the study involved 231 Nepali women, of whom 77 were supported continuously by their husbands, 75 by female friends, and 79 were not supported by any companion during childbirth. They were contacted at six to eight weeks post partum, when postpartum support questionnaires, a state-trait anxiety inventory and the Edinburgh postnatal depression scale were administered. Structural equation modelling was conducted. observations showed that continuous support from a husband during his wife's labour was related to a greater degree of postnatal support than those who were not supported by their husband during labour (β=0.23, p<0.001). Similarly, the more the women considered they were being supported, the less likely they were to experience maternal anxiety (β=-0.52, p<0.001), which in turn was associated with a lower level of depression (β=0.43, p<0.001). These findings were consistent, even after adjustments for the effect of female support during the postnatal period. the study suggests that continuous support from husbands during labour has a direct impact on the perceived postnatal support, and an indirect impact on anxiety and depression in new mothers in Nepal. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Introduction of Shimane University's outside funded support project for female researchers and healthcare staff].

PubMed

Tsumori, Toshiko

2013-09-01

Shimane University has started to provide facilities and services to female researchers and healthcare staff who have worked for the university or its hospital after 2007. This initiative had been supported by grants from the Japanese Ministry of Education, Culture, Sports, Science and Technology until 2010. Over time, it has become clear that these efforts, including a day-and-night nursery, day-care for sick children, temporary day-care, after-school programs, and research support system have effectively sustained female researchers and staff in maintaining a balance between private life and work. It is essential that the university devote part of its budget along with outside funding for continued childcare, which has so motivated these female employees. Moreover, it is expected that these efforts will become an effective recruitment tool for excellent young teachers and researchers.

JPL Innovation Foundry

NASA Technical Reports Server (NTRS)

Sherwood, Brent; McCleese, Daniel J.

2012-01-01

NASA supports the community of mission principal investigators by helping them ideate, mature, and propose concepts for new missions. As NASA's Federally Funded Research and Development Center (FFRDC), JPL is a primary resource for providing this service. The environmental context for the formulation lifecycle evolves continuously. Contemporary trends include: more competitors; more-complex mission ideas; scarcer formulation resources; and higher standards for technical evaluation. Derived requirements for formulation support include: stable, clear, reliable methods tailored for each stage of the formulation lifecycle; on-demand access to standout technical and programmatic subject-matter experts; optimized, outfitted facilities; smart access to learning embodied in a vast oeuvre of prior formulation work; hands-on method coaching. JPL has retooled its provision of integrated formulation lifecycle support to PIs, teams, and program offices in response to this need. This mission formulation enterprise is the JPL Innovation Foundry.

Adolescent health care maintenance in a teen-friendly clinic.

PubMed

Chaisson, Nicole; Shore, William B

2014-09-01

Adolescence is marked by complex physical, cognitive, social, and emotional development, which can be stressful for families and adolescents. Before the onset of puberty, providers should clearly lay the groundwork for clinical care and office visits during the adolescent years. This article addresses the guidelines and current legal standards for confidentiality in adolescent care, the most frequently used psychosocial screening tools, and current recommendations for preventive health services and immunizations. Through the creation of teen-friendly clinics, primary care providers are well positioned to offer guidance and support to teens and their parents during this time of transition and growth. Copyright © 2014 Elsevier Inc. All rights reserved.

THE ONCE AND FUTURE AIR SUPPORT OPERATIONS CENTER: A CRITICAL REFLECTION ON DEVELOPMENTS IN AIR-TO-GROUND COMMAND AND CONTROL

DTIC Science & Technology

2017-02-01

call for an examination of ASOC history to provide clear guidance for leaders designing the contemporary ASOC. Research Question What does the...be combined in the design of the future ASOC and what is required to enhance and sustain its capability. 4 Finally, the research concludes by...DEVELOPMENTS IN AIR-TO- GROUND COMMAND AND CONTROL by Seth D. Spidahl, Capt, USAF A Research Report Submitted to the Faculty In Partial Fulfillment

Providing Additional Support for MNA by Including Quantitative Lines of Evidence for Abiotic Degradation and Co-metabolic Oxidation of Chlorinated Ethylenes

DTIC Science & Technology

2017-02-08

cost benefit of the technology. 7.1 COST MODEL A simple cost model for the technology is presented so that a remediation professional can understand...reporting costs . The benefit of the qPCR analyses is that they allow the user to determine if aerobic cometabolism is possible. Because the PHE and...of Chlorinated Ethylenes February 2017 This document has been cleared for public release; Distribution Statement A Page Intentionally Left

HIV testing experience of drug users in Bali, Indonesia.

PubMed

Sagung Sawitri, A A; Sumantera, G M; Wirawan, D N; Ford, K; Lehman, E

2006-08-01

Recently, large increases have been noted in injection drug use and HIV prevalence among drug users in Indonesia. The objective of this study was to examine the experience of drug users with HIV testing in Bali, Indonesia. In-depth interviews were conducted with a sample of 40 drug users who had injected heroin in the Denpasar, Bali area. The users' experience with testing highlighted the importance of pre- and post-test counselling that provides clear information, confidentiality and assistance in developing social support.

Key components of a service model providing early childhood support for women attending opioid treatment clinics: an Australian state health service review.

PubMed

Harvey, Susan R; Schmied, Virginia; Nicholls, Daniel; Dahlen, Hannah

2012-09-01

To report the findings of a service review--specifically the strategy to provide early childhood services 'on site' at opioid treatment clinics to address access difficulties. Child and family health nurses are skilled in the assessment and support of families during early childhood. However, women with a history of substance abuse are often cautious when engaging with universal and other health services, with the result that the infant may miss recommended developmental screening and early referral to improve health outcomes. In 2006, an internal review was undertaken of the integration of early childhood and parenting services at opioid treatment clinics in a large Area Health Service of New South Wales, Australia. A qualitative study design, using semi-structured interview questions was used. Data were collected via six focus groups (4-15 participants in each group) and individual interview of child and family health nurses, nurse unit managers and clinical staff (n=58). Three key components of a model for providing early childhood support in collaboration with opioid treatment services were identified. First, the importance of building a trusting relationship between the woman and the child and family health nurses, second, maintaining continuity of care and a multidisciplinary/multiagency approach, and finally the importance of staff education, support and professional development. The provision of early childhood and parenting services on site, as part of a multidisciplinary 'one stop shop' approach to service delivery was a clear recommendation of the review. Reduction of access difficulties to specialised early childhood support is of benefit to clients, community health services attempting to provide a service to this difficult to reach population and to drug and alcohol services seeking to provide a high level of holistic care for clients. © 2012 Blackwell Publishing Ltd.

Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.

PubMed

Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina

2009-01-01

The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.

Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

PubMed

Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

2018-07-01

We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

Component-Level Electronic-Assembly Repair (CLEAR) System Architecture

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

2011-01-01

This document captures the system architecture for a Component-Level Electronic-Assembly Repair (CLEAR) capability needed for electronics maintenance and repair of the Constellation Program (CxP). CLEAR is intended to improve flight system supportability and reduce the mass of spares required to maintain the electronics of human rated spacecraft on long duration missions. By necessity it allows the crew to make repairs that would otherwise be performed by Earth based repair depots. Because of practical knowledge and skill limitations of small spaceflight crews they must be augmented by Earth based support crews and automated repair equipment. This system architecture covers the complete system from ground-user to flight hardware and flight crew and defines an Earth segment and a Space segment. The Earth Segment involves database management, operational planning, and remote equipment programming and validation processes. The Space Segment involves the automated diagnostic, test and repair equipment required for a complete repair process. This document defines three major subsystems including, tele-operations that links the flight hardware to ground support, highly reconfigurable diagnostics and test instruments, and a CLEAR Repair Apparatus that automates the physical repair process.

Reasoning about beliefs: a human specialization?

PubMed

Povinelli, D J; Giambrone, S

2001-01-01

A recent meta-analysis performed by Wellman, Cross, and Watson clears the air surrounding young children's performance on tests of false belief by showing that it is highly likely that there is some type of conceptual development between 3 and 5 years of age that supports improved task performance. The data concerning the evolutionary origin of these abilities, however, is considerably less clear. Nonetheless, there is some reason to suspect that theory of mind is unique to our species, and that its original function was to provide a more abstract level of describing ancient behavioral patterns (such as deception, reconciliation, and gaze following)-behaviors that humans share in common with many other species. Thus, the initial selective advantage of theory of mind may have been because it increased the flexibility of already-existing behaviors, not because it generated scores of radically new ones.

What are the goals and principles of management in the early treatment of rheumatoid arthritis?

PubMed

Bykerk, Vivian Patricia; Keystone, Edward Clark

2005-02-01

The management of patients with new-onset rheumatoid arthritis (RA) requires an awareness of the potential issues and needs that are unique to each patient with regards to their perceptions of their disease, physical needs and nutritional issues. Arthritis specialists should have a clear approach to the goals of management that are specific to patients with early rheumatoid arthritis (ERA). In this chapter, evidence for the goals and principles of management in the early treatment of RA is discussed. Patient education, the role of self-management, physical therapies, exercise, diet and drug management are addressed. This chapter aims to provide clinicians with a clear understanding of which interventions have supporting evidence and where further research is required. Where evidence for patients with ERA is lacking, evidence from patients with established RA is reviewed.

Perspectives of key stakeholders regarding task shifting of care for HIV patients in Mozambique: a qualitative interview-based study with Ministry of Health leaders, clinicians, and donors.

PubMed

Rustagi, Alison S; Manjate, Rosa Marlene; Gloyd, Stephen; John-Stewart, Grace; Micek, Mark; Gimbel, Sarah; Sherr, Kenneth

2015-04-01

Task shifting is a common strategy to deliver antiretroviral therapy (ART) in resource-limited settings and is safe and effective if implemented appropriately. Consensus among stakeholders is necessary to formulate clear national policies that maintain high-quality care. We sought to understand key stakeholders' opinions regarding task shifting of HIV care in Mozambique and to characterize which specific tasks stakeholders considered appropriate for specific cadres of health workers. National and provincial Ministry of Health leaders, representatives from donor and non-governmental organizations (NGOs), and clinicians providing HIV care were intentionally selected to represent diverse viewpoints. Using open- and closed-ended questions, interviewees were asked about their general support of task shifting, its potential advantages and disadvantages, and whether each of seven cadres of non-physician health workers should perform each of eight tasks related to ART provision. Responses were tallied overall and stratified by current job category. Interviews were conducted between November 2007 and June 2008. Of 62 stakeholders interviewed, 44% held leadership positions in the Ministry of Health, 44% were clinicians providing HIV care, and 13% were donors or employed by NGOs; 89% held a medical degree. Stakeholders were highly supportive of physician assistants performing simple ART-related tasks and unanimous in opposing community health workers providing any ART-related services. The most commonly cited motives to implement task shifting were to increase ART access, decrease physician workload, and decrease patient wait time, whereas chief concerns included reduced quality of care and poor training and supervision. Support for task shifting was higher among clinicians than policy and programme leaders for three specific task/cadre combinations: general mid-level nurses to initiate ART in adults (supported by 75% of clinicians vs. 41% of non-clinicians) and in pregnant women (75% vs. 34%, respectively) and physician assistants to change ART regimens in adults (43% vs. 24%, respectively). Stakeholders agreed on some ART-related task delegation to lower health worker cadres. Clinicians were more likely to support task shifting than policy and programme leaders, perhaps motivated by their front-line experiences. Harmonizing policy and programme managers' views with those of clinicians will be important to formulate and implement clear policy.

Lessons learned from the implementation of an online infertility community into an IVF clinic's daily practice.

PubMed

Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M

2015-01-01

The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.

Rural medical education in Europe: the relevance of the Australian experience.

PubMed

Hays, Richard B

2007-01-01

The drive to increase recognition of the different health care needs of rural communities has been more successful in North America and Australia than in Europe. This success has translated into political support for a range of education, workforce and service model initiatives that appear to be effective in providing a better prepared and supported healthcare workforce in rural communities, providing services through specifically developed delivery models, all with the aim of improving the quality of health care for rural people. The reasons for the differences between Europe and nations with greater success appear to relate to: the absence of a clear, shared definition of rurality across a very diverse group of nations within Europe, and a weaker coalition of interests advocating rural health issues. As a result, although very similar rural health issues are present in Europe, governments are not particularly supportive of initiatives aimed specifically at rural health and so rural medical education is much less well developed. This article explores how the rural health movement in Europe might build on success elsewhere to develop and successfully promote locally relevant models of rural medical education.

Successful use of plasma exchange for profound hemolysis in a child with loxoscelism.

PubMed

Said, Ahmed; Hmiel, Paul; Goldsmith, Matthew; Dietzen, Dennis; Hartman, Mary E

2014-11-01

We describe a 6-year-old boy who presented with massive hemolysis, shock, disseminated intravascular coagulopathy, and acute renal failure after loxosceles envenomation. In this patient, plasma exchange therapy (PEX) successfully cleared the plasma from an initial hemolytic index of 2000 (equivalent to 2 g/dL hemoglobin, where optimetric laboratory evaluation is impossible) to an index of <50 (no detectable hemolysis). This allowed the PICU team to correct his coagulopathy, assess his degree of organ dysfunction, and provide routine laboratory assessments during continuous venovenous hemodiafiltration. After 9 single volume PEX sessions, his hemolysis and coagulopathy had resolved and his plasma had cleared sufficiently to permit routine laboratory assessments without difficulty. Multiorgan system support with an aggressive transfusion strategy, mechanical ventilation, inotropes, and continuous venovenous hemodiafiltration resulted in complete recovery. We conclude that in the presence of overwhelming hemolysis, plasma can become so icteric that optimetric laboratory evaluation is impossible. In this setting, PEX can be used to clear the plasma, restoring the ability to perform routine laboratory assessments. Copyright © 2014 by the American Academy of Pediatrics.

Data latency and the user community

NASA Astrophysics Data System (ADS)

Escobar, V. M.; Brown, M. E.; Carroll, M.

2013-12-01

The community using NASA Earth science observations in applications has grown significantly, with increasing sophistication to serve national interests. The National Research Council's Earth Science Decadal Survey report stated that the planning for applied and operational considerations in the missions should accompany the acquisition of new knowledge about Earth (NRC, 2007). This directive has made product applications at NASA an integral part of converting the data collected into actionable knowledge that can be used to inform policy. However, successfully bridging scientific research with operational decision making in different application areas requires looking into user data requirements and operational needs. This study was conducted to determine how users are incorporating NASA data into applications and operational processes. The approach included a review of published materials, direct interviews with mission representatives, and an online professional review, which was distributed to over 6000 individuals. We provide a complete description of the findings with definitions and explanations of what goes into measuring latency as well as how users and applications utilize NASA data products. We identified 3 classes of users: operational (need data in 3 hours or less), near real time (need data within a day of acquisition), and scientific users (need highest quality data, time independent). We also determined that most users with applications are interested in specific types of products that may come from multiple missions. These users will take the observations when they are available, however the observations may have additional applications value if they are available either by a certain time of day or within a period of time after acquisition. NASA has supported the need for access to low latency data on an ad-hoc basis and more substantively in stand-alone systems such as the MODIS Rapid Response system and more recently with LANCE. The increased level of support and advertising of that support has grown the community of individuals and organizations that use low-latency science data to supply decision making processes with updated information. These applications are increasingly high profile and have high societal value, which is of importance to NASA, the US Government and the broader society. The primary conclusions of this report revolve around clarifying NASA's intentions to support operations and near real time needs for quick access to data after acquisition. Specifically, clear statements from NASA Headquarters are needed to indicate the level of support that will be provided for low latency data products and whether that support should come directly from the missions or whether this support will come from separate stand-alone systems or direct broadcast. The results of the analysis clearly show the significant benefit to society for serving the needs of the agricultural, emergency response, environmental monitoring and weather communities who use low latency data today, and to grow the use of low latency NASA science data products into new communities in the future. These benefits can be achieved with a clear and consistent NASA policy on product latency.

The Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) Model: An Integrated Model for Medical Student Success.

PubMed

Stegers-Jager, Karen M; Cohen-Schotanus, Janke; Themmen, Axel P N

2017-11-01

Not all students cope successfully with the demands of medical school, and students' struggles may result in study delay or dropout. To prevent these outcomes, medical schools need to identify students who are experiencing academic difficul ties and provide them with timely interventions through access to support programs. Although the importance of early identification and intervention is well recognized, less is known about successful strategies for identifying and supporting struggling students.Building on the literature and their own empirical findings, the authors propose an integrated, school-wide model for medical student success comprising a continuum of academic and behavioral support. This Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) model focuses on improving both academic and behavioral outcomes by offering support for students at four levels, which range from adequate instruction for all, to targeted small-group interventions, to individualized support, and also include exit support for students who might be better off in another degree program. Additionally, medical schools should provide both academic and behavioral support; set high, yet realistic expectations and clearly communicate these to students; and intervene early, which requires timely identification of at-risk students who would benefit from the different types and tiers of support. Finally, interventions should be evidence based and fit the needs of the identified groups of students. The authors argue that adopting the core principles of the 4T-CABS model will enable medical schools to maximize academic engagement and performance for all students.

Implementing partnership-driven clinical federated electronic health record data sharing networks.

PubMed

Stephens, Kari A; Anderson, Nicholas; Lin, Ching-Ping; Estiri, Hossein

2016-09-01

Building federated data sharing architectures requires supporting a range of data owners, effective and validated semantic alignment between data resources, and consistent focus on end-users. Establishing these resources requires development methodologies that support internal validation of data extraction and translation processes, sustaining meaningful partnerships, and delivering clear and measurable system utility. We describe findings from two federated data sharing case examples that detail critical factors, shared outcomes, and production environment results. Two federated data sharing pilot architectures developed to support network-based research associated with the University of Washington's Institute of Translational Health Sciences provided the basis for the findings. A spiral model for implementation and evaluation was used to structure iterations of development and support knowledge share between the two network development teams, which cross collaborated to support and manage common stages. We found that using a spiral model of software development and multiple cycles of iteration was effective in achieving early network design goals. Both networks required time and resource intensive efforts to establish a trusted environment to create the data sharing architectures. Both networks were challenged by the need for adaptive use cases to define and test utility. An iterative cyclical model of development provided a process for developing trust with data partners and refining the design, and supported measureable success in the development of new federated data sharing architectures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Tracking Expected Improvements of Decadal Prediction in Climate Services

NASA Astrophysics Data System (ADS)

Suckling, E.; Thompson, E.; Smith, L. A.

2013-12-01

Physics-based simulation models are ultimately expected to provide the best available (decision-relevant) probabilistic climate predictions, as they can capture the dynamics of the Earth System across a range of situations, situations for which observations for the construction of empirical models are scant if not nonexistent. This fact in itself provides neither evidence that predictions from today's Earth Systems Models will outperform today's empirical models, nor a guide to the space and time scales on which today's model predictions are adequate for a given purpose. Empirical (data-based) models are employed to make probability forecasts on decadal timescales. The skill of these forecasts is contrasted with that of state-of-the-art climate models, and the challenges faced by each approach are discussed. The focus is on providing decision-relevant probability forecasts for decision support. An empirical model, known as Dynamic Climatology is shown to be competitive with CMIP5 climate models on decadal scale probability forecasts. Contrasting the skill of simulation models not only with each other but also with empirical models can reveal the space and time scales on which a generation of simulation models exploits their physical basis effectively. It can also quantify their ability to add information in the formation of operational forecasts. Difficulties (i) of information contamination (ii) of the interpretation of probabilistic skill and (iii) of artificial skill complicate each modelling approach, and are discussed. "Physics free" empirical models provide fixed, quantitative benchmarks for the evaluation of ever more complex climate models, that is not available from (inter)comparisons restricted to only complex models. At present, empirical models can also provide a background term for blending in the formation of probability forecasts from ensembles of simulation models. In weather forecasting this role is filled by the climatological distribution, and can significantly enhance the value of longer lead-time weather forecasts to those who use them. It is suggested that the direct comparison of simulation models with empirical models become a regular component of large model forecast intercomparison and evaluation. This would clarify the extent to which a given generation of state-of-the-art simulation models provide information beyond that available from simpler empirical models. It would also clarify current limitations in using simulation forecasting for decision support. No model-based probability forecast is complete without a quantitative estimate if its own irrelevance; this estimate is likely to increase as a function of lead time. A lack of decision-relevant quantitative skill would not bring the science-based foundation of anthropogenic warming into doubt. Similar levels of skill with empirical models does suggest a clear quantification of limits, as a function of lead time, for spatial and temporal scales on which decisions based on such model output are expected to prove maladaptive. Failing to clearly state such weaknesses of a given generation of simulation models, while clearly stating their strength and their foundation, risks the credibility of science in support of policy in the long term.

UAS Well Clear Recovery Against Non-Cooperative Intruders Using Vertical Maneuvers

NASA Technical Reports Server (NTRS)

Cone, Andrew; Thipphavong, David; Lee, Seung Man; Santiago, Confesor

2017-01-01

This paper documents a study that drove the development of a mathematical expression in the minimum operational performance standards (MOPS) of detect-and-avoid (DAA) systems for unmanned aircraft systems (UAS). This equation describes the conditions under which vertical maneuver guidance could be provided during recovery of well clear separation with a non-cooperative VFR aircraft in addition to horizontal maneuver guidance. Although suppressing vertical maneuver guidance in these situations increased the minimum horizontal separation from 500 to 800 feet, the maximum severity of loss of well clear increased in about 35 of the encounters compared to when a vertical maneuver was preferred and allowed. Additionally, analysis of individual cases led to the identification of a class of encounter where vertical rate error had a large effect on horizontal maneuvers due to the difficulty of making the correct left-right turn decision: crossing conflict with intruder changing altitude. These results supported allowing vertical maneuvers when UAS vertical performance exceeds the relative vertical position and velocity accuracy of the DAA tracker given the current velocity of the UAS and the relative vertical position and velocity estimated by the DAA tracker. Looking ahead, these results indicate a need to improve guidance algorithms by utilizing maneuver stability and near mid-air collision risk when determining maneuver guidance to regain well clear separation.

School Year Versus Summer Differences in Child Weight Gain: A Narrative Review

PubMed Central

O'Connor, Teresia; Johnston, Craig; Hughes, Sheryl; Moreno, Jennette; Chen, Tzu-An; Meltzer, Lisa; Baranowski, Janice

2014-01-01

Abstract The causes of the current high prevalence of overweight and obesity among children are not clearly known. Schools have been implicated in the causal chain to high child obesity prevalence. Recent studies have compared school year versus summertime changes (herein called seasonal differences) in child adiposity or related phenomena. The most common seasonal pattern in six longitudinal descriptive studies was that overweight and obese children experienced accelerated gain in weight or some BMI indicator during the summer, whereas healthy weight children gained less or not at all. Four physical activity (PA) intervention studies demonstrated that school year fitness improvements were lost during the summer. One study showed that PA declined across the summer. Another study provided conflicting results of lower total energy expenditure in the summer, but no seasonal difference in total energy expenditure after adjusting for fat-free mass. This pattern of fairly rapid seasonal differences suggests that PA is the primary factor contributing to seasonal differences in weight or BMI, but the documented seasonal pattern in PA (i.e., higher in summer) does not support this relationship. Sleep duration has also been inversely related to child adiposity. Seasonal patterns in adiposity, PA, and sleep need to be clearly established separately for overweight and healthy weight children in further longitudinal research to provide a clear focus for national policy. PMID:24367922

School year versus summer differences in child weight gain: a narrative review.

PubMed

Baranowski, Tom; O'Connor, Teresia; Johnston, Craig; Hughes, Sheryl; Moreno, Jennette; Chen, Tzu-An; Meltzer, Lisa; Baranowski, Janice

2014-02-01

The causes of the current high prevalence of overweight and obesity among children are not clearly known. Schools have been implicated in the causal chain to high child obesity prevalence. Recent studies have compared school year versus summertime changes (herein called seasonal differences) in child adiposity or related phenomena. The most common seasonal pattern in six longitudinal descriptive studies was that overweight and obese children experienced accelerated gain in weight or some BMI indicator during the summer, whereas healthy weight children gained less or not at all. Four physical activity (PA) intervention studies demonstrated that school year fitness improvements were lost during the summer. One study showed that PA declined across the summer. Another study provided conflicting results of lower total energy expenditure in the summer, but no seasonal difference in total energy expenditure after adjusting for fat-free mass. This pattern of fairly rapid seasonal differences suggests that PA is the primary factor contributing to seasonal differences in weight or BMI, but the documented seasonal pattern in PA (i.e., higher in summer) does not support this relationship. Sleep duration has also been inversely related to child adiposity. Seasonal patterns in adiposity, PA, and sleep need to be clearly established separately for overweight and healthy weight children in further longitudinal research to provide a clear focus for national policy.

Clear air turbulence radiometric detection program.

DOT National Transportation Integrated Search

1971-07-01

The report presents a review of accomplishments for the Clear Air Turbulence Detection Program. The objectives, instrumentation, supporting hardware and interfaces leading up to and including the test flights for the reporting period are given. The u...

Facilitating the implementation of evidence- based practice through contextual support and nursing leadership.

PubMed

Kueny, Angela; Shever, Leah L; Lehan Mackin, Melissa; Titler, Marita G

2015-01-01

Nurse managers (NMs) play an important role promoting evidence-based practice (EBP) on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality-monitoring departments, as critical to the implementation of EBP on their units. This study contributes to a deeper understanding of institutional contextual factors that can be used to support NMs in their efforts to drive EBP changes at the unit level.

Nuclear markers confirm taxonomic status and relationships among highly endangered and closely related right whale species

PubMed Central

Gaines, C.A; Hare, M.P; Beck, S.E; Rosenbaum, H.C

2005-01-01

Right whales (genus: Eubalaena) are among the most endangered mammals, yet their taxonomy and phylogeny have been questioned. A phylogenetic hypothesis based on mitochondrial DNA (mtDNA) variation recently prompted a taxonomic revision, increasing the number of right whale species to three. We critically evaluated this hypothesis using sequence data from 13 nuclear DNA (nuDNA) loci as well as the mtDNA control region. Fixed diagnostic characters among the nuclear markers strongly support the hypothesis of three genetically distinct species, despite the lack of any diagnostic morphological characters. A phylogenetic analysis of all data produced a strict consensus cladogram with strong support at nodes that define each right whale species as well as relationships among species. Results showed very little conflict among the individual partitions as well as congruence between the mtDNA and nuDNA datasets. These data clearly demonstrate the strength of using numerous independent genetic markers during a phylogenetic analysis of closely related species. In evaluating phylogenetic support contributed by individual loci, 11 of the 14 loci provided support for at least one of the nodes of interest to this study. Only a single marker (mtDNA control region) provided support at all four nodes. A study using any single nuclear marker would have failed to support the proposed phylogeny, and a strong phylogenetic hypothesis was only revealed by the simultaneous analysis of many nuclear loci. In addition, nuDNA and mtDNA data provided complementary levels of support at nodes of different evolutionary depth indicating that the combined use of mtDNA and nuDNA data is both practical and desirable. PMID:15846869

Human-computer interface for the study of information fusion concepts in situation analysis and command decision support systems

NASA Astrophysics Data System (ADS)

Roy, Jean; Breton, Richard; Paradis, Stephane

2001-08-01

Situation Awareness (SAW) is essential for commanders to conduct decision-making (DM) activities. Situation Analysis (SA) is defined as a process, the examination of a situation, its elements, and their relations, to provide and maintain a product, i.e., a state of SAW for the decision maker. Operational trends in warfare put the situation analysis process under pressure. This emphasizes the need for a real-time computer-based Situation analysis Support System (SASS) to aid commanders in achieving the appropriate situation awareness, thereby supporting their response to actual or anticipated threats. Data fusion is clearly a key enabler for SA and a SASS. Since data fusion is used for SA in support of dynamic human decision-making, the exploration of the SA concepts and the design of data fusion techniques must take into account human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight integration of the human element with the SA technology is essential. Regarding these issues, this paper provides a description of CODSI (Command Decision Support Interface), and operational- like human machine interface prototype for investigations in computer-based SA and command decision support. With CODSI, one objective was to apply recent developments in SA theory and information display technology to the problem of enhancing SAW quality. It thus provides a capability to adequately convey tactical information to command decision makers. It also supports the study of human-computer interactions for SA, and methodologies for SAW measurement.

Unattended sensors community of interest: expanding intelligence awareness, optimizing mission support

NASA Astrophysics Data System (ADS)

Helt, Paul J.; DuBois, Dennis

2012-06-01

The scope and success of Department of Defense (DoD), Intelligence Community (IC), and other United States Government (USG) Unattended Sensor efforts clearly requires a focused, expanded effort at integration and best practices development. Discussions with key stakeholders indicate strong support for the standup of an Unattended Sensors Community of Interest (USCOI) to improve visibility across programs and foster greater mission partnerships. The USCOI will advance understanding of legal and privacy issues, data sharing, Intelligence Surveillance and Reconnaissance (ISR) architecture integration standards, technical specifications, and other issues of common interest (power management, concealment, etc.); promoting opportunities for cost avoidance and improved effectiveness. Launching the USCOI concept provides a stakeholders' forum to identify, discuss, and facilitate Doctrine, Organization, Training, Material, Leadership, Personnel and Facilities (DOTMLPF) resolutions to issues related to the acquisition, development, and employment of unattended sensors across the DoD, IC, and broader USG, as appropriate. USCOI also provides a structured forum where appropriately cleared law enforcement can share operational and technical experiences and expertise on integration of unattended sensor data in existing/planned collection and analysis architectures. The USCOI concept can help facilitate extensive independent discussion across the community and enhance subject matter expert and leadership perspectives. Many senior leaders believe DoD and the IC have a great deal to learn from law enforcement use of unattended sensors and data integration. The USCOI will broaden awareness and open dialogue among users and developers across the interagency, law enforcement, and academia.

The technology roadmap for plant/crop-based renewable resources 2020

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

McLaren, J.

1999-02-22

The long-term well-being of the nation and maintenance of a sustainable leadership position in agriculture, forestry, and manufacturing, clearly depend on current and near-term support of multidisciplinary research for the development of a reliable renewable resource base. This document sets a roadmap and priorities for that research. America needs leadership that will continue to recognize, support, and move rapidly to meet the need to expand the use of sustainable renewable resources. This roadmap has highlighted potential ways for progress and has identified goals in specific components of the system. Achieving success with these goals will provide the opportunity to hitmore » the vision target of a fivefold increase in renewable resource use by 2020.« less

The Technology Roadmap for Plant/Crop-Based Renewable Resources 2020

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

None

1999-02-01

The long-term well-being of the nation and maintenance of a sustainable leadership position in agriculture, forestry, and manufacturing, clearly depend on current and near-term support of multidisciplinary research for the development of a reliable renewable resource base. This document sets a roadmap and priorities for that research. America needs leadership that will continue to recognize, support, and move rapidly to meet the need to expand the use of sustainable renewable resources. This roadmap has highlighted potential ways for progress and has identified goals in specific components of the system. Achieving success with these goals will provide the opportunity to hitmore » the vision target of a fivefold increase in renewable resource use by 2020.« less

HIV and Pregnancy Intentions: Do Services Adequately Respond to Women's Needs?

PubMed Central

Firestone, Rebecca; MacCarthy, Sarah; Ferguson, Laura

2008-01-01

Too little is known about how an HIV diagnosis and access to care and treatment affect women's childbearing intentions. As access to antiretroviral therapy improves, greater numbers of HIV-positive women are living longer, healthier lives, and many want to have children. Effectively supporting women's reproductive decisionmaking in the context of HIV requires understanding how pregnancy, reproduction, and HIV intersect and asking questions that bridge the biomedical and social sciences. Considering women to be at the center of decisions on health policy and service delivery can help provide an appropriate constellation of services. A clear research agenda is needed to create a more coordinated approach to policies and programs supporting the pregnancy intentions of women with HIV. PMID:18703432

CMMAD Usability Case Study in Support of Countermine and Hazard Sensing

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

Victor G. Walker; David I. Gertman

2010-04-01

During field trials, operator usability data were collected in support of lane clearing missions and hazard sensing for two robot platforms with Robot Intelligence Kernel (RIK) software and sensor scanning payloads onboard. The tests featured autonomous and shared robot autonomy levels where tasking of the robot used a graphical interface featuring mine location and sensor readings. The goal of this work was to provide insights that could be used to further technology development. The efficacy of countermine systems in terms of mobility, search, path planning, detection, and localization were assessed. Findings from objective and subjective operator interaction measures are reviewedmore » along with commentary from soldiers having taken part in the study who strongly endorse the system.« less

Health care reforms.

PubMed

Marušič, Dorjan; Prevolnik Rupel, Valentina

2016-09-01

In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

How to Find Lessons from the Public Health Literature: Example of a Scoping Study Protocol on the Neighborhood Environment

PubMed Central

Levasseur, Mélanie; Généreux, Mélissa; Desroches, Josiane; Carrier, Annie; Lacasse, Francis; Chabot, Éric; Abecia, Ana; Gosselin, Louise; Vanasse, Alain

2016-01-01

Background: As key determinants of many favorable health and quality of life outcomes, it is important to identify factors associated with mobility and social participation. Although several investigations have been carried out on mobility, social participation and neighborhood environment, there is no clear integration of these results. This paper presents a scoping study protocol that aims to provide a comprehensive understanding of how the physical and social neighborhood environment is associated with or influences mobility and social participation in older adults. Methods: The rigorous methodological framework for scoping studies is used to synthesize and disseminate current knowledge on the associations or influence of the neighborhood environment on mobility and social participation in aging. Nine databases from public health and other fields are searched with 51 predetermined keywords. Using content analysis, all data are exhaustively analyzed, organized, and synthesized independently by two research assistants. Discussion: A comprehensive synthesis of empirical studies provides decision-makers, clinicians and researchers with current knowledge and best practices regarding neighborhood environments with a view to enhancing mobility and social participation. Such a synthesis represents an original contribution and can ultimately support decisions and development of innovative interventions and clear guidelines for the creation of age-supportive environments. Improvements in public health and clinical interventions might be the new innovation needed to foster health and quality of life for aging population. Finally, the aspects of the associations or influence of the neighborhood environment on mobility and social participation not covered by previous research are identified. Conclusions: Among factors that impact mobility and social participation, the neighborhood environment is important since interventions targeting it may have a greater impact on an individual's mobility and social participation than those targeting individual factors. Although investigations from various domains have been carried out on this topic, no clear integration of these results is available yet. PMID:27413514

Peer support for parents of disabled children part 2: how organizational and process factors influenced shared experience in a one-to-one service, a qualitative study.

PubMed

Shilling, V; Bailey, S; Logan, S; Morris, C

2015-07-01

Parents of disabled children often seek support from their peers. The shared experience between parents appears to be a crucial mediating factor. Understanding how a sense of shared experience is fostered can help to design and evaluate services that seek to provide peer support. We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education. Formal structures and processes in place such as training and ongoing supervision and support were highly valued as was the highly personalized, confidential, flexible, one-to-one at-home nature of the service. Crucial to establishing rapport was putting the right people together and ensuring a good match between befrienders and parents. Clearly, the befriending parent has to be emotionally prepared to provide help. However, if the parent being offered support was not ready to accept help at the time it was offered or the type of support was not right for them, they are less likely to engage with the service. Organizational and process factors as well as characteristics of the parents offering and receiving support contribute to the sense of shared experience in one-to-one peer support. These factors interact to influence whether peer support is effective and should be explicitly considered when designing and evaluating services. © 2015 John Wiley & Sons Ltd.

Prerequisites required for the provision and use of web-based communication for psychosocial support in haematologic care.

PubMed

Högberg, K; Sandman, L; Nyström, M; Stockelberg, D; Broström, A

2013-10-01

The purpose of this study was to describe the prerequisites required for the provision and use of web-based communication for psychosocial support within a haematology clinic, from a patient and family perspective. A qualitative design using content analysis was used. A strategically selected sample of patients (n = 11) and family members (n = 6) were offered access to a web-based communication capability with a nurse. After four months, individual interviews were conducted with all participants, in order to identify necessary prerequisites. Preferences and characteristics of the individual patient or family member are crucial as to whether web-based communication for support is perceived as useful. To feel comfortable with writing and to self-identify the need for support are fundamental in getting motivated to use web-based communication. An effective organization around psychosocial support in general is another prerequisite. Goals and responsibilities must be clearly defined for patients and family members to understand their rights and enable the transformation of opportunities into practice. The use of web-based communication must also be a convenient and naturally incorporated part of both individual and organizational use of the web in general. Prerequisites of taking into account caretakers' different preferences and needs, providing highly structured psychosocial support activities and providing a congruent range of web services, are necessary for successful provision and use of web-based communication for psychosocial support. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sounding Out Science: Incorporating Audio Technology to Assist Students with Learning Differences in Science Education

NASA Astrophysics Data System (ADS)

Gomes, Clement V.

With the current focus to have all students reach scientific literacy in the U.S, there exists a need to support marginalized students, such as those with Learning Disabilities/Differences (LD), to reach the same educational goals as their mainstream counterparts. This dissertation examines the benefits of using audio assistive technology on the iPad to support LD students to achieve comprehension of science vocabulary and semantics. This dissertation is composed of two papers, both of which include qualitative information supported by quantified data. The first paper, titled Using Technology to Overcome Fundamental Literacy Constraints for Students with Learning Differences to Achieve Scientific Literacy, provides quantified evidence from pretest and posttest analysis that audio technology can be beneficial for seventh grade LD students when learning new and unfamiliar science content. Analysis of observations and student interviews support the findings. The second paper, titled Time, Energy, and Motivation: Utilizing Technology to Ease Science Understanding for Students with Learning Differences, supports the importance of creating technology that is clear, audible, and easy for students to use so they benefit and desire to utilize the learning tool. Multiple correlation of Likert Survey analysis was used to identify four major items and was supported with analysis from observations of and interviews with students, parents, and educators. This study provides useful information to support the rising number of identified LD students and their parents and teachers by presenting the benefits of using audio assistive technology to learn science.

Clear cell papillary renal cell carcinoma as part of histologically discordant multifocal renal cell carcinoma: A case report and review of literature.

PubMed

Shao, Tiffany; Yousef, Peter; Shipilova, Irina; Saleeb, Rola; Lee, Jason Y; Krizova, Adriana

2016-03-01

Multifocal renal cell carcinoma of different histological subtypes within a single kidney is rare. We report a recently classified clear cell (tubulo) papillary renal cell carcinoma as part of an unusual case of multifocal renal cell carcinoma of discordant histological subtypes. A 57 year-old-man was found to have multiple renal tumors and cysts on imaging and underwent a laparoscopic left radical nephrectomy. Pathological review showed multifocal renal cell carcinoma (clear cell (tubulo) papillary, clear cell and papillary renal cell carcinomas and papillary adenomas). Morphology of clear cell papillary renal cell carcinoma was supported by immunohistochemical profile (CK7+, HMWK+, CAIX+, AMACR-, CD10-, TFE3-). This is the first report of clear cell papillary renal cell carcinoma as part of multifocal renal cell carcinoma of different histological subtypes. Related lineage of clear cell renal cell carcinoma and papillary renal cell carcinoma is supported by the highest prevalence of their combination within multifocal renal cell carcinoma of different histological subtypes along with their molecular interconnection. Clear cell papillary renal cell carcinoma may be uniquely placed between clear cell and papillary renal cell carcinomas since it shows morphological features intermediate between clear cell and papillary renal cell carcinoma along with overlapping but unique immunohistochemical profile. Clear cell papillary renal cell carcinoma may be molecularly related to clear cell and papillary renal cell carcinomas since the tumors overexpress markers of HIF pathway activation with normal/elevated VHL mRNA expression and some tumors show losses of chromosome 3. Due to the overlapping morphology, it is possible that cases of clear cell papillary renal cell carcinoma may have been misclassified as papillary or clear cell renal cell carcinoma in the literature, incorrectly increasing their reported prevalence. Identification of multifocal RCCs may be related to the extent of pathological sampling. Copyright © 2016 Elsevier GmbH. All rights reserved.

76 FR 51087 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

... organizations to plan for the possibility of a default by two or more clearing members in a short time frame.\\9... and Rules To Establish a Clearing Fund Amount Intended To Support Losses Under a Defined Set of... discussed any comments it received on the proposed rule change. The text of these statements may be examined...

Motivational techniques to improve self-care in hemophilia: the need to support autonomy in children.

PubMed

Bérubé, Sarah; Mouillard, Florine; Amesse, Claudine; Sultan, Serge

2016-01-11

In pediatric hemophilia, caregivers are facing unique challenges to adherence and self-care in children and adolescents with hemophilia. Hemophilia treatment requires adequate prophylaxis and on-demand treatment, as well as a clear behavioral strategy to limit risk-taking in terms of physical exercise and diet. Medication adherence rates of hemophilia patients have been reported to decrease during late childhood and adolescence. In the developing child, moving safely from parent-care to self-care is one of the greatest challenges of integrative care within this domain. There is a clear need for initiatives designed to increase an individual's motivation for treatment and self-care activities. Among motivational approaches, the self-determination perspective offers a useful framework to explain how the transition to self-care can be facilitated. We discuss how motivation regarding hemophilia treatment may be increased through parental autonomy support and we offer examples of applied communication techniques to facilitate autonomy-supportive caregiving. Although it has not yet been tested in the context of hemophilia, these communication techniques could potentially help caregivers promote adherence and self-care in children. Confronted by unique challenges to adherence and self-care, caregivers of children with hemophilia should move from an exclusive focus on illness-management education to an integrative strategy, including motivation-enhancing communication. The self-determination perspective provides important proximal objectives (e.g. autonomy support) to maintain optimal adherence in adolescents as they move from parent-care to self-care. Future research initiatives should address the practice of these communication techniques and evaluate them in the context of hemophilia.

Nursing philosophy: A review of current pre registration curricula in the UK.

PubMed

Mackintosh-Franklin, Carolyn

2016-02-01

Nursing in the UK has been subject to criticism for failing to provide care and compassion in practice, with a series of reports highlighting inadequacies in care. This scrutiny provides nursing with an ideal opportunity to evaluate the underpinning philosophy of nursing practice, and for nurse educators to use this philosophy as the basis for programmes which can inculcate neophyte student nurses with a fundamental understanding of the profession, whilst providing other health care professionals and service users with a clear representation of professional nursing practice. The key word philosophy was used in a systematic stepwise descriptive content analysis of the programme specifications of 33 current undergraduate programme documents, leading to an undergraduate award and professional registration as a nurse. The word philosophy featured minimally in programme specification documents, with 12 (36%) documents including it. Its use was superficial in 3 documents and focused on educational philosophy in a further 3 documents. 2 programme specifications identified their philosophy as the NMC (2010) standards for pre-registration nurse education. 2 programme specifications articulated a philosophy specific to that programme and HEI, focusing on caring, and 2 made reference to underpinning philosophies present in nursing literature; the Relationship Centred Care Approach, and The Humanising Care Philosophy. The philosophy of nursing practice is not clearly articulated in pre-registration curricula. This failure to identify the fundamental nature of nursing is detrimental to the development of the profession, and given this lack of direction it is not surprising that some commentators feel nursing has lost its way. Nurse educators must review their current curricula to ensure that there is clear articulation of nursing's professional philosophical stance, and use this as the framework for pre-registration curricula to support the development of neophyte nursing students towards a clear and focused understanding of what nursing practice is. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of RxNorm for Medication Clinical Decision Support.

PubMed

Freimuth, Robert R; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G

2014-01-01

We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS.

Evaluation of RxNorm for Medication Clinical Decision Support

PubMed Central

Freimuth, Robert R.; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G.

2014-01-01

We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS. PMID:25954360

Experiences of older people following the introduction of consumer-directed care to home care packages: A qualitative descriptive study.

PubMed

Day, Jenny; Thorington Taylor, Ann C; Hunter, Sharyn; Summons, Peter; van der Riet, Pamela; Harris, Margaret; Maguire, Jane; Dilworth, Sophie; Jeong, Sarah; Bellchambers, Helen; Haydon, Gunilla; Higgins, Isabel

2018-06-12

To explore the experiences of older people receiving home care package (HCP) support following the introduction of consumer-directed care (CDC) by the Australian government on 1 July 2015. Thirty-one older people with existing HCP support from two service providers in regional New South Wales, Australia, participated in a face-to-face interview and/or a qualitative survey. Analysis revealed the theme of Choices: Preferences, constraints, balancing and choosing. Participants described choosing to live at home with HCP support; however, they were constrained by poor communication and information about service changes and options, personal budgets and access to future care. HCP services remained largely unchanged during transition to CDC. Many aspects of the initial implementation of CDC were challenging for older people. Clear, relevant and timely communication and information about CDC and its consequences for consumers appear to be needed to enhance CDC. © 2018 AJA Inc.

Factors relating to the perceived management of emergency situations: a survey of former Advanced Life Support course participants' clinical experiences.

PubMed

Rasmussen, Maria B; Tolsgaard, Martin G; Dieckmann, Peter; Issenberg, S Barry; Ostergaard, Doris; Søreide, Eldar; Rosenberg, Jens; Ringsted, Charlotte V

2014-12-01

This study explored individual, team, and setting factors associated with the quality of management of in-hospital emergency situations experienced by former Advanced Life Support (ALS) course participants. This study was a survey of former ALS course participants' long-term experience of management of in-hospital, emergency situations. The survey was carried out in 2012 in Denmark and Norway. A questionnaire was send to 526 potential responders and (281/479 × 100) 58.7% responded. The results demonstrated that 75% of the emergency situations were perceived as "managed well". In general, the responders' confidence in being ALS providers was high, mean 4.3 (SD 0.8), scale 1-5. Significant differences between the perceived "well" and "not well" managed situations were found for all questions, p<0.001. The largest differences related to perception of co-workers' ability to apply ALS principles, the team atmosphere and communication. Responders' ratings of quality of management of emergency situations increased with intensity of setting. However, the 'clinical setting' was rated significantly lower as attributor to ability to apply ALS principles compared to 'co-workers familiarity with ALS principles', 'own confidence as ALS-provider' and 'own social/inter-personal skills'. The results of this survey emphasise that ALS providers' perceived ability to apply ALS skills were substantially affected by teamwork skills and co-workers' skills. Team related factors associated with successful outcome were related to clear role distribution, clear inter-personal communication and attentive listening, as well as respectful behaviour and positive team atmosphere. Although intensity of setting was attributed to ability to apply ALS principles, this did not affect management of emergency situations to the same extent as individual and team factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Automation in visual inspection tasks: X-ray luggage screening supported by a system of direct, indirect or adaptable cueing with low and high system reliability.

PubMed

Chavaillaz, Alain; Schwaninger, Adrian; Michel, Stefan; Sauer, Juergen

2018-05-25

The present study evaluated three automation modes for improving performance in an X-ray luggage screening task. 140 participants were asked to detect the presence of prohibited items in X-ray images of cabin luggage. Twenty participants conducted this task without automatic support (control group), whereas the others worked with either indirect cues (system indicated the target presence without specifying its location), or direct cues (system pointed out the exact target location) or adaptable automation (participants could freely choose between no cue, direct and indirect cues). Furthermore, automatic support reliability was manipulated (low vs. high). The results showed a clear advantage for direct cues regarding detection performance and response time. No benefits were observed for adaptable automation. Finally, high automation reliability led to better performance and higher operator trust. The findings overall confirmed that automatic support systems for luggage screening should be designed such that they provide direct, highly reliable cues.

Linking research, education and public engagement in geoscience: Leadership and strategic partnerships (invited)

NASA Astrophysics Data System (ADS)

Harcourt, P.

2017-12-01

Addressing the urgent issue of climate change requires mitigation and adaptation actions on individual to global scales, and appropriate action must be based upon geoscience literacy across population sectors. The NSF-funded MADE CLEAR (Maryland and Delaware Climate Change Education, Assessment, and Research) project provides a coordinated approach to embed climate change into education programs at the university level, in formal K12 classrooms, and among informal educators. We have worked with state agencies, university systems, non-profit organizations, and community groups to establish and support research-based education about climate change. In this panel I will describe how MADE CLEAR approached the task of infusing climate change education across sectors in the highly diverse states of Delaware and Maryland. I will share the characteristics of our strongest alliances, an analysis of significant barriers to climate change education, and our perspective on the outlook for the future of climate change education.

Delivering proportionate governance in the era of eHealth

PubMed Central

Sethi, Nayha; Laurie, Graeme T.

2013-01-01

This article advances a principled proportionate governance model (PPGM) that overcomes key impediments to using health records for research. Despite increasing initiatives for maximising benefits of data linkage, significant challenges remain, including a culture of caution around data sharing and linkage, failure to make use of flexibilities within the law and failure to incorporate intelligent iterative design. The article identifies key issues for consideration and posits a flexible and accessible governance model that provides a robust and efficient means of paying due regard to both privacy and the public interests in research. We argue that proportionate governance based on clear guiding principles accurately gauges risks associated with data uses and assigns safeguards accordingly. This requires a clear articulation of roles and responsibilities at all levels of decision-making and effective training for researchers and data custodians. Accordingly, the PPGM encourages and supports defensible judgements about data linkage in the public interest. PMID:24634569

Near Real-Time Applications of Earth Remote Sensing for Response to Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2013-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged area. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. Other applications are being developed to refine light source detections with the VIIRS day-night band and to map hail during the growing season through combination of available satellite and radar imagery. The aforementioned products and support are not useful unless they are distributed in a timely manner and within an appropriate decision support system. This presentation will provide an update on ongoing activities to support inclusion of these data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

A wall of information? Exploring the public health component of maternity care in England.

PubMed

Sanders, Julia; Hunter, Billie; Warren, Lucie

2016-03-01

midwives have traditionally had an important role in providing public health messages to women. The range and diversity of the public health remit within maternity services has expanded rapidly over the past decade and maternity support workers as well as midwives are now engaged in public health work in many areas. Given these changes a review of current practice was indicated. to identify student midwives׳, midwives׳ and midwifery support workers׳ current knowledge of and involvement in the public health agenda in England. descriptive qualitative study using online discussion forums. England, United Kingdom undergraduate student midwives, midwives and maternity support workers employed by the National Health Service in England and University employed Leads for Midwifery Education. key themes identified were: the scope of the midwives׳ public health role, training and support for public health role, barriers and facilitators, specific client groups, specialist referral services. Student midwives, midwives and maternity support workers view engagement with, and delivery of, public health initiatives as an integral component of their roles, but are on occasions frustrated by constraints of time, training and public engagement. the National Health Service in England aims to engage pregnant women and new mothers in a diverse range of population based and individualised, public health initiatives. Currently, there are high levels of involvement in the public health agenda from the maternity workforce across a wide range of activities. However, midwives and maternity support workers are restricted by barriers of time, training and resources. These barriers will need addressing for optimal maternity care engagement in public health to be realised. policy makers, commissioners and National Health Service providers need to provide clear guidance on the expectations of the public health remit of midwives and maternity support workers and ensure that such expectations are appropriately resourced to provide effective delivery. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Near Real-­Time Applications of Earth Remote Sensing for Response to Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2013-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged area. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. Other applications are being developed to refine light source detections with the VIIRS day-night band and to map hail during the growing season through combination of available satellite and radar imagery. The aforementioned products and support are not useful unless they are distributed in a timely manner and within an appropriate decision support system. This presentation will provide an update on ongoing activities to support inclusion of these data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group.

PubMed

Sarkar, Rashmi; Aurangabadkar, Sanjeev; Salim, T; Das, Anupam; Shah, Swapnil; Majid, Imran; Singh, Mohan; Ravichandran, G; Godse, Kiran; Arsiwala, Shehnaz; Arya, Latika; Gokhale, Narendra; Sarma, Nilendu; Torsekar, R G; Sonthalia, Sidharth; Somani, V K

2017-01-01

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly.

Reading and assessing reports of treatment studies in oncology.

PubMed

Simon, R

2000-04-01

Rapid advances in tumor biology, immunology, genomics, and technology give physicians great hopes for providing patients with better chances in the struggle against cancer. The pace of progress will be slowed, however, if we do not have clear answers regarding which treatments work and do not work. Such answers come from carefully designed, randomized, clinical trials. Such trials require infrastructure, commitment, cooperation, time, and money, and they provide little fame. They are, however, an invaluable contribution of the medical profession to their patients, to their next generation of colleagues, and to future patients. Randomized clinical trials that answer important medical questions definitively should be supported, participated in, and demanded by surgeons and oncologists.

Fluid dynamics of the unsteady two phase processes leading to DDT in granular solid propellants

NASA Technical Reports Server (NTRS)

Krier, H.; Butler, P. B.; Lembeck, M. F.

1980-01-01

Deflagration to Detonation (DDT) was predicted to occur in porous beds of high-energy solid propellants by solving the unsteady fluid mechanical convective heat transfer from hot gas products, obtained from the rapid burning at high pressures, provides the impetus to develop a narrow combustion zone and a resulting strong shock. A parametric study clearly indicates that DDT occurs only when a combination of the solids loading fraction, the burning rate constants, the propellant chemical energy, and the particle size provide for critical energy and gas release to support a detonation wave. Predictions for the run-up length to detonation as a function of these parameters are presented.

Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group

PubMed Central

Sarkar, Rashmi; Aurangabadkar, Sanjeev; Salim, T; Das, Anupam; Shah, Swapnil; Majid, Imran; Singh, Mohan; Ravichandran, G; Godse, Kiran; Arsiwala, Shehnaz; Arya, Latika; Gokhale, Narendra; Sarma, Nilendu; Torsekar, R G; Sonthalia, Sidharth; Somani, V K

2017-01-01

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly. PMID:29263531

Transient dynamics of NbOx threshold switches explained by Poole-Frenkel based thermal feedback mechanism

NASA Astrophysics Data System (ADS)

Wang, Ziwen; Kumar, Suhas; Nishi, Yoshio; Wong, H.-S. Philip

2018-05-01

Niobium oxide (NbOx) two-terminal threshold switches are potential candidates as selector devices in crossbar memory arrays and as building blocks for neuromorphic systems. However, the physical mechanism of NbOx threshold switches is still under debate. In this paper, we show that a thermal feedback mechanism based on Poole-Frenkel conduction can explain both the quasi-static and the transient electrical characteristics that are experimentally observed for NbOx threshold switches, providing strong support for the validity of this mechanism. Furthermore, a clear picture of the transient dynamics during the thermal-feedback-induced threshold switching is presented, providing useful insights required to model nonlinear devices where thermal feedback is important.

Novel nano-semiconductor film layer supported nano-Pd Complex Nanostructured Catalyst Pd/Ⓕ-MeOx/AC for High Efficient Selective Hydrogenation of Phenol to Cyclohexanone.

PubMed

Si, Jiaqi; Ouyang, Wenbing; Zhang, Yanji; Xu, Wentao; Zhou, Jicheng

2017-04-28

Supported metal as a type of heterogeneous catalysts are the most widely used in industrial processes. High dispersion of the metal particles of supported catalyst is a key factor in determining the performance of such catalysts. Here we report a novel catalyst Pd/Ⓕ-MeO x /AC with complex nanostructured, Pd nanoparticles supported on the platelike nano-semiconductor film/activated carbon, prepared by the photocatalytic reduction method, which exhibited high efficient catalytic performance for selective hydrogenation of phenol to cyclohexanone. Conversion of phenol achieved up to more than 99% with a lower mole ratio (0.5%) of active components Pd and phenol within 2 h at 70 °C. The synergistic effect of metal nanoparticles and nano-semiconductors support layer and the greatly increasing of contact interface of nano-metal-semiconductors may be responsible for the high efficiency. This work provides a clear demonstration that complex nanostructured catalysts with nano-metal and nano-semiconductor film layer supported on high specific surface AC can yield enhanced catalytic activity and can afford promising approach for developing new supported catalyst.

NASA's Astronant Family Support Office

NASA Technical Reports Server (NTRS)

Beven, Gary; Curtis, Kelly D.; Holland, Al W.; Sipes, Walter; VanderArk, Steve

2014-01-01

During the NASA-Mir program of the 1990s and due to the challenges inherent in the International Space Station training schedule and operations tempo, it was clear that a special focus on supporting families was a key to overall mission success for the ISS crewmembers pre-, in- and post-flight. To that end, in January 2001 the first Family Services Coordinator was hired by the Behavioral Health and Performance group at NASA JSC and matrixed from Medical Operations into the Astronaut Office's organization. The initial roles and responsibilities were driven by critical needs, including facilitating family communication during training deployments, providing mission-specific and other relevant trainings for spouses, serving as liaison for families with NASA organizations such as Medical Operations, NASA management and the Astronaut Office, and providing assistance to ensure success of an Astronaut Spouses Group. The role of the Family Support Office (FSO) has modified as the ISS Program matured and the needs of families changed. The FSO is currently an integral part of the Astronaut Office's ISS Operations Branch. It still serves the critical function of providing information to families, as well as being the primary contact for US and international partner families with resources at JSC. Since crews launch and return on Russian vehicles, the FSO has the added responsibility for coordinating with Flight Crew Operations, the families, and their guests for Soyuz launches, landings, and Direct Return to Houston post-flight. This presentation will provide a summary of the family support services provided for astronauts, and how they have changed with the Program and families the FSO serves. Considerations for future FSO services will be discussed briefly as NASA proposes one year missions and beyond ISS missions. Learning Objective: 1) Obtain an understanding of the reasons a Family Support Office was important for NASA. 2) Become familiar with the services provided for astronauts and their families and how they changed with the Program and family needs.

Japanese Cancer Survivors' Awareness of and Participation in Support Groups.

PubMed

Hatano, Yutaka; Mitsuki, Sachiko; Hosokawa, Toyoshi; Fukui, Kenji

2018-02-01

Cancer survivors face many challenges, and cancer support groups provide a range of support. Several reports have shown the benefits of support groups. However, it is not clear how Japanese cancer survivors use them. This study aimed to examine cancer survivors' awareness of and reasons for participation or non-participation in cancer support groups. We conducted a cross-sectional questionnaire survey with ambulatory patients with cancer across eight designated cancer hospitals. The questionnaire covered patients' demographics, disease characteristics, participation/non-participation in cancer support groups, and reasons for participation/non-participation. In total, 569 questionnaires were distributed, and responses were received from 275 patients with cancer. Of these, 135 patients were aware of support groups and 23 had participated in a group. Patients who were aware of support groups were more likely to be young, female patients. Many patients learned about support groups from hospital notices. Most support group participants expected to receive information about the disease and treatment (91%). They also wanted to hear about other patients' experiences (73%). The most common reasons for non-participation were "no particular reason" (38%) and "family or friends support me" (27%). About half of participating patients were unaware of support groups. Even among patients who were aware, many did not attend a support group. Developing a better understanding of support group use in cancer survivors may enhance provision of adequate care based on individual needs.

Long-term scientific benefits from preserving old-growth hemlock stands at Clear Lake near Minden, Ontario, Canada

Treesearch

R. A. Reid; K. M. Somers; J. E. Nighswander; A. M. Zobel

2000-01-01

Clear Lake is located in the centre of the 1300 ha Clear Lake Conservation Reserve in Haliburton County, Ontario, Canada. In 1988, the reserve was designated as a protected area representing undisturbed, old-growth ecosystems. The reserve includes several headwater lakes and their associated catchments which support old-growth hemlock stands that are estimated to be up...

SOMM: A New Service Oriented Middleware for Generic Wireless Multimedia Sensor Networks Based on Code Mobility

PubMed Central

Faghih, Mohammad Mehdi; Moghaddam, Mohsen Ebrahimi

2011-01-01

Although much research in the area of Wireless Multimedia Sensor Networks (WMSNs) has been done in recent years, the programming of sensor nodes is still time-consuming and tedious. It requires expertise in low-level programming, mainly because of the use of resource constrained hardware and also the low level API provided by current operating systems. The code of the resulting systems has typically no clear separation between application and system logic. This minimizes the possibility of reusing code and often leads to the necessity of major changes when the underlying platform is changed. In this paper, we present a service oriented middleware named SOMM to support application development for WMSNs. The main goal of SOMM is to enable the development of modifiable and scalable WMSN applications. A network which uses the SOMM is capable of providing multiple services to multiple clients at the same time with the specified Quality of Service (QoS). SOMM uses a virtual machine with the ability to support mobile agents. Services in SOMM are provided by mobile agents and SOMM also provides a t space on each node which agents can use to communicate with each other. PMID:22346646

SOMM: A new service oriented middleware for generic wireless multimedia sensor networks based on code mobility.

PubMed

Faghih, Mohammad Mehdi; Moghaddam, Mohsen Ebrahimi

2011-01-01

Although much research in the area of Wireless Multimedia Sensor Networks (WMSNs) has been done in recent years, the programming of sensor nodes is still time-consuming and tedious. It requires expertise in low-level programming, mainly because of the use of resource constrained hardware and also the low level API provided by current operating systems. The code of the resulting systems has typically no clear separation between application and system logic. This minimizes the possibility of reusing code and often leads to the necessity of major changes when the underlying platform is changed. In this paper, we present a service oriented middleware named SOMM to support application development for WMSNs. The main goal of SOMM is to enable the development of modifiable and scalable WMSN applications. A network which uses the SOMM is capable of providing multiple services to multiple clients at the same time with the specified Quality of Service (QoS). SOMM uses a virtual machine with the ability to support mobile agents. Services in SOMM are provided by mobile agents and SOMM also provides a t space on each node which agents can use to communicate with each other.

An exploration of self-management support in the context of palliative nursing: a modified concept analysis

PubMed Central

2014-01-01

Background The role of self-management is often ambiguous, yet, it is an important area in clinical practice for palliative nurses. A clear conceptual understanding, however, of what it represents is lacking. Method This paper reports an analysis of the concept of self-management support in palliative nursing. Avant and Walker’s method was used to guide this concept analysis. A search of electronic databases (1990–2013), use of internet search engines and supplementary hand searching produced an international data set of reviews, empirical research, editorials, protocols and guidelines. Results Based on the analysis self-management support in palliative nursing has been defined as assessing, planning, and implementing appropriate care to enable the patient to live until they die and supporting the patient to be given the means to master or deal with their illness or their effects of their illness themselves. Conclusions Clarity with the concept of self-management support and palliative nursing could enable nurses to provide more patient and family centred care to people facing life threatening illnesses. PMID:25120381

The influence of worksite and employee variables on employee engagement in telephonic health coaching programs: a retrospective multivariate analysis.

PubMed

Grossmeier, Jessica

2013-01-01

This study assessed 11 determinants of health coaching program participation. A cross-sectional study design used secondary data to assess the role of six employee-level and five worksite-level variables on telephone-based coaching enrollment, active participation, and completion. Data was provided by a national provider of worksite health promotion program services for employers. A random sample of 34,291 employees from 52 companies was selected for inclusion in the study. Survey-based measures included age, gender, job type, health risk status, tobacco risk, social support, financial incentives, comprehensive communications, senior leadership support, cultural support, and comprehensive program design. Gender-stratified multivariate logistic regression models were applied using backwards elimination procedures to yield parsimonious prediction models for each of the dependent variables. Employees were more likely to enroll in coaching programs if they were older, female, and in poorer health, and if they were at worksites with fewer environmental supports for health, clear financial incentives for participation in coaching, more comprehensive communications, and more comprehensive programs. Once employees were enrolled, program completion was greater among those who were older, did not use tobacco, worked at a company with strong communications, and had fewer environmental supports for health. Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.

77 FR 24546 - Self-Regulatory Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule To Provide...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... the Initial Margin Requirement for Client-Related Positions Cleared in a Clearing Participant's...-related liquidity requirements for client-related positions cleared in a clearing participant's customer...%) of the initial margin requirement for client-related positions cleared in a clearing participant's...

Conditionally Teleported States Using Optical Squeezers and Photon Counting

NASA Astrophysics Data System (ADS)

Fan, Hong-Yi; Fan, Yue; Cheng, Hai-Ling

2002-04-01

By virtue of the neat expression of the two-mode squeezing operator in the Einstein, Podolsky and Rosen entangled state representation, we provide a new approach for discussing the teleportation scheme using optical squeezers and photon counting devices. We derive the explicit form of the teleported states, so that the conditional property of teleportation and teleportation fidelity of this protocol can be seen more clearly. The derivation is concise. The project supported by the President Foundation of the Chinese Academy of Sciences and National Natural Science Foundation of China

Information technology research: Transforming our future

NASA Astrophysics Data System (ADS)

Bajcsy, Ruzena, Dr.

2001-08-01

The Information Age is transforming our economy and our lives. In its pathbreaking 1999 report to President Clinton, the Presidential Information Technology Advisory Committee (PITAC) outlined the ten crucial ways that new technologies are transforming society in the U.S. It is clear that the Federal government will need to provide the critical R&D investments that will help retain and bolster the U.S. technological lead in the 21st century. These investments will also support efforts to make new technologies and their benefits available to all U.S. citizens.

Guidelines - A Primer for Communicating Effectively with NABIR Stakeholders

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

Weber, James R.; Schell, Charlotte J.; Marino, T

2004-02-10

This version of the communication primer comprises two interlocking parts: Pat 1, a practical section, intended to prepare you for public interactions, and Part 2, a theoretical section that provides social and technical bases for the practices recommended in Part 1. The mutual support of practice and theory is very familiar in science and clearly requires a willingness to observe and revise our prior assumptions--in this document, we invoke both. We hope that is offering will represent a step both towards improving practice and maturing the theory of practical science communication.

Diamond Pixel Luminosity Telescopes

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

Halyo, Valerie

2014-12-15

In this document, Halyo summaries her key contributions to CMS at the LHC and provide an explanation of their importance and her role in each project. At the end Halyo describes her recent research interest that includes GPU/MIC Acceleration of the High Level Trigger (HLT) to Extend the Physics Research at the LHC. A description of her work the recent promising results that she accomplished and the deliverable are also elaborated. These contribution were only possible thanks to DOE support of junior faculty research and their clear goal to promote research and innovations.

Stimulating debate: ethics in a multidisciplinary functional neurosurgery committee

PubMed Central

Ford, Paul J; Kubu, Cynthia S

2006-01-01

Multidisciplinary healthcare committees meet regularly to discuss patients' candidacy for emerging functional neurosurgical procedures, such as Deep Brain Stimulation (DBS). Through debate and discussion around the surgical candidacy of particular patients, functional neurosurgery programs begin to mold practice and policy supported both by scientific evidence and clear value choices. These neurosurgical decisions have special considerations not found in non‐neurologic committees. The professional time used to resolve these conflicts provides opportunities for the emergence of careful, ethical practices simultaneous with the expansion of therapy applications PMID:16446416

The role of volunteer support in the community for adults with hearing loss and hearing aids.

PubMed

Pryce, Helen; Hall, Amanda; Gooberman-Hill, Rachael

2015-08-01

To explore interactions between audiology patients and volunteers, to describe encounters and define the role of volunteers. Qualitative ethnographic and interview study of volunteer-patient interactions. Ten volunteer participants from two volunteer schemes in South West England were observed and interviewed. Three patient participants were interviewed. Analysis of observational data showed that volunteers provided support relating to local services and hearing aids, but did not engage in discussions about hearing loss. Interviews with volunteers identified gaps in audiology provision, including accessible services and clear information and highlighted a need for more support from audiology services to enable them to fulfil their role. Volunteer interactions with patients mimicked a clinician-patient encounter and volunteers employed strategies and behaviours used by professional audiologists. Audiology volunteers could provide an accessible bridge between health services and the community but their care is limited to focus on hearing aids. Volunteers enable patients to use hearing aids appropriately and are a core element of current care arrangements. However, volunteers express a need for adequate support from audiology services. Volunteers have the potential to increase service capacity and to bridge the gaps between community and audiology healthcare services. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Choosing a Model of Maternity Care: Decision Support Needs of Australian Women.

PubMed

Stevens, Gabrielle; Miller, Yvette D; Watson, Bernadette; Thompson, Rachel

2016-06-01

Access to information on the features and outcomes associated with the various models of maternity care available in Australia is vital for women's informed decision-making. This study sought to identify women's preferences for information access and decision-making involvement, as well as their priority information needs, for model of care decision-making. A convenience sample of adult women of childbearing age in Queensland, Australia were recruited to complete an online survey assessing their model of care decision support needs. Knowledge on models of care and socio-demographic characteristics were also assessed. Altogether, 641 women provided usable survey data. Of these women, 26.7 percent had heard of all available models of care before starting the survey. Most women wanted access to information on models of care (90.4%) and an active role in decision-making (99.0%). Nine priority information needs were identified: cost, access to choice of mode of birth and care provider, after hours provider contact, continuity of carer in labor/birth, mobility during labor, discussion of the pros/cons of medical procedures, rates of skin-to-skin contact after birth, and availability at a preferred birth location. This information encompassed the priority needs of women across age, birth history, and insurance status subgroups. This study demonstrates Australian women's unmet needs for information that supports them to effectively compare available options for model of maternity care. Findings provide clear direction on what information should be prioritized and ideal channels for information access to support quality decision-making in practice. © 2015 Wiley Periodicals, Inc.

The Protective Effects of Family Support on the Relationship between Official Intervention and General Delinquency across the Life Course.

PubMed

Dong, Beidi; Krohn, Marvin D

2017-03-01

Previous research on the labeling perspective has identified mediational processes and the long-term effects of official intervention in the life course. However, it is not yet clear what factors may moderate the relationship between labeling and subsequent offending. The current study integrates Cullen's (1994) social support theory to examine how family social support conditions the criminogenic, stigmatizing effects of official intervention on delinquency and whether such protective effects vary by developmental stage. Using longitudinal data from the Rochester Youth Development Study, we estimated negative binomial regression models to investigate the relationships between police arrest, family social support, and criminal offending during both adolescence and young adulthood. Police arrest is a significant predictor of self-reported delinquency in both the adolescent and adult models. Expressive family support exhibits main effects in the adolescent models; instrumental family support exhibits main effects at both developmental stages. Additionally, instrumental family support diminishes some of the predicted adverse effects of official intervention in adulthood. Perception of family support can be critical in reducing general delinquency as well as buffering against the adverse effects of official intervention on subsequent offending. Policies and programs that work with families subsequent to a criminal justice intervention should emphasize the importance of providing a supportive environment for those who are labeled.

Software Tools For Building Decision-support Models For Flood Emergency Situations

NASA Astrophysics Data System (ADS)

Garrote, L.; Molina, M.; Ruiz, J. M.; Mosquera, J. C.

The SAIDA decision-support system was developed by the Spanish Ministry of the Environment to provide assistance to decision-makers during flood situations. SAIDA has been tentatively implemented in two test basins: Jucar and Guadalhorce, and the Ministry is currently planning to have it implemented in all major Spanish basins in a few years' time. During the development cycle of SAIDA, the need for providing as- sistance to end-users in model definition and calibration was clearly identified. System developers usually emphasise abstraction and generality with the goal of providing a versatile software environment. End users, on the other hand, require concretion and specificity to adapt the general model to their local basins. As decision-support models become more complex, the gap between model developers and users gets wider: Who takes care of model definition, calibration and validation?. Initially, model developers perform these tasks, but the scope is usually limited to a few small test basins. Before the model enters operational stage, end users must get involved in model construction and calibration, in order to gain confidence in the model recommendations. However, getting the users involved in these activities is a difficult task. The goal of this re- search is to develop representation techniques for simulation and management models in order to define, develop and validate a mechanism, supported by a software envi- ronment, oriented to provide assistance to the end-user in building decision models for the prediction and management of river floods in real time. The system is based on three main building blocks: A library of simulators of the physical system, an editor to assist the user in building simulation models, and a machine learning method to calibrate decision models based on the simulation models provided by the user.

State health care financing strategies for children with intellectual and developmental disabilities.

PubMed

Bachman, Sara S; Comeau, Margaret; Tobias, Carol; Allen, Deborah; Epstein, Susan; Jantz, Kathryn; Honberg, Lynda

2012-06-01

We provide the first descriptive summary of selected programs developed to help expand the scope of coverage, mitigate family financial hardship, and provide health and support services that children with intellectual and developmental disabilities need to maximize their functional status and quality of life. State financing initiatives were identified through interviews with family advocacy, Title V, and Medicaid organizational representatives. Results showed that states use myriad strategies to pay for care and maximize supports, including benefits counseling, consumer- and family-directed care, flexible funding, mandated benefits, Medicaid buy-in programs, and Tax Equity and Fiscal Responsibility Act of 1982 funding. Although health reform may reduce variation among states, its impact on families of children with intellectual and developmental disabilities is not yet clear. As health reform is implemented, state strategies to ameliorate financial hardship among families of children with intellectual and developmental disabilities show promise for immediate use. However, further analysis and evaluation are required to understand their impact on family and child well-being.

A Water Budget for Riparian Vegetation on the Lower Colorado River: the Myth of Water Salvage

NASA Astrophysics Data System (ADS)

Nagler, P. L.; Glenn, E. P.; Webb, R. H.; Howard, K. A.

2007-05-01

For many years, river managers have envisaged large saving of water by clearing the exotic plant, saltcedar (Tamarix ramosissima) from western U.S. rivers. Early estimates of evapotranspiration (ET) by saltcedar ranged as high as 3-4 m/yr, and it was estimated that saltcedar on the Lower Colorado River used more water than Los Angeles. Furthermore, saltcedar was considered to have low habitat value, so clearing projects might enhance habitat value by allowing the return of more valuable native species. We have examined these assumptions based on recent evidence. Moisture flux towers set in dense saltcedar stands show that ET is moderate, ranging from 0.8-1.4 m/yr with a mean value of 1 m/yr over five studies on three rivers, similar to wide-area estimates from remote sensing studies. Projected over the 18,200 ha of dense saltcedar monocultures estimated for the Lower Colorado River riparian corridor in the U.S., the potential water saving would only be about 1 percent of the annual flow (assuming no replacement vegetation). A similar acreage of saltcedar monoculture exists in the Colorado River delta in Mexico, but these stands are supported by outflow of brackish water from the irrigation district rather than river water. The assumption of low habitat value is not supported by recent studies. For example, Hinojosa- Huerta (2006) found that saltcedar monocultures away from the river channel supported 65 percent as many bird numbers and 74 percent as many bird species as the best habitat type, mixed saltcedar and native trees in proximity to water, in the delta of the Colorado River in Mexico, and saltcedar provided equal habitat value as native trees for endangered willow flycatchers on Arizona and New Mexico rivers (Owen et al., 2005). Hence, the prospects for saving water without destroying habitat by clearing saltcedar are doubtful for this river system.

Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records.

PubMed

Darcy, Diana C; Lewis, Eleanor T; Ormond, Kelly E; Clark, David J; Trafton, Jodie A

2011-11-02

Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. As health care systems increasingly implement electronic medical record systems (EMRs) they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT) to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications.

Revealing the synergetic effects in Ni nanoparticle-carbon nanotube hybrids by scanning transmission X-ray microscopy and their application in the hydrolysis of ammonia borane

NASA Astrophysics Data System (ADS)

Zhao, Guanqi; Zhong, Jun; Wang, Jian; Sham, Tsun-Kong; Sun, Xuhui; Lee, Shuit-Tong

2015-05-01

The hybrids of carbon nanotubes (CNTs) and the supported Ni nanoparticles (NPs) have been studied by scanning transmission X-ray microscopy (STXM) and tested by the hydrolysis reaction of ammonia borane (AB, NH3BH3). Data clearly showed the existence of a strong interaction between Ni NPs and thin CNTs (C-O-Ni bonds), which favored the tunable (buffer) electronic structure of Ni NPs facilitating the catalytic process. The hydrolysis process of AB confirmed the hypothesis that the hybrids with a strong interfacial interaction would show superior catalytic performance, while the hybrids with a weak interfacial interaction show poor performance. Our results provide a wealth of detailed information regarding the electronic structure of the NP-CNT hybrids and provide guidance towards the rational design of high-performance catalysts for energy applications.The hybrids of carbon nanotubes (CNTs) and the supported Ni nanoparticles (NPs) have been studied by scanning transmission X-ray microscopy (STXM) and tested by the hydrolysis reaction of ammonia borane (AB, NH3BH3). Data clearly showed the existence of a strong interaction between Ni NPs and thin CNTs (C-O-Ni bonds), which favored the tunable (buffer) electronic structure of Ni NPs facilitating the catalytic process. The hydrolysis process of AB confirmed the hypothesis that the hybrids with a strong interfacial interaction would show superior catalytic performance, while the hybrids with a weak interfacial interaction show poor performance. Our results provide a wealth of detailed information regarding the electronic structure of the NP-CNT hybrids and provide guidance towards the rational design of high-performance catalysts for energy applications. Electronic supplementary information (ESI) available: Magnified TEM images, high resolution TEM images and the particle size distributions of the samples, the STXM results of a thick tube at different positions, XPS results, stability test. See DOI: 10.1039/c5nr01168j

Caplan syndrome

MedlinePlus

... not clear how RP develops. There are two theories: When people breathe in inorganic dust, it affects ... than treating any lung and joint disease. Support Groups Attending a support group with people who have ...

Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention.

PubMed

Swift, Damon L; Lavie, Carl J; Johannsen, Neil M; Arena, Ross; Earnest, Conrad P; O'Keefe, James H; Milani, Richard V; Blair, Steven N; Church, Timothy S

2013-01-01

Substantial data have established that higher levels of physical activity (PA), participating in exercise training (ET), and higher overall cardiorespiratory fitness (CRF) provide considerable protection in the primary and secondary prevention of coronary heart disease (CHD). This review surveys data from epidemiological and prospective ET studies supporting the favorable impact of PA, ET, and CRF in primary CHD prevention. Clearly, cardiac rehabilitation and ET (CRET) programs have been underutilized for patients with CHD, particularly considering the effect of CRET on CHD risk factors, including CRF, obesity indices, fat distribution, plasma lipids, inflammation, and psychological distress, as well as overall morbidity and mortality. These data strongly support the routine referral of patients with CHD to CRET programs and that patients should be vigorously encouraged to attend CRET following major CHD events.

From health as a rational choice to health as an affordable choice.

PubMed

Maziak, Wasim; Ward, Kenneth D

2009-12-01

Sedentary, consumption-based lifestyles are placing entire populations at serious health risks; obesity is a prime example. The individual approach to obesity, which targets those at risk, has largely failed because it ignores wider influences on behavior. Although the population-ecological approach is gaining support, it cannot disentangle clear targets for policy change. Consequently, health promotion has been relegated to the mass marketing of healthy behaviors, which is based on a rational notion that informed people tend to behave in their best interest. Creating environments that support behavior change and providing individuals incentives can be more effective to reduce lifestyle-related risks. A paradigm shift from trying to sell health to the public to creating the conditions whereby healthy choices become accessible and affordable is required.

From Health as a Rational Choice to Health as an Affordable Choice

PubMed Central

Ward, Kenneth D.

2009-01-01

Sedentary, consumption-based lifestyles are placing entire populations at serious health risks; obesity is a prime example. The individual approach to obesity, which targets those at risk, has largely failed because it ignores wider influences on behavior. Although the population–ecological approach is gaining support, it cannot disentangle clear targets for policy change. Consequently, health promotion has been relegated to the mass marketing of healthy behaviors, which is based on a rational notion that informed people tend to behave in their best interest. Creating environments that support behavior change and providing individuals incentives can be more effective to reduce lifestyle-related risks. A paradigm shift from trying to sell health to the public to creating the conditions whereby healthy choices become accessible and affordable is required. PMID:19833991

Decision making in the neonatal intensive care environment.

PubMed

Rivers, R P

1996-04-01

Consideration as to whether withdrawal of intensive care support might be a more appropriate line of action than to continue with full intensive care has become a part of the life and death decision making process undertaken in neonatal intensive care units. After outlining the moral objectives of delivery of health care, the arguments for taking quality of life and its various components into account during these deliberations are presented. The circumstances in which the appropriateness of continuing care should be considered are highlighted and the care options presented. The crucial importance of allowing time for parents to come to terms with the situation is emphasised as is the need for giving clear guidelines to junior staff over resuscitation issues. Finally, an environment for providing optimal family support during the process of withdrawal is suggested.

The Role and Implications of the Internet in Healthcare Delivery

NASA Astrophysics Data System (ADS)

Broom, Alex

Drawing on a study of the Internet usage of Australian men with prostate cancer, this chapter investigates how access to information and online support affects men’s experiences of disease and, in particular, the possible implications of Internet-informed patients for the doctor/patient relationship. The data reveal that accessing information and/or support online can have a profound effect on men’s experiences of prostate cancer, providing a method of taking some control over their disease and limiting inhibitions experienced in face-to-face encounters. However, it is also clear that some medical specialists view Internet-informed patients as a challenge to their power within medical encounters and, as a result, employ disciplinary strategies that reinforce traditional patient roles and alienate patients who use the Internet.

Plasticity following early-life brain injury: Insights from quantitative MRI.

PubMed

Fiori, Simona; Guzzetta, Andrea

2015-03-01

Over the last decade, the application of novel advanced neuroimaging techniques to study congenital brain damage has provided invaluable insights into the mechanisms underlying early neuroplasticity. The concept that is clearly emerging, both from human and nun-human studies, is that functional reorganization in the immature brain is substantially different from that of the more mature, developed brain. This applies to the reorganization of language, the sensorimotor system, and the visual system. The rapid implementation and development of higher order imaging methods will offer increased, currently unavailable knowledge about the specific mechanisms of cerebral plasticity in infancy, which is essential to support the development of early therapeutic interventions aimed at supporting and enhancing functional reorganization during a time of greatest potential brain plasticity. Copyright © 2015. Published by Elsevier Inc.

Why do drivers maintain short headways in fog? A driving-simulator study evaluating feeling of risk and lateral control during automated and manual car following.

PubMed

Saffarian, M; Happee, R; Winter, J C F de

2012-01-01

Drivers in fog tend to maintain short headways, but the reasons behind this phenomenon are not well understood. This study evaluated the effect of headway on lateral control and feeling of risk in both foggy and clear conditions. Twenty-seven participants completed four sessions in a driving simulator: clear automated (CA), clear manual (CM), fog automated (FA) and fog manual (FM). In CM and FM, the drivers used the steering wheel, throttle and brake pedals. In CA and FA, a controller regulated the distance to the lead car, and the driver only had to steer. Drivers indicated how much risk they felt on a touchscreen. Consistent with our hypothesis, feeling of risk and steering activity were elevated when the lead car was not visible. These results might explain why drivers adopt short headways in fog. Practitioner Summary: Fog poses a serious road safety hazard. Our driving-simulator study provides the first experimental evidence to explain the role of risk-feeling and lateral control in headway reduction. These results are valuable for devising effective driver assistance and support systems.

Supporting and structuring "contributing student pedagogy" in Computer Science curricula

NASA Astrophysics Data System (ADS)

Falkner, Katrina; Falkner, Nickolas J. G.

2012-12-01

Contributing student pedagogy (CSP) builds upon social constructivist and community-based learning principles to create engaging and productive learning experiences. What makes CSP different from other, related, learning approaches is that it involves students both learning from and also explicitly valuing the contributions of other students. The creation of such a learning community builds upon established educational psychology that encourages deep learning, reflection and engagement. Our school has recently completed a review and update of its curriculum, incorporating student content-creation and collaboration into the design of key courses across the curriculum. Our experiences, based on several years of experimentation and development, support CSP-based curriculum design to reinforce the value of the student perspective, the clear description of their own transformative pathway to knowledge and the importance of establishing student-to-student networks in which students are active and willing participants. In this paper, we discuss the tools and approaches that we have employed to guide, support and structure student collaboration across a range of courses and year levels. By providing an account of our intentions, our approaches and tools, we hope to provide useful and transferrable knowledge that can be readily used by other academics who are considering this approach.

A multi-site review of policies affecting opportunities for children with developmental disabilities to become bilingual.

PubMed

Pesco, Diane; MacLeod, Andrea A A N; Kay-Raining Bird, Elizabeth; Cleave, Patricia; Trudeau, Natacha; de Valenzuela, Julia Scherba; Cain, Kate; Marinova-Todd, Stefka H; Colozzo, Paola; Stahl, Hillary; Segers, Eliane; Verhoeven, Ludo

This review of special education and language-in-education policies at six sites in four countries (Canada, United States, United Kingdom, and Netherlands) aimed to determine the opportunities for bilingualism provided at school for children with developmental disabilities (DD). While research has demonstrated that children with DD are capable of learning more than one language (see Kay Raining Bird, Genesee, & Verhoeven, this issue), it was not clear whether recent policies reflect these findings. The review, conducted using the same protocol across sites, showed that special education policies rarely addressed second language learning explicitly. However, at all sites, the policies favoured inclusion and educational planning based on individual needs, and thus implied that students with DD would have opportunities for second language learning. The language-in-education policies occasionally specified the support individuals with special needs would receive. At some sites, policies and educational options provided little support for minority languages, a factor that could contribute to subtractive bilingualism. At others, we found stronger support for minority languages and optional majority languages: conditions that could be more conducive to additive bilingualism. Copyright © 2016 Elsevier Inc. All rights reserved.

Opportunities for disease state management in prostate cancer.

PubMed

Pickard, A Simon; Hung, Shih-Ying; McKoy, June M; Witt, Whitney P; Arseven, Adnan; Sharifi, Roohollah; Wu, Zhigang; Knight, Sara J; McWilliams, Norene; Schumock, Glen T; Bennett, Charles L

2005-08-01

In this paper, we examine how the management of prostate cancer lends itself to a disease state management (DSM)-based approach, and propose a framework that emphasizes the patient-provider-caregiver triad in managing the long-term implications of the condition. There is often no clearly superior approach to the management of patients with prostate cancer (eg, watchful waiting and hormonal therapy), and each option entails different trade-offs in quality of life. Ideally, the physician and patient discuss the options, issues, and patient preferences for treatment through the shared decision-making process. A family caregiver such as the spouse of the patient is often involved in the treatment decision and in the long-term management of the cancer experience. In order to develop a DSM program supporting both patient and caregiver, educational, psychosocial, and health care system support needs should be tailored to each phase of cancer treatment/management. To embrace the unique aspects of prostate cancer management, the proposed framework emphasizes communication among the patient-caregiver-provider triad, inclusion of family caregivers in the program, cancer phase-specific support, and psychosocial services as a basis for implementation and evaluation of a DSM program in prostate cancer.

The context and development of a global framework for plant conservation.

PubMed

Jackson, Peter Wyse; Sharrock, Suzanne

2011-01-01

A new international initiative for plant conservation was first called for as a resolution of the International Botanical Congress in 1999. The natural home for such an initiative was considered to be the Convention on Biological Diversity (CBD), and the Conference of the Parties (COP) to the CBD agreed to consider a Global Strategy for Plant Conservation (GSPC) at its 5th meeting in 2000. It was proposed that the GSPC could provide an innovative model approach for target setting within the CBD and, prior to COP5, a series of inter-sessional papers on proposed targets and their justification were developed by plant conservation experts. Key factors that ensured the adoption of the GSPC by the CBD in 2002 included: (1) ensuring that prior to and during COP5, key Parties in each region were supportive of the Strategy; (2) setting targets at the global level and not attempting to impose these nationally; and (3) the offer by Botanic Gardens Conservation International (BGCI) to support a GSPC position in the CBD Secretariat for 3 years, which provided a clear indication of the support for the GSPC from non-governmental organizations (NGO).

Making a measurable difference in advanced Huntington disease care.

PubMed

Moskowitz, Carol Brown; Rao, Ashwini K

2017-01-01

Neurologists' role in the care of people with advanced Huntington disease (HD) (total functional capacity <7), often limited by a lack of clinical research to support good practice, includes the following: (1) provide comprehensive health records to an interdisciplinary care staff before admission to a more intense care setting (home health services, day program, assisted living, group home, long-term skilled nursing facility, palliative care); (2) consult with and refer to rehabilitation (occupational therapy, physical therapy, speech and language pathology), behavioral and psychiatric professionals for problem-solving strategies, which must be reviewed with direct care staff before implementation; (3) encourage and support qualitative and quantitative interdisciplinary research studies, and randomized controlled studies of nonpharmacologic interventions; and (4) assist in the development of meaningful measures to further document what works to provide a good quality of life for the patient and family and a comfortable thoughtful approach to a good death. Collaborative models of care depend on: (1) clear communication; (2) ongoing education and support programs; with (3) pharmacologic and rehabilitation interventions, always in the context of respect for the person with HD, a preservation of the individuals' dignity, autonomy, and individual preferences. Copyright © 2017 Elsevier B.V. All rights reserved.

Single, Integrated, Service-Centric Model of Military Health System Governance

DTIC Science & Technology

and effectiveness of operational medical support. According to the Joint Concept for Health Services (JCHS), the need for integrated medical support...that keeps pace with the operational agility and organizational flexibility requirements to support globally integrated operations is clear. This

Elements of implant-supported rehabilitation planning in patients with bruxism.

PubMed

Sarmento, Hugo Ramalho; Dantas, Raquel Venâncio Fernandes; Pereira-Cenci, Tatiana; Faot, Fernanda

2012-11-01

The rehabilitation of partial or completely edentulous patients with implant-supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to revise the literature and identify risk factors in implant-supported rehabilitation planning in subjects with bruxism. Available literature was searched through Medline, with no time limit, including only studies in English. Topics discussed were etiology of bruxism and its implications on dental implants, biomechanical considerations regarding the overload on dental implants, and methods to prevent the occurrence of overloads in implant-supported prostheses. The rehabilitation of bruxers using implant-supported prostheses, using implants with adequate length and diameter, as well as proper positioning seems to be a reliable treatment, with reduced risks of failure. Bruxism control through the use of a nightguard by rigid occlusal stabilization appliance relieved in the region of implants is highly indicated. Although it is clear that implant-supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

The prioritisation of invasive alien plant control projects using a multi-criteria decision model informed by stakeholder input and spatial data.

PubMed

Forsyth, G G; Le Maitre, D C; O'Farrell, P J; van Wilgen, B W

2012-07-30

Invasions by alien plants are a significant threat to the biodiversity and functioning of ecosystems and the services they provide. The South African Working for Water program was established to address this problem. It needs to formulate objective and transparent priorities for clearing in the face of multiple and sometimes conflicting demands. This study used the analytic hierarchy process (a multi-criteria decision support technique) to develop and rank criteria for prioritising alien plant control operations in the Western Cape, South Africa. Stakeholder workshops were held to identify a goal and criteria and to conduct pair-wise comparisons to weight the criteria with respect to invasive alien plant control. The combination of stakeholder input (to develop decision models) with data-driven model solutions enabled us to include many alternatives (water catchments), that would otherwise not have been feasible. The most important criteria included the capacity to maintain gains made through control operations, the potential to enhance water resources and conserve biodiversity, and threats from priority invasive alien plant species. We selected spatial datasets and used them to generate weights that could be used to objectively compare alternatives with respect to agreed criteria. The analysis showed that there are many high priority catchments which are not receiving any funding and low priority catchments which are receiving substantial allocations. Clearly, there is a need for realigning priorities, including directing sufficient funds to the highest priority catchments to provide effective control. This approach provided a tractable, consensus-based solution that can be used to direct clearing operations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Resilience and quality of life among Wenchuan earthquake survivors: the mediating role of social support.

PubMed

Xu, J; Ou, L

2014-05-01

To examine the extent social support mediates resilience and quality of life in Wenchuan earthquake survivors. Originals. Self-report psychological questionnaires, the standard Chinese 12-item Short Form (SF-12v2), the Resilience Scale for Adults (RSA), and the Social Support Rating Scale (SSRS) were used to interview a total of 2080 survivors from 19 counties in the 2008 Wenchuan Earthquake area. A regression analysis was conducted to evaluate the mediating effect of social support on quality of life. Males and individuals with a higher level of education were found to have a better quality of life. The association between resilience and quality of life improved after social support was included, suggesting that at least a part of this association was mediated by the level of social support provided. This analysis highlighted that the level of resilience and quality of life after an earthquake was associated with the level of social support. This result has clear policy implications, and indicates that more focus needs to be placed on policies that aim for the provision of early mental health intervention and social support to improve the quality of life of earthquake survivors. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The lived experience of Jordanian women who received family support during labor.

PubMed

Khresheh, Reham; Barclay, Lesley

2010-01-01

Policies regarding childbirth in Jordan currently exclude attendance by a female relative to provide support. This study was done in order to describe the experience of a group of Jordanian women who had been afforded support from a female relative during a nursing research project. Semistructured interviews were conducted with 25 women at 6 weeks postpartum. All of the women had given birth at the main hospital in the southern region of Jordan. Women had positive experiences with their female relative support. Four themes were identified as common to the women involved: (1) increased sense of security, (2) provision of physical help, (3) communicating the woman's needs/wishes to her professional caregivers, and (4) emotional support and encouragement. The results show that the support of a female relative was helpful for this small group of Jordanian women experiencing their first labor and birth. Since the literature clearly shows that support in labor is appropriate and produces improved outcomes, public health practitioners in maternal and child health, along with hospitals, should emphasize this as a valuable resource for pregnant women. Non-Western or developing countries could benefit from more fully using evidence currently in the literature on a range of practices, including that of emotional and social support in labor.

Supporting Technology Integration within a Teacher Education System

ERIC Educational Resources Information Center

Schaffer, Scott P.; Richardson, Jennifer C.

2004-01-01

The purpose of this case study was to examine a teacher education system relative to the degree of performance support for the use of technology to support learning. Performance support was measured by the presence of factors such as clear expectations, feedback, tools, rewards, incentives, motivation, capacity, skills, and knowledge within the…

24 CFR 3280.402 - Test procedure for roof trusses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... trusses that are supported at the ends and support design loads. Where roof trusses act as support for... shall be spaced at the design spacing and shall be mounted on solid support accurately positioned to give the required clear span distance (L) as specified in the design. The top and bottom chords shall...

Choose Your Own Adventure: Designing an Environment that Supports NASA Scientists' Goals in Education, Outreach, and Inreach

NASA Astrophysics Data System (ADS)

DeWitt, S.

2015-12-01

What is your communication goal? That is the opening question asked in NASA's first agency-wide science communication leadership development program. Many scientists know what they want to communicate, some know to whom they'd like to communicate, but few can clearly express why they want to do it. So what? First, being clear about one's goal is critical in being able to measure success. Second, when asked to think critically about communication goals, some scientists may shift their communication behaviors and practices to better achieve those goals. To that end, NASA has designed a deep learning experience for scientists (and engineers and others) to: critically examine their communication goals; learn techniques for getting to know their intended audience; and develop and apply specific communication skills to a project of their choice. Participants in this program come into the classroom with projects that span a wide spectrum including: formal and informal education, public outreach, media interviews, public speaking, stakeholder briefings, and internal awareness-building. Through expert advisors, professional coaches and peer networks, this program provides a supportive environment for individuals to workshop their project in the classroom and receive feedback before, during, and after the project is complete. This program also provides an opportunity for scientists and other participants to learn more about communication at NASA, and to directly influence the agency's science communication culture through action learning. In this presentation, I will summarize NASA's dual-design science communication leadership development program and present some lessons-learned, participant feedback and evaluation data from the initial course offerings.

Developing a Web-based system by integrating VGI and SDI for real estate management and marketing

NASA Astrophysics Data System (ADS)

Salajegheh, J.; Hakimpour, F.; Esmaeily, A.

2014-10-01

Property importance of various aspects, especially the impact on various sectors of the economy and the country's macroeconomic is clear. Because of the real, multi-dimensional and heterogeneous nature of housing as a commodity, the lack of an integrated system includes comprehensive information of property, the lack of awareness of some actors in this field about comprehensive information about property and the lack of clear and comprehensive rules and regulations for the trading and pricing, several problems arise for the people involved in this field. In this research implementation of a crowd-sourced Web-based real estate support system is desired. Creating a Spatial Data Infrastructure (SDI) in this system for collecting, updating and integrating all official data about property is also desired in this study. In this system a Web2.0 broker and technologies such as Web services and service composition has been used. This work aims to provide comprehensive and diverse information about property from different sources. For this purpose five-level real estate support system architecture is used. PostgreSql DBMS is used to implement the desired system. Geoserver software is also used as map server and reference implementation of OGC (Open Geospatial Consortium) standards. And Apache server is used to run web pages and user interfaces. Integration introduced methods and technologies provide a proper environment for various users to use the system and share their information. This goal is only achieved by cooperation between all involved organizations in real estate with implementation their required infrastructures in interoperability Web services format.

Coloration affects heating and cooling in three color morphs of the Australian bluetongue lizard, Tiliqua scincoides.

PubMed

Geen, Michael R S; Johnston, Gregory R

2014-07-01

The color-mediated thermoregulation hypothesis predicts that dark body color (low reflectance) allows organisms to gain heat more efficiently than does pale coloration (high reflectance). This prediction is intuitive and widely assumed to be true, but has poor empirical support. We used rare, captive-bred, mutant melanistic, albino and wild-type Australian bluetongue lizards, Tiliqua scincoides to measure the effects of skin reflectance on the heating and cooling rates. We measured heating under an artificial radiant heat source and cooling rates in an ice-cooled box using live lizards in a room with still air. The effect of skin reflectance on heat transfer was clear, despite the substantial influence of body size. Melanistic T. scincoides showed low reflectance and gained heat faster than highly reflective albinos. Melanistic lizards also lost heat faster than albinos. Wild-type lizards were intermediate in reflectance, gained heat at rates indistinguishable from melanistic lizards, and lost heat at rates indistinguishable from albino lizards. This study system allowed us to control for variables that were confounded in other studies and may explain the inconsistent support for the color-mediated thermoregulation hypothesis. Our results provide clear evidence that skin reflectance influences the rate of heating and cooling in ectotherms. Copyright © 2014 Elsevier Ltd. All rights reserved.

Perceptions of genetic testing and genomic medicine among drug users.

PubMed

Perlman, David C; Gelpí-Acosta, Camila; Friedman, Samuel R; Jordan, Ashly E; Hagan, Holly

2015-01-01

Genetic testing will soon enter care for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), and for addiction. There is a paucity of data on how to disseminate genetic testing into healthcare for marginalized populations. We explored drug users' perceptions of genetic testing. Six focus groups were conducted with 34 drug users recruited from syringe exchange programmes and an HIV clinic between May and June 2012. Individual interviews were conducted with participants reporting previous genetic testing. All participants expressed acceptance of genetic testing to improve care, but most had concerns regarding confidentiality and implications for law enforcement. Most expressed more comfort with genetic testing based on individual considerations rather than testing based on race/ethnicity. Participants expressed comfort with genetic testing in medical care rather than drug treatment settings and when specifically asked permission, with peer support, and given a clear rationale. Although participants understood the potential value of genetic testing, concerns regarding breaches in confidentiality and discrimination may reduce testing willingness. Safeguards against these risks, peer support, and testing in medical settings based on individual factors and with clear rationales provided may be critical in efforts to promote acceptance of genetic testing among drug users. Copyright © 2014 Elsevier B.V. All rights reserved.

Becoming a "second victim" in health care: Pathway of recovery after adverse event.

PubMed

Rinaldi, C; Leigheb, F; Vanhaecht, K; Donnarumma, C; Panella, M

2016-07-01

The healthcare worker involved in an unanticipated adverse patient event can become second victim. These workers suffer physically and psycho-socially and try to overcome the post-event emotional stress by obtaining emotional support in a variety of ways. The goal of this research was to study second victims among health care providers in Italy. This contribution contains the results of 33 interviews of nurses, physicians and other healthcare workers. After institutional approval, the semi-structured interview, composed of 25 questions, was translated from English into Italian. The audio-interviews were transcribed on paper verbatim by the interviewer. It was then verified if the interviewees experienced the six post-event stages of second victim recovery previously described within the literature. The interviewees described the post-event recovery stages described by literature but stages were not detailed in the exact succession order as the American study. All participants clearly remembered the adverse event and referred the physical and psycho-social symptoms. The psychological support obtained by second victims was described as poor and inefficient. The post-event recovery pathway is predictable but not always clearly respected as defined within this Italian sample. Future study of the second-victim phenomenon and desired supportive interventions is necessary to understand the experience and interventions to mitigate harm of future clinicians. Every day healthcare workers become second victims and, considering that human resources are the most important heritage of healthcare infrastructures, after an adverse event it is very important to execute valid interventional programs to support and train these workers. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

The road to smoke-free legislation in Ireland.

PubMed

Currie, Laura M; Clancy, Luke

2011-01-01

To describe the process through which Ireland changed its policies towards smoking in work-places and distil lessons for others implementing or extending smoke-free laws. This analysis is informed by a review of secondary sources including a commissioned media analysis, documentary analysis and key informant interviews with policy actors who provide insight into the process of smoke-free policy development. The policy analysis techniques used include the development of a time-line for policy reform, stakeholder analysis, policy mapping techniques, impact analysis through use of secondary data and a review process. The policy analysis triangle, which highlights the importance of examining policy content, context, actors and processes, will be used as an analytical framework. The importance of the political, economic, social and cultural context emerged clearly. The interaction of the context with the policy process both in identification of need for policy and its formulation demonstrated the opportunity for advocates to exert influence at all points of the process. The campaign to support the legislation had the following characteristics: a sustained consistent simple health message, sustained political leadership/commitment, a strong coalition between the Health Alliance, the Office of Tobacco Control and the Department of Health and Children, with cross-party political support and trade union support. The public and the media support clearly defined the benefit of deliberate and consistent planning and organization of a communication strategy. The Irish smoke-free legislation was a success as a policy initiative because of timing, dedication, planning, implementation and the existence of strong leadership and a powerful convinced credible political champion. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Changing Provider Behavior in the Context of Chronic Disease Management: Focus on Clinical Inertia.

PubMed

Lavoie, Kim L; Rash, Joshua A; Campbell, Tavis S

2017-01-06

Widespread acceptance of evidence-based medicine has led to the proliferation of clinical practice guidelines as the primary mode of communicating current best practices across a range of chronic diseases. Despite overwhelming evidence supporting the benefits of their use, there is a long history of poor uptake by providers. Nonadherence to clinical practice guidelines is referred to as clinical inertia and represents provider failure to initiate or intensify treatment despite a clear indication to do so. Here we review evidence for the ubiquity of clinical inertia across a variety of chronic health conditions, as well as the organizational and system, patient, and provider factors that serve to maintain it. Limitations are highlighted in the emerging literature examining interventions to reduce clinical inertia. An evidence-based framework to address these limitations is proposed that uses behavior change theory and advocates for shared decision making and enhanced guideline development and dissemination.

Leveraging Partnerships: Families, Schools, and Providers Working Together to Improve Asthma Management.

PubMed

Gleason, Melanie; Cicutto, Lisa; Haas-Howard, Christy; Raleigh, Bridget M; Szefler, Stanley J

2016-10-01

Asthma is one of the most common illnesses of school-aged children and can lead to both health and educational disparities. Children from low socioeconomic backgrounds and racial/ethnic minorities suffer the greatest impact. They often lack the asthma self-management skills to successfully monitor, navigate, and negotiate appropriate asthma care. School settings are a strategic point of contact for this additional support. School nurses can monitor for signs of asthma worsening, manage symptoms, provide care coordination, and reinforce self-management skills. Likewise, school-based asthma programs have the potential to reduce health and educational disparities, but it is the strong linkage to the asthma care provider that is critical to successful school-based asthma management. Healthcare providers are encouraged to establish partnerships with families through patient-centered care and schools through clear communication and care coordination to ensure asthma is well controlled so the child is in school and ready to learn.

77 FR 34434 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... introducing broker proprietary accounts along with key personnel to Apex Clearing (the ``Transferring Accounts... Member, will provide the clearing and execution services currently provided to the Transferring Accounts... the Transferring Accounts, Apex Clearing has requested that the Exchange temporarily suspend its new...

Commercial Support and the Quandary of Continuing Medical Education.

ERIC Educational Resources Information Center

Schaffer, Mark H.

2000-01-01

Although commercial funding supports much continuing medical education, there is a public perception that funders may influence physician behavior. Solutions include having multiple grantors for continuing education activities, establishing clear standards for grantor behavior, and prohibiting commercial support for related social activities. (SK)

Final Environmental Assessment: Implementation of the Natural Resources Management Program Clear Air Force Station, Alaska

DTIC Science & Technology

2003-06-01

the management intensity level that would allow for the effective ecosystem management of Clear AFS lands, (2) continue with mission support for...Implementation of Al ternative A would not effect outdoor recreation at Clear AFS. Minimal changes to outdoor recreation would occur under Allemative B...environmental effects of the Proposed Action and Alternatives analyzed are not significant and the preparation of an EIS is not warranted

Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

PubMed

Bennett, Hunter; Davison, Kade; Arnold, John; Slattery, Flynn; Martin, Max; Norton, Kevin

2017-10-01

Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

78 FR 9088 - Self-Regulatory Organizations; ICE Clear Europe Limited; Order Approving Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... Customer Clearing Model for CDS Products and To Amend, Clarify, and Consolidate Certain Rules and... the proposed rule change is to provide for a Customer CDS Clearing Model whereby customers of ICE... changes that are unrelated to Customer CDS Clearing Model. Currently, ICE Clear Europe Clearing Members...

78 FR 26069 - Top RX Pharmacy; Decision and Order

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

.... 1980) (upholding jury instruction that knowledge may be inferred from evidence that pharmacists... are clearly not issued for legitimate medical purposes, a pharmacist may not intentionally close his... make clear, inaction on the part of a pharmacist who fills a prescription can by, itself, support a...

Telehealth, Wearable Sensors, and the Internet: Will They Improve Stroke Outcomes Through Increased Intensity of Therapy, Motivation, and Adherence to Rehabilitation Programs?

PubMed

Burridge, Jane H; Lee, Alan Chong W; Turk, Ruth; Stokes, Maria; Whitall, Jill; Vaidyanathan, Ravi; Clatworthy, Phil; Hughes, Ann-Marie; Meagher, Claire; Franco, Enrico; Yardley, Lucy

2017-07-01

Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, "LifeCIT," is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.

Evolving Roles For Teaching Assistants In Introductory Courses

NASA Astrophysics Data System (ADS)

Dunbar, R. W.; Egger, A. E.; Schwartz, J. K.

2008-12-01

As we bring new research-based learning approaches, curricular innovations, and student engagement practices into the introductory science classroom, expectations of teaching assistants (TAs) should have, and have, changed. Similarly, the 21st century teaching assistant has different expectations of us. Maintaining relevance in this context means bringing TAs into an integrated teaching team that supports effective learning for students and provides structured professional development opportunities for TAs. A number of support efforts on our campus, with counterparts at many other universities, seek to optimize the instructional impact of faculty and teaching assistants, thus opening the door to enhanced student engagement (e.g. the quality of effort students put forth, their persistence in science and/or engineering courses, and their perception of scientific relevance in everyday life). Among these efforts, School of Earth Sciences course development TAs work 1:1 in advance of the term with introductory course faculty to design exercises and course materials that meet clearly articulated student learning goals or pedagogical challenges. Throughout the process, TAs are mentored by the faculty as well as science pedagogy experts. Initially funded by a major teaching award, the School is now moving to institutionalize this successful program which has broadened the definition of the TA role. Another area of optimization, reflecting Shulman's concept of pedagogical content knowledge, is our campus mandate that TA development take place within a departmental, as well as general, context. Both Chemistry and Physics expect introductory course TAs to lead interactive, guided-inquiry or tutorial-style sections. Integrating these sections with lecture and positively reinforcing course goals requires TA buy-in and a set of pedagogical facilitation skills cultivated through course-specific training and active mentoring while teaching. To better support the mentoring process in these and other departments, the MinT (Mentors in Teaching) program provides resources and a learning community for advanced graduate students who mentor TAs. There is clearly more to do, but we have come a long way from sink or swim toward an enriched infrastructure of support for teaching and learning in the introductory science classroom.

Using systems thinking to support clinical system transformation.

PubMed

Best, Allan; Berland, Alex; Herbert, Carol; Bitz, Jennifer; van Dijk, Marlies W; Krause, Christina; Cochrane, Douglas; Noel, Kevin; Marsden, Julian; McKeown, Shari; Millar, John

2016-05-16

Purpose - The British Columbia Ministry of Health's Clinical Care Management initiative was used as a case study to better understand large-scale change (LSC) within BC's health system. Using a complex system framework, the purpose of this paper is to examine mechanisms that enable and constrain the implementation of clinical guidelines across various clinical settings. Design/methodology/approach - Researchers applied a general model of complex adaptive systems plus two specific conceptual frameworks (realist evaluation and system dynamics mapping) to define and study enablers and constraints. Focus group sessions and interviews with clinicians, executives, managers and board members were validated through an online survey. Findings - The functional themes for managing large-scale clinical change included: creating a context to prepare clinicians for health system transformation initiatives; promoting shared clinical leadership; strengthening knowledge management, strategic communications and opportunities for networking; and clearing pathways through the complexity of a multilevel, dynamic system. Research limitations/implications - The action research methodology was designed to guide continuing improvement of implementation. A sample of initiatives was selected; it was not intended to compare and contrast facilitators and barriers across all initiatives and regions. Similarly, evaluating the results or process of guideline implementation was outside the scope; the methods were designed to enable conversations at multiple levels - policy, management and practice - about how to improve implementation. The study is best seen as a case study of LSC, offering a possible model for replication by others and a tool to shape further dialogue. Practical implications - Recommended action-oriented strategies included engaging local champions; supporting local adaptation for implementation of clinical guidelines; strengthening local teams to guide implementation; reducing change fatigue; ensuring adequate resources; providing consistent communication especially for front-line care providers; and supporting local teams to demonstrate the clinical value of the guidelines to their colleagues. Originality/value - Bringing a complex systems perspective to clinical guideline implementation resulted in a clear understanding of the challenges involved in LSC.

Detection of damaged supports under railway track based on frequency shift

NASA Astrophysics Data System (ADS)

Wang, Longqi; Zhang, Yao; Lie, Seng Tjhen

2017-03-01

In railway transportation systems, the tracks are usually fastened on sleepers which are supported by the ballast. A lot of research has been conducted to guarantee the safety of railway track because of its importance, and more concern is expressed about monitoring of track itself such as railway level and alignment. The ballast and fasteners which provide strong support to the railway track are important as well whereas the detection of loose or missing fasteners and damaged ballast mainly relies on visual inspection. Although it is reliable when the fastener is missing and the damaged ballast is on the surface, it provides less help if the fastener is only loose and the damaged ballast is under the sleepers, which are however frequently observed in practice. This paper proposes an approach based on frequency shift to identify the damaged supports including the loose or missing fasteners and damaged ballast. In this study, the rail-sleeper-ballast system is modeled as an Euler beam evenly supported by a series of springs, the stiffness of which are reduced when the fastener is loose or missing and the ballast under the sleepers is damaged. An auxiliary mass is utilized herein and when it is mounted on the beam, the natural frequencies of the whole system will change with respect to the location of the auxiliary mass. The auxiliary mass induced frequency shift is analyzed and it is found the natural frequencies change periodically when the supports are undamaged, whereas the periodicity will be broken due to damaged supports. In fact, the natural frequencies drop clearly when the auxiliary mass moves over the damaged support. A special damage index only using the information of the damaged states is proposed and both numerical and experimental examples are carried out to validate the proposed method.

Teachers' perspectives on providing support to children after trauma: a qualitative study.

PubMed

Alisic, Eva

2012-03-01

A considerable number of children are exposed to extreme stressors such as the sudden loss of a loved one, serious traffic accidents, violence, and disaster. In order to facilitate school psychologists' assistance of teachers working with traumatized children, this study aimed to explore elementary school teachers' perspectives. Using a qualitative design, the study explored the perspectives of a purposively varied sample of 21 elementary school teachers (ages 22-55 years; with 0.5-30 years of teaching experience; 5 men). The teachers participated in semistructured interviews, which were transcribed and analyzed in line with the method of "summative analysis" by F. Rapport. Even though some teachers expressed confidence in working with children after traumatic exposure and many referred to a supportive atmosphere within the school, the most prominent themes in the participants' narratives reflected uncertainty about, or a struggle with, providing optimal support to children. They searched for a clear role definition as well as a good balance in answering conflicting needs of the exposed children and classmates, wished for better knowledge and skills, and experienced difficulties related to the emotional burden of their work. The findings suggest a need for further research into this understudied topic. In addition, the identified themes can be used by school psychologists to systematically explore individual teachers' strengths and difficulties and to provide them with tailored advice and training. (c) 2012 APA, all rights reserved.

Calorimetry, activity, and micro-FTIR analysis of CO chemisorption, titration, and oxidation on supported Pt

NASA Technical Reports Server (NTRS)

Sermon, Paul A.; Self, Valerie A.; Vong, Mariana S. W.; Wurie, Alpha T.

1990-01-01

The value of in situ analysis on CO chemisorption, titration and oxidation over supported Pt catalysts using calorimetry, catalytic and micro-FTIR methods is illustrated using silica- and titania-supported samples. Isothermal CO-O and O2-CO titrations have not been widely used on metal surfaces and may be complicated if some oxide supports are reduced by CO titrant. However, they can illuminate the kinetics of CO oxidation on metal/oxide catalysts since during such titrations all O and CO coverages are scanned as a function of time. There are clear advantages in following the rates of the catalyzed CO oxidation via calorimetry and gc-ms simultaneously. At lower temperatures the evidence they provide is complementary. CO oxidation and its catalysis of CO oxidation have been extensively studied with hysteresis and oscillations apparent, and the present results suggest the benefits of a combined approach. Silica support porosity may be important in defining activity-temperature hysteresis. FTIR microspectroscopy reveals the chemical heterogeneity of the catalytic surfaces used; it is interesting that the evidence with regard to the dominant CO surface species and their reactivities with regard to surface oxygen for present oxide-supported Pt are different from those seen on graphite-supported Pt.

77 FR 42559 - End-User Exception to the Clearing Requirement for Swaps

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-19

...-owners to support their general business activities, rather than to finance purchases from its member... using non-cleared swaps to hedge risks associated with their underlying business, such as manufacturing... (IPM&CSA) stated that the end-user exception should be narrowly tailored to businesses that produce...

Applications of Satellite Remote Sensing for Response to and Recovery from Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew I.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2014-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged areas. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. This presentation will provide an overview of near real-time data products developed for dissemination to SPoRT's partners in NOAA's National Weather Service, through collaboration with the USGS and other federal agencies. Specifically, it will focus on integration of various data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Safety in numbers? Tackling domestic abuse in couples and network therapies.

PubMed

Galvani, Sarah A

2007-03-01

Family, network or couples-based therapies have been helping to support people with substance problems for decades. Their value in supporting a person to change their alcohol or drug use is clear. However, as links between substance use and domestic abuse are increasingly recognised, these approaches need to reflect on the potential safety risks they present to people taking part. The prevalence of domestic abuse among people receiving drug and alcohol services is considerably higher than general population estimates, yet this does not appear to have been adequately addressed in network therapies. This article suggests that this needs to change and that safety of service users needs to be at least as important as the intervention itself. It offers for debate a number of potential safety issues raised by network therapies where there is evidence of domestic abuse; it provides examples of three approaches used to marshal social and network support in substance interventions; and offers a number of suggestions for how network therapies can ensure their use remains safe and supportive where there is domestic abuse.

Narrative Review of the Educational, Vocational, and Financial Needs of Adolescents and Young Adults with Cancer: Recommendations for Support and Research.

PubMed

Fardell, Joanna E; Wakefield, Claire E; Patterson, Pandora; Lum, Alistair; Cohn, Richard J; Pini, Simon A; Sansom-Daly, Ursula M

2018-04-01

Adolescents and young adults (AYAs) with cancer have unique needs around education and vocation during and after treatment. This narrative review series aims at documenting the unique needs of AYAs from the current literature and at providing recommendations to inform an update of the Australian National Service Delivery Framework for AYAs with Cancer. AYAs with cancer may experience impairments to cognitive, physical, and psychological functioning and health, which can adversely affect their academic grades, peer relationships, and likelihood of entering the workforce. Treatment expenses and time off work can stifle AYAs' financial independence from their parents. The combined effect of disrupted education, vocation, and financial dependence can reduce AYAs' sense of identity. Although support is available in some countries, support efficacy is yet to be clearly established. Continued research is required to deliver successful education and work reintegration programs that build the confidence of AYAs with cancer to achieve their best. Educational and vocational support, as well as financial advice, may improve AYAs' financial security and quality of life during survivorship.

Towards public health decision support: a systematic review of bidirectional communication approaches.

PubMed

Dixon, Brian E; Gamache, Roland E; Grannis, Shaun J

2013-05-01

To summarize the literature describing computer-based interventions aimed at improving bidirectional communication between clinical and public health. A systematic review of English articles using MEDLINE and Google Scholar. Search terms included public health, epidemiology, electronic health records, decision support, expert systems, and decision-making. Only articles that described the communication of information regarding emerging health threats from public health agencies to clinicians or provider organizations were included. Each article was independently reviewed by two authors. Ten peer-reviewed articles highlight a nascent but promising area of research and practice related to alerting clinicians about emerging threats. Current literature suggests that additional research and development in bidirectional communication infrastructure should focus on defining a coherent architecture, improving interoperability, establishing clear governance, and creating usable systems that will effectively deliver targeted, specific information to clinicians in support of patient and population decision-making. Increasingly available clinical information systems make it possible to deliver timely, relevant knowledge to frontline clinicians in support of population health. Future work should focus on developing a flexible, interoperable infrastructure for bidirectional communications capable of integrating public health knowledge into clinical systems and workflows.

Multifaceted support for a new medical school in Nepal devoted to rural health by a Canadian Faculty of Medicine and Dentistry.

PubMed

Solez, Kim; Karki, Arjun; Rana, Sabita; Bjerland, Holli; Cujec, Bibiana; Aaron, Stephen; Morrish, Don; Walker, Maryann; Gowrishankar, Manjula; Bamforth, Fiona; Satkunam, Lalith; Glick, Naomi; Stevenson, Thomas; Ross, Shelly; Dhakal, Sanjaya; Allain, Dominic; Konkin, Jill; Zakus, David; Nichols, Darren

2012-09-10

Nepal and Alberta are literally a world apart. Yet they share a common problem of restricted access to health services in remote and rural areas. In Nepal, urban-rural disparities were one of the main issues in the recent civil war, which ended in 2006. In response to the need for improved health equity in Nepal a dedicated group of Nepali physicians began planning the Patan Academy of Health Sciences (PAHS), a new health sciences university dedicated to the education of rural health providers in the early 2000s. Beginning with a medical school the Patan Academy of Health Sciences uses international help to plan, deliver and assess its curriculum. PAHS developed an International Advisory Board (IAB) attracting international help using a model of broad, intentional recruitment and then on individuals' natural attraction to a clear mission of peace-making through health equity. Such a model provides for flexible recruitment of globally diverse experts, though it risks a lack of coordination. Until recently, the PAHS IAB has not enjoyed significant or formal support from any single international institution. However, an increasing number of the international consultants recruited by PAHS to its International Advisory Board are from the University of Alberta in Edmonton, Alberta, Canada (UAlberta). The number of UAlberta Faculty of Medicine and Dentistry members involved in the project has risen to fifteen, providing a critical mass for a coordinated effort to leverage institutional support for this partnership. This paper describes the organic growth of the UAlberta group supporting PAHS, and the ways in which it supports a sister institution in a developing nation.

Roll Back Malaria in the aftermath of complex emergencies: the example of Afghanistan.

PubMed

Kolaczinski, Jan

2005-09-01

The Roll Back Malaria (RBM) partnership was established in 1998 to address the worldwide malaria burden through a new approach. It was founded by four multilateral agencies that were already committed to supporting malaria control: the United Nations Development Programme, the United Nations Children's Fund, the World Bank and the World Health Organization. In contrast to previous campaigns, RBM focuses on strengthening existing health services to ensure that malaria can be controlled through an integrated approach, rather than through creation and maintenance of a separate structure. Field experience of RBM is rarely documented in the open scientific literature, making it difficult to judge its success and apply lessons learned to other settings. This paper aims at improving on this by documenting experience of RBM support in Afghanistan during initial post-conflict reconstruction. From the analysis some recommendations emerged: (i) technical in-country support needs to be provided for a number of years, as short postings are likely to provide only temporary solutions and may fail to contribute towards medium or long-term development; (ii) the role and responsibilities of support staff need to be clear to all RBM partners; (iii) part of this role should be to act as focal point, in an attempt to improve on coordination and (iv) if possible, support staff should be seconded to the MoH, to avoid association of the RBM initiative with a specific international organization and to further the multi-sectorial partnership approach.

Special-purpose fiber type 475--toxicological assessment.

PubMed

Bernstein, D M

2007-02-01

Type 475 special-purpose glass fiber is rather unique among the family of synthetic mineral fibers. It is used not for insulation but for "high-end" filtration products designed for high and ultra-high purity filtration of air and liquids. The designation for these types of filters varies with country and includes HEPA, ULPA, EU 10-13, EN1822, and S3. In its evaluation, type 475 has been grouped together with E-glass another special-purpose fibre often with little distinction made in terms of its chemistry and corresponding toxicological response. The detailed review of the available toxicology data on type 475 glass fibers clearly shows that following inhalation of this fiber even at relatively high doses, which likely exceed that at which lung overload in the rat is known to occur, type 475 glass fibers are not fibrogenic and do not cause tumors. These data clearly show an important differentiation in potency between type 475 glass fibers and E-glass and support treating these two types of fibers independently and not equating them though the term "special-purpose fibers." Analysis of the intraperitoneal studies taking into account fibre dimensions shows that at 109 fibers injected, there was a 0.3 tumor incidence. While these studies indicate according to the European Commission (EC) classification criteria that 475 should not be fully exonerated as a carcinogen, the results of the inhalation study fully support classification in category 3. The IP results are more difficult to interpret, however, the IP study itself provides no toxicological basis for determining what range of dose-response should correspond to EU category 3 or 2. Following the EC classification criteria, the toxicological data clearly indicate that 475 fibers are appropriately classified in EC category 3.

Astigmatism transfer phenomena in the optical parametric amplification process

NASA Astrophysics Data System (ADS)

Li, Wenkai; Chen, Yun; Li, Yanyan; Xu, Yi; Guo, Xiaoyang; Lu, Jun; Leng, Yuxin

2017-01-01

We numerically and experimentally investigate the astigmatism transfer phenomena in femtosecond optical parametric amplification (OPA). We model the OPA process based on the coupled second-order three-wave nonlinear propagation equations. The numerical and experimental results support that the input pump pulse astigmatism can be transferred into the idler pulse but not the signal pulse, and the idler pulse astigmatism originating from spatial walk-off is less than the idler pulse astigmatism received from the pump. Thus, we can provide a clear understanding of astigmatism transfer mechanisms in the OPA process, and make better use of broadband tunable OPA sources.

General surgical complications associated with the use of long-term mechanical circulatory support devices: are we 'under-reporting' problems?

PubMed

Tchantchaleishvili, Vakhtang; Umakanthan, Ramanan; Karp, Seth; Stulak, John M; Keebler, Mary E; Maltais, Simon

2013-05-01

Multiple complications are associated with use of ventricular assist devices (VADs). Cardiac-related complications and infections are most frequently reported. VADs, however, can also lead to a number of general surgical complications equally significant in terms of morbidity and mortality. The authors performed a systematic literature search to review current data that specifically relate general surgical complications to patients who undergo left VAD implantation. The review provides a relatively clear understanding of the spectrum of general surgical complications and shows that they contribute significantly to morbidity and mortality in these patients.

The role of Mycoplasma and Ureaplasma in adverse pregnancy outcomes.

PubMed

Murtha, Amy P; Edwards, James M

2014-12-01

Genital mycoplasmas are frequently found in the vaginal flora across socioeconomic and ethnic groups and have been demonstrated to be involved in adverse perinatal outcomes. Both Mycoplasma and Ureaplasma spp cause inflammation potentially leading to spontaneous preterm birth and PPROM as well as postdelivery infectious complications and neonatal infections. Herein we have provided an overview of the existing literature and supportive evidence for genital mycoplasma's role in perinatal complications. Future research will need to focus on clearly delineating the species, allowing for discrimination of their effects. Copyright © 2014 Elsevier Inc. All rights reserved.

Why Hart found narrow ecospheres--a minor science mystery solved.

PubMed

Levenson, Barton Paul

2015-05-01

To explain why two NASA computer simulation studies in the 1970s (Hart, 1978 , 1979 ) briefly rocked the subfield of astrobiology and SETI studies by showing very narrow habitable zones (HZs) for solar-type stars. Although other studies later supported wider HZs, it was never clear why the Hart simulations found the narrow limits they did. Investigation of the state of climate studies and radiative transfer models in the period 1960-1970 provides a likely explanation. Hart's findings were in line with earlier results, preventing him from noticing that his radiation model was inadequate.

Recent progress in tissue optical clearing

PubMed Central

Zhu, Dan; Larin, Kirill V; Luo, Qingming; Tuchin, Valery V

2013-01-01

Tissue optical clearing technique provides a prospective solution for the application of advanced optical methods in life sciences. This paper gives a review of recent developments in tissue optical clearing techniques. The physical, molecular and physiological mechanisms of tissue optical clearing are overviewed and discussed. Various methods for enhancing penetration of optical-clearing agents into tissue, such as physical methods, chemical-penetration enhancers and combination of physical and chemical methods are introduced. Combining the tissue optical clearing technique with advanced microscopy image or labeling technique, applications for 3D microstructure of whole tissues such as brain and central nervous system with unprecedented resolution are demonstrated. Moreover, the difference in diffusion and/or clearing ability of selected agents in healthy versus pathological tissues can provide a highly sensitive indicator of the tissue health/pathology condition. Finally, recent advances in optical clearing of soft or hard tissue for in vivo imaging and phototherapy are introduced. PMID:24348874

Electroporation of the Testis

NASA Astrophysics Data System (ADS)

Yomogida, Kentaro

The mature mammalian testis is a marvelous organ that produces numerous sperm cells during its reproductive phase. This biologically significant process consists of three steps: stem cell self-renewal and differentiation, meiosis and genetic recombination, and haploid cell morphogenesis into sperm (Russell et al., 1990). The first step provides a good model for investigating the molecular mechanism of stem cell regulation. Currently, the mechanism underlying sperm cell production is a very exciting topic in regenerative medicine (Lensch et al. 2007; Okita et al., 2007). The spermatogonial stem cell system has several advantages, including the easy histological identification of stem cells (Russell et al., 1990), a clear relationship between stem cells and the supporting Sertoli cells, which provide a stem cell niche (Tadokoro et al., 2002; Yomogida et al., 2003), and a transplantation assay for stem cell activity (Oatley & Brinster, 2006). Although germline stem (GS) cells derived from the gonocytes in newborn testis constitute a suitable in vitro system for investigating the properties of spermatogonial stem cells (Kanatsu-Shinohara et al., 2003, 2004), studies using living mammalian testes continue to provide information regarding the roles of the stem cell niche. In vivo electroporation of the supporting cells in the testis will expand our ability to study it.

Gratitude facilitates private conformity: A test of the social alignment hypothesis.

PubMed

Ng, Jomel W X; Tong, Eddie M W; Sim, Dael L Y; Teo, Samantha W Y; Loy, Xingqi; Giesbrecht, Timo

2017-03-01

Past research has established clear support for the prosocial function of gratitude in improving the well-being of others. The present research provides evidence for another hypothesized function of gratitude: the social alignment function, which enhances the tendency of grateful individuals to follow social norms. We tested the social alignment hypothesis of gratitude in 2 studies with large samples. Using 2 different conformity paradigms, participants were subjected to a color judgment task (Experiment 1) and a material consumption task (Experiment 2). They were provided with information showing choices allegedly made by others, but were allowed to state their responses in private. Supporting the social alignment hypothesis, the results showed that induced gratitude increased private conformity. Specifically, participants induced to feel gratitude were more likely to conform to the purportedly popular choice, even if the option was factually incorrect (Experiment 1). This effect appears to be specific to gratitude; induction of joy produced significantly less conformity than gratitude (Experiment 2). We discuss whether the social alignment function provides a behavioral pathway in the role of gratitude in building social relationships. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Service Learning In Physics: The Consultant Model

NASA Astrophysics Data System (ADS)

Guerra, David

2005-04-01

Each year thousands of students across the country and across the academic disciplines participate in service learning. Unfortunately, with no clear model for integrating community service into the physics curriculum, there are very few physics students engaged in service learning. To overcome this shortfall, a consultant based service-learning program has been developed and successfully implemented at Saint Anselm College (SAC). As consultants, students in upper level physics courses apply their problem solving skills in the service of others. Most recently, SAC students provided technical and managerial support to a group from Girl's Inc., a national empowerment program for girls in high-risk, underserved areas, who were participating in the national FIRST Lego League Robotics competition. In their role as consultants the SAC students provided technical information through brainstorming sessions and helped the girls stay on task with project management techniques, like milestone charting. This consultant model of service-learning, provides technical support to groups that may not have a great deal of resources and gives physics students a way to improve their interpersonal skills, test their technical expertise, and better define the marketable skill set they are developing through the physics curriculum.

Distributing Leadership for Sustainable Peer Feedback on Tertiary Teaching

ERIC Educational Resources Information Center

Wingrove, Dallas; Clarke, Angela; Chester, Andrea

2015-01-01

A growing evidence-based literature supports the value of peer feedback as a positive professional learning activity that enhances confidence, builds collegial relationships and supports reflective practice. Less clear is how best to embed such programs in university practices. This paper describes a leadership approach developed to support the…

The Protective Effects of Family Support on the Relationship between Official Intervention and General Delinquency across the Life Course

PubMed Central

Dong, Beidi; Krohn, Marvin D.

2016-01-01

Purpose Previous research on the labeling perspective has identified mediational processes and the long-term effects of official intervention in the life course. However, it is not yet clear what factors may moderate the relationship between labeling and subsequent offending. The current study integrates Cullen’s (1994) social support theory to examine how family social support conditions the criminogenic, stigmatizing effects of official intervention on delinquency and whether such protective effects vary by developmental stage. Methods Using longitudinal data from the Rochester Youth Development Study, we estimated negative binomial regression models to investigate the relationships between police arrest, family social support, and criminal offending during both adolescence and young adulthood. Results Police arrest is a significant predictor of self-reported delinquency in both the adolescent and adult models. Expressive family support exhibits main effects in the adolescent models; instrumental family support exhibits main effects at both developmental stages. Additionally, instrumental family support diminishes some of the predicted adverse effects of official intervention in adulthood. Conclusions Perception of family support can be critical in reducing general delinquency as well as buffering against the adverse effects of official intervention on subsequent offending. Policies and programs that work with families subsequent to a criminal justice intervention should emphasize the importance of providing a supportive environment for those who are labeled. PMID:28729962

Conceptual Sound System Design for Clifford Odets' "GOLDEN BOY"

NASA Astrophysics Data System (ADS)

Yang, Yen Chun

There are two different aspects in the process of sound design, "Arts" and "Science". In my opinion, the sound design should engage both aspects strongly and in interaction with each other. I started the process of designing the sound for GOLDEN BOY by building the city soundscape of New York City in 1937. The scenic design for this piece is designed in the round, putting the audience all around the stage; this gave me a great opportunity to use surround and specialization techniques to transform the space into a different sonic world. My specialization design is composed of two subsystems -- one is the four (4) speakers center cluster diffusing towards the four (4) sections of audience, and the other is the four (4) speakers on the four (4) corners of the theatre. The outside ring provides rich sound source localization and the inside ring provides more support for control of the specialization details. In my design four (4) lavalier microphones are hung under the center iron cage from the four (4) corners of the stage. Each microphone is ten (10) feet above the stage. The signal for each microphone is sent to the two (2) center speakers in the cluster diagonally opposite the microphone. With the appropriate level adjustment of the microphones, the audience will not notice the amplification of the voices; however, through my specialization system, the presence and location of the voices of all actors are preserved for all audiences clearly. With such vocal reinforcements provided by the microphones, I no longer need to worry about overwhelming the dialogue on stage by the underscoring. A successful sound system design should not only provide a functional system, but also take the responsibility of bringing actors' voices to the audience and engaging the audience with the world that we create on stage. By designing a system which reinforces the actors' voices while at the same time providing control over localization of movement of sound effects, I was able not only to make the text present and clear for the audiences, but also to support the storyline strongly through my composed music, environmental soundscapes, and underscoring.

Use of Gaming in Self-Management of Diabetes in Teens.

PubMed

Swartwout, Ellen; El-Zein, Ashley; Deyo, Patricia; Sweenie, Rachel; Streisand, Randi

2016-07-01

With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change.

Ingredients for Success: Strategies to Support Local Food Use in Health Care Institutions.

PubMed

Linton, Emily; Keller, Heather; Duizer, Lisa

2018-06-12

There is growing interest in use of local food within health care institutions such as hospitals and long-term care homes. This study explored stakeholder perspectives on (i) influences on local food use and (ii) strategies that support success and sustainability of use in health care institutions. Fifteen participants who were institutional leaders with experience in implementing or supporting local food use in health care institutions in Ontario were recruited through purposeful and snowball sampling. A semi-structured interview was conducted by telephone and audio-recorded. Qualitative content analysis identified that influences on local food use were: product availability, staff and management engagement, and legislation and resources (e.g., funding, labour). Several strategies were offered for building and sustaining success including: setting goals, requesting local food availability from suppliers, and more clearly identifying local foods in product lists. The influences and potential strategies highlighted in this paper provide a greater understanding for dietitians and food service managers on how local foods can be incorporated into health care institutions.

Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

PubMed

Soekarjo, Damayanti; Zehner, Elizabeth

2011-10-01

It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

Mineral content as a basis for food selection by western lowland gorillas in a forest clearing.

PubMed

Magliocca, Florence; Gautier-Hion, Annie

2002-06-01

The forests in northwest Republic of Congo contain a number of herbaceous swamp clearings that provide foraging sites for lowland gorillas (G.g. gorilla). A 10-month study at the Maya Nord clearing (Parc National d'Odzala) showed that feeding activities occupied 72% of the time visiting gorillas spent on the clearing. They fed on four plant species: Enydra fluctuans (Asteraceae), Cyperus sp., Pycreus mundtii, and Rhynchospora corymbosa (Cyperaceae) among the 45 species recorded on the clearing. These clearing food species have higher mineral contents (especially Na and Ca) than the dominant Marantaceae species (Haumania liebrechtsiana) that constituted a staple food plant for gorillas in this forest. They also have higher potassium contents and contain less lignin than non-eaten clearing items/species. Finally, the most actively searched for clearing food (Enydra fluctuans) was characterized by the highest amount of Na and Ca. These results suggest that the mineral content (especially in Na, Ca, and/or K) could determine the feeding selectivity of gorillas at the clearing. They also tend to confirm that the amount of fiber plays a deterrent role in food selectivity, as has been found by many authors. The high density of gorillas in that region could result from the combination of the large areas of Marantaceae forests that provide abundant though monotonous food, and the number of clearings that provide sufficient mineral supplies. Clearings should thus be considered as key habitats for the conservation of gorillas. Copyright 2002 Wiley-Liss, Inc.

International Space Station Increment Operations Services

NASA Astrophysics Data System (ADS)

Michaelis, Horst; Sielaff, Christian

2002-01-01

The Industrial Operator (IO) has defined End-to-End services to perform efficiently all required operations tasks for the Manned Space Program (MSP) as agreed during the Ministerial Council in Edinburgh in November 2001. Those services are the result of a detailed task analysis based on the operations processes as derived from the Space Station Program Implementation Plans (SPIP) and defined in the Operations Processes Documents (OPD). These services are related to ISS Increment Operations and ATV Mission Operations. Each of these End-to-End services is typically characterised by the following properties: It has a clearly defined starting point, where all requirements on the end-product are fixed and associated performance metrics of the customer are well defined. It has a clearly defined ending point, when the product or service is delivered to the customer and accepted by him, according to the performance metrics defined at the start point. The implementation of the process might be restricted by external boundary conditions and constraints mutually agreed with the customer. As far as those are respected the IO has the free choice to select methods and means of implementation. The ISS Increment Operations Service (IOS) activities required for the MSP Exploitation program cover the complete increment specific cycle starting with the support to strategic planning and ending with the post increment evaluation. These activities are divided into sub-services including the following tasks: - ISS Planning Support covering the support to strategic and tactical planning up to the generation - Development &Payload Integration Support - ISS Increment Preparation - ISS Increment Execution These processes are tight together by the Increment Integration Management, which provides the planning and scheduling of all activities as well as the technical management of the overall process . The paper describes the entire End-to-End ISS Increment Operations service and the implementation to support the Columbus Flight 1E related increment and subsequent ISS increments. Special attention is paid to the implications caused by long term operations on hardware, software and operations personnel.

Flood Forecast Accuracy and Decision Support System Approach: the Venice Case

NASA Astrophysics Data System (ADS)

Canestrelli, A.; Di Donato, M.

2016-02-01

In the recent years numerical models for weather predictions have experienced continuous advances in technology. As a result, all the disciplines making use of weather forecasts have made significant steps forward. In the case of the Safeguard of Venice, a large effort has been put in order to improve the forecast of tidal levels. In this context, the Istituzione Centro Previsioni e Segnalazioni Maree (ICPSM) of the Venice Municipality has developed and tested many different forecast models, both of the statistical and deterministic type, and has shown to produce very accurate forecasts. For Venice, the maximum admissible forecast error should be (ideally) of the order of ten centimeters at 24 hours. The entity of the forecast error clearly affects the decisional process, which mainly consists of alerting the population, activating the movable barriers installed at the three tidal inlets and contacting the port authority. This process becomes more challenging whenever the weather predictions, and therefore the water level forecasts, suddenly change. These new forecasts have to be quickly transformed into operational tasks. Therefore, it is of the utter importance to set up scheduled alerts and emergency plans by means of easy-to-follow procedures. On this direction, Technital has set up a Decision Support System based on expert procedures that minimizes the human mistakes and, as a consequence, reduces the risk of flooding of the historical center. Moreover, the Decision Support System can communicate predefined alerts to all the interested subjects. The System uses the water levels forecasts produced by the ICPSM by taking into account the accuracy at different leading times. The Decision Support System has been successfully tested with 8 years of data, 6 of them in real time. Venice experience shows that the Decision Support System is an essential tool which assesses the risks associated with a particular event, provides clear operational procedures and minimizes the impact of natural floods on human lives, private properties and historical monuments.

Blood transfusion safety: a new philosophy.

PubMed

Franklin, I M

2012-12-01

Blood transfusion safety has had a chequered history, and there are current and future challenges. Internationally, there is no clear consensus for many aspects of the provision of safe blood, although pan-national legislation does provide a baseline framework in the European Union. Costs are rising, and new safety measures can appear expensive, especially when tested against some other medical interventions, such as cancer treatment and vaccination programmes. In this article, it is proposed that a comprehensive approach is taken to the issue of blood transfusion safety that considers all aspects of the process rather than considering only new measures. The need for an agreed level of safety for specified and unknown risks is also suggested. The importance of providing care and support for those inadvertently injured as a result of transfusion problems is also made. Given that the current blood safety decision process often uses a utilitarian principle for decision making--through the calculation of Quality Adjusted Life Years--an alternative philosophy is proposed. A social contract for blood safety, based on the principles of 'justice as fairness' developed by John Rawls, is recommended as a means of providing an agreed level of safety, containing costs and providing support for any adverse outcomes. © 2012 The Author. Transfusion Medicine © 2012 British Blood Transfusion Society.

Forensic Assertive Community Treatment: A Review of the Literature.

PubMed

Marquant, Thomas; Sabbe, Bernard; Van Nuffel, Meike; Goethals, Kris

2016-11-01

An extensive body of literature provides evidence supporting the effectiveness of assertive community treatment (ACT) with regard to non-forensic outcome measures, such as number of hospital admissions and length of stay. However, research findings on the effectiveness of ACT for forensic outcome measures, such as rearrests or detentions, is much less clear. The present review, therefore, focuses on the application of ACT in forensic populations, combining key elements of ACT with elements of forensic rehabilitation models. Specifically, a review of the literature was conducted using a systematic methodology in an attempt to combine evidence-based elements of 40 years of research on regular ACT with elements of forensic rehabilitation models. Results reveal limited yet promising evidence in support of the effectiveness of forensic ACT for forensic outcome measures. Implications for future research and clinical practice are discussed.

A fractal model for nuclear organization: current evidence and biological implications

PubMed Central

Bancaud, Aurélien; Lavelle, Christophe; Huet, Sébastien; Ellenberg, Jan

2012-01-01

Chromatin is a multiscale structure on which transcription, replication, recombination and repair of the genome occur. To fully understand any of these processes at the molecular level under physiological conditions, a clear picture of the polymorphic and dynamic organization of chromatin in the eukaryotic nucleus is required. Recent studies indicate that a fractal model of chromatin architecture is consistent with both the reaction-diffusion properties of chromatin interacting proteins and with structural data on chromatin interminglement. In this study, we provide a critical overview of the experimental evidence that support a fractal organization of chromatin. On this basis, we discuss the functional implications of a fractal chromatin model for biological processes and propose future experiments to probe chromatin organization further that should allow to strongly support or invalidate the fractal hypothesis. PMID:22790985

The role of sleep in human declarative memory consolidation.

PubMed

Alger, Sara E; Chambers, Alexis M; Cunningham, Tony; Payne, Jessica D

2015-01-01

Through a variety of methods, researchers have begun unraveling the mystery of why humans spend one-third of their lives asleep. Though sleep likely serves multiple functions, it has become clear that the sleeping brain offers an ideal environment for solidifying newly learned information in the brain. Sleep , which comprises a complex collection of brain states, supports the consolidation of many different types of information. It not only promotes learning and memory stabilization, but also memory reorganization that can lead to various forms of insightful behavior. As this chapter will describe, research provides ample support for these crucial cognitive functions of sleep . Focusing on the declarative memory system in humans, we review the literature regarding the benefits of sleep for both neutral and emotionally salient declarative memory. Finally, we discuss the literature regarding the impact of sleep on emotion regulation.

Rural health network development: public policy issues and state initiatives.

PubMed

Casey, M M; Wellever, A; Moscovice, I

1997-02-01

Rural health networks are a potential way for rural health care systems to improve access to care, reduce costs, and enhance quality of care. Networks provide a means for rural providers to contract with managed care organizations, develop their own managed care entities, share resources, and structure practice opportunities to support recruitment and retention of rural physicians and other health care professionals. The results of early network development initiatives indicate a need for state officials and others interested in encouraging network development to agree on common rural health network definitions, to identify clearly the goals of network development programs, and to document and analyze program outcomes. Future network development efforts need to be much more comprehensive if they are to have a significant impact on rural health care. This article analyzes public policy issues related to integrated rural health network development, discusses current efforts to encourage network development in rural areas, and suggests actions that states may take if they desire to support rural health network development. These actions include adopting a formal rural health network definition, providing networks with alternatives to certain regulatory requirements, and providing incentives such as matching grants, loans, or technical assistance. Without public sector support for networks, managed care options may continue to be unavailable in many less densely populated rural areas of the country, and locally controlled rural health networks are unlikely to develop as an alternative to the dominant pattern of managed care expansion by large urban entities. Implementation of Medicare reform legislation could provide significant incentives for the development of rural health networks, depending on the reimbursement provisions, financial solvency standards, and antitrust exemptions for provider-sponsored networks in the final legislation and federal regulations.

77 FR 26066 - Self-Regulatory Organizations; ICE Clear Europe Limited; Order Approving Proposed Rule Change to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

...-Regulatory Organizations; ICE Clear Europe Limited; Order Approving Proposed Rule Change to Provide for a T+1 Settlement of the Initial Payment Related to the CDS Contracts Cleared by ICE Clear Europe Limited April 26, 2012. I. Introduction On March 6, 2012, ICE Clear Europe Limited (``ICE Clear Europe'') filed with the...

KSC-98pc778

NASA Image and Video Library

1998-06-25

KENNEDY SPACE CENTER, FLA. -- A forest fire burning in Volusia County, Florida, is clearly visible from NASA's Huey UH-1 helicopter. The helicopter has been outfitted with a Forward Looking Infrared Radar (FLIR) and a portable global positioning satellite (GPS) system to support Florida's Division of Forestry as they fight the brush fires which have been plaguing the state as a result of extremely dry conditions and lightning storms. The FLIR includes a beach ball-sized infrared camera that is mounted on the helicopter's right siderail and a real-time television monitor and recorder installed inside. While the FLIR collects temperature data and images, the GPS system provides the exact coordinates of the fires being observed and transmits the data to the firefighters on the ground. The Kennedy Space Center (KSC) security team routinely uses the FLIR equipment prior to Shuttle launch and landing activities to ensure that the area surrounding the launch pad and runway are clear of unauthorized personnel. KSC's Base Operations Contractor, EG&G Florida, operates the NASA-owned helicopter

[A brief review of research on chronic disease management based on collaborative care model in China].

PubMed

Li, Huayan; Fuller, Jeffrey; Sun, Mei; Wang, Yong; Xu, Shuang; Feng, Hui

2014-11-01

To evaluate the situation for chronic disease management in China, and to seek the method for improving the collaborative management for chronic diseases in community. We searched literature between January 2008 and November 2013 from the Database, such as China Academic Journal Full-Text Database, and PubMed. The screening was strictly in accordance with the inclusion and exclusion criteria and a summary was made among the selected literature based on a collaboration model. We got 698 articles after rough screen and finally selected 33. All studies were involved in patient's self-management support, but only 9 studies mentioned the communication within the team, and 11 showed a clear team division of labor. Chronic disease community management in China displays some disadvantages. It really needs a general service team with clear roles and responsibilities for team members to improve the service ability of team members and provide patients with various forms of self management services.

Does the type of pancreaticojejunostomy after Whipple alter the leak rate?

PubMed

Ball, Chad G; Howard, Thomas J

2010-01-01

Despite the overwhelming limitations that plague the literature surrounding the optimal method of reestablishing pancreatico-enteric continuity following a Whipple operation, it is clear that all successful techniques conform to sound surgical principles. These principles include a water-tight and tension-free anastomosis, preservation of adequate blood supply for both organs involved in the anastomosis, and minimal trauma to the pancreas gland. Although surgeon experience, gland texture, and pancreatic duct size are clearly the dominate risk factors from a long list of variables associated with pancreatic leaks following pancreatoduodenectomy, these are nonmodifiable covariates. Although the plethora of current literature cannot provide a single definitive technical solution for restoring pancreatico-enteric continuity, a small number of well-designed RCTs support the use of transanastomotic external stenting for high-risk pancreatic glands and an end-to-side invaginated pancreaticojejunostomy. The truth remains that an individual surgeon's mastery of a specific anastomotic technique, in conjunction with a large personal experience, is likely to be the best predictor of a low pancreas leak rate following pancreatoduodenectomy.

Medical Physics Practice Guidelines - the AAPM's minimum practice recommendations for medical physicists.

PubMed

Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H

2013-11-04

The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.

Keep wetlands wet: the myth of sustainable development of tropical peatlands - implications for policies and management.

PubMed

Evers, Stephanie; Yule, Catherine M; Padfield, Rory; O'Reilly, Patrick; Varkkey, Helena

2017-02-01

Pristine tropical peat swamp forests (PSFs) represent a unique wetland ecosystem of distinctive hydrology which support unique biodiversity and globally significant stores of soil carbon. Yet in Indonesia and Malaysia, home to 56% of the world's tropical peatland, they are subject to considerable developmental pressures, including widespread drainage to support agricultural needs. In this article, we review the ecology behind the functioning and ecosystem services provided by PSFs, with a particular focus on hydrological processes as well as the role of the forest itself in maintaining those services. Drawing on this, we review the suitability of current policy frameworks and consider the efficacy of their implementation. We suggest that policies in Malaysia and Indonesia are often based around the narrative of oil palm and other major monocrops as drivers of prosperity and development. However, we also argue that this narrative is also being supported by a priori claims concerning the possibility of sustainability of peat swamp exploitation via drainage-based agriculture through the adherence to best management practices. We discuss how this limits their efficacy, uptake and the political will towards enforcement. Further, we consider how both narratives (prosperity and sustainability) clearly exclude important considerations concerning the ecosystem value of tropical PSFs which are dependent on their unimpacted hydrology. Current research clearly shows that the actual debate should be focused not on how to develop drainage-based plantations sustainably, but on whether the sustainable conversion to drainage-based systems is possible at all. © 2016 John Wiley & Sons Ltd.

77 FR 13678 - Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Filing of Proposed Rule To Provide...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

...%) of the Initial Margin Requirement for Client-related Positions Cleared in a Clearing Participant's... satisfy the initial margin-related liquidity requirements for client-related positions cleared in a... hundred percent (100%) of the initial margin requirement for client-related positions cleared in a...

Short-stay rural and remote placements in dental education, an effective model for rural exposure: a review of eight-year experience in Western Australia.

PubMed

Kruger, Estie; Tennant, Marc

2010-08-01

The increase in demand for dental care over the next 10 years is expected to outstrip the supply of dental visits in Australia, resulting in an ongoing shortage of dental practitioners. As trends in medicine have shown, the greatest effect will be felt in rural and remote regions, where an undersupply of dentists already exists. It is clearly evident that it is important to provide strategies that will increase the recruitment and retention of practitioners in rural and remote areas. Previous research suggested an increased likelihood for health graduates to choose rural practice if they have a rural background, or were exposed to rural practice during their education. Short-stay (three to four weeks) placements for final-year dental students has been part of dental education in Western Australia for near on a decade. This paper reflects on the experiences gained from managing this placement program. Short-stay placements are a quality learning initiative but need a high level of planning and a clear vision to be effective. The key factors in ensuring sustainable, student centred learning is driven through a small core group of staff who have strong direct links with rural and remote communities, students and support providers. The integration of service, education and research goals have played a critical role in sustaining placements. The philosophy underpinning the rural placements needs to be clearly articulated and applied effectively in each step of their implementation and a highly focused customer-service driven implementation is required to make short-stay rural and remote placements effective.

The Power of 2: Partnership Paves the Way for Teacher Leadership Academy

ERIC Educational Resources Information Center

Harmon, Jeanne; Herren, Kip; Luke, Rod; Emry, Terese

2012-01-01

A clear vision is the essential foundation for making decisions about precious resources for implementing professional learning: (1) people; (2) time; and (3) money. The Auburn School District in Washington state learned firsthand how a clear vision drives resource allocation to support strategic actions and how effective partnerships can be the…

76 FR 79258 - Self-Regulatory Organizations; Chicago Mercantile Exchange, Inc.; Notice of Filing and Order...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... to amend rules related to existing cleared-only foreign exchange (``FX'') currency derivatives... SR-CME-2011-12 to establish rules to expand its cleared-only, foreign currency (``FX'') swaps offering to support the introduction of (1) twenty-six new foreign FX currency derivatives for over-the...

Clear Communication in the Digital Age

ERIC Educational Resources Information Center

Manchester, Bette

2009-01-01

One of the essential factors of successful integration of technology in classrooms is the role and relationship of the technology coordinator in supporting integration efforts. The vision for the use of technology in each school and district and the leadership role of the tech coordinator must be clear and understood by all. This article presents…

UAS Well Clear Recovery Against Non-Cooperative Intruders Using Vertical Maneuvers

NASA Technical Reports Server (NTRS)

Cone, Andrew C.; Thipphavong, David; Lee, Seung Man; Santiago, Confesor

2017-01-01

This paper documents a study that drove the development of a mathematical expression in the detect-and-avoid (DAA) minimum operational performance standards (MOPS) for unmanned aircraft systems (UAS). This equation describes the conditions under which vertical maneuver guidance should be provided during recovery of DAA well clear separation with a non-cooperative VFR aircraft. Although the original hypothesis was that vertical maneuvers for DAA well clear recovery should only be offered when sensor vertical rate errors are small, this paper suggests that UAS climb and descent performance should be considered-in addition to sensor errors for vertical position and vertical rate-when determining whether to offer vertical guidance. A fast-time simulation study involving 108,000 encounters between a UAS and a non-cooperative visual-flight-rules aircraft was conducted. Results are presented showing that, when vertical maneuver guidance for DAA well clear recovery was suppressed, the minimum vertical separation increased by roughly 50 feet (or horizontal separation by 500 to 800 feet). However, the percentage of encounters that had a risk of collision when performing vertical well clear recovery maneuvers was reduced as UAS vertical rate performance increased and sensor vertical rate errors decreased. A class of encounter is identified for which vertical-rate error had a large effect on the efficacy of horizontal maneuvers due to the difficulty of making the correct left/right turn decision: crossing conflict with intruder changing altitude. Overall, these results support logic that would allow vertical maneuvers when UAS vertical performance is sufficient to avoid the intruder, based on the intruder's estimated vertical position and vertical rate, as well as the vertical rate error of the UAS' sensor.

A survey of exercise advice and recommendations in United Kingdom paediatric cardiac clinics.

PubMed

Williams, Craig A; Gowing, Lucy; Horn, Richard; Stuart, Alan Graham

2017-07-01

Physical activity and exercise have important health benefits for children and adolescents with CHD. The objective of this study was to survey the provision of advice and recommendations in United Kingdom paediatric CHD clinics. A three-page questionnaire was sent out to paediatric cardiac consultants in the United Kingdom, paediatric consultants with expertise in cardiology, and nursing staff (Paediatricians with Expertise in Cardiology Special Interest Group), as well as all members of the British Congenital Cardiovascular Association. The aim of this questionnaire was to determine the extent and scope of current information provision and to assess the importance that clinicians place on this advice. There were 68 responses in total, and the data showed that, of these, 24 (36%) clinicians had never provided paediatric CHD patients with written advice about exercise. Only 27 (39%) clinicians provided physical activity advice at every appointment. Lack of time during consultation (n=39, 56.9%), lack of training (n=38, 55.2%), and uncertainty about appropriate recommendations (n=38, 55.2%) were identified as the main factors preventing clinicians from providing patients with advice about physical activity. Although healthcare providers consider physical activity to be very important, the provision of clear, specific advice and recommendations is underutilised; therefore, more education and provision of resources to support the promotion of exercise need to be provided to clinicians and their support teams.

Final Overview of ACES Simulation for Evaluation SARP Well-Clear Definitions

NASA Technical Reports Server (NTRS)

Santiago, Confesor; Johnson, Marcus A.; Isaacson, Doug; Hershey, David

2014-01-01

The UAS in the NAS project is studying the minimum operational performance standards for unmanned aerial systems (UAS's) detect-and-avoid (DAA) system in order to operate in the National Airspace System. The DoD's Science and research Panel (SARP) Well-Clear Workshop is investigating the time and spatial boundary at which an UAS violates well-clear. NASA is supporting this effort through use of its Airspace Concept Evaluation System (ACES) simulation platform. This briefing presents the final results to the SARP, which will be used to judge the three candidate well-clear definitions, and for the selection of the most operationally suitable option.

Exploring a neuroplasticity model of music therapy.

PubMed

Stegemöller, Elizabeth L

2014-01-01

Given that music therapists work across a wide range of disabilities, it is important that therapists have at least a fundamental understanding of the neurophysiology associated with the client/patient populations that they serve. Yet, there is a large gap of evidence regarding the neurophysiological changes associated with applying music as therapy. The purpose of this article is to provide music therapists with a general background in neuroplasticity principles that can be applied to the use of music therapy with multiple populations. This article will review literature on neuroplasticity and literature supporting the specific attributes of music therapy that apply to neuroplasticity. Finally, examples of how to use neuroplasticity principles to explain and support clinical music therapy will be provided. Using the material presented in this review, music therapists will be equipped with information to effectively communicate why music therapy works using three neuroplasticity principles; increase in dopamine, neural synchrony, and a clear signal. Music therapy is a powerful tool to enhance neuroplasticity in the brain. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Supporting evidence-based health care in crises: what information do humanitarian organizations need?

PubMed

Turner, Tari; Green, Sally; Harris, Claire

2011-03-01

In crisis situations, there is an enormous burden of disease and very limited resources. To achieve the best possible health outcomes in these situations and ensure that scarce resources are not wasted, knowledge from health research needs to be translated into practice. We investigated what information from health research was needed by humanitarian aid workers in crisis settings and how it could be best provided. Semistructured interviews were conducted by telephone with 19 humanitarian aid workers from a range of organizations around the world and the results analyzed thematically. Participants identified a clear and currently unmet need for access to high-quality health research to support evidence-based practice in crisis situations. They emphasized that research into delivery of health care was potentially more valuable than research into the effectiveness of particular clinical interventions and highlighted the importance of including contextual information to enable the relevance of the research to be assessed. They suggested that providers of health research information and humanitarian aid organizations work together to develop these resources. ©2011 American Medical Association. All rights reserved.

Knowledge assisted diagnosis of mood disorders using DSM-3

NASA Technical Reports Server (NTRS)

Fritz, Robert H.

1990-01-01

As part of an Expert Systems class at the University of Houston Clear Lake, a system has been developed using CLIPS to allow a clinical psychologist or psychiatrist to diagnose mood disturbances by providing answers to questions corresponding to branches of a DSM-III criteria tree. Experienced clinicians may assert indications of the client's behavior in order to circumvent multiple levels of the tree, thus speeding diagnosis. An explanation facility was developed for validation of the diagnosis . It also allows for 'what if' scenarios by allowing the clinician to move backwards from the diagnosis to any decision branch and alter the answer previously provided. The system was implemented with a limited vocabulary of symptoms associated primarily with depressive disorders. However, the design supports the addition of vocabulary modules and knowledge bases for other types of disorders. The system currently has applicability in an instructional setting. With the addition of a more complete vocabulary, it could have applicability in a clinical setting. The overall design will support any application where determinations are made via a decision tree.

Refining the Measurement of Distress Intolerance

PubMed Central

McHugh, R. Kathryn; Otto, Michael W.

2012-01-01

Distress intolerance is an important transdiagnostic variable that has long been implicated in the development and maintenance of psychological disorders. Self-report measurement strategies for distress intolerance have emerged from several different models of psychopathology and these measures have been applied inconsistently in the literature in the absence of a clear gold standard. The absence of a consistent assessment strategy has limited the ability to compare across studies and samples, thus hampering the advancement of this research agenda. This study evaluated the latent factor structure of existing measures of DI to examine the degree to which they are capturing the same construct. Results of confirmatory factor analysis in 3 samples totaling 400 participants provided support for a single factor latent structure. Individual items of these four scales were then correlated with this factor to identify those that best capture the core construct. Results provided consistent supported for 10 items that demonstrated the strongest concordance with this factor. The use of these 10 items as a unifying measure in the study of DI and future directions for the evaluation of its utility are discussed. PMID:22697451

Assessment of Cloud Screening with Apparent Surface Reflectance in Support of the ICESat-2 Mission

NASA Technical Reports Server (NTRS)

Yang, Yuekui; Marshak, Alexander; Palm, Stephen P.; Wang, Zhuosen; Schaaf, Crystal

2011-01-01

The separation of cloud and clear scenes is usually one of the first steps in satellite data analysis. Before deriving a geophysical product, almost every satellite mission requires a cloud mask to label a scene as either clear or cloudy through a cloud detection procedure. For clear scenes, products such as surface properties may be retrieved; for cloudy scenes, scientist can focus on studying the cloud properties. Hence the quality of cloud detection directly affects the quality of most satellite operational and research products. This is certainly true for the Ice, Cloud, and land Elevation Satellite-2 (lCESat-2), which is the successor to the ICESat-l. As a top priority mission, ICESat-2 will continue to provide measurements of ice sheets and sea ice elevation on a global scale. Studies have shown that clouds can significantly affect the accuracy of the retrieved results. For example, some of the photons (a photon is a basic unit of light) in the laser beam will be scattered by cloud particles on its way. So instead of traveling in a straight line, these photons are scattered sideways and have traveled a longer path. This will result in biases in ice sheet elevation measurements. Hence cloud screening must be done and be done accurately before the retrievals.

Neurophysiological evidence that perceptions of fluency produce mere exposure effects.

PubMed

Leynes, P Andrew; Addante, Richard J

2016-08-01

Recent exposure to people or objects increases liking ratings, the "mere exposure effect" (Zajonc in American Psychologist, 35, 117-123, 1968), and an increase in processing fluency has been identified as a potential mechanism for producing this effect. This fluency hypothesis was directly tested by altering the trial-by-trial image clarity (i.e., fluency) while Event-Related Potentials (ERPs) were recorded. In Experiment 1, clarity was altered across two trial blocks that each had homogenous trial-by-trial clarity, whereas clarity varied randomly across trials in Experiment 2. Blocking or randomizing image clarity across trials was expected to produce different levels of relative fluency and alter mere exposure effects. The mere exposure effect (i.e., old products liked more than new products) was observed when stimulus clarity remained constant across trials, and clear image ERPs were more positive than blurry image ERPs. Importantly, these patterns were reversed when clarity varied randomly across test trials, such that participants liked clear images more than blurry (i.e., no mere exposure effect) and clear image ERPs were more negative than blurry image ERPs. The findings provide direct experimental support from both behavioral and electrophysiological measures that, in some contexts, mere exposure is the product of top-down interpretations of fluency.

In their own words: treating very young BRCA1/2 mutation-positive women with care and caution.

PubMed

Hoskins, Lindsey M; Werner-Lin, Allison; Greene, Mark H

2014-01-01

Young women who have been identified as carrying a deleterious mutation in BRCA1 or BRCA2 face a unique set of challenges related to managing cancer risk during a demographically-dense stage of life. They may struggle with decision-making in the absence of clear age-specific guidelines for medical management and because they have not yet fully developed the capacity to make life-altering decisions confidently. This study sought a patient-centered perspective on the dilemmas faced by 18-24 year olds who completed BRCA1/2 gene mutation testing prior to their 25(th) birthdays. This study integrated qualitative data from three independent investigations of BRCA1/2-positive women recruited through cancer risk clinics, hospital-based research centers, and online organizations. All 32 participants were women aged 21-25 who tested positive for a BRCA1/2 gene mutation between 2 and 60 months prior to data collection. Investigators used techniques of grounded theory and interpretive description to conduct both within and cross-study analysis. Participants expressed needs for (1) greater clarity in recommendations for screening and prevention before age 25, especially with consideration of early and regular exposure to radiation associated with mammography or to hormones used in birth control, and (2) ongoing contact with providers to discuss risk management protocols as they become available. Health care needs during the young adult years evolve with the cognitive capacity to address abrupt and pressing change. Specific needs of women in this population include a desire to balance autonomous decision-making with supportive guidance, a need for clear, accurate and consistent medical recommendations. Optimally, these women are best cared for by a team of genetically-oriented providers as part of a sustained program of ongoing support, rather than seen in an episodic, crisis-driven fashion. A discussion of insurance issues and provider-patient cultural differences is presented.

The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives.

PubMed

Stergiou-Kita, Mary; Pritlove, Cheryl; van Eerd, Dwayne; Holness, Linn D; Kirsh, Bonnie; Duncan, Andrea; Jones, Jennifer

2016-06-01

With improvements in screening, diagnosis, and treatment, the number of persons surviving cancer and staying at or returning to work is increasing. While workplace accommodations optimize workers' abilities to participate in the workforce, there has been little in-depth investigation of the types of accommodations reported to have been provided to cancer survivors and the processes relevant to ensuring their successful implementation. We employed an exploratory qualitative method and conducted 40 semi-structured interviews with three groups: (i) cancers survivors (n = 16), (ii) health/vocational service providers (n = 16), and (iii) employer representatives (n = 8) to explore return to work and accommodation processes, successes, and challenges. An inductive thematic analysis approach was used to analyze the data. Four types of accommodations were recommended: (1) graduated return to work plans and flexible scheduling, (2) modification of work duties and performance expectations, (3) retraining and supports at the workplace, and (4) modification of the physical work environment and/or the provision of adaptive aids/technologies. Processes relevant to ensuring effective accommodations included: (1) developing knowledge about accommodations, (2) employer's ability to accommodate, (3) negotiating reasonable accommodations, (4) customizing accommodations, and (5) implementing and monitoring accommodation plans. Accommodation challenges included: (1) survivors' fears requesting accommodations, (2) developing clear and specific accommodations, (3) difficult to accommodate jobs, and (4) workplace challenges, including strained pre-cancer workplace relationships, insufficient/inflexible workplace policies, employer concerns regarding productivity and precedent setting, and limited modified duties. Accommodations need to be customized and clearly linked to survivors' specific job demands, work context, and available workplace supports. Survivors need to feel comfortable disclosing the need for accommodations. Ongoing communication and monitoring are required to ensure accommodations are implemented and changes made to the return to work plan as required. The provision of appropriate workplace accommodations can enhance survivors' abilities to stay or return to work.

Semi-Automated Diagnosis, Repair, and Rework of Spacecraft Electronics

NASA Technical Reports Server (NTRS)

Struk, Peter M.; Oeftering, Richard C.; Easton, John W.; Anderson, Eric E.

2008-01-01

NASA's Constellation Program for Exploration of the Moon and Mars places human crews in extreme isolation in resource scarce environments. Near Earth, the discontinuation of Space Shuttle flights after 2010 will alter the up- and down-mass capacity for the International Space Station (ISS). NASA is considering new options for logistics support strategies for future missions. Aerospace systems are often composed of replaceable modular blocks that minimize the need for complex service operations in the field. Such a strategy however, implies a robust and responsive logistics infrastructure with relatively low transportation costs. The modular Orbital Replacement Units (ORU) used for ISS requires relatively large blocks of replacement hardware even though the actual failed component may really be three orders of magnitude smaller. The ability to perform in-situ repair of electronics circuits at the component level can dramatically reduce the scale of spares and related logistics cost. This ability also reduces mission risk, increases crew independence and improves the overall supportability of the program. The Component-Level Electronics Assembly Repair (CLEAR) task under the NASA Supportability program was established to demonstrate the practicality of repair by first investigating widely used soldering materials and processes (M&P) performed by modest manual means. The work will result in program guidelines for performing manual repairs along with design guidance for circuit reparability. The next phase of CLEAR recognizes that manual repair has its limitations and some highly integrated devices are extremely difficult to handle and demand semi-automated equipment. Further, electronics repairs require a broad range of diagnostic capability to isolate the faulty components. Finally repairs must pass functional tests to determine that the repairs are successful and the circuit can be returned to service. To prevent equipment demands from exceeding spacecraft volume capacity and skill demands from exceeding crew time and training limits, the CLEAR project is examining options provided by non-real time tele-operations, robotics, and a new generation of diagnostic equipment. This paper outlines a strategy to create an effective repair environment where, with the support of ground based engineers, crewmembers can diagnose, repair and test flight electronics in-situ. This paper also discusses the implications of successful tele-robotic repairs when expanded to rework and reconfiguration of used flight assets for building Constellation infrastructure elements.

Mental health nursing and stress: maintaining balance.

PubMed

Ward, Louise

2011-04-01

The recruitment and retention of mental health nurses within acute inpatient mental health facilities continues to be an ongoing issue. Literature and current research highlight an environment fraught with pressure and stress, identifying several key factors contributing to job dissatisfaction. These factors include greater patient acuity, unpredictable and challenging workspaces, violence, increased paperwork, and reduced managerial support. This qualitative, critical, feminist exploration investigated the lived experiences of 13 female mental health nurses working in inpatient services. They were asked about their practice and perceptions of workplace culture, and they shared their thoughts on stress management and professional well-being. Positive workplace practice was highlighted, and the participants revealed an environment they were proud to be a part of. Individual interviews, focus groups, and reflective practice were all used to collect data. The findings from the investigation unanimously support current literature that clearly confirms mental health nursing to be stressful. Interestingly, however, the findings also clearly identified that the way in which the nurse participants managed their stress was intrinsically linked to their job satisfaction. The major theme identified throughout the present study revealed that the female participants' ability to manage an at times complex workspace through the notions of teamwork, diversity, and creativity. All of the participants considered these elements as significant to providing a high standard in patient care. This research might provide an opportunity for others to view mental health nursing from a different perspective, and through the lived experiences of the participants, embrace the positive and rewarding aspects of the role. © 2011 The Author. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Does your equipment maintenance management program measure up?

PubMed

Deinstadt, Deborah C

2003-01-01

Identifying a clear maintenance philosophy is the first step toward choosing the right program for your healthcare organization. The second step is gaining a clear understanding of how proposed savings and improvements will be delivered. The third and last step is requiring that the proposed company or manager have specific tools in place for measuring and analyzing program performance. There are three primary philosophies underlying current equipment management options. These include risk-transfer philosophy (e.g., maintenance insurance, service contracts, multi-vendor and outsource programs), asset management philosophy (e.g., programs delivering a management system based on managed time-and-materials), and internal management (in-house managed programs). The last step in selecting the right program is insisting that proper performance measurements be built into the proposed management program. A well-managed program provides results in three general areas: financial outcomes, operational improvements and process improvements. Financial outcomes are the easiest to measure. Operational and process improvements are more challenging to assess but equally important to the program's overall success. To accurately identify results in these three areas, the overall management program should measure the following eight separate components: procedures and support for department staff; equipment inventory, benchmark costs, and budget guidelines; experienced equipment support team; objective, independent analysis of maintenance events; repair documentation and reporting; vendor relations; equipment acquisition analysis; and recommendations for improvement. Do everything you reasonably can to assure that the selected company can work side-by-side with you, providing objective, measurable advice that is ultimately in your best interest. You will then know that you have been thorough in your marketplace selection and can confidently move into implementation, expecting tangible and successful results.

Improving the Quality of End-of-Life Care in Pediatric Oncology Patients Through the Early Implementation of Palliative Care.

PubMed

Ranallo, Lauren

Providing end-of-life care to children with cancer is most ideally achieved by initiating palliative care at the time of diagnosis, advocating for supportive care throughout the treatment trajectory, and implementing hospice care during the terminal phase. The guiding principles behind offering palliative care to pediatric oncology patients are the prioritization of providing holistic care and management of disease-based symptoms. Pediatric hematology-oncology nurses and clinicians have a unique responsibility to support the patient and family unit and foster a sense of hope, while also preparing the family for the prognosis and a challenging treatment trajectory that could result in the child's death. In order to alleviate potential suffering the child may experience, there needs to be an emphasis on supportive care and symptom management. There are barriers to implementing palliative care for children with cancer, including the need to clarify the palliative care philosophy, parental acknowledgement and acceptance of a child's disease and uncertain future, nursing awareness of services, perception of availability, and a shortage of research guidance. It is important for nurses and clinicians to have a clear understanding of the fundamentals of palliative and end-of-life care for pediatric oncology patients to receive the best care possible.

Three-dimensional analysis of implanted magnetic-resonance-visible meshes.

PubMed

Sindhwani, Nikhil; Feola, Andrew; De Keyzer, Frederik; Claus, Filip; Callewaert, Geertje; Urbankova, Iva; Ourselin, Sebastien; D'hooge, Jan; Deprest, Jan

2015-10-01

Our primary objective was to develop relevant algorithms for quantification of mesh position and 3D shape in magnetic resonance (MR) images. In this proof-of-principle study, one patient with severe anterior vaginal wall prolapse was implanted with an MR-visible mesh. High-resolution MR images of the pelvis were acquired 6 weeks and 8 months postsurgery. 3D models were created using semiautomatic segmentation techniques. Conformational changes were recorded quantitatively using part-comparison analysis. An ellipticity measure is proposed to record longitudinal conformational changes in the mesh arms. The surface that is the effective reinforcement provided by the mesh is calculated using a novel methodology. The area of this surface is the effective support area (ESA). MR-visible mesh was clearly outlined in the images, which allowed us to longitudinally quantify mesh configuration between 6 weeks and 8 months after implantation. No significant changes were found in mesh position, effective support area, conformation of the mesh's main body, and arm length during the period of observation. Ellipticity profiles show longitudinal conformational changes in posterior arms. This paper proposes novel methodologies for a systematic 3D assessment of the position and morphology of MR-visible meshes. A novel semiautomatic tool was developed to calculate the effective area of support provided by the mesh, a potentially clinically important parameter.

Restoring the Great Lakes: DOI stories of success and partnership in implementing the Great Lakes Restoration Initiative

USGS Publications Warehouse

,; ,; ,; ,; ,

2013-01-01

The Great Lakes are a monumentally unique national treasure containing nearly ninety-five percent of the United States' fresh surface water. Formed by receding glaciers, the Great Lakes support a thriving, resilient ecosystem rich with fish, wildlife, and abundant natural resources. The Great Lakes also support an array of commercial uses, including shipping, and provide a source of recreation, drinking water, and other critical services that drive the economy of the region and the Nation. Regrettably, activities such as clear cutting of mature forests, over-harvesting of fish populations, industrial pollution, invasive species, and agricultural runoffs have degraded these treasured lakes over the decades creating long-term impacts to the surrounding watershed. Fortunately, the people who live, work, and recreate in the region recognize the critical importance of a healthy Great Lakes ecosystem, and have come together to support comprehensive restoration. To stimulate and promote the goal of a healthy Great Lakes region, President Obama and Congress created the Great Lakes Restoration Initiative (GLRI) in 2009. This program provides the seed money to clean up legacy pollution, restore habitats, protect wildlife, combat invasive species, and address agricultural runoff in the Great Lakes watershed. At the same time GLRI promotes public outreach, education, accountability, and partnerships.

A clearing house for diagnostic testing: the solution to ensure access to and use of patented genetic inventions?

PubMed Central

van Zimmeren, Esther; Verbeure, Birgit; Matthijs, Gert; Van Overwalle, Geertrui

2006-01-01

In genetic diagnostics, the emergence of a so-called "patent thicket" is imminent. Such an overlapping set of patent rights may have restrictive effects on further research and development of diagnostic tests, and the provision of clinical diagnostic services. Currently, two models that may facilitate access to and use of patented genetic inventions are attracting much debate in various national and international fora: patent pools and clearing houses. In this article, we explore the concept of clearing houses. Several types of clearing houses are identified. First, we describe and discuss two types that would provide access to information on the patented inventions: the information clearing house and the technology exchange clearing house. Second, three types of clearing houses are analysed that not only offer access to information but also provide an instrument to facilitate the use of the patented inventions: the open access clearing house, the standardized licences clearing house and the royalty collection clearing house. A royalty collection clearing house for genetic diagnostic testing would be the most comprehensive as it would serve several functions: identifying patents and patent claims essential to diagnostic testing, matching licensees with licensors, developing and supplying standardized licences, collecting royalties, monitoring whether users respect licensing conditions, and providing dispute resolution services such as mediation and arbitration. In this way, it might function as an effective model for users to facilitate access to and use of the patented inventions. However, it remains to be seen whether patent holders with a strong patent portfolio will be convinced by the advantages of the royalty collection clearing house and be willing to participate. PMID:16710543

Mission analysis report for single-shell tank leakage mitigation

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

Cruse, J.M.

1994-09-01

This document provides an analysis of the leakage mitigation mission applicable to past and potential future leakage from the Hanford Site`s 149 single-shell high-level waste tanks. This mission is a part of the overall missions of the Westinghouse Hanford Company Tank Waste Remediation System division to remediate the tank waste in a safe and acceptable manner. Systems engineers principles are being applied to this effort. Mission analysis supports early decision making by clearly defining program objectives. This documents identifies the initial conditions and acceptable final conditions, defines the programmatic and physical interfaces and constraints, estimates the resources to carry outmore » the mission, and establishes measures of success. The results of the mission analysis provide a consistent basis for subsequent systems engineering work.« less

Personalization of Rule-based Web Services.

PubMed

Choi, Okkyung; Han, Sang Yong

2008-04-04

Nowadays Web users have clearly expressed their wishes to receive personalized services directly. Personalization is the way to tailor services directly to the immediate requirements of the user. However, the current Web Services System does not provide any features supporting this such as consideration of personalization of services and intelligent matchmaking. In this research a flexible, personalized Rule-based Web Services System to address these problems and to enable efficient search, discovery and construction across general Web documents and Semantic Web documents in a Web Services System is proposed. This system utilizes matchmaking among service requesters', service providers' and users' preferences using a Rule-based Search Method, and subsequently ranks search results. A prototype of efficient Web Services search and construction for the suggested system is developed based on the current work.

Helping teachers change science instruction

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

Consuegra, G.F.

1994-12-31

Scientists and science educators jointly believe that science is important to society. So strong are these beliefs that many educational and scientific organizations have issued reports and recommendations calling for systemic revisions to science education. Collectively these documents describe an enlightened view of science and science education. Such a view includes identifying key concepts, skills, and attitudes in science for the scientifically literate citizen, and describes effective instructional strategies, delineates characteristics of successful science programs for others to imitate and emulate, and lists resources for educators, scientists, and parents to use. The effects of these resources have been clearly visiblemore » over the past five years. Science process-based objectives provide infrastructure and promote modern and traditional science teachers` efforts to provide science programming that supports scientific literacy needed for the 21st century.« less

Rural energy - ODA`s perspective

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

Woolnough, D.

1997-12-01

The Overseas Development Administration has as a goal `to improve the quality of life of people in poorer countries by contributing to sustainable development and reducing poverty and suffering.` Rural energy fits into this goal as a means to an end. The emphasis is firmly on the service provided, with the aim being provision of basic needs as a part of rural development. ODA plays a role in this task on a number of fronts: research and development; support for NGO`s; aid in a bilateral or multilateral form. The view of ODA is that even rural energy projects must emphasizemore » the service provided and must be economically sustainable. Within its sphere of influence, there is a clearly growing position for the employment of rural energy programs.« less

The missing link: Creating science policies that facilitate the use of research in environmental and water-related decision-making

NASA Astrophysics Data System (ADS)

Dilling, L.; Pielke, R.; Sarewitz, D.

2005-12-01

Despite all good intentions, it is clear that science intended to serve decision making needs often fails to achieve that purpose. The aftermath of Hurricane Katrina provides a recent, tragic example. The reasons for failures of science to support decision making are varied. Researchers studying forecasts of climate variability have found, for example, cases where information provided is not needed; information is needed but not provided; information lacks regional specificity; information is provided in an inaccessible form; poor communication exists between potential users and providers; there is a lack of trust in information or deliverers; institutional constraints prevent use of new information; and so on. Traditional science policies have institutionalized the separation of the conduct of science from its application and use. It is clear that as long as such a separation, reinforced by tradition, institution and culture, is the dominant paradigm of science policies, the efficient and effective use of science in environmental and water-related decision making will be hampered. We introduce here a research methodology for examining the decision making involved in setting science policies for research aimed at being useful. Based on the economic concept, the notion of "reconciling supply and demand" for information offers a framework for identifying missed opportunities where science policies can be adjusted to improve the usefulness of a given research portfolio. We present results from a case study focused on internal science policies and decision making within the Regional Integrated Sciences and Assessments (RISA) projects. The RISA program aims to "expand the range of choices available to private and public communities in a region, by...enabling practical decisions...using research-based knowledge" and so provides an excellent opportunity for harvesting lessons for creating usable science.

A Comparison of Types of Support for Lower-Skill Workers: Evidence for the Importance of Family Supportive Supervisors

ERIC Educational Resources Information Center

Muse, Lori A.; Pichler, Shaun

2011-01-01

The work-family literature to date does not offer a clear picture in terms of the relative importance of different types of supports for balancing work and family demands. Grounded in conservation or resources theory, we develop an integrative model relating multiple forms of social support, both formal (i.e., work-life benefit use) and informal…

Social Support and Motivation to Transfer as Predictors of Training Transfer: Testing Full and Partial Mediation Using Meta-Analytic Structural Equation Modelling

ERIC Educational Resources Information Center

Reinhold, Sarah; Gegenfurtner, Andreas; Lewalter, Doris

2018-01-01

Social support and motivation to transfer are important components in conceptual models on transfer of training. Previous research indicates that both support and motivation influence transfer. To date, however, it is not yet clear if social support influences transfer of training directly, or if this influence is mediated by motivation to…

Handing the pen to the patient: reflective writing for children and families affected by genetic conditions.

PubMed

Murali, Chaya; Fernbach, Susan D; Potocki, Lorraine

2014-12-01

Genetic diagnoses impact the Quality of Life (QoL) of patients and their families. While some patients and families report a positive impact on QoL, others are affected negatively by a genetic diagnosis. No matter the impact, it is clear that social support is needed for this population. Genetic healthcare providers should be aware of the need for psychosocial support and be equipped to provide or direct patients and families to the appropriate resources. Reflective writing offers a unique opportunity for families and health care providers to engage in self-reflection and expression, activities which have the potential to enhance QoL in a positive manner. The therapeutic potential of writing has been studied in many populations, from caregivers of elderly individuals with dementia, to cancer survivors, to survivors of traumatic experiences. Some of these interventions have shown promise for improving participants' QoL. However, reflective writing has never been studied in patients and families affected by genetic conditions. We propose that reflective writing therapy is a feasible, reproducible, and enjoyable approach to providing psychosocial support for our patients. Get it Write is a reflective writing workshop pilot project for those who have a personal or family history of a genetic diagnosis. Our hypothesis is that reflective writing will help engender acceptance and alleviate feelings of isolation. Get it Write does not focus on the stressful factors in the participants' lives, rather it serves to facilitate interactions with peers facing the same struggles, and with medical students in a non-medical context. © 2014 Wiley Periodicals, Inc.

[Current situation and existing problems of acupuncture for primary hypertension].

PubMed

Zhang, Lili; Wei, Pengfei; Chen, Shaozong

2018-03-12

To analyze the present situation and existing problems of acupuncture for primary hypertension (PH) based on clinical research literature in recent 20 years. The clinical research literature regarding acupuncture for PH were searched from China National Knowledge Infrastructure (CNKI), VIP data network (VIP) and Wanfang database from 1997 through 2016; a total of 218 papers met the inclusive criteria. Microsoft Excel and Apriori algorithm of SPSS Clementine software were applied to analyze the data. The main acupoints of acupuncture for PH were Taichong (LR 3), Quchi (LI 11), Zusanli (ST 36) and Hegu (LI 4), but its support degree was only 12.21%. 127 papers were randomized controlled trials, accounting for 58.26%. 158 papers had clear diagnostic criteria, accounting for 72.48%. 138 papers had clear efficacy evaluation criteria, accounting for 63.30%. Only 5.05% of the papers were classified as high-quality literature by using Jadad scale. In recent 20 years, some rules existed in acupoint selection for PH, but the support degree was low so it could not accurately guide clinical treatment. Although the clinical literature quality of acupuncture for PH was gradually increasing, the proportion of high-quality literature was low, therefore modern medical research model and foreign similar research should be followed to design a more rigorous trial protocol. As a result, the quality of clinical research is increased to provide reference for future clinical treatment.

Correlates of Family Satisfaction with Hospice Care: General Inpatient Hospice Care versus Routine Home Hospice Care.

PubMed

Ong, Jeremy; Brennsteiner, Alex; Chow, Elizabeth; Hebert, Randy S

2016-01-01

The quality of communication and support provided to families is associated with greater satisfaction with hospice care. Prior work has not explored whether the predictors of family satisfaction are different in different hospice care settings. The study objective was to explore whether correlates of family satisfaction are different in general inpatient hospice care versus routine home hospice care. Survey data from bereaved family members of approximately 1600 patients from a nonprofit, midsized hospice in western Pennsylvania were used. Data was obtained from Family Evaluation of Hospice Care (FEHC) survey responses from 2008-2013 and separated into two groups, general inpatient hospice care and routine home hospice care. The analysis was completed using a binomial logistic regression model. Three variables were associated with greater overall satisfaction in both care settings: being kept informed about the patient's condition (adjusted odds ratio [AOR]: 9.64, CI: 6.56-14.36); being provided with clear/consistent information (AOR: 2.34, CI: 1.47-3.72); and the perception that patients were provided with adequate treatment for anxiety (AOR: 2.64, CI: 1.19-5.81). Two variables, sufficient discussion with hospice team members concerning family members' religious or spiritual beliefs (AOR: 1.64, CI: 1.17-2.30) and being provided with the correct amount of emotional support after the patient's death (AOR: 2.01, CI: 1.10-3.66), were correlated with greater satisfaction in routine home hospice care only. Good communication is strongly associated with greater family satisfaction across hospice care settings. Hospices must ensure that they provide patients and families with consistent information and support.

The CLEAR[TM] Problem-Solving Model: Discovering Strengths and Solutions

ERIC Educational Resources Information Center

Koehler, Nancy; Seger, Vikki

2011-01-01

This article introduces a unique team approach to planning and positive behavior support. The young person becomes a key participant in solving problems and setting goals for growth. The CLEAR Team Problem Solving model shifts the focus from deficits to strengths and solutions. The goal is to identify how a child's private logic and interpersonal…

Clear Goals, Clear Results: Content-Focused Routines Support Learning for Everyone--Including Coaches

ERIC Educational Resources Information Center

Bickel, Donna DiPrima; Bernstein-Danis, Tabetha; Matsumura, Lindsay Clare

2014-01-01

Learning how to give effective feedback can be a difficult task for teacher leaders. This is especially true for what is called "hard feedback"--that is, feedback that challenges the teacher's practice and therefore may cause some level of professional discomfort. Educators at the University of Pittsburgh's Institute for Learning have…

Habitat structure mediates predation risk for sedentary prey: Experimental tests of alternative hypotheses

USGS Publications Warehouse

Chalfoun, A.D.; Martin, T.E.

2009-01-01

Predation is an important and ubiquitous selective force that can shape habitat preferences of prey species, but tests of alternative mechanistic hypotheses of habitat influences on predation risk are lacking. 2. We studied predation risk at nest sites of a passerine bird and tested two hypotheses based on theories of predator foraging behaviour. The total-foliage hypothesis predicts that predation will decline in areas of greater overall vegetation density by impeding cues for detection by predators. The potential-prey-site hypothesis predicts that predation decreases where predators must search more unoccupied potential nest sites. 3. Both observational data and results from a habitat manipulation provided clear support for the potential-prey-site hypothesis and rejection of the total-foliage hypothesis. Birds chose nest patches containing both greater total foliage and potential nest site density (which were correlated in their abundance) than at random sites, yet only potential nest site density significantly influenced nest predation risk. 4. Our results therefore provided a clear and rare example of adaptive nest site selection that would have been missed had structural complexity or total vegetation density been considered alone. 5. Our results also demonstrated that interactions between predator foraging success and habitat structure can be more complex than simple impedance or occlusion by vegetation. ?? 2008 British Ecological Society.

Lexical prediction via forward models: N400 evidence from German Sign Language.

PubMed

Hosemann, Jana; Herrmann, Annika; Steinbach, Markus; Bornkessel-Schlesewsky, Ina; Schlesewsky, Matthias

2013-09-01

Models of language processing in the human brain often emphasize the prediction of upcoming input-for example in order to explain the rapidity of language understanding. However, the precise mechanisms of prediction are still poorly understood. Forward models, which draw upon the language production system to set up expectations during comprehension, provide a promising approach in this regard. Here, we present an event-related potential (ERP) study on German Sign Language (DGS) which tested the hypotheses of a forward model perspective on prediction. Sign languages involve relatively long transition phases between one sign and the next, which should be anticipated as part of a forward model-based prediction even though they are semantically empty. Native speakers of DGS watched videos of naturally signed DGS sentences which either ended with an expected or a (semantically) unexpected sign. Unexpected signs engendered a biphasic N400-late positivity pattern. Crucially, N400 onset preceded critical sign onset and was thus clearly elicited by properties of the transition phase. The comprehension system thereby clearly anticipated modality-specific information about the realization of the predicted semantic item. These results provide strong converging support for the application of forward models in language comprehension. © 2013 Elsevier Ltd. All rights reserved.

Gastroesophageal reflux disease in children.

PubMed

Barnhart, Douglas C

2016-08-01

Despite the frequency with which antireflux procedures are performed, decisions about gastroesophageal reflux disease treatment remain challenging. Several factors contribute to the difficulties in managing gastroesophageal reflux. First, the distinction between physiologic and pathologic gastroesophageal reflux (gastroesophageal reflux disease-GERD) is not always clear. Second, measures of the extent of gastroesophageal reflux often poorly correlate to symptoms or other complications attributed to reflux in infants and children. A third challenge is that the outcome of antireflux procedures, predominately fundoplications, are relatively poorly characterized. All of these factors contribute to difficulty in knowing when to recommend antireflux surgery. One of the manifestations of the uncertainties surrounding GERD is the high degree of variability in the utilization of pediatric antireflux procedures throughout the United States. Pediatric surgeons are frequently consulted for GERD and fundoplication, uncertainties notwithstanding. Although retrospective series and anecdotal observations support fundoplication in some patients, there are many important questions for which sufficient high-quality data to provide a clear answer is lacking. In spite of this, surgeons need to provide guidance to patients and families while awaiting the development of improved evidence to aid in these recommendations. The purpose of this article is to define what is known and what is uncertain, with an emphasis on the most recent evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

[Expectations of women with endometriosis: What information to deliver? CNGOF-HAS Endometriosis Guidelines].

PubMed

Denouel, A; Fauconnier, A; Torre, A

2018-03-01

Women with endometriosis often say that the information doctors give them should be improved. Patient support groups can provide missing information but may lack objectivity, or reliability, and may even generate anxiety or even harm their health. Clear unbiased medical information is the ideal. New patients with endometriosis wish to be taken seriously by primary care physicians, and be referred quickly to a specialist without further unnecessary investigation or delay. The diagnosis of endometriosis should ideally be made quickly, and should clearly specify the nature of the disease, its evolution, and its consequences on quality of life, relationships, and fertility. When choosing a treatment, information should state the risks of each treatment, the risks of recurrence long term, and the therapeutic alternatives. These should include conventional medical treatment, lifestyle adaptation, or alternative therapies. In case of surgery, prior written information should be provided, the likely scar appearance, the short and long term consequences in terms of pain, postoperative recovery time and complication rates. Once the surgery is performed, the degree of endometriotic involvement and the treatment undertaken should be explained. At discharge, patients should be told the expected recovery time, and the consequences of the operation on daily life. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

77 FR 67427 - Self-Regulatory Organizations; ICE Clear Europe Limited; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

... would not apply to that relationship. The adoption of the Customer CDS Clearing Model will also require... Customer Clearing Model for CDS Products and To Amend, Clarify and Consolidate Certain Rules and Procedures... provide for a clearing model for CDS products whereby customers of ICE Clear Europe have the ability to...

77 FR 25522 - Self-Regulatory Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-30

... Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change to Provide for a T+1 Settlement of the Initial Payment Related to the CDS Contracts Cleared by ICE Clear Credit LLC April 24, 2012. I. Introduction On March 1, 2012, ICE Clear Credit LLC (``ICC'') filed with the Securities and Exchange Commission...

77 FR 16105 - Self-Regulatory Organizations; ICE Clear Europe Limited; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-19

...-Regulatory Organizations; ICE Clear Europe Limited; Notice of Filing of Proposed Rule Change To Provide for a T+1 Settlement of the Initial Payment Related to the CDS Contracts Cleared by ICE Clear Europe...\\ and Rule 19b-4 thereunder \\2\\ notice is hereby given that on March 6, 2012, ICE Clear Europe Limited...

Implementation of Internet-based preventive interventions for depression and anxiety: role of support? The design of a randomized controlled trial

PubMed Central

Donker, Tara; van Straten, Annemieke; Riper, Heleen; Marks, Isaac; Andersson, Gerhard; Cuijpers, Pim

2009-01-01

Background Internet-based self-help is an effective preventive intervention for highly prevalent disorders, such as depression and anxiety. It is not clear, however, whether it is necessary to offer these interventions with professional support or if they work without any guidance. In case support is necessary, it is not clear which level of support is needed. This study examines whether an internet-based self-help intervention with a coach is more effective than the same intervention without a coach in terms of clinical outcomes, drop-out and economic costs. Moreover, we will investigate which level of support by a coach is more effective compared to other levels of support. Methods In this randomized controlled trial, a total of 500 subjects (18 year and older) from the general population with mild to moderate depression and/or anxiety will be assigned to one of five conditions: (1) web-based problem solving through the internet (self-examination therapy) without a coach; (2) the same as 1, but with the possibility to ask help from a coach on the initiative of the respondent (on demand, by email); (3) the same as 1, but with weekly scheduled contacts initiated by a coach (once per week, by email); (4) weekly scheduled contacts initiated by a coach, but no web-based intervention; (5) information only (through the internet). The interventions will consist of five weekly lessons. Primary outcome measures are symptoms of depression and anxiety. Secondary outcome measures are drop-out from the intervention, quality of life, and economic costs. Other secondary outcome measures that may predict outcome are also studied, e.g. client satisfaction and problem-solving skills. Measures are taken at baseline (pre-test), directly after the intervention (post-test, five weeks after baseline), 3 months later, and 12 months later. Analysis will be conducted on the intention-to-treat sample. Discussion This study aims to provide more insight into the clinical effectiveness, differences in drop-out rate and costs between interventions with and without support, and in particular different levels of support. This is important to know in relation to the dissemination of internet-based self-help interventions. Trial Registration Nederlands Trial Register (NTR): TC1355 PMID:19635128

Healthcare providers' perceptions of barriers in implementing of home telecare in Taiwan: a qualitative study.

PubMed

Chiang, Kuei-Feng; Wang, Hsiu-Hung; Chien, I-Kuang; Liou, Jhao-Kun; Hung, Chung-Lieh; Huang, Chien-Min; Yang, Feng-Yueh

2015-04-01

Telecare has not only brought down medical expenses, but has also become an important tool to address healthcare needs. In recent years, the Taiwanese government has been concerned about this healthcare issue. However, only a few hospitals provide telecare. This study aims at investigating the barriers that healthcare providers face while implementing home telecare in Taiwan. A qualitative research design was employed in this study, with semi-structured in-depth interviews. The sample was obtained from five hospitals, including three medical centers and two regional hospitals. A total of 31 healthcare providers were interviewed, including case managers (n=11), administrators (n=7), physicians (n=7), and nurses (n=6). The results were summarized into five themes, including: (1) unsuitable laws and vague policies, (2) the policy implementation fails to meet public needs, (3) lack of organizational support, (4) lack of quality and convenience of the system, and (5) inadequate public perception and attitudes. Obstacles in policy and regulations are the most fundamental difficulties for telecare implementation, therefore the government should provide a clear direction by planning policies, legislate appropriate regulations, and incorporate telecare into the scope of medical insurance, in order to improve the environment and stimulate the telecare service market. In order to improve the success rate of telecare, administrators should be able to identify an appropriate cost-benefit model to build a humane system to satisfy public needs and to provide staff with resources and support. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

COMPARISON OF HOPCALITE AND A SUPPORTED HOPCALITE FOR APPLICABILITY TO SUBMARINE USE.

DTIC Science & Technology

have been investigated with regard to suitable physical properties and catalytic activity. In this report the presently used Hopcalite catalyst is...compared with a supported Hopcalite catalyst with an alumina base. It was found that the present Hopcalite was clearly superior in almost all aspects of catalytic activity to the supported Hopcalite . (Author)

[The Professional Practice of Midwives in Home-based Postnatal Care: A Literature Analysis].

PubMed

Simon, S; Schnepp, W; Zu Sayn-Wittgenstein, F

2017-02-01

Due to the reduction of the length of stay in hospital, postnatal care today takes place primarily in the ambulant sector. Midwives provide the health care and support young families. This literature study examines home-based postnatal care from the perspectives of midwives with the aim of exploring how midwives provide postnatal care and what influencing factors exist. A systematic literature search was conducted. Studies that integrated the perceptions of midwives during their work in home-based postpartum care were included. A thematic analysis of the selected articles was undertaken. Besides monitoring the health and well-being of mother and child, the focus of postnatal care is on psychosocial aspects and on support and advice on issues concerning the new situation and structural changes in the family. However, midwives do not always feel sufficiently prepared for dealing with complex psychosocial issues and require extra knowledge and better access to information. Besides temporal limitations of midwives, continuity of care as well as different care approaches are also relevant. Home-based postnatal care constitutes complex professional procedures during an important period of life of women and their families. Besides ensuring continuity of care, appropriate knowledge resources and midwifery skills are required. The development of theory-guided concepts, improved training and further training programmes as well as a clearly defined provider contract can support the professional behaviour patterns of midwives. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of a 2 to 1 peer placement supervision model by physiotherapy students and their educators.

PubMed

Alpine, Lucy M; Caldas, Francieli Tanji; Barrett, Emer M

2018-04-02

The objective of the study was to investigate student and practice educator evaluations of practice placements using a structured 2 to 1 supervision and implementation model. Cross-sectional pilot study set in clinical sites providing placements for physiotherapy students in Ireland. Students and practice educators completing a 2.1 peer placement between 2013 and 2015 participated. A self-reported questionnaire which measured indicators linked to quality assured placements was used. Three open-ended questions captured comments on the benefits and challenges associated with the 2 to 1 model. Ten students (10/20; 50% response rate) and 10 practice educators (10/10; 100% response rate) responded to the questionnaire. Student responses included four pairs of students and one student from a further two pairs. There was generally positive agreement with the questionnaire indicating that placements using the 2 to 1 model were positively evaluated by participants. There were no significant differences between students and practice educators. The main benefits of the 2 to 1 model were shared learning experiences, a peer supported environment, and the development of peer evaluation and feedback skills by students. A key component of the model was the peer scripting process which provided time for reflection, self-evaluation, and peer review. 2 to 1 placements were positively evaluated by students and educators when supported by a structured supervision model. Clear guidance to students on the provision of peer feedback and support for educators providing feedback to two different students is recommended.

Waste Management Improvement Initiatives at Atomic Energy of Canada Limited - 13091

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

Chan, Nicholas; Adams, Lynne; Wong, Pierre

2013-07-01

Atomic Energy of Canada Limited's (AECL) Chalk River Laboratories (CRL) has been in operation for over 60 years. Radioactive, mixed, hazardous and non-hazardous wastes have been and continue to be generated at CRL as a result of research and development, radioisotope production, reactor operation and facility decommissioning activities. AECL has implemented several improvement initiatives at CRL to simplify the interface between waste generators and waste receivers: - Introduction of trained Waste Officers representing their facilities or activities at CRL; - Establishment of a Waste Management Customer Support Service as a Single-Point of Contact to provide guidance to waste generators formore » all waste management processes; and - Implementation of a streamlined approach for waste identification with emphasis on early identification of waste types and potential disposition paths. As a result of implementing these improvement initiatives, improvements in waste management and waste transfer efficiencies have been realized at CRL. These included: 1) waste generators contacting the Customer Support Service for information or guidance instead of various waste receivers; 2) more clear and consistent guidance provided to waste generators for waste management through the Customer Support Service; 3) more consistent and correct waste information provided to waste receivers through Waste Officers, resulting in reduced time and resources required for waste management (i.e., overall cost); 4) improved waste minimization and segregation approaches, as identified by in-house Waste Officers; and 5) enhanced communication between waste generators and waste management groups. (authors)« less

Planetary Gearbox Fault Detection Using Vibration Separation Techniques

NASA Technical Reports Server (NTRS)

Lewicki, David G.; LaBerge, Kelsen E.; Ehinger, Ryan T.; Fetty, Jason

2011-01-01

Studies were performed to demonstrate the capability to detect planetary gear and bearing faults in helicopter main-rotor transmissions. The work supported the Operations Support and Sustainment (OSST) program with the U.S. Army Aviation Applied Technology Directorate (AATD) and Bell Helicopter Textron. Vibration data from the OH-58C planetary system were collected on a healthy transmission as well as with various seeded-fault components. Planetary fault detection algorithms were used with the collected data to evaluate fault detection effectiveness. Planet gear tooth cracks and spalls were detectable using the vibration separation techniques. Sun gear tooth cracks were not discernibly detectable from the vibration separation process. Sun gear tooth spall defects were detectable. Ring gear tooth cracks were only clearly detectable by accelerometers located near the crack location or directly across from the crack. Enveloping provided an effective method for planet bearing inner- and outer-race spalling fault detection.

Artificial Sweeteners: A systematic review of metabolic effects in youth

PubMed Central

Brown, Rebecca J.; De Banate, Mary Ann; Rother, Kristina I.

2010-01-01

Epidemiological data have demonstrated an association between artificial sweetener use and weight gain. Evidence of a causal relationship linking artificial sweetener use to weight gain and other metabolic health effects is limited. However, recent animal studies provide intriguing information that supports an active metabolic role of artificial sweeteners. This systematic review examines the current literature on artificial sweetener consumption in children and its health effects. Eighteen studies were identified. Data from large, epidemiologic studies support the existence of an association between artificially-sweetened beverage consumption and weight gain in children. Randomized controlled trials in children are very limited, and do not clearly demonstrate either beneficial or adverse metabolic effects of artificial sweeteners. Presently, there is no strong clinical evidence for causality regarding artificial sweetener use and metabolic health effects, but it is important to examine possible contributions of these common food additives to the global rise in pediatric obesity and diabetes. PMID:20078374

Artificial sweeteners: a systematic review of metabolic effects in youth.

PubMed

Brown, Rebecca J; de Banate, Mary Ann; Rother, Kristina I

2010-08-01

Epidemiological data have demonstrated an association between artificial sweetener use and weight gain. Evidence of a causal relationship linking artificial sweetener use to weight gain and other metabolic health effects is limited. However, recent animal studies provide intriguing information that supports an active metabolic role of artificial sweeteners. This systematic review examines the current literature on artificial sweetener consumption in children and its health effects. Eighteen studies were identified. Data from large, epidemiologic studies support the existence of an association between artificially-sweetened beverage consumption and weight gain in children. Randomized controlled trials in children are very limited, and do not clearly demonstrate either beneficial or adverse metabolic effects of artificial sweeteners. Presently, there is no strong clinical evidence for causality regarding artificial sweetener use and metabolic health effects, but it is important to examine possible contributions of these common food additives to the global rise in pediatric obesity and diabetes.

LinkEHR-Ed: a multi-reference model archetype editor based on formal semantics.

PubMed

Maldonado, José A; Moner, David; Boscá, Diego; Fernández-Breis, Jesualdo T; Angulo, Carlos; Robles, Montserrat

2009-08-01

To develop a powerful archetype editing framework capable of handling multiple reference models and oriented towards the semantic description and standardization of legacy data. The main prerequisite for implementing tools providing enhanced support for archetypes is the clear specification of archetype semantics. We propose a formalization of the definition section of archetypes based on types over tree-structured data. It covers the specialization of archetypes, the relationship between reference models and archetypes and conformance of data instances to archetypes. LinkEHR-Ed, a visual archetype editor based on the former formalization with advanced processing capabilities that supports multiple reference models, the editing and semantic validation of archetypes, the specification of mappings to data sources, and the automatic generation of data transformation scripts, is developed. LinkEHR-Ed is a useful tool for building, processing and validating archetypes based on any reference model.

Beyond shared perceptions of trust and monitoring in teams: implications of asymmetry and dissensus.

PubMed

De Jong, Bart A; Dirks, Kurt T

2012-03-01

Past research has implicitly assumed that only mean levels of trust and monitoring in teams are critical for explaining their interrelations and their relationships with team performance. In this article, the authors argue that it is equally important to consider the dispersion in trust and monitoring that exists within teams. The authors introduce "trust asymmetry" and "monitoring dissensus" as critical dispersion properties of trust and monitoring and hypothesize that these moderate the relationships between mean monitoring, mean trust, and team performance. Data from a cross-lagged panel study and a partially lagged study support the hypotheses. The first study also offered support for an integrative model that includes mean and dispersion levels of both trust and monitoring. Overall, the studies provide a comprehensive and clear picture of how trust and monitoring emerge and function at the team level via mean and dispersion.

Differing Strategies to Meet Information-Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems' Enterprise Health Information Exchanges.

PubMed

Vest, Joshua R; Kash, Bita A

2016-03-01

Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations. Noninteroperable electronic health records and vendors' expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges. Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less-than-interoperable technology. Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers' attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation. © 2016 Milbank Memorial Fund.

Evaluation of a pilot 'peer support' training programme for volunteers in a hospital-based cancer information and support centre.

PubMed

Kinnane, Nicole Anne; Waters, Trish; Aranda, Sanchia

2011-01-01

Volunteers from Peter MacCallum Cancer Centre (Peter Mac) Patient Information and Support Centre (PISC) assist the Cancer Support Nurse by helping patients and families/carers find information and provide face-to-face peer support. Benefits of shared personal experiences between volunteer and patient are clearly different from professional support. Volunteers require specific skill sets and detailed preparation for this role. Volunteers completed a 3-day training programme adapted from the Cancer Council Victoria's 'Cancer Connect Telephone Peer Support Volunteer' training programme. The focus was role expectations and boundaries for peer support volunteers, debriefing, communication skills training, support services, complementary and alternative therapies and internet information. Assessment included a quiz and observation for a range of competencies. Role-play with simulated patients developed appropriate support skills. Eight volunteers participated. Pre-training questionnaires revealed all volunteers highly self-rated existing skills supporting people affected by cancer. During training, volunteers recognised these skills were inadequate. All agreed that role-play using an actor as a 'simulated patient' helped develop communication skills; however, the experience proved challenging. Post-training all reported increased knowledge of role definition and boundaries, supportive communication skills, supports available for patients and families/carers and importance of self-care. Facilitators recommended seven of the eight participants be accredited PISC Peer Support Volunteers. One volunteer was assessed unsuitable for consistently overstepping the boundaries of the peer support role and withdrew from training. Success of the programme resulted in a trained 'face-to-face peer support volunteer' group better equipped for their role. Sixteen months following training, all who completed the programme remain active volunteers in the PISC. Planned educational updates include needs identified by the volunteers. The training programme would require adapting for future peer support volunteers.

77 FR 12896 - Self-Regulatory Organizations; Midwest Clearing Corporation; Order Cancelling Clearing Agency...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... Act provides that in the event any self- regulatory organization is no longer in existence or has... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66458; File No. 600-9] Self-Regulatory Organizations; Midwest Clearing Corporation; Order Cancelling Clearing Agency Registration February 24, 2012. I...

Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the Common Sense Model contribute to decision support interventions?

PubMed Central

Sivell, Stephanie; Edwards, Adrian; Elwyn, Glyn; Manstead, Antony S. R.

2010-01-01

Abstract Objective  To describe the evidence about factors influencing breast cancer patients’ surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). Background  A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservation surgery with radiotherapy. However, research does not always reflect the complexities of decision making and is often atheoretical. A theoretical approach, as provided by the CSM and the TPB, could help to identify and tailor support by focusing on patients’ representations of their breast cancer and predicting surgery choices. Design  Literature search and narrative synthesis of data. Synthesis  Twenty‐six studies reported women’s surgery choices to be influenced by perceived clinical outcomes of surgery, appearance and body image, treatment concerns, involvement in decision making and preferences of clinicians. These factors can be mapped onto the key constructs of both the TPB and CSM and used to inform the design and development of decision support interventions to ensure accurate information is provided in areas most important to patients. Conclusions  The TPB and CSM have the potential to inform the design of decision support for breast cancer patients, with accurate and clear information that avoids leading patients to make decisions they may come to regret. Further research is needed examining how the components of the extended TPB and CSM account for patients’ surgery choices. PMID:20579123

Grandparents of children with cancer: a controlled study of distress, support, and barriers to care.

PubMed

Wakefield, Claire E; Drew, Donna; Ellis, Sarah J; Doolan, Emma L; McLoone, Jordana K; Cohn, Richard J

2014-08-01

For families under stress, positive grandparental relationships provide a valued 'safety net'. However, coping with family stressors can place a heavy burden on older individuals who may be experiencing declining health/energy themselves. This mixed-methods study assessed the prevalence of distress in grandparents of children with, and without, cancer, aiming to identify predictors of grandparental distress and quantify their barriers to care. Two hundred twenty-one grandparents [87 cancer group; 134 controls; mean age 65.47 years (SD = 6.97); 33.5% male] completed self-report questionnaires assessing distress, anxiety, depression, anger, 'need for help', support use, and barriers to psychosocial care. A higher proportion of grandparents in the cancer group reported clinically relevant distress (32.9% vs. 12.7%; p < 0.001), anxiety (48.8% vs. 23.9%; p < 0.001), depression (24.4% vs. 6.0%; p < 0.001), and anger (23.5% vs. 6.8%; p = 0.001). In the cancer group, distress was higher in grandmothers and in families with fewer siblings. Grandparents rarely accessed evidence-based psychosocial support (<5% in both groups), although grandparents of children with cancer were more likely to seek religious/spiritual support. Barriers to help seeking included lack of knowledge and rurality. Grandparents of children with cancer qualitatively described undisclosed feelings of uncertainty and helplessness and provided advice to other grandparents to facilitate their coping. Grandparents of children with cancer were clearly more distressed than controls. Grandparents' capacity to support their families may be limited by their own, untreated, distress. Copyright © 2014 John Wiley & Sons, Ltd.

Increasing clinical presence of mobile communication technology: avoiding the pitfalls.

PubMed

Visvanathan, Akila; Gibb, Alan P; Brady, Richard R W

2011-10-01

Mobile communication technologies are employed in many diverse areas of healthcare delivery to provide improved quality and efficiency of communication and facilitate increased rapidity of data or information transfer. Mobile phones enable healthcare professionals to possess a portable platform from which to provide many healthcare-related applications and are a popular means to directly communicate with colleagues and patients. As involvement of mobile communication technology in healthcare delivery continues to rapidly expand, there are also important considerations of relevance to patient safety and security as a result. Here, we review the previous evidence of reported clinical risks associated with mobile communication technology, such as electromagnetic interference, confidentiality and data security, distraction/noise, infection control, and cross contamination. In conclusion, although mobile phones provide much putative potential improvement to healthcare delivery, further evaluation and research are required to both inform and protect health professionals and users of such technology in the healthcare environment and provide the evidence base to support the provision of clear and comprehensive guidelines.

Reiki Is Better Than Placebo and Has Broad Potential as a Complementary Health Therapy

PubMed Central

2017-01-01

This study reviews the available clinical studies of Reiki to determine whether there is evidence for Reiki providing more than just a placebo effect. The available English-language literature of Reiki was reviewed, specifically for peer-reviewed clinical studies with more than 20 participants in the Reiki treatment arm, controlling for a placebo effect. Of the 13 suitable studies, 8 demonstrated Reiki being more effective than placebo, 4 found no difference but had questionable statistical resolving power, and only one provided clear evidence for not providing benefit. Viewed collectively, these studies provide reasonably strong support for Reiki being more effective than placebo. From the information currently available, Reiki is a safe and gentle “complementary” therapy that activates the parasympathetic nervous system to heal body and mind. It has potential for broader use in management of chronic health conditions, and possibly in postoperative recovery. Research is needed to optimize the delivery of Reiki. PMID:28874060

22 CFR 1423.28 - Briefs in support of exceptions; oppositions to exceptions; cross-exceptions.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., presenting clearly the points of fact and law relied on in support of the position taken on each question, with specific page reference to the transcript and the legal or other material relied on. (b) Any party...

22 CFR 1423.28 - Briefs in support of exceptions; oppositions to exceptions; cross-exceptions.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., presenting clearly the points of fact and law relied on in support of the position taken on each question, with specific page reference to the transcript and the legal or other material relied on. (b) Any party...

22 CFR 1423.28 - Briefs in support of exceptions; oppositions to exceptions; cross-exceptions.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., presenting clearly the points of fact and law relied on in support of the position taken on each question, with specific page reference to the transcript and the legal or other material relied on. (b) Any party...

22 CFR 67.4 - Description of functions and procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... strong democratic civic culture, including support for publications and other communications media and... fraught with violence. (14) Proposes a program, project or activity that is clearly relevant to NED... purpose of supporting physical violence by individuals, groups or governments; (6) The proposing...

22 CFR 67.4 - Description of functions and procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... strong democratic civic culture, including support for publications and other communications media and... fraught with violence. (14) Proposes a program, project or activity that is clearly relevant to NED... purpose of supporting physical violence by individuals, groups or governments; (6) The proposing...

22 CFR 67.4 - Description of functions and procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... strong democratic civic culture, including support for publications and other communications media and... fraught with violence. (14) Proposes a program, project or activity that is clearly relevant to NED... purpose of supporting physical violence by individuals, groups or governments; (6) The proposing...

22 CFR 67.4 - Description of functions and procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... strong democratic civic culture, including support for publications and other communications media and... fraught with violence. (14) Proposes a program, project or activity that is clearly relevant to NED... purpose of supporting physical violence by individuals, groups or governments; (6) The proposing...

22 CFR 67.4 - Description of functions and procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... strong democratic civic culture, including support for publications and other communications media and... fraught with violence. (14) Proposes a program, project or activity that is clearly relevant to NED... purpose of supporting physical violence by individuals, groups or governments; (6) The proposing...

Data based abnormality detection

NASA Astrophysics Data System (ADS)

Purwar, Yashasvi

Data based abnormality detection is a growing research field focussed on extracting information from feature rich data. They are considered to be non-intrusive and non-destructive in nature which gives them a clear advantage over conventional methods. In this study, we explore different streams of data based anomalies detection. We propose extension and revisions to existing valve stiction detection algorithm supported with industrial case study. We also explored the area of image analysis and proposed a complete solution for Malaria diagnosis. The proposed method is tested over images provided by pathology laboratory at Alberta Health Service. We also address the robustness and practicality of the solution proposed.

Hypnotic Approaches for Chronic Pain Management

PubMed Central

Jensen, Mark P.; Patterson, David R.

2015-01-01

The empirical support for hypnosis for chronic pain management has flourished over the past two decades. Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain control. Neurophysiological studies reveal that hypnotic analgesia has clear effects on brain and spinal-cord functioning that differ as a function of the specific hypnotic suggestions made, providing further evidence for the specific effects of hypnosis. The research results have important implications for how clinicians can help their clients experience maximum benefits from hypnosis and treatments that include hypnotic components. PMID:24547802

New glossary of terms used in regenerative medicine: standardization continues to emerge as regenerative medicine matures.

PubMed

Sheridan, Ben; Harris, Neil

2009-07-01

Regenerative medicine is an evolving, cross-disciplinary, international field that, as a result, uses terms that are either not widely understood, or may have a number of different meanings. Many stakeholders have identified this lack of clarity as a potential barrier to effective communication within the field. To address this, BSI British Standards, supported by the UK Department for Innovation, Universities and Skills (DIUS), was commissioned to develop guidance on the definitions of terms used within regenerative medicine. The resulting document aims to provide clear consensus terminology to improve communication and facilitate a common understanding for a broad range of potential users.

Apollo food technology

NASA Technical Reports Server (NTRS)

Smith, M. C., Jr.; Heidelbaugh, N. D.; Rambaut, P. C.; Rapp, R. M.; Wheeler, H. O.; Huber, C. S.; Bourland, C. T.

1975-01-01

Large improvements and advances in space food systems achieved during the Apollo food program are discussed. Modifications of the Apollo food system were directed primarily toward improving delivery of adequate nutrition to the astronaut. Individual food items and flight menus were modified as nutritional countermeasures to the effects of weightlessness. Unique food items were developed, including some that provided nutritional completeness, high acceptability, and ready-to-eat, shelf-stable convenience. Specialized food packages were also developed. The Apollo program experience clearly showed that future space food systems will require well-directed efforts to achieve the optimum potential of food systems in support of the physiological and psychological well-being of astronauts and crews.

Facilitating ADLs by Caregivers of Persons with Dementia: The C3P Model

PubMed Central

Amella, Elaine J.; Batchelor-Aselage, Melissa B.

2015-01-01

The purpose of this paper is to explicate a change model for caregivers of persons with dementia to assist them in facilitating meals in the home, at community-based programs and in institutional settings. Building on a Social Ecological Model, the C3P Model—Change the Person, Change the People, Change the Place offers a clear method to adapt care strategies to foster independence while providing appropriate support as the person with dementia cognitively and functionally declines. Meals are highly embedded within a culture and are ritualized events within a family requiring an individualized approach when modifications are needed. PMID:24354332

Space motion sickness monitoring experiment - Spacelab 1

NASA Technical Reports Server (NTRS)

Oman, Charles M.; Lichtenberg, Byron K.; Money, Kenneth E.

1990-01-01

A detailed firsthand report on symptoms and signs of space motion sickness and fluid shift observed by four specially trained crewmembers during Shuttle/Spacelab 1, launched on November 28, 1983 is presented. Results show that three crewmen experienced persistent overall discomfort and vomited repeatedly. Symptom pattern was generally similar to that seen in the individuals preflight, except that prodromalnausea was brief or absent in some cases. Symptoms were clearly modulated by head movement, were exacerbated by unfamiliar visual cues, and could be reduced by physical restraint providing contact cues around the body. The results support the view that space sickness is a form of motion sickness.

GLUE 2 deployment: Ensuring quality in the EGI/WLCG information system

NASA Astrophysics Data System (ADS)

Burke, Stephen; Alandes Pradillo, Maria; Field, Laurence; Keeble, Oliver

2014-06-01

The GLUE 2 information model is now fully supported in the production EGI/WLCG information system. However, to make it usable and allow clients to rely on the published information it is important that the meaning is clearly defined, and that information providers and site configurations are validated to ensure as far as possible that what they publish is correct. In this paper we describe the definition of a detailed schema usage profile, the implementation of a software tool to validate published information according to the profile and the use of the tool in the production Grid, and also summarise the overall state of GLUE 2 deployment.

A case of timely satellite image acquisitions in support of coastal emergency environmental response management

USGS Publications Warehouse

Ramsey, Elijah W.; Werle, Dirk; Lu, Zhong; Rangoonwala, Amina; Suzuoki, Yukihiro

2009-01-01

The synergistic application of optical and radar satellite imagery improves emergency response and advance coastal monitoring from the realm of “opportunistic” to that of “strategic.” As illustrated by the Hurricane Ike example, synthetic aperture radar imaging capabilities are clearly applicable for emergency response operations, but they are also relevant to emergency environmental management. Integrated with optical monitoring, the nearly real-time availability of synthetic aperture radar provides superior consistency in status and trends monitoring and enhanced information concerning causal forces of change that are critical to coastal resource sustainability, including flooding extent, depth, and frequency.

Social Support and Performance in Complex Organizations.

DTIC Science & Technology

1984-01-30

which subjects’ perceptions of their parents ’ interest in and overprotection of them were related to current social support levels. The findings...support levels are related to subjects’ perceptions of experiences earlier in life. Using the Parental Bonding Instrument, studies were carried out in...indicated clearly that, while parental over-protection is unrelated to scores on the Social Sarason 7 Support Questionnaire there is a highly significant

The Effect of Framework Design on Stress Distribution in Implant-Supported FPDs: A 3-D FEM Study

PubMed Central

Eraslan, Oguz; Inan, Ozgur; Secilmis, Asli

2010-01-01

Objectives: The biomechanical behavior of the superstructure plays an important role in the functional longevity of dental implants. However, information about the influence of framework design on stresses transmitted to the implants and supporting tissues is limited. The purpose of this study was to evaluate the effects of framework designs on stress distribution at the supporting bone and supporting implants. Methods: In this study, the three-dimensional (3D) finite element stress analysis method was used. Three types of 3D mathematical models simulating three different framework designs for implant-supported 3-unit posterior fixed partial dentures were prepared with supporting structures. Convex (1), concave (2), and conventional (3) pontic framework designs were simulated. A 300-N static vertical occlusal load was applied on the node at the center of occlusal surface of the pontic to calculate the stress distributions. As a second condition, frameworks were directly loaded to evaluate the effect of the framework design clearly. The Solidworks/Cosmosworks structural analysis programs were used for finite element modeling/analysis. Results: The analysis of the von Mises stress values revealed that maximum stress concentrations were located at the loading areas for all models. The pontic side marginal edges of restorations and the necks of implants were other stress concentration regions. There was no clear difference among models when the restorations were loaded at occlusal surfaces. When the veneering porcelain was removed, and load was applied directly to the framework, there was a clear increase in stress concentration with a concave design on supporting implants and bone structure. Conclusions: The present study showed that the use of a concave design in the pontic frameworks of fixed partial dentures increases the von Mises stress levels on implant abutments and supporting bone structure. However, the veneering porcelain element reduces the effect of the framework and compensates for design weaknesses. PMID:20922156

Science Support: The Building Blocks of Active Data Curation

NASA Astrophysics Data System (ADS)

Guillory, A.

2013-12-01

While the scientific method is built on reproducibility and transparency, and results are published in peer reviewed literature, we have come to the digital age of very large datasets (now of the order of petabytes and soon exabytes) which cannot be published in the traditional way. To preserve reproducibility and transparency, active curation is necessary to keep and protect the information in the long term, and 'science support' activities provide the building blocks for active data curation. With the explosive growth of data in all fields in recent years, there is a pressing urge for data centres to now provide adequate services to ensure long-term preservation and digital curation of project data outputs, however complex those may be. Science support provides advice and support to science projects on data and information management, from file formats through to general data management awareness. Another purpose of science support is to raise awareness in the science community of data and metadata standards and best practice, engendering a culture where data outputs are seen as valued assets. At the heart of Science support is the Data Management Plan (DMP) which sets out a coherent approach to data issues pertaining to the data generating project. It provides an agreed record of the data management needs and issues within the project. The DMP is agreed upon with project investigators to ensure that a high quality documented data archive is created. It includes conditions of use and deposit to clearly express the ownership, responsibilities and rights associated with the data. Project specific needs are also identified for data processing, visualization tools and data sharing services. As part of the National Centre for Atmospheric Science (NCAS) and National Centre for Earth Observation (NCEO), the Centre for Environmental Data Archival (CEDA) fulfills this science support role of facilitating atmospheric and Earth observation data generating projects to ensure successful management of the data and accompanying information for reuse and repurpose. Specific examples at CEDA include science support provided to FAAM (Facility for Airborne Atmospheric Measurements) aircraft campaigns and large-scale modelling projects such as UPSCALE, the largest ever PRACE (Partnership for Advanced Computing in Europe) computational project, dependent on CEDA to provide the high-performance storage, transfer capability and data analysis environment on the 'super-data-cluster' JASMIN. The impact of science support on scientific research is conspicuous: better documented datasets with an increasing collection of metadata associated to the archived data, ease of data sharing with the use of standards in formats and metadata and data citation. These establish a high-quality of data management ensuring long-term preservation and enabling re-use by peer scientists which ultimately leads to faster paced progress in science.

77 FR 14578 - Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Filing of Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... Organizations; ICE Clear Credit LLC; Notice of Filing of Proposed Rule Change To Provide for a T+1 Settlement of the Initial Payment Related to the CDS Contracts Cleared by ICE Clear Credit LLC March 6, 2012... \\2\\ notice is hereby given that on March 1, 2012, the ICE Clear Credit LLC (``ICC'') filed with the...

Dynamic quality of service differentiation using fixed code weight in optical CDMA networks

NASA Astrophysics Data System (ADS)

Kakaee, Majid H.; Essa, Shawnim I.; Abd, Thanaa H.; Seyedzadeh, Saleh

2015-11-01

The emergence of network-driven applications, such as internet, video conferencing, and online gaming, brings in the need for a network the environments with capability of providing diverse Quality of Services (QoS). In this paper, a new code family of novel spreading sequences, called a Multi-Service (MS) code, has been constructed to support multiple services in Optical- Code Division Multiple Access (CDMA) system. The proposed method uses fixed weight for all services, however reducing the interfering codewords for the users requiring higher QoS. The performance of the proposed code is demonstrated using mathematical analysis. It shown that the total number of served users with satisfactory BER of 10-9 using NB=2 is 82, while they are only 36 and 10 when NB=3 and 4 respectively. The developed MS code is compared with variable-weight codes such as Variable Weight-Khazani Syed (VW-KS) and Multi-Weight-Random Diagonal (MW-RD). Different numbers of basic users (NB) are used to support triple-play services (audio, data and video) with different QoS requirements. Furthermore, reference to the BER of 10-12, 10-9, and 10-3 for video, data and audio, respectively, the system can support up to 45 total users. Hence, results show that the technique can clearly provide a relative QoS differentiation with lower value of basic users can support larger number of subscribers as well as better performance in terms of acceptable BER of 10-9 at fixed code weight.

Communities of practice in support of collaborative multi-disciplinary learning and action in response to climate change

NASA Astrophysics Data System (ADS)

Heimlich, J. E.; Stylinski, C.; Palmquist, S.; Wasserman, D.

2017-12-01

Collaborative efforts reaching across interdisciplinary boundaries to address controversial issues such as climate change present significant complexities, including developing shared language, agreeing on common outcomes, and even establishing habits of regular dialogue. Such collaborative efforts should include museums, aquariums, zoos, parks, and youth groups as each of these informal education institutions provides a critical avenue for supporting learning about and responding to climate change. The community of practice framework offers a potential effective approach to support learning and action of diverse groups with a shared interest. Our study applied this framework to the NSF-funded Maryland and Delaware Climate Change Assessment and Education (MADE-CLEAR) project, facilitating informal educators across these two states to advance their climate change education practices, and could provide insight for a building a citywide multi-sector collaborative effort. We found strategies that center on the process of group evolution; support different perspectives, levels of participation, and community spaces; focus on value as defined by members; and balance familiarity and fun produced a dynamic and functional community with a shared practice where none had existed before. Also important was expanding the community-of-practice focus on relationship building to include structured professional development and spin-off opportunities for small-group team-based endeavors. Our findings suggest that this collaborative professional learning approach is well suited to diverse groups seeking creative solutions to complex and even divisive challenges.

Three Boundary Conditions for Computing the Fixed-Point Property in Binary Mixture Data.

PubMed

van Maanen, Leendert; Couto, Joaquina; Lebreton, Mael

2016-01-01

The notion of "mixtures" has become pervasive in behavioral and cognitive sciences, due to the success of dual-process theories of cognition. However, providing support for such dual-process theories is not trivial, as it crucially requires properties in the data that are specific to mixture of cognitive processes. In theory, one such property could be the fixed-point property of binary mixture data, applied-for instance- to response times. In that case, the fixed-point property entails that response time distributions obtained in an experiment in which the mixture proportion is manipulated would have a common density point. In the current article, we discuss the application of the fixed-point property and identify three boundary conditions under which the fixed-point property will not be interpretable. In Boundary condition 1, a finding in support of the fixed-point will be mute because of a lack of difference between conditions. Boundary condition 2 refers to the case in which the extreme conditions are so different that a mixture may display bimodality. In this case, a mixture hypothesis is clearly supported, yet the fixed-point may not be found. In Boundary condition 3 the fixed-point may also not be present, yet a mixture might still exist but is occluded due to additional changes in behavior. Finding the fixed-property provides strong support for a dual-process account, yet the boundary conditions that we identify should be considered before making inferences about underlying psychological processes.

Three Boundary Conditions for Computing the Fixed-Point Property in Binary Mixture Data

PubMed Central

Couto, Joaquina; Lebreton, Mael

2016-01-01

The notion of “mixtures” has become pervasive in behavioral and cognitive sciences, due to the success of dual-process theories of cognition. However, providing support for such dual-process theories is not trivial, as it crucially requires properties in the data that are specific to mixture of cognitive processes. In theory, one such property could be the fixed-point property of binary mixture data, applied–for instance- to response times. In that case, the fixed-point property entails that response time distributions obtained in an experiment in which the mixture proportion is manipulated would have a common density point. In the current article, we discuss the application of the fixed-point property and identify three boundary conditions under which the fixed-point property will not be interpretable. In Boundary condition 1, a finding in support of the fixed-point will be mute because of a lack of difference between conditions. Boundary condition 2 refers to the case in which the extreme conditions are so different that a mixture may display bimodality. In this case, a mixture hypothesis is clearly supported, yet the fixed-point may not be found. In Boundary condition 3 the fixed-point may also not be present, yet a mixture might still exist but is occluded due to additional changes in behavior. Finding the fixed-property provides strong support for a dual-process account, yet the boundary conditions that we identify should be considered before making inferences about underlying psychological processes. PMID:27893868

The impact of system of care support in adherence to wraparound principles in Child and Family Teams in child welfare in North Carolina.

PubMed

Snyder, Elizabeth H; Lawrence, C Nicole; Dodge, Kenneth A

2012-04-01

North Carolina is one of a growing number of states to implement family meeting models in child welfare as a way to engage families, while simultaneously addressing complex familial needs and child safety issues. However, much is still unknown regarding how family meetings actually operate in child welfare, underscoring a clear need for further evaluation of this process. Utilizing direct observational data of Child and Family Team (CFT) meetings, collected as part of two separate evaluations of the North Carolina Division of Social Service's Multiple Response System (MRS) and System of Care (SOC) initiatives, the purpose of the current study was to examine whether the support provided by SOC improved fidelity to the CFT model in child welfare. The observations were conducted using the Team Observation Measure consisting of 78 indicators that measure adherence to ten domains associated with high quality family team meetings (e.g., collaborative, individualized, natural supports, outcomes based, strengths-based). Findings indicate that receiving SOC support in child welfare leads to a more collaborative and individualized decision-making process with families. Meeting facilitators in SOC counties were better prepared for CFTs, and had greater ability to lead a more robust and creative brainstorming process to develop a family-driven case plan. The current study also provides a much needed description of the CFT meeting process within child welfare using a direct observational measure.

Designing for Clinical Change: Creating an Intervention to Implement New Statin Guidelines in a Primary Care Clinic.

PubMed

DeJonckheere, Melissa; Robinson, Claire H; Evans, Lindsey; Lowery, Julie; Youles, Bradley; Tremblay, Adam; Kelley, Caitlin; Sussman, Jeremy B

2018-04-24

Recent clinical practice guidelines from major national organizations, including a joint United States Department of Veterans Affairs (VA) and Department of Defense (DoD) committee, have substantially changed recommendations for the use of the cholesterol-lowering statin medications after years of relative stability. Because statin medications are among the most commonly prescribed treatments in the United States, any change in their use may have significant implications for patients and providers alike. Prior research has shown that effective implementation interventions should be both user centered and specifically chosen to address identified barriers. The objectives of this study were to identify potential determinants of provider uptake of the new statin guidelines and to use that information to tailor a coordinated and streamlined local quality improvement intervention focused on prescribing appropriate statins. We employed user-centered design principles to guide the development and testing of a multicomponent guideline implementation intervention to improve statin prescribing. This paper describes the intervention development process whereby semistructured qualitative interviews with providers were conducted to (1) illuminate the knowledge, attitudes, and behaviors of providers and (2) elicit feedback on intervention prototypes developed to align with and support the use of the VA/DoD guidelines. Our aim was to use this information to design a local quality improvement intervention focused on statin prescribing that was tailored to the needs of primary care providers at our facility. Cabana's Clinical Practice Guidelines Framework for Improvement and Nielsen's Usability Heuristics were used to guide the analysis of data obtained in the intervention development process. Semistructured qualitative interviews were conducted with 15 primary care Patient Aligned Care Team professionals (13 physicians and 2 clinical pharmacists) at a single VA medical center. Findings highlight that providers were generally comfortable with the paradigm shift to risk-based guidelines but less clear on the need for the VA/DoD guidelines in specific. Providers preferred a clinical decision support tool that helped them calculate patient risk and guide their care without limiting autonomy. They were less comfortable with risk communication and performance measurement systems that do not account for shared decision making. When possible, we incorporated their recommendations into the intervention. By combining qualitative methods and user-centered design principles, we could inform the design of a multicomponent guideline implementation intervention to better address the needs and preferences of providers, including clear and direct language, logical decision prompts with an option to dismiss a clinical decision support tool, and logical ordering of feedback information. Additionally, this process allowed us to identify future design considerations for quality improvement interventions. ©Melissa DeJonckheere, Claire H Robinson, Lindsey Evans, Julie Lowery, Bradley Youles, Adam Tremblay, Caitlin Kelley, Jeremy B Sussman. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 24.04.2018.

Towards public health decision support: a systematic review of bidirectional communication approaches

PubMed Central

Dixon, Brian E; Gamache, Roland E; Grannis, Shaun J

2013-01-01

Objective To summarize the literature describing computer-based interventions aimed at improving bidirectional communication between clinical and public health. Materials and Methods A systematic review of English articles using MEDLINE and Google Scholar. Search terms included public health, epidemiology, electronic health records, decision support, expert systems, and decision-making. Only articles that described the communication of information regarding emerging health threats from public health agencies to clinicians or provider organizations were included. Each article was independently reviewed by two authors. Results Ten peer-reviewed articles highlight a nascent but promising area of research and practice related to alerting clinicians about emerging threats. Current literature suggests that additional research and development in bidirectional communication infrastructure should focus on defining a coherent architecture, improving interoperability, establishing clear governance, and creating usable systems that will effectively deliver targeted, specific information to clinicians in support of patient and population decision-making. Conclusions Increasingly available clinical information systems make it possible to deliver timely, relevant knowledge to frontline clinicians in support of population health. Future work should focus on developing a flexible, interoperable infrastructure for bidirectional communications capable of integrating public health knowledge into clinical systems and workflows. PMID:23467470

Integrated Modeling and Simulation Verification, Validation, and Accreditation Strategy for Exploration Systems Mission Directorate

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

2006-01-01

Models and simulations (M&S) are critical resources in the exploration of space. They support program management, systems engineering, integration, analysis, test, and operations and provide critical information and data supporting key analyses and decisions (technical, cost and schedule). Consequently, there is a clear need to establish a solid understanding of M&S strengths and weaknesses, and the bounds within which they can credibly support decision-making. Their usage requires the implementation of a rigorous approach to verification, validation and accreditation (W&A) and establishment of formal process and practices associated with their application. To ensure decision-making is suitably supported by information (data, models, test beds) from activities (studies, exercises) from M&S applications that are understood and characterized, ESMD is establishing formal, tailored W&A processes and practices. In addition, to ensure the successful application of M&S within ESMD, a formal process for the certification of analysts that use M&S is being implemented. This presentation will highlight NASA's Exploration Systems Mission Directorate (ESMD) management approach for M&S W&A to ensure decision-makers receive timely information on the model's fidelity, credibility, and quality.

Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy

PubMed Central

Ryan, Cathal; Bergin, Michael; Chalder, Trudie; Wells, John SG

2017-01-01

Objectives: This review sought to determine what is currently known about the focus, form, and efficacy of web-based interventions that aim to support the well-being of workers and enable them to manage their work-related stress. Method: A scoping review of the literature as this relates to web-based interventions for the management of work-related stress and supporting the psychological well-being of workers was conducted. Results: Forty-eight web-based interventions were identified and reviewed, the majority of which (n = 37) were "individual" -focused and utilized cognitive-behavioral techniques, relaxation exercises, mindfulness, or cognitive behavior therapy. Most interventions identified were provided via a website (n = 34) and were atheoretical in nature. Conclusions: There is some low-to-moderate quality evidence that "individual" -focused interventions are effective for supporting employee well-being and managing their work-related stress. There are few web-based interventions that target "organizational" or "individual/organization" interface factors, and there is limited support for their efficacy. A clear gap appears to exist between work-stress theory and its application in the design and development of web-based interventions for the management of work-related stress. PMID:28320977

Geometric interpretations for resonances of plasmonic nanoparticles

NASA Astrophysics Data System (ADS)

Liu, Wei; Oulton, Rupert F.; Kivshar, Yuri S.

2015-07-01

The field of plasmonics can be roughly categorized into two branches: surface plasmon polaritons (SPPs) propagating in waveguides and localized surface plasmons (LSPs) supported by scattering particles. Investigations along these two directions usually employ different approaches, resulting in more or less a dogma that the two branches progress almost independently of each other, with few interactions. Here in this work we interpret LSPs from a Bohr model based geometric perspective relying on SPPs, thus establishing a connection between these two sub-fields. Besides the clear explanations of conventional scattering features of plasmonic nanoparticles, based on this geometric model we further demonstrate other anomalous scattering features (higher order modes supported at lower frequencies, and blueshift of the resonance with increasing particle sizes) and multiple electric resonances of the same order supported at different frequencies, which have been revealed to originate from backward SPP modes and multiple dispersion bands supported in the corresponding plasmonic waveguides, respectively. Inspired by this geometric model, it is also shown that, through solely geometric tuning, the absorption of each LSP resonance can be maximized to reach the single channel absorption limit, provided that the scattering and absorption rates are tuned to be equal.

Development of CO2 laser Doppler instrumentation for detection of clear air turbulence, volume 1

NASA Technical Reports Server (NTRS)

Harris, C. E.; Jelalian, A. V.

1979-01-01

Modification, construction, test and operation of an advanced airborne carbon dioxide laser Doppler system for detecting clear air turbulence are described. The second generation CAT program and those auxiliary activities required to support and verify such a first-of-a-kind system are detailed: aircraft interface; ground and flight verification tests; data analysis; and laboratory examinations.

Variability in Word Duration as a Function of Probability, Speech Style, and Prosody

PubMed Central

Baker, Rachel E.; Bradlow, Ann R.

2010-01-01

This article examines how probability (lexical frequency and previous mention), speech style, and prosody affect word duration, and how these factors interact. Participants read controlled materials in clear and plain speech styles. As expected, more probable words (higher frequencies and second mentions) were significantly shorter than less probable words, and words in plain speech were significantly shorter than those in clear speech. Interestingly, we found second mention reduction effects in both clear and plain speech, indicating that while clear speech is hyper-articulated, this hyper-articulation does not override probabilistic effects on duration. We also found an interaction between mention and frequency, but only in plain speech. High frequency words allowed more second mention reduction than low frequency words in plain speech, revealing a tendency to hypo-articulate as much as possible when all factors support it. Finally, we found that first mentions were more likely to be accented than second mentions. However, when these differences in accent likelihood were controlled, a significant second mention reduction effect remained. This supports the concept of a direct link between probability and duration, rather than a relationship solely mediated by prosodic prominence. PMID:20121039

77 FR 12896 - Self-Regulatory Organizations; Pacific Clearing Corporation; Order Cancelling Clearing Agency...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66459; File No. 600-11] Self-Regulatory Organizations; Pacific Clearing Corporation; Order Cancelling Clearing Agency Registration February 24, 2012. I..., 2006), 72 FR 814 (Jan. 8, 2007). Section 19(a)(3) of the Act \\14\\ provides that in the event any self...

78 FR 62846 - Self-Regulatory Organizations; National Securities Clearing Corporation; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... Proposed Rule Change, as Previously Modified by Amendment Nos. 1 and 2, To Institute Supplemental Liquidity Deposits to Its Clearing Fund Designed To Increase Liquidity Resources To Meet Its Liquidity Needs October...'') to provide for supplemental liquidity deposits to its Clearing Fund (the ``NSCC Clearing Fund'') to...

Impact of intramural leiomyomata on in-vitro fertilization-embryo transfer cycle outcome.

PubMed

Surrey, Eric S

2003-06-01

The effect of leiomyomata on implantation and pregnancy rates resulting from in-vitro fertilization-embryo transfer has not been clearly defined. Submucosal and intramural leiomyomata which distort the endometrial cavity clearly affect outcome. However, the impact and possible mechanism of action of intramural lesions, which do not clearly alter the contour of the endometrial cavity, remain controversial. This review evaluates recent literature addressing these issues. Several recent studies have evaluated the impact of leiomyomata on the uterine environment. Alterations in uterine artery blood flow may have an impact on implantation, although conflicting results have been reported. Other recent studies have evaluated alterations in gene expression and local cytokine release which may also play a role. Five recently published clinical case-controlled trials provide conflicting information regarding the impact of these lesions on in-vitro fertilization-embryo transfer cycle outcome as measured by clinical pregnancy and implantation rates. Results varied from no effect to a highly significant and deleterious impact on cycle outcomes. These differences may be partly attributable to differences in patient inclusion criteria and inconsistencies in analyses of precise fibroid location and size. Intramural leiomyomata, which impinge upon the uterine cavity, negatively affect in-vitro fertilization-embryo transfer cycle outcome. Myomectomy should be beneficial in these circumstances despite an absence of data in this regard. No definitive statements can be made regarding intramural leiomyomata, which do not distort the cavity due to differing outcomes from currently available investigations. In the absence of more clear cut data, no recommendation can be made to support routine myomectomy in these cases. Rather, clinical management should be individualized.

Health economics education in undergraduate medical training: introducing the health economics education (HEe) website.

PubMed

Oppong, Raymond; Mistry, Hema; Frew, Emma

2013-09-13

In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula.

Health economics education in undergraduate medical training: introducing the health economics education (HEe) website

PubMed Central

2013-01-01

In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula. PMID:24034906

Cancer patient experience with navigation service in an urban hospital setting: a qualitative study.

PubMed

Gotlib Conn, L; Hammond Mobilio, M; Rotstein, O D; Blacker, S

2016-01-01

Cancer patient navigators are increasingly present on the oncology health care team. The positive impact of navigation on cancer care is recognised, yet a clear understanding of what the patient navigator does and how he/she executes the role continues to emerge. This study aimed to understand cancer patients' perceptions of, and experiences with patient navigation, exploring how navigation may enhance the patient experience in an urban hospital setting where patients with varying needs are treated. A qualitative study using a constructionist approach was conducted. Fifteen colorectal cancer patients participated in semi-structured telephone interviews. Data were analyzed inductively and iteratively. Findings provide insight into two central aspects of cancer navigation: navigation as patient-centred coordination and explanation of clinical care, and navigation as individualised, holistic support. Within these themes, the key benefits of navigation from the patients' perspective were demystifying the system; ensuring comprehension, managing expectations; and, delivering patient-centred care. The navigator provided individualised and extended family support; a holistic approach; and, addressed emotional and psychological needs. These findings provide a means to operationalise and validate an emerging role description and competency framework for the cancer navigator who must identify and adapt to patients' varying needs throughout the cancer care continuum. © 2014 John Wiley & Sons Ltd.

Global Turbulence Decision Support for Aviation

NASA Astrophysics Data System (ADS)

Williams, J.; Sharman, R.; Kessinger, C.; Feltz, W.; Wimmers, A.

2009-09-01

Turbulence is widely recognized as the leading cause of injuries to flight attendants and passengers on commercial air carriers, yet legacy decision support products such as SIGMETs and SIGWX charts provide relatively low spatial- and temporal-resolution assessments and forecasts of turbulence, with limited usefulness for strategic planning and tactical turbulence avoidance. A new effort is underway to develop an automated, rapid-update, gridded global turbulence diagnosis and forecast system that addresses upper-level clear-air turbulence, mountain-wave turbulence, and convectively-induced turbulence. This NASA-funded effort, modeled on the U.S. Federal Aviation Administration's Graphical Turbulence Guidance (GTG) and GTG Nowcast systems, employs NCEP Global Forecast System (GFS) model output and data from NASA and operational satellites to produce quantitative turbulence nowcasts and forecasts. A convective nowcast element based on GFS forecasts and satellite data provides a basis for diagnosing convective turbulence. An operational prototype "Global GTG” system has been running in real-time at the U.S. National Center for Atmospheric Research since the spring of 2009. Initial verification based on data from TRMM, Cloudsat and MODIS (for the convection nowcasting) and AIREPs and AMDAR data (for turbulence) are presented. This product aims to provide the "single authoritative source” for global turbulence information for the U.S. Next Generation Air Transportation System.

Australia's proactive approach to radiation protection of the environment: how integrated is it with radiation protection of humans?

PubMed

Hirth, G A; Grzechnik, M; Tinker, R; Larsson, C M

2018-01-01

Australia's regulatory framework has evolved over the past decade from the assumption that protection of humans implies protection of the environment to the situation now where radiological impacts on non-human species (wildlife) are considered in their own right. In an Australian context, there was a recognised need for specific national guidance on protection of non-human species, for which the uranium mining industry provides the major backdrop. National guidance supported by publications of the Australian Radiation Protection and Nuclear Safety Agency (Radiation Protection Series) provides clear and consistent advice to operators and regulators on protection of non-human species, including advice on specific assessment methods and models, and how these might be applied in an Australian context. These approaches and the supporting assessment tools provide a mechanism for industry to assess and demonstrate compliance with the environmental protection objectives of relevant legislation, and to meet stakeholder expectations that radiological protection of the environment is taken into consideration in accordance with international best practice. Experiences from the past 5-10 years, and examples of where the approach to radiation protection of the environment has been well integrated or presented some challenges will be discussed. Future challenges in addressing protection of the environment in existing exposure situations will also be discussed.

The ReACH Collaborative--improving quality home care.

PubMed

Boyce, Patricia Simino; Pace, Karen B; Lauder, Bonnie; Solomon, Debra A

2007-08-01

Research on quality of care has shown that vigorous leadership, clear goals, and compatible incentive systems are critical factors in influencing successful change (Institute of Medicine, 2001). Quality improvement is a complex process, and clinical quality improvement applications are more likely to be effective in organizations that are ready for change and have strong leaders, who are committed to creating and reinforcing a work environment that supports quality goals (Shortell, 1998). Key leadership roles include providing clear and sustained direction, articulating a coherent set of values and incentives to guide group and individual activities, aligning and integrating improvement efforts into organizational priorities, obtaining or freeing up resources to implement improvement activities, and creating a culture of "continuous improvement" that encourages and rewards the pursuit and achievement of shared quality aims (Institute of Medicine, 2001, 70-71). In summary, home health care is a significant and growing sector of the health care system that provides care to millions of vulnerable patients. There seems little doubt that home health agencies want to focus on quality of care issues and provide optimal care to home-based patients. Furthermore, there is a growing awareness of the value for adapting innovative, effective models for improving the culture of home care practice. This awareness stems from the notion that some agencies see quality improvement activities as a way for them to distinguish themselves not only to regulators and customers, but also to meet the cultural and transformational needs to remain viable in a constantly evolving and competitive health care industry.

Competency-based education: the essential basis of pre-service education for the professional midwifery workforce.

PubMed

Fullerton, Judith T; Thompson, Joyce B; Johnson, Peter

2013-10-01

many articles published in the decade since promulgation of the Millennium Development Goals have acknowledged the distinct advantages to maternal and newborn health outcomes that can be achieved as a result of expanding access to skilled birth attendant (including midwifery) services. However, these advantages are often predicated on the assumption that the midwifery workforce shares a common definition and identity. Regrettably, a clear delineation of midwifery competencies is rarely addressed. A core set of midwifery competencies is essential to providing the high quality services that lead to the desirable health outcomes described in that body of research. Attribution of improved outcomes to access to midwifery cannot be made without a common understanding of a defined set of services provided to standard by the midwifery workforce across the inter-conceptional and childbearing time frame. The International Confederation of Midwives (ICM) has developed a clear list of competencies that delineate the domains of practice for the fully qualified, professional midwife. These domains frame the educational outcomes that must be conveyed within competency-based education programmes. this article explores the concept of competency-based education for midwives; first exploring the concept of competency itself, then providing examples of what is already known about competency-based approaches to curriculum design, teacher preparation, teacher support and assessment of student learning. These concepts are linked to the ICM competencies as the unifying construct for education of individuals who share a common definition and identity as midwives. © 2013 Elsevier Ltd. All rights reserved.

Patients’ experiences of support for learning to live with diabetes to promote health and well-being: A lifeworld phenomenological study

PubMed Central

Johansson, Karin; Österberg, Sofia Almerud; Leksell, Janeth; Berglund, Mia

2016-01-01

Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient’s perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being. PMID:27539956

In the company of men: quality of life and social support among the Ariaal of northern Kenya.

PubMed

Campbell, Benjamin C; Gray, Peter B; Radak, Jason

2011-09-01

To determine the age-related pattern of well-being among men and its predictors in a subsistence society, we collected anthropometric and questionnaire data among Ariaal pastoral nomads of northern Kenya. The sample consisted of 102 settled and 103 nomadic men ages 20 to 60+ stratified by 10 year age groups. Measures included questions from the WHO quality of life questionnaire (WHOQOL), anthropometrics, and hand grip strength, as well as questions about the number of friends and kin who gave material and emotional support. Results show that while reported quality of life declined significantly across age groups in both sub-populations, nomadic males reported significantly higher overall quality of life than did settled males. Support from other males, but not marital status, was a significant predictor of quality of life, controlled for age group and residence. Among the physical measures, % body fat was positively related to quality of life among the nomads, while grip strength was not related to quality of life. In a multivariate model, male support was the strongest predictor of quality of life. These results provide the first clear demonstration of age-related declines in male quality of life and the importance of social support to men's quality of life in a subsistence population.

Parent-to-parent support for parents with children who are deaf or hard of hearing: a conceptual framework.

PubMed

Henderson, Rebecca J; Johnson, Andrew; Moodie, Sheila

2014-12-01

Parent-to-parent support for parents with children who are deaf or hard of hearing (D/HH) is identified as an important component of Early Hearing Detection and Intervention (EHDI) programs for children with hearing loss. The specific aim of this review was to identify the constructs and components of parent-to-parent support for parents of children who are D/HH. An extensive scoping literature review identified 39 peer-reviewed articles published from 2000 to 2014. Studies were selected and reviewed based on standardized procedures. Data were identified, extracted, and organized into libraries of thematic and descriptive content. A conceptual framework of parent-to-parent support for parents of children who are D/HH was developed and presented in a comprehensive, bidirectional informational graphic. The constructs and components of the conceptual framework are (a) well-being: parent, family, and child; (b) knowledge: advocacy, system navigation, and education; and (c) empowerment: confidence and competence. The findings from this scoping review led to the development of a structured conceptual framework of parent-to-parent support for parents of children who are D/HH. The conceptual framework provides an important opportunity to explore and clearly define the vital contribution of parents in EHDI programs.

The sunshine act and medical publications: Guidance from professional medical associations.

PubMed

Toroser, Dikran; DeTora, Lisa; Cairns, Angela; Juneja, Renu; Georgieva, Anna; Weigel, Al; Pepitone, Kim

2015-01-01

To review guidance from professional medical associations to physicians on the Sunshine Act, with a focus on industry support for medical publications. Using 'Sunshine Act' as a search term, we searched PubMed (dates February 2013 to November 2014) and the 'grey literature' using Google and Google Scholar. Online information was extracted from websites of pre-identified professional medical associations. Some professional medical associations have published peer-reviewed recommendations, position statements or general advice on their websites and in journals around the Sunshine Act. Associations also provided broad online educational resources for physicians. There was universal agreement between peer-reviewed publications, including guidelines, for the need for full transparency and disclosure of industry support. Surveys by some professional associations showed variance in opinion on the forecasted impact of the Sunshine Act on physician-industry relationships. There was scarce information specifically related to reporting requirements for industry-supported medical publications. There is a shortage of information for physicians from professional associations regarding the Sunshine Act and support for medical publications. Due to the lack of clear guidance regarding support for publications, there are presently varying interpretations of the Sunshine Act. The literature debates the potential impact of the Sunshine Act and expresses some concerns that physician-enabled innovation in drug development may be hindered.

Patients' experiences of support for learning to live with diabetes to promote health and well-being: A lifeworld phenomenological study.

PubMed

Johansson, Karin; Österberg, Sofia Almerud; Leksell, Janeth; Berglund, Mia

2016-01-01

Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.

Appropriate Environments for Children under Three. Supporting Children from Birth to Three

ERIC Educational Resources Information Center

Bradford, Helen

2011-01-01

The most rapid and significant phase of development occurs in the first three years of a child's life. The "Supporting Children from Birth to Three" series focuses on the care and support of the youngest children. Each book takes a key aspect of working with this age group and gives clear and detailed explanations of relevant theories together…

Supporting Museums--Serving Communities: An Evaluation of the Museums for America Program. Full Report

ERIC Educational Resources Information Center

Apley, Alice; Frankel, Susan; Goldman, Elizabeth; Streitburger, Kim

2011-01-01

The Institute of Museum and Library Services is the primary source of federal support for the nation's museums. Museums for America (MFA) is the largest IMLS grant program for museums; it supports institutions by investing in high-priority, high-value activities that are clearly linked to the institution's strategic plan and enhance its value to…

Prevention in practice – a summary.

PubMed Central

2015-01-01

Background This paper is a summary document of the Prevention in Practice Conference and Special Supplement of BMC Oral Health. It represents the consensus view of the presenters and captures the questions, comments and suggestions of the assembled audience. Methods Using the prepared manuscripts for the conference, collected materials from scribes during the conference and additional resources collated in advance of the meeting, authors agreed on the summary document. Results The Prevention in Practice conference aimed to collate information about which diseases could be prevented in practice, how diseases could be identified early enough to facilitate prevention, what evidence based therapies and treatments were available and how, given the collective evidence, could these be introduced in general dental practice within different reimbursement models. Conclusions While examples of best practice were provided from both social care and insurance models it was clear that further work was required on both provider and payer side to ensure that evidence based prevention was both implemented properly but also reimbursed sufficiently. It is clear that savings can be made but these must not be overstated and that the use of effective skill mix would be key to realizing efficiencies. The evidence base for prevention of caries and periodontal disease has been available for many years, as have the tools and techniques to detect, diagnose and stage the diseases appropriately. Dentistry finds itself in a enviable position with respect to its ability to prevent, arrest and reverse much of the burden of disease, however, it is clear that the infrastructure within primary care must be changed, and practitioners and their teams appropriately supported to deliver this paradigm shift from a surgical to a medical model. PMID:26391906

Bacterial fitness shapes the population dynamics of antibiotic-resistant and -susceptible bacteria in a model of combined antibiotic and anti-virulence treatment

PubMed Central

Ternent, Lucy; Dyson, Rosemary J.; Krachler, Anne-Marie; Jabbari, Sara

2015-01-01

Bacterial resistance to antibiotic treatment is a huge concern: introduction of any new antibiotic is shortly followed by the emergence of resistant bacterial isolates in the clinic. This issue is compounded by a severe lack of new antibiotics reaching the market. The significant rise in clinical resistance to antibiotics is especially problematic in nosocomial infections, where already vulnerable patients may fail to respond to treatment, causing even greater health concern. A recent focus has been on the development of anti-virulence drugs as a second line of defence in the treatment of antibiotic-resistant infections. This treatment, which weakens bacteria by reducing their virulence rather than killing them, should allow infections to be cleared through the body׳s natural defence mechanisms. In this way there should be little to no selective pressure exerted on the organism and, as such, a predominantly resistant population should be less likely to emerge. However, before the likelihood of resistance to these novel drugs emerging can be predicted, we must first establish whether such drugs can actually be effective. Many believe that anti-virulence drugs would not be powerful enough to clear existing infections, restricting their potential application to prophylaxis. We have developed a mathematical model that provides a theoretical framework to reveal the circumstances under which anti-virulence drugs may or may not be successful. We demonstrate that by harnessing and combining the advantages of antibiotics with those provided by anti-virulence drugs, given infection-specific parameters, it is possible to identify treatment strategies that would efficiently clear bacterial infections, while preventing the emergence of antibiotic-resistant subpopulations. Our findings strongly support the continuation of research into anti-virulence drugs and demonstrate that their applicability may reach beyond infection prevention. PMID:25701634

FAST: A fully asynchronous and status-tracking pattern for geoprocessing services orchestration

NASA Astrophysics Data System (ADS)

Wu, Huayi; You, Lan; Gui, Zhipeng; Gao, Shuang; Li, Zhenqiang; Yu, Jingmin

2014-09-01

Geoprocessing service orchestration (GSO) provides a unified and flexible way to implement cross-application, long-lived, and multi-step geoprocessing service workflows by coordinating geoprocessing services collaboratively. Usually, geoprocessing services and geoprocessing service workflows are data and/or computing intensive. The intensity feature may make the execution process of a workflow time-consuming. Since it initials an execution request without blocking other interactions on the client side, an asynchronous mechanism is especially appropriate for GSO workflows. Many critical problems remain to be solved in existing asynchronous patterns for GSO including difficulties in improving performance, status tracking, and clarifying the workflow structure. These problems are a challenge when orchestrating performance efficiency, making statuses instantly available, and constructing clearly structured GSO workflows. A Fully Asynchronous and Status-Tracking (FAST) pattern that adopts asynchronous interactions throughout the whole communication tier of a workflow is proposed for GSO. The proposed FAST pattern includes a mechanism that actively pushes the latest status to clients instantly and economically. An independent proxy was designed to isolate the status tracking logic from the geoprocessing business logic, which assists the formation of a clear GSO workflow structure. A workflow was implemented in the FAST pattern to simulate the flooding process in the Poyang Lake region. Experimental results show that the proposed FAST pattern can efficiently tackle data/computing intensive geoprocessing tasks. The performance of all collaborative partners was improved due to the asynchronous mechanism throughout communication tier. A status-tracking mechanism helps users retrieve the latest running status of a GSO workflow in an efficient and instant way. The clear structure of the GSO workflow lowers the barriers for geospatial domain experts and model designers to compose asynchronous GSO workflows. Most importantly, it provides better support for locating and diagnosing potential exceptions.

Five Sarsiellidae ostracods (Crustacea: Myodocopida) from the South Coast of Korea (East China Sea).

PubMed

Karanovic, Ivana; Soh, Ho-Young

2015-04-17

The East China Sea is part of the Warm Temperate Northwest Pacific zoogeographic province and, as such, has a high biodiversity and many tropical and subtropical biotic elements. Nevertheless, many invertebrate groups from this area remain poorly studied. Ostracods are one of them, especially those belonging to the subclass Myodocopa. In this paper we provide the first data on a diverse myodocopid family, Sarsiellidae, not only for the East China Sea, but also for Korea. Five species are reported in this paper from three Korean islands (Jeju, Chuja, and Maemul), and they are only a part of the ostracods collected during this study, indicating a high diversity of the group in this region. Three new species, Eurypylus koreanus sp. nov., Eusarsiella hanguk sp. nov., and Sarsiella nereis sp. nov., clearly stand apart from their respective congeners, mostly by prominent shell characters but also by details of the soft part morphology. Their affinity though clearly indicates a close connection of the region with the more southern zoogeographical realms, especially Central Indo Pacific and partly Temperate Australasia. Two species previously known from Japan (north part of the Sea of Japan and southeastern part of the Pacific Coast of Japan), Sarsiella japonica Hiruta, 1977 and S. misakiensis Kajiyama, 1912, are redescribed. Based on 11 newly obtained COI sequences we construct a preliminary phylogenetic tree, which supports previous hypotheses based on the morphological data, that Eusarsiella Cohen & Kornicker, 1975 is a polyphyletic taxon. With the maps of species distribution provided for each of the three genera, we give an overview of their current zoogeography, and clearly indicate areas that have no data, mostly due to the lack of investigation.

Fitness for purpose of pharmacy technician education and training: The case of Great Britain.

PubMed

Schafheutle, Ellen I; Jee, Samuel D; Willis, Sarah C

To enable pharmacists to become increasingly patient-centered, clinical professionals, they need to work with suitably trained and competent support staff; pharmacy technicians (PTs) may be the most appropriate to take on additional roles and responsibilities. However, clarity on PT roles, particularly in community pharmacy, is lacking, and pharmacists may be reluctant to delegate due to concerns over PTs' competence. This paper aims to explore the fitness for purpose of PT education and training in Great Britain. A mixed methods study was conducted in 2013-14. Semi-structured interviews were undertaken with face-to-face and distance education providers; and different types of community (n = 16) and hospital pharmacy (n = 15) employers. Interviews explored views on education delivery, work-based learning and assessment, and quality assurance; they were transcribed verbatim and analyzed thematically. Interviews informed a questionnaire that was piloted and distributed (with reminders) to all 1457 recently registered PTs. Survey data were analyzed using SPSS v20, employing comparative statistics (Mann-Whitney U, Chi-Square). University ethics approval was obtained. Staff in 17 Further Education (FE) colleges, 6 distance providers, 16 community pharmacies and 15 NHS organizations were interviewed. Participants from different sectors, education providers and employing organizations questioned whether standards met current practice requirements. Certain topics were considered as redundant or over-taught whereas others, such as professionalism (attitudes, behaviors), were perceived to be lacking. Hospital interviewees felt that PT education and training lacked clinical detail, whereas many community interviewees felt that requirements for PTs were more advanced than required. Various comments suggested that PTs' roles in community pharmacy were not clearly defined or sufficiently different from other support staff. In order to define appropriate and up-to-date education and training standards, comments suggested the role of PTs in all sectors of practice needed to be clearly defined. There were usable responses of the questionnaire returned from 632 PTs. Three-quarters (475; 75.9%) of respondents had trained in community. The majority (n = 550; 88.0%) were female, with a significantly larger proportion of females in community pharmacy (90.7%) than hospital (77.4% - X 2  = 20.021, P < .001). The average age of respondents was 35.26 ± 10.22. Respondents working in hospital were more likely to agree (n = 121; 84.0%) that their role in the workplace was clearly defined (U = 10740.500, Z = -2.563, P = .010) than their community colleagues (n = 303; 73.9%). Role clarity is required for PTs so that regulatory standards can be designed to meet current and future practice needs. This will support effective skill mix configurations to enable pharmacists, particularly in community, to take on extended, clinical roles. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of a novel motivational interviewing (MI) informed peer-support intervention to support mothers to breastfeed for longer.

PubMed

Phillips, Rhiannon; Copeland, Lauren; Grant, Aimee; Sanders, Julia; Gobat, Nina; Tedstone, Sally; Stanton, Helen; Merrett, Laura; Rollnick, Stephen; Robling, Michael; Brown, Amy; Hunter, Billie; Fitzsimmons, Deborah; Regan, Sian; Trickey, Heather; Paranjothy, Shantini

2018-04-11

Many women in the UK stop breastfeeding before they would like to, and earlier than is recommended by the World Health Organization (WHO). Given the potential health benefits for mother and baby, new ways of supporting women to breastfeed for longer are required. The purpose of this study was to develop and characterise a novel Motivational Interviewing (MI) informed breastfeeding peer-support intervention. Qualitative interviews with health professionals and service providers (n = 14), and focus groups with mothers (n = 14), fathers (n = 3), and breastfeeding peer-supporters (n = 15) were carried out to understand experiences of breastfeeding peer-support and identify intervention options. Data were audio-recorded, transcribed, and analysed thematically. Consultation took place with a combined professional and lay Stakeholder Group (n = 23). The Behaviour Change Wheel (BCW) guided intervention development process used the findings of the qualitative research and stakeholder consultation, alongside evidence from existing literature, to identify: the target behaviour to be changed; sources of this behaviour based on the Capability, Opportunity and Motivation (COM-B) model; intervention functions that could alter this behaviour; and; mode of delivery for the intervention. Behaviour change techniques included in the intervention were categorised using the Behaviour Change Technique Taxonomy Version 1 (BCTTv1). Building knowledge, skills, confidence, and providing social support were perceived to be key functions of breastfeeding peer-support interventions that aim to decrease early discontinuation of breastfeeding. These features of breastfeeding peer-support mapped onto the BCW education, training, modelling and environmental restructuring intervention functions. Behaviour change techniques (BCTTv1) included social support, problem solving, and goal setting. The intervention included important inter-personal relational features (e.g. trust, honesty, kindness), and the BCTTv1 needed adaptation to incorporate this. The MI-informed breastfeeding peer-support intervention developed using this systematic and user-informed approach has a clear theoretical basis and well-described behaviour change techniques. The process described could be useful in developing other complex interventions that incorporate peer-support and/or MI.

Differing Strategies to Meet Information‐Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges

PubMed Central

KASH, BITA A.

2016-01-01

Policy Points: Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations.Noninteroperable electronic health records and vendors’ expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges.Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. Context The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. Methods We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Findings Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less‐than‐interoperable technology. Conclusions Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers’ attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation. PMID:26994710

How mental health occupational therapists address issues of diet with their clients: a qualitative study.

PubMed

Mahony, Georgia; Haracz, Kirsti; Williams, Lauren T

2012-08-01

Poor diet is a contributing factor to the high rates of obesity and related comorbidities in people with severe mental illness, and dietary change is a key treatment strategy. Providing healthy lifestyle interventions is a recognised role for occupational therapists. However, the existing literature fails to elucidate boundaries of this role. To begin to address this gap in the literature, this study explored the attitudes, actions and beliefs of mental health occupational therapists about providing diet-related interventions. Semi-structured interviews were conducted with mental health occupational therapists working in one Area Health Service in New South Wales. Purposive sampling was used. Data were analysed using Constructivist Grounded Theory methods, where meaning is co-constructed by, and the theory ultimately grounded in the experiences of, the participant and researcher. The participants felt confident providing clients with interventions to promote diet-related skill development and providing general healthy eating education to support this development. However, they were not comfortable providing clients with specific dietary advice. Participants identified a need for further training and support to enhance their effectiveness in providing healthy eating education and highlighted the need for more dietitians in mental health services. The occupational therapists in this study identified clear boundaries of their role in providing diet-related interventions for people with severe mental illness. Suggestions for improvement in this area included further training for occupational therapists as well as increased access to dietitians for those services that lie outside the occupational therapy role. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

Using Landsat satellite data to support pesticide exposure assessment in California

USGS Publications Warehouse

Maxwell, Susan K.; Airola, Matthew; Nuckols, John R.

2010-01-01

We found the combination of Landsat 5 and 7 image data would clearly benefit pesticide exposure assessment in this region by 1) providing information on crop field conditions at or near the time when pesticides are applied, and 2) providing information for validating the CDWR map. The Landsat image time-series was useful for identifying idle, single-, and multi-cropped fields. Landsat data will be limited during the winter months due to cloud cover, and for years prior to the Landsat 7 launch (1999) when only one satellite was operational at any given time. We suggest additional research to determine the feasibility of integrating CDWR land use maps and Landsat data to derive crop maps in locations and time periods where maps are not available, which will allow for substantial improvements to chemical exposure estimation.

Evidence-based recommendations for the prescription of exercise for major depressive disorder.

PubMed

Rethorst, Chad D; Trivedi, Madhukar H

2013-05-01

Major depressive disorder (MDD) is a source of great disease burden, due in part to the limited accessibility and effectiveness of current treatments. Although current treatments are efficacious in a segment of the population with MDD, there is a clear need for alternative and augmentation treatment strategies. Exercise is one such alternative treatment option. Research has shown exercise to be efficacious as both a stand-alone and an augmentation therapy. As a result, exercise is now included in the American Psychiatric Association's treatment recommendations. The purpose of this article is to provide clinicians with a knowledge base to prescribe exercise to their patients. The authors describe the evidence supporting the use of exercise in the treatment of MDD, provide evidence-based recommendations for prescribing exercise, and address practical considerations related to prescribing exercise in real-world treatment settings.

Glooveth: healthy living, fun and serious gaming.

PubMed

Macías, Enric; García, Oscar; Moreno, Pau; Presno, Maria Montserrat; Forrest, Tallulah

2012-01-01

Serious Games and Gamification deliver powerful and truthful experiences by providing the user with goals, challenges, problem solving and rules, besides a clear internal value and an interactive experience. In fact, Serious Games can be considered memorable experiences that deliver intense moments with the support of different platforms and social networks while ensuring high degrees of motivation, efficiency and performance. Here, we describe Glooveth, an educational game for children ages 6 to 12 years, which was the winner of the Silver Award in the Global eHealth Challenge 2010. Glooveth is a platform computer game that teaches healthy living. We developed a game to be used by three different peripherals: a mouse and two special gloves. These peripherals provide the user with a more intense gameplaying and learning experience. The paper explains the project, from concept to application to usability testing.

A Reply to the Commentaries on "School-wide PBIS: An Example of Applied Behavior Analysis Implemented at a Scale of Social Importance" by Horner and Sugai (2015): PBIS is Function over Form: The Clear Behavioral Roots and Opportunities the PBIS Framework presents to the Field of Behavior Analysis Moving Forward.

PubMed

Putnam, Robert F; Knoster, Tim

2016-03-01

In the previous issue of Behavior Analysis in Practice (May 2015), a special section of the journal was devoted to positive behavior intervention and support (PBIS). Horner and Sugai (2015) published a manuscript providing an overview of school-wide PBIS describing how PBIS is an example of applied behavior analysis at a scale of social importance. A number of manuscripts providing commentary on the Horner and Sugai manuscript were also published in this special section of the journal. This paper will review this PBIS manuscript along with the associated commentaries published in the May 2015 special section.

The APGAR rubric for scoring online discussion boards.

PubMed

Phillippi, Julia C; Schorn, Mavis N; Moore-Davis, Tonia

2015-05-01

The World Health Organization has called for a dramatic increase in the number of midwives and supports the use of innovative programs to assist students in achieving midwifery competencies. Online discussion boards are excellent educational tools for stimulating in-depth student engagement. However, complex discussions can be difficult to grade without a well-constructed rubric. The 'discussion-board APGAR' provides clear scoring criteria for discussions of midwifery care. The discussion-board APGAR has 5 components: Application, Professionalism, Group work, Analysis, and Rationale and provides scoring criteria for unacceptable, marginal, and proficient performance. The discussion-board APGAR is based on the Core Competencies for Basic Midwifery Practice in the United States (US), consistent with the International Confederation of Midwives Essential Competencies for Basic Midwifery Practice, and can be adjusted to be congruent with other midwifery standards. Copyright © 2014 Elsevier Ltd. All rights reserved.

A software platform for the analysis of dermatology images

NASA Astrophysics Data System (ADS)

Vlassi, Maria; Mavraganis, Vlasios; Asvestas, Panteleimon

2017-11-01

The purpose of this paper is to present a software platform developed in Python programming environment that can be used for the processing and analysis of dermatology images. The platform provides the capability for reading a file that contains a dermatology image. The platform supports image formats such as Windows bitmaps, JPEG, JPEG2000, portable network graphics, TIFF. Furthermore, it provides suitable tools for selecting, either manually or automatically, a region of interest (ROI) on the image. The automated selection of a ROI includes filtering for smoothing the image and thresholding. The proposed software platform has a friendly and clear graphical user interface and could be a useful second-opinion tool to a dermatologist. Furthermore, it could be used to classify images including from other anatomical parts such as breast or lung, after proper re-training of the classification algorithms.

ADHD Symptoms in Preschool Children: Examining Psychometric Properties using IRT

PubMed Central

Purpura, David J.; Wilson, Shauna B.; Lonigan, Christopher J.

2010-01-01

Clear and empirically supported diagnostic symptoms are important for proper diagnosis and treatment of psychological disorders. Unfortunately, symptoms of many disorders presented in the DSM-IV-TR lack sufficient psychometric evaluation. In this study, an Item Response Theory analysis was applied to ratings of the 18 Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in 268 preschool children. Children (55% boys) in this sample ranged in age from 37 to 74 months; 80.4% were identified as African American, 15.1% Caucasian, and 4.5% other ethnicity. Dichotomous and polytomous scoring methods for rating ADHD symptoms were compared and psychometric properties of these symptoms were calculated. Symptom-level analyses revealed that, in general, the current symptoms provided useful information in diagnosing ADHD in preschool children; however, several symptoms provided redundant information and should be examined further. PMID:20822267

Improving recovery of ECG signal with deterministic guarantees using split signal for multiple supports of matching pursuit (SS-MSMP) algorithm.

PubMed

Tawfic, Israa Shaker; Kayhan, Sema Koc

2017-02-01

Compressed sensing (CS) is a new field used for signal acquisition and design of sensor that made a large drooping in the cost of acquiring sparse signals. In this paper, new algorithms are developed to improve the performance of the greedy algorithms. In this paper, a new greedy pursuit algorithm, SS-MSMP (Split Signal for Multiple Support of Matching Pursuit), is introduced and theoretical analyses are given. The SS-MSMP is suggested for sparse data acquisition, in order to reconstruct analog and efficient signals via a small set of general measurements. This paper proposes a new fast method which depends on a study of the behavior of the support indices through picking the best estimation of the corrosion between residual and measurement matrix. The term multiple supports originates from an algorithm; in each iteration, the best support indices are picked based on maximum quality created by discovering correlation for a particular length of support. We depend on this new algorithm upon our previous derivative of halting condition that we produce for Least Support Orthogonal Matching Pursuit (LS-OMP) for clear and noisy signal. For better reconstructed results, SS-MSMP algorithm provides the recovery of support set for long signals such as signals used in WBAN. Numerical experiments demonstrate that the new suggested algorithm performs well compared to existing algorithms in terms of many factors used for reconstruction performance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Marine Corps Close Air Support Development from Guadalcanal to Okinawa

DTIC Science & Technology

2011-03-05

air support (CAS) of troops in contact with the enemy came of age . While the capability clearly had potential, issues of coordination, accurate...including the first use of an Air Support Control Unit ( ASCU ), predecessor of the Fire S.upport Coordination Center.71 The Command Ship initially...which artillery had to cease fire for low- level napalm air strikes. When two or more battalions fired on the same location, the ASCU used maximum

Pragmatic, consensus-based minimum standards and structured interview to guide the selection and development of cancer support group leaders: a protocol paper.

PubMed

Pomery, Amanda; Schofield, Penelope; Xhilaga, Miranda; Gough, Karla

2017-06-30

Across the globe, peer support groups have emerged as a community-led approach to accessing support and connecting with others with cancer experiences. Little is known about qualities required to lead a peer support group or how to determine suitability for the role. Organisations providing assistance to cancer support groups and their leaders are currently operating independently, without a standard national framework or published guidelines. This protocol describes the methods that will be used to generate pragmatic consensus-based minimum standards and an accessible structured interview with user manual to guide the selection and development of cancer support group leaders. We will: (A) identify and collate peer-reviewed literature that describes qualities of support group leaders through a systematic review; (B) content analyse eligible documents for information relevant to requisite knowledge, skills and attributes of group leaders generally and specifically to cancer support groups; (C) use an online reactive Delphi method with an interdisciplinary panel of experts to produce a clear, suitable, relevant and appropriate structured interview comprising a set of agreed questions with behaviourally anchored rating scales; (D) produce a user manual to facilitate standard delivery of the structured interview; (E) pilot the structured interview to improve clinical utility; and (F) field test the structured interview to develop a rational scoring model and provide a summary of existing group leader qualities. The study is approved by the Department Human Ethics Advisory Group of The University of Melbourne. The study is based on voluntary participation and informed written consent, with participants able to withdraw at any time. The results will be disseminated at research conferences and peer review journals. Presentations and free access to the developed structured interview and user manual will be available to cancer agencies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Information management to enable personalized medicine: stakeholder roles in building clinical decision support.

PubMed

Downing, Gregory J; Boyle, Scott N; Brinner, Kristin M; Osheroff, Jerome A

2009-10-08

Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized decision-making, a comparison of current and future applications of clinical decision support to enable individualized medical treatment plans is presented. If clinical decision support tools are to impact outcomes in a clear and positive manner, their development and deployment must therefore consider the needs of the providers, including specific practice needs, information workflow, and practice environment.

Information management to enable personalized medicine: stakeholder roles in building clinical decision support

PubMed Central

2009-01-01

Background Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Discussion Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. Summary This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized decision-making, a comparison of current and future applications of clinical decision support to enable individualized medical treatment plans is presented. If clinical decision support tools are to impact outcomes in a clear and positive manner, their development and deployment must therefore consider the needs of the providers, including specific practice needs, information workflow, and practice environment. PMID:19814826

Pragmatic, consensus-based minimum standards and structured interview to guide the selection and development of cancer support group leaders: a protocol paper

PubMed Central

Schofield, Penelope; Xhilaga, Miranda; Gough, Karla

2017-01-01

Introduction Across the globe, peer support groups have emerged as a community-led approach to accessing support and connecting with others with cancer experiences. Little is known about qualities required to lead a peer support group or how to determine suitability for the role. Organisations providing assistance to cancer support groups and their leaders are currently operating independently, without a standard national framework or published guidelines. This protocol describes the methods that will be used to generate pragmatic consensus-based minimum standards and an accessible structured interview with user manual to guide the selection and development of cancer support group leaders. Methods and analysis We will: (A) identify and collate peer-reviewed literature that describes qualities of support group leaders through a systematic review; (B) content analyse eligible documents for information relevant to requisite knowledge, skills and attributes of group leaders generally and specifically to cancer support groups; (C) use an online reactive Delphi method with an interdisciplinary panel of experts to produce a clear, suitable, relevant and appropriate structured interview comprising a set of agreed questions with behaviourally anchored rating scales; (D) produce a user manual to facilitate standard delivery of the structured interview; (E) pilot the structured interview to improve clinical utility; and (F) field test the structured interview to develop a rational scoring model and provide a summary of existing group leader qualities. Ethics and dissemination The study is approved by the Department Human Ethics Advisory Group of The University of Melbourne. The study is based on voluntary participation and informed written consent, with participants able to withdraw at any time. The results will be disseminated at research conferences and peer review journals. Presentations and free access to the developed structured interview and user manual will be available to cancer agencies. PMID:28667202

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Collective ritual and social support networks in rural South India

PubMed Central

2018-01-01

The scholarship on religion has long argued that collective worship helps foster social cohesion. Despite the pervasiveness of this contention, rigorous quantitative evaluations of it have been surprisingly limited. Here, I draw on network data representing the ties of social support among Hindu residents of a South Indian village to evaluate the association between collective religious ritual and social cohesion. I find that those who partake in collective religious rituals together have a higher probability of having a supportive relationship than those who do not. At the structural level, this corresponds to denser connections among co-participants. At the individual level, participants are more embedded in the local community of co-religionists, but are not disassociating themselves from members of other religious denominations. These patterns hold most strongly for co-participation in the recurrent, low-arousal monthly worships at the temple, and are suggestive for co-participation in the intense and dysphoric ritual acts carried out as part of an annual festival. Together, these findings provide clear empirical evidence of the lasting relationship between collective religious ritual and social cohesion. PMID:29794040

Ending on a positive: Examining the role of safety leadership decisions, behaviours and actions in a safety critical situation.

PubMed

Donovan, Sarah-Louise; Salmon, Paul M; Horberry, Timothy; Lenné, Michael G

2018-01-01

Safety leadership is an important factor in supporting safe performance in the workplace. The present case study examined the role of safety leadership during the Bingham Canyon Mine high-wall failure, a significant mining incident in which no fatalities or injuries were incurred. The Critical Decision Method (CDM) was used in conjunction with a self-reporting approach to examine safety leadership in terms of decisions, behaviours and actions that contributed to the incidents' safe outcome. Mapping the analysis onto Rasmussen's Risk Management Framework (Rasmussen, 1997), the findings demonstrate clear links between safety leadership decisions, and emergent behaviours and actions across the work system. Communication and engagement based decisions featured most prominently, and were linked to different leadership practices across the work system. Further, a core sub-set of CDM decision elements were linked to the open flow and exchange of information across the work system, which was critical to supporting the safe outcome. The findings provide practical implications for the development of safety leadership capability to support safety within the mining industry. Copyright © 2017 Elsevier Ltd. All rights reserved.

Progressor: social navigation support through open social student modeling

NASA Astrophysics Data System (ADS)

Hsiao, I.-Han; Bakalov, Fedor; Brusilovsky, Peter; König-Ries, Birgitta

2013-06-01

The increased volumes of online learning content have produced two problems: how to help students to find the most appropriate resources and how to engage them in using these resources. Personalized and social learning have been suggested as potential ways to address these problems. Our work presented in this paper combines the ideas of personalized and social learning in the context of educational hypermedia. We introduce Progressor, an innovative Web-based tool based on the concepts of social navigation and open student modeling that helps students to find the most relevant resources in a large collection of parameterized self-assessment questions on Java programming. We have evaluated Progressor in a semester-long classroom study, the results of which are presented in this paper. The study confirmed the impact of personalized social navigation support provided by the system in the target context. The interface encouraged students to explore more topics attempting more questions and achieving higher success rates in answering them. A deeper analysis of the social navigation support mechanism revealed that the top students successfully led the way to discovering most relevant resources by creating clear pathways for weaker students.

Computer image generation: Reconfigurability as a strategy in high fidelity space applications

NASA Technical Reports Server (NTRS)

Bartholomew, Michael J.

1989-01-01

The demand for realistic, high fidelity, computer image generation systems to support space simulation is well established. However, as the number and diversity of space applications increase, the complexity and cost of computer image generation systems also increase. One strategy used to harmonize cost with varied requirements is establishment of a reconfigurable image generation system that can be adapted rapidly and easily to meet new and changing requirements. The reconfigurability strategy through the life cycle of system conception, specification, design, implementation, operation, and support for high fidelity computer image generation systems are discussed. The discussion is limited to those issues directly associated with reconfigurability and adaptability of a specialized scene generation system in a multi-faceted space applications environment. Examples and insights gained through the recent development and installation of the Improved Multi-function Scene Generation System at Johnson Space Center, Systems Engineering Simulator are reviewed and compared with current simulator industry practices. The results are clear; the strategy of reconfigurability applied to space simulation requirements provides a viable path to supporting diverse applications with an adaptable computer image generation system.

Optical clearing of articular cartilage: a comparison of clearing agents

NASA Astrophysics Data System (ADS)

Bykov, Alexander; Hautala, Tapio; Kinnunen, Matti; Popov, Alexey; Karhula, Sakari; Saarakkala, Simo; Nieminen, Miika T.; Tuchin, Valery

2015-07-01

Optical clearing technique was applied to the problem of OCT imaging of articular cartilage and subchondral bone. We show that optical clearing significantly enhances visualization of articular cartilage and cartilage-bone interface. The effect of different clearing agents was analyzed. For the clearing, iohexol solution and propylene glycol (PG) were used. Clearing was performed in vitro at room temperature by immersion method. Cylindrical osteochondral samples (d=4.8mm) were drilled from bovine lateral femur and stored in phosphate-buffered saline at -20°C until clearing. Monitoring of clearing process was performed using high-speed spectral-domain OCT system providing axial resolution of 5.8μm at 930nm. Total duration of experiment was 90-100min to ensure saturation of clearing. We have shown that iohexol solution and PG are capable to optically clear articular cartilage enabling reliable characterization of cartilagebone interface with OCT. Being a low osmolarity agent, iohexol provides minimal changes to the thickness of cartilage sample. Clearing saturation time for the cartilage sample with the thickness of 0.9 mm measured with OCT is of 50 min. However, less than 15 min is enough to reliably detect the rear cartilage boundary. Alternatively, PG significantly (60%) reduces the cartilage thickness enabling better visualization of subchondral bone. It was observed that PG has higher clearing rate. The clearing saturation time is of 30 min, however less than 5 min is enough to detect cartilage-bone interface. We conclude that iohexol solution is superior for OCT imaging of cartilage and cartilage-bone interface, while PG suits better for subhondral bone visualization.

Educating the Whole Child: Social-Emotional Learning and Ethics Education

ERIC Educational Resources Information Center

Burroughs, Michael D.; Barkauskas, Nikolaus J.

2017-01-01

Research supporting social and emotional learning (SEL) in schools demonstrates numerous benefits for students, including increased academic achievement and social and emotional competencies. However, research supporting the adoption of SEL lacks a clear conception of "ethical competence." This lack of clarity is problematic for two…

The Truman Administration and Federal Aid to Education.

ERIC Educational Resources Information Center

McCann, Maurice

During the Truman administration, the concept of federal aid to education became clearly defined and gained considerable political support. President Truman supported general aid for education as a policy consistent with the administration's overall objectives in domestic programs, but he avoided leadership because of the controversies surrounding…

The role of unregulated care providers in home care: A scoping review.

PubMed

Saari, Margaret; Xiao, Sarah; Rowe, Alissa; Patterson, Erin; Killackey, Tieghan; Raffaghello, Julia; Tourangeau, Ann E

2018-04-30

Health care needs of individuals living in the community are increasing. To meet the rising need, unregulated care providers are providing more complex patient care. The aim of this review is to articulate the unregulated care provider role by identifying patient care activities offered by unregulated care providers in home care. A scoping review was conducted. One thousand and eleven published manuscripts were identified in CINAHL, Ageline and MEDLINE. Eleven additional manuscripts were identified through hand searching. Manuscripts were screened for relevancy and data were abstracted to address the research question. Twenty-eight studies originating from Canada, Sweden, Belgium, UK, USA and New Zealand were included. Three categories of patient care activities provided by unregulated care providers were found: (1) personal care and core skills; (2) delegated tasks and added skills; and (3) specialty roles. Unregulated care providers predominantly provide assistance with personal care and activities of daily living. However, unregulated care providers also provide care outside their training, including care once provided by nurses. Guidelines clearly articulating responsibilities of nurses transferring care activities to unregulated care providers should be developed. Processes and policies regarding evaluation and supervision of unregulated care providers providing added skills should be developed to ensure appropriate monitoring and support. © 2018 John Wiley & Sons Ltd.

The gene patent controversy on Twitter: a case study of Twitter users' responses to the CHEO lawsuit against Long QT gene patents.

PubMed

Du, Li; Kamenova, Kalina; Caulfield, Timothy

2015-08-25

The recent Canadian lawsuit on patent infringement, filed by the Children's Hospital of Eastern Ontario (CHEO), has engendered a significant public debate on whether patenting genes should be legal in Canada. In part, this public debate has involved the use of social networking sites, such as Twitter. This case provides an opportunity to examine how Twitter was used in the context of this gene patent controversy. We collected 310 English-language tweets that contained the keyword "gene patents" by using TOPSY.com and Twitter's built-in search engine. A content analysis of the messages was conducted to establish the users' perspectives on both CHEO's court challenge and the broader controversy over the patenting of human DNA. More specifically, we analyzed the users' demographics, geographic locations, and attitudes toward the CHEO position on gene patents and the patentability of human genes in principle. Our analysis has shown that messages tweeted by news media and health care organizations were re-tweeted most frequently in Twitter discussions regarding both the CHEO patent infringement lawsuit and gene patents in general. 34.8% of tweets were supportive of CHEO, with 52.8% of the supportive tweets suggesting that gene patents contravene patients' rights to health care access. 17.6% of the supportive tweets cited ethical and social concerns against gene patents. Nearly 40% of tweets clearly expressed that human genes should not be patentable, and there were no tweets that presented perspectives favourable toward the patenting of human genes. Access to healthcare and the use of genetic testing were the most important concerns raised by Twitter users in the context of the CHEO case. Our analysis of tweets reveals an expectation that the CHEO lawsuit will provide an opportunity to clear the confusion on gene patents by establishing a legal precedent on the patentability of human genes in Canada. In general, there were no tweets arguing in favour of gene patents. Given the emerging role of social media in framing the public dialogue on these issues, this sentiment could potentially have an impact on the nature and tone of the Canadian policy debate.

Crisis resolution and home treatment: stakeholders' views on critical ingredients and implementation in England.

PubMed

Morant, Nicola; Lloyd-Evans, Brynmor; Lamb, Danielle; Fullarton, Kate; Brown, Eleanor; Paterson, Beth; Istead, Hannah; Kelly, Kathleen; Hindle, David; Fahmy, Sarah; Henderson, Claire; Mason, Oliver; Johnson, Sonia

2017-07-17

Crisis resolution teams (CRTs) can provide effective home-based treatment for acute mental health crises, although critical ingredients of the model have not been clearly identified, and implementation has been inconsistent. In order to inform development of a more highly specified CRT model that meets service users' needs, this study used qualitative methods to investigate stakeholders' experiences and views of CRTs, and what is important in good quality home-based crisis care. Semi-structured interviews and focus groups were conducted with service users (n = 41), carers (n = 20) and practitioners (CRT staff, managers and referrers; n = 147, 26 focus groups, 9 interviews) in 10 mental health catchment areas in England, and with international CRT developers (n = 11). Data were analysed using thematic analysis. Three domains salient to views about optimal care were identified. 1. The organisation of CRT care: Providing a rapid initial responses, and frequent home visits from the same staff were seen as central to good care, particularly by service users and carers. Being accessible, reliable, and having some flexibility were also valued. Negative experiences of some referral pathways, and particularly lack of staff continuity were identified as problematic. 2. The content of CRT work: Emotional support was at the centre of service users' experiences. All stakeholder groups thought CRTs should involve the whole family, and offer a range of interventions. However, carers often feel excluded, and medication is often prioritised over other forms of support. 3. The role of CRTs within the care system: Gate-keeping admissions is seen as a key role for CRTs within the acute care system. Service users and carers report that recovery is quicker compared to in-patient care. Lack of knowledge and misunderstandings about CRTs among referrers are common. Overall, levels of stakeholder agreement about the critical ingredients of good crisis care were high, although aspects of this were not always seen as achievable. Stakeholders' views about optimal CRT care suggest that staff continuity, carer involvement, and emotional and practical support should be prioritised in service improvements and more clearly specified CRT models.

77 FR 27529 - Self-Regulatory Organizations; ICE Clear Credit LLC; Order Granting Accelerated Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

... Organizations; ICE Clear Credit LLC; Order Granting Accelerated Approval of Proposed Rule Change to Membership Qualifications May 4, 2012. I. Introduction On April 3, 2012, ICE Clear Credit LLC (``ICC'') filed with the... limitations provided for in ICC Rule 203(b)) require such Clearing Participant to prepay and maintain with ICE...

Basic Strategies of Dynamic Supportive Therapy

PubMed Central

Misch, Donald A.

2000-01-01

Supportive therapy is the psychotherapeutic approach employed with the majority of mentally ill individuals. Nevertheless, most mental health professional training programs dedicate little time and effort to the teaching and learning of supportive therapy, and many mental health professionals are unable to clearly and concisely articulate the nature or process of supportive work. Although supportive therapy incorporates many specific techniques from a wide variety of psychotherapy schools, it can be conceptualized as consisting of a more limited number of underlying strategies. The fundamental strategies that underpin effective supportive therapy with mentally ill individuals are described. PMID:11069130

Supporting and Inhibiting Factors When Coping with Endometriosis From the Patientsʼ Perspective

PubMed Central

Kundu, S.; Wildgrube, J.; Schippert, C.; Hillemanns, P.; Brandes, I.

2015-01-01

Aim: Endometriosis is a chronic gynaecological disorder with manifold symptoms and psychosocial effects on the lives of affected women. The prevalence of endometriosis is estimated to be up to ten percent of women of reproductive age. As a result of its unclear aetiology, only limited treatment options are available. The treatment and care of affected women is therefore a challenge for their doctors. There is a need for healthcare services to provide affected women with support to cope with the disorder better. The aim of the study was to identify supporting and inhibiting factors on disease management to develop new support ideas. Materials and Methods: The results are based on a content analysis evaluation of text responses from 135 women with confirmed endometriosis. Open questions about disease management were posed in a patient questionnaire. A classification system was developed according to Mayrings Qualitative Content Analysis, which allowed the main topics to be identified and summarised qualitatively using a quantitative intermediate step. Results: Social support, treatment, as well as professional and healthcare system performance were found to be particularly supportive by patients. However, when questioned about inhibiting factors, healthcare system professionals and their performance were most commonly criticised. Just over 50 % of women expressed their criticism of doctors. Quality of care and empathy towards the patients were especially criticised. There is also a need for improvement with regard to communication and general support from doctors. The results illustrate the importance of doctors for women affected by endometriosis, but make it clear that there is a great need for improvement with regard to the profession. Conclusion: The results provide the first indication of problem areas in the management of endometriosis from which approaches could be developed to improve care. However, it must be pointed out that the perspective of affected women was solely investigated. For a comprehensive analysis, it would be necessary to include the perspective of care providers and the influence of society as well as the healthcare system. PMID:26097250

Unmanned Aircraft Systems Minimum Operations Performance Standards End-to-End Verification and Validation (E2-V2) Simulation

NASA Technical Reports Server (NTRS)

Ghatas, Rania W.; Jack, Devin P.; Tsakpinis, Dimitrios; Vincent, Michael J.; Sturdy, James L.; Munoz, Cesar A.; Hoffler, Keith D.; Dutle, Aaron M.; Myer, Robert R.; Dehaven, Anna M.;

Socio-economic exposure to natural disasters

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

Marin, Giovanni, E-mail: giovanni.marin@uniurb.it; IRCrES - CNR, Research Institute on Sustainable Economic Growth, Via Corti 12, 20133 - Milano; SEEDS, Ferrara

Even though the correct assessment of risks is a key aspect of the risk management analysis, we argue that limited effort has been devoted in the assessment of comprehensive measures of economic exposure at very low scale. For this reason, we aim at providing a series of suitable methodologies to provide a complete and detailed list of the exposure of economic activities to natural disasters. We use Input-Output models to provide information about several socio-economic variables, such as population density, employment density, firms' turnover and capital stock, that can be seen as direct and indirect socio-economic exposure to natural disasters.more » We then provide an application to the Italian context. These measures can be easily incorporated into risk assessment models to provide a clear picture of the disaster risk for local areas. - Highlights: • Ex ante assessment of economic exposure to disasters at very low geographical scale • Assessment of the cost of natural disasters in ex-post perspective • IO model and spatial autocorrelation to get information on socio-economic variables • Indicators supporting risk assessment and risk management models.« less

Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

PubMed

Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

2013-01-01

The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

Non-physician providers as clinical providers in cystic fibrosis: survey of U.S. programs.

PubMed

Brown, Rebekah F; Willey-Courand, Donna Beth; George, Cindy; McMullen, Ann; Dunitz, Jordan; Slovis, Bonnie; Perkett, Elizabeth

2013-04-01

Non-physician providers (NPPs) including nurse practitioners (NPs) and physician assistants (PAs) are important members of CF care teams, but limited data exist about the extent NPPs are involved in CF care. A subcommittee was established by the CF Foundation to gather information about current involvement of NPPs. Surveys were sent to adult, pediatric and affiliate CF program directors (PDs) and NPPs working in US CF programs. Responses were received from 108 PDs (49% pediatric, 34% adult, 17% affiliate). Overall, 53% of the 108 programs had NPPs and 70% had or planned to hire NPPs. Reasons for NPP use included ideal clinical role (75%), expansion of services (72%), and physician shortage (40%). The survey collected 73 responses from NPPs (96% NPs, 4% PAs) who worked in pediatric (49%), adult (29%), affiliate (3%), or multiple programs (19%). Training occurred on the job in 88% and from prior CF experience in 21%. NPPs provided coverage in outpatient clinics (82%), inpatient care (64%), and weekend and/or night call (22%). In addition to clinical roles, NPPs are involved in education (95%), research (81%), and leadership (55%). The major obstacle reported by PDs and NPPs was billing with only 12% of programs reporting NPP salaries covered by billing revenue alone. Salary support included hospital support (67%), billing (39%), center grant (35%), and other grant/contract (25%). NPPs bill for outpatient and inpatient care in 65% and 28% of programs, respectively. NPPs are working with physicians in many centers and have the potential to help meet the increasing clinical workforce demands. Further evaluation of financial issues is indicated to continue the support of NPP jobs in CF. Roles and expectations need to be clearly defined. Initial and ongoing training standards and opportunities should be explored. Copyright © 2012 Wiley Periodicals, Inc.

Challenges in Providing Counselling to MSM in Highly Stigmatized Contexts: Results of a Qualitative Study from Kenya

PubMed Central

Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M.; Graham, Susan M.; Price, Matt A.; Sanders, Eduard J.

2013-01-01

The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa. PMID:23762241

Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.

PubMed

Alexander, Gregory L; Pasupathy, Kalyan S; Steege, Linsey M; Strecker, E Bradley; Carley, Kathleen M

2014-08-01

The role of nursing home (NH) information technology (IT) in quality improvement has not been clearly established, and its impacts on communication between care givers and patient outcomes in these settings deserve further attention. In this research, we describe a mixed method approach to explore communication strategies used by healthcare providers for resident skin risk in NH with high IT sophistication (ITS). Sample included NH participating in the statewide survey of ITS. We incorporated rigorous observation of 8- and 12-h shifts, and focus groups to identify how NH IT and a range of synchronous and asynchronous tools are used. Social network analysis tools and qualitative analysis were used to analyze data and identify relationships between ITS dimensions and communication interactions between care providers. Two of the nine ITS dimensions (resident care-technological and administrative activities-technological) and total ITS were significantly negatively correlated with number of unique interactions. As more processes in resident care and administrative activities are supported by technology, the lower the number of observed unique interactions. Additionally, four thematic areas emerged from staff focus groups that demonstrate how important IT is to resident care in these facilities including providing resident-centered care, teamwork and collaboration, maintaining safety and quality, and using standardized information resources. Our findings in this study confirm prior research that as technology support (resident care and administrative activities) and overall ITS increases, observed interactions between staff members decrease. Conversations during staff interviews focused on how technology facilitated resident centered care through enhanced information sharing, greater virtual collaboration between team members, and improved care delivery. These results provide evidence for improving the design and implementation of IT in long term care systems to support communication and associated resident outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Commercial Contributions to the Success of the HEDS Enterprise: A Working Model

NASA Technical Reports Server (NTRS)

Nall, Mark; Askew, Ray

2000-01-01

The future of NASA involves the exploration of space beyond the confines of orbit about the Earth. This includes robotic investigations and Human Exploration and Development of Space (HEDS). The HEDS Strategic Plan states: "HEDS will join with the private sector to stimulate opportunities for commercial development in space as a key to future settlement. Near-term efforts will emphasize joint pilot projects that provide clear benefit to Earth from the development of near-Earth space." In support of this endeavor, NASA has established the Commercial Development of Space as a prime goal and is exploring all the ways in which NASA might make contributions to this development. NASA has long supported the development of space for commercial use. In 1985 it formally established and provided funds to support a program which created a number of joint ventures between universities and industry for this purpose. These were known as Centers for the Commercial Development of Space (CCDS). In 1999 NASA established a broader policy on commercialization with the aim of encouraging near-term commercial investment in conjunction with the International Space Station. Joint pilot projects will be initiated to stimulate this near-term investment. The long-term development of commercial concepts utilizing space access continues through the activities of the Commercial Space Centers (CSC), a sub-set of the original CCDS group. These Centers primarily require access to space for the conduct of their work. The remainder of the initial Centers focus on the development of tools and infrastructure to support users of the space environment. It is in this arena that long term development for commercial use and infrastructure development will occur. This paper will provide a retrospective examination of the Commercial Centers, the variety of models employed, the lessons learned, and the progress to date. This review will provide the bases for how successful models can be employed to accelerate private investment in the development of the infrastructure necessary for the success of the HEDS enterprise.

Key Performance Indicators for the Assessment of Pediatric Pharmacotherapeutic Guidance

PubMed Central

Barrett, Jeffrey S.; Patel, Dimple; Jayaraman, Bhuvana; Narayan, Mahesh; Zuppa, Athena

2008-01-01

Given the paucity of actual guidance provided for managing pediatric drug therapy, prescribing caregivers must be able to draw on the limited published information in pediatrics and/or guidance provided in adults with some account for expected pediatric response. Guidance for managing drug therapy in children is clearly desirable. Our objectives were to construct key performance indicators (KPIs) for pediatric pharmacotherapy guidance to identify drugs where pharmacotherapy guidance would be most beneficial. A pilot survey to assess variation in caregiver appreciation for pediatric dosing guidance has also been constructed to provide a complementary subjective assessment. Three KPI categories, drug utilization (based on hospital admission and billing data collected from 2001 through 2006), medical need, and guidance outcome value along with a KPI composite score have been proposed. Low scores are favored with respect to prioritization for pharmacotherapy guidance. The pilot survey consisted of 15 questions to assess 1) physician knowledge regarding dosing guidance, 2) attitudes toward dose modification and patient individualization, 3) the accessibility, ease of use and appropriateness of existing data stores, and 4) frequency of dosing modification, consultation of dosing compendiums and estimate of success rate in dosing guidance. Pilot results suggest that dosing guidance is generally viewed as important and that the existing resources are insufficient to guide recommendations for all drugs. While the majority of respondents check more than one resource less than 25% of the time, at least 25% of the respondents check more than one resource 25–50% of the time. The majority viewed the relevance of dosing guidance very important to the management of drug therapy. The questionnaire is being extended to the primary care centers, the Kids First Network and specialty care centers. Results will guide the development of decision support systems (DSS) that provide patient-specific pharmacotherapy guidance as part of our pediatric knowledgebase initiative. For the top 25 most utilized agents at our institution over the last 6 years, KPI score ranged from 35 (dexamethasone) to 77 (cefazolin and ampicillin) with an average score of 55. Prototype DSS for tacrolimus and methotrexate are strongly supported by the KPI scoring which ranks their selection in the top 5% of drugs on formulary. KPI metrics provide an objective means of ranking agents for which pediatric pharmacotherapeutic guidance is clearly needed. PMID:23055875

Key performance indicators for the assessment of pediatric pharmacotherapeutic guidance.

PubMed

Barrett, Jeffrey S; Patel, Dimple; Jayaraman, Bhuvana; Narayan, Mahesh; Zuppa, Athena

2008-07-01

Given the paucity of actual guidance provided for managing pediatric drug therapy, prescribing caregivers must be able to draw on the limited published information in pediatrics and/or guidance provided in adults with some account for expected pediatric response. Guidance for managing drug therapy in children is clearly desirable. Our objectives were to construct key performance indicators (KPIs) for pediatric pharmacotherapy guidance to identify drugs where pharmacotherapy guidance would be most beneficial. A pilot survey to assess variation in caregiver appreciation for pediatric dosing guidance has also been constructed to provide a complementary subjective assessment. Three KPI categories, drug utilization (based on hospital admission and billing data collected from 2001 through 2006), medical need, and guidance outcome value along with a KPI composite score have been proposed. Low scores are favored with respect to prioritization for pharmacotherapy guidance. The pilot survey consisted of 15 questions to assess 1) physician knowledge regarding dosing guidance, 2) attitudes toward dose modification and patient individualization, 3) the accessibility, ease of use and appropriateness of existing data stores, and 4) frequency of dosing modification, consultation of dosing compendiums and estimate of success rate in dosing guidance. Pilot results suggest that dosing guidance is generally viewed as important and that the existing resources are insufficient to guide recommendations for all drugs. While the majority of respondents check more than one resource less than 25% of the time, at least 25% of the respondents check more than one resource 25-50% of the time. The majority viewed the relevance of dosing guidance very important to the management of drug therapy. The questionnaire is being extended to the primary care centers, the Kids First Network and specialty care centers. Results will guide the development of decision support systems (DSS) that provide patient-specific pharmacotherapy guidance as part of our pediatric knowledgebase initiative. For the top 25 most utilized agents at our institution over the last 6 years, KPI score ranged from 35 (dexamethasone) to 77 (cefazolin and ampicillin) with an average score of 55. Prototype DSS for tacrolimus and methotrexate are strongly supported by the KPI scoring which ranks their selection in the top 5% of drugs on formulary. KPI metrics provide an objective means of ranking agents for which pediatric pharmacotherapeutic guidance is clearly needed.

The relationship of parental style to depression and self-esteem in adulthood.

PubMed

Lloyd, C; Miller, P M

1997-11-01

Previous studies have implicated low parental care and parental overprotection as risk factors for depression in adulthood. The present study further examined the association between perceived parental style and depression in two samples of medical students. In general, both low maternal and paternal care were associated with depression. Furthermore, maternal overprotection in the U.S. sample and paternal overprotection in the Scottish sample were also associated with depression. However, when results were analyzed separately for men and women, clear gender differences emerged, indicating that the observed relationships were occurring chiefly in the men, although there were some indications that low paternal care was associated with depression in women. Because such gender differences have not been previously reported, women medical students may be a unique group with respect to these relationships. Also intriguing was that although parental style characteristics demonstrated significant associations with self-esteem, this was clearly true only for men and not for women. Finally, the study provided the first partial support for the hypothesis that self-esteem mediates the relationship between parental style and depression.

[Analysis on composition principles of prescriptions for stranguria in dictionary of traditional Chinese medicine prescription].

PubMed

Sun, Jing-Chang; Wang, Miao-Miao

2014-03-01

By using traditional Chinese medicine inheritance support system to analyze the dominant experience and recessive principles of the prescriptions for stranguria in the dictionary of traditional Chinese medicine prescription (DCMP), we aim to define the medication pattern and rule and to acquire new prescriptions. In dominant experience analysis, we were able to find 22 drugs used over 50 times, including drugs of clearing heat, diuresis and relieving stranguria which are the most used and drugs of clearing heat, cooling blood, benefiting Qi and nourishing Yin. In addition, drugs of activating Qi and Xue, eliminating phlegm and removing toxic are often used, including 34 herb pairs and 5 combinations of three-taste drugs are used more than 35 times. These results fully reflect the composition principles and compatibility characteristic of prescriptions for treating stranguria in DCMP. Thirteen new prescriptions by way of recessive principle excavating were acquired. These new prescriptions might be suitable to clinical treatments of variable syndromes. This article provides an useful clue to research and produce new drugs.

An EGR performance evaluation and decision-making approach based on grey theory and grey entropy analysis

PubMed Central

2018-01-01

Exhaust gas recirculation (EGR) is one of the main methods of reducing NOX emissions and has been widely used in marine diesel engines. This paper proposes an optimized comprehensive assessment method based on multi-objective grey situation decision theory, grey relation theory and grey entropy analysis to evaluate the performance and optimize rate determination of EGR, which currently lack clear theoretical guidance. First, multi-objective grey situation decision theory is used to establish the initial decision-making model according to the main EGR parameters. The optimal compromise between diesel engine combustion and emission performance is transformed into a decision-making target weight problem. After establishing the initial model and considering the characteristics of EGR under different conditions, an optimized target weight algorithm based on grey relation theory and grey entropy analysis is applied to generate the comprehensive evaluation and decision-making model. Finally, the proposed method is successfully applied to a TBD234V12 turbocharged diesel engine, and the results clearly illustrate the feasibility of the proposed method for providing theoretical support and a reference for further EGR optimization. PMID:29377956

Improved Constraints on the Disk around MWC 349A from the 23 m LBTI

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

Sallum, S.; Eisner, J. A.; Hinz, P. M.

2017-07-20

We present new spatially resolved observations of MWC 349A from the Large Binocular Telescope Interferometer (LBTI), a 23 m baseline interferometer made up of two, co-mounted 8 m telescopes. MWC 349A is a B[e] star with an unknown evolutionary state. Proposed scenarios range from a young stellar object, to a B[e] supergiant, to a tight binary system. Radio continuum and recombination line observations of this source revealed a sub-arcsecond bipolar outflow surrounding an ∼100 mas circumstellar disk. Follow-up infrared studies detected the disk, and suggested that it may have skew and an inner clearing. Our new infrared interferometric observations, whichmore » have more than twice the resolution of previously published data sets, support the presence of both skew and a compact infrared excess. They rule out inner clearings with radii greater than ∼14 mas. We show the improvements in disk parameter constraints provided by LBTI, and discuss the inferred disk parameters in the context of the posited evolutionary states for MWC 349A.« less

An EGR performance evaluation and decision-making approach based on grey theory and grey entropy analysis.

PubMed

Zu, Xianghuan; Yang, Chuanlei; Wang, Hechun; Wang, Yinyan

2018-01-01

Exhaust gas recirculation (EGR) is one of the main methods of reducing NOX emissions and has been widely used in marine diesel engines. This paper proposes an optimized comprehensive assessment method based on multi-objective grey situation decision theory, grey relation theory and grey entropy analysis to evaluate the performance and optimize rate determination of EGR, which currently lack clear theoretical guidance. First, multi-objective grey situation decision theory is used to establish the initial decision-making model according to the main EGR parameters. The optimal compromise between diesel engine combustion and emission performance is transformed into a decision-making target weight problem. After establishing the initial model and considering the characteristics of EGR under different conditions, an optimized target weight algorithm based on grey relation theory and grey entropy analysis is applied to generate the comprehensive evaluation and decision-making model. Finally, the proposed method is successfully applied to a TBD234V12 turbocharged diesel engine, and the results clearly illustrate the feasibility of the proposed method for providing theoretical support and a reference for further EGR optimization.

Pulsating Magnetic Reconnection Driven by Three-Dimensional Flux-Rope Interactions.

PubMed

Gekelman, W; De Haas, T; Daughton, W; Van Compernolle, B; Intrator, T; Vincena, S

2016-06-10

The dynamics of magnetic reconnection is investigated in a laboratory experiment consisting of two magnetic flux ropes, with currents slightly above the threshold for the kink instability. The evolution features periodic bursts of magnetic reconnection. To diagnose this complex evolution, volumetric three-dimensional data were acquired for both the magnetic and electric fields, allowing key field-line mapping quantities to be directly evaluated for the first time with experimental data. The ropes interact by rotating about each other and periodically bouncing at the kink frequency. During each reconnection event, the formation of a quasiseparatrix layer (QSL) is observed in the magnetic field between the flux ropes. Furthermore, a clear correlation is demonstrated between the quasiseparatrix layer and enhanced values of the quasipotential computed by integrating the parallel electric field along magnetic field lines. These results provide clear evidence that field lines passing through the quasiseparatrix layer are undergoing reconnection and give a direct measure of the nonlinear reconnection rate. The measurements suggest that the parallel electric field within the QSL is supported predominantly by electron pressure; however, resistivity may play a role.