Chapter 5. Essential equipment, pharmaceuticals and supplies. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Kesecioglu, Jozef

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including essential equipment, pharmaceuticals and supplies. Key recommendations include: (1) ensure that adequate essential medical equipment, pharmaceuticals and important supplies are available during a disaster; (2) develop a communication and coordination system between health care facilities and local/regional/state/country governmental authorities for the provision of additional support; (3) determine the required resources, order and stockpile adequate resources, and judiciously distribute them; (4) acquire additional mechanical ventilators that are portable, provide adequate gas exchange for a range of clinical conditions, function with low-flow oxygen and without high pressure, and are safe for patients and staff; (5) provide advanced ventilatory support and rescue therapies including high levels of inspired oxygen and positive end-expiratory pressure, volume and pressure control ventilation, inhaled nitric oxide, high-frequency ventilation, prone positioning ventilation and extracorporeal membrane oxygenation; (6) triage scarce resources including equipment, pharmaceuticals and supplies based on those who are likely to benefit most or on a 'first come, first served' basis. Judicious planning and adoption of protocols for providing adequate equipment, pharmaceuticals and supplies are necessary to optimize outcomes during a pandemic.

Research essentials: How to find funds to support projects.

PubMed

Higham, Sue; Simons, Joan

2014-10-01

IF YOU HAVE an idea for a research project, whether it is an investigation or a literature review, it can be difficult to know where to start looking for financial support. Finding colleagues to work with will provide you with a sounding board for your idea, as well as support and encouragement.

Blended Coaching: Skills and Strategies to Support Principal Development

ERIC Educational Resources Information Center

Bloom, Gary S.; Castagna, Claire L.; Moir, Ellen; Warren, Betsy

2005-01-01

Research shows conclusively that principals and other school leaders are essential to school improvement, and that these individuals benefit from the intensive, contextualized support that a coach or mentor can provide. But how does a coach support a school leader in mastering the professional and emotional challenges of school leadership for a…

School Nurses' Experiences of Managing Young People with Mental Health Problems

ERIC Educational Resources Information Center

Ravenna, Jean; Cleaver, Karen

2016-01-01

Prevalence of mental health disorder is increasing among young people. It is recognized that early intervention is essential in supporting young people, and care provided within schools to support emotional well-being is recommended as part of this process. A scoping review was undertaken examining school nurses' experiences of supporting the…

The Influence of School Leadership on Classroom Participation: Examining Configurations of Organizational Supports

ERIC Educational Resources Information Center

Sebastian, James; Allensworth, Elaine; Stevens, David

2014-01-01

Background: In this paper we call for studying school leadership and its relationship to instruction and learning through approaches that highlight the role of configurations of multiple organizational supports. A configuration-focused approach to studying leadership and other essential supports provides a valuable addition to existing tools in…

What's at Stake in the Lives of People with Intellectual Disability? Part II: Recommendations for Naming, Defining, Diagnosing, Classifying, and Planning Supports

ERIC Educational Resources Information Center

Luckasson, Ruth; Schalock, Robert L.

2013-01-01

This article focuses on recommendations for naming, defining, diagnosing, classifying, and planning supports for individuals with intellectual disability (ID). The article provides an overview of the essential questions addressed by the respective functions and provides a series of specific recommendations that address the high stakes involved for…

Kernel Ada Programming Support Environment (KAPSE) Interface Team: Public Report. Volume II.

DTIC Science & Technology

1982-10-28

essential I parameters from our work so far in this area and, using trade-offs concerning these, construct the KIT’s recommended alternative. 1145...environment that are also in the development states. At this point in development it is essential for the KITEC to provide a forum and act as a focal...standardization in this area. Moreover, this is an area with considerable divergence in proposed approaches. Or the other hand, an essential tool from the point of

Land Surface Modeling and Data Assimilation to Support Physical Precipitation Retrievals for GPM

NASA Technical Reports Server (NTRS)

Peters-Lidard, Christa D.; Tian. Yudong; Kumar, Sujay; Geiger, James; Choudhury, Bhaskar

2010-01-01

Objective: The objective of this proposal is to provide a routine land surface modeling and data assimilation capability for GPM in order to provide global land surface states that are necessary to support physical precipitation retrieval algorithms over land. It is well-known that surface emission, particularly over the range of frequencies to be included in GPM, is sensitive to land surface states, including soil properties, vegetation type and greenness, soil moisture, surface temperature, and snow cover, density, and grain size. Therefore, providing a robust capability to routinely provide these critical land states is essential to support GPM-era physical retrieval algorithms over land.

Position of the Academy of Nutrition and Dietetics: The Role of Medical Nutrition Therapy and Registered Dietitian Nutritionists in the Prevention and Treatment of Prediabetes and Type 2 Diabetes.

PubMed

Briggs Early, Kathaleen; Stanley, Kathleen

2018-02-01

It is the position of the Academy of Nutrition and Dietetics that for adults with prediabetes or type 2 diabetes, medical nutrition therapy (MNT) provided by registered dietitian nutritionists (RDNs) is effective in improving medical outcomes and quality of life, and is cost-effective. MNT provided by RDNs is also successful and essential to preventing progression of prediabetes and obesity to type 2 diabetes. It is essential that MNT provided by RDNs be integrated into health care systems and public health programs and be adequately reimbursed. The Academy's evidence-based nutrition practice guidelines for the prevention of diabetes and the management of diabetes document strong evidence supporting the clinical effectiveness of MNT provided by RDNs. Cost-effectiveness has also been documented. The nutrition practice guidelines recommend that as part of evidence-based health care, providers caring for individuals with prediabetes or type 2 diabetes should be referred to an RDN for individualized MNT upon diagnosis and at regular intervals throughout the lifespan as part of their treatment regimen. Standards of care for three levels of diabetes practice have been published by the Diabetes Care and Education Practice Group. RDNs are also qualified to provide additional services beyond MNT in diabetes care and management. Unfortunately, barriers to accessing RDN services exist. Reimbursement for services is essential. Major medical and health organizations have provided support for the essential role of MNT and RDNs for the prevention and treatment of type 2 diabetes. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Identifying Students for Secondary and Tertiary Prevention Efforts: How Do We Determine Which Students Have Tier 2 and Tier 3 Needs?

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Ennis, Robin Parks; Hirsch, Shanna Eisner

2014-01-01

In comprehensive, integrated, three-tiered models, it is essential to have a systematic method for identifying students who need supports at Tier 2 or Tier 3. This article provides explicit information on how to use multiple sources of data to determine which students might benefit from these supports. First, the authors provide an overview of how…

Growth and clinical variables in nitrogen-restricted piglets fed an adjusted essential amino acid mix: Effects using partially intact protein-based diets

USDA-ARS?s Scientific Manuscript database

Current recommendations for protein levels in infant formula ensure that growth matches or exceeds growth of breast-fed infants, but may provide a surplus of amino acids (AA). Recent studies in infants using AA-based formulas support specific adjustment of the essential AA (EAA) composition allowing...

Dramatherapy and Family Therapy in Education: Essential Pieces of the Multi-Agency Jigsaw

ERIC Educational Resources Information Center

McFarlane, Penny; Harvey, Jenny

2012-01-01

A collaborative therapeutic approach often proves the best way to assess and meet the needs of children experiencing barriers to learning. This book gives a concise overview of drama and family therapy and describes how both therapies can work together to provide essential pieces of the jigsaw of emotional support for troubled children within an…

State Policies and Practices in Behavior Supports for Persons with Intellectual and Developmental Disabilities in the United States: A National Survey

ERIC Educational Resources Information Center

Rotholz, David A.; Moseley, Charles R.; Carlson, Kinsey B.

2013-01-01

Providing effective behavioral supports to decrease challenging behavior and replace it with appropriate alternative skills is essential to meeting the needs of many individuals with intellectual and developmental disabilities (IDD). It is also necessary for fulfilling the requirements of Medicaid-funded individual support plans and is important…

Musicals Enrich Middle School Programs

ERIC Educational Resources Information Center

Thomas, Douglas D.; North, Rita

2005-01-01

An enriching fine arts program has long been advocated as an essential element of an effective middle school program. The vocal music program at Pleasant Hill (Missouri) Middle School supports student growth and development beyond the regular classroom. It supports students' existing skills and talents and provides opportunities for them to…

Prediction and analysis of essential genes using the enrichments of gene ontology and KEGG pathways.

PubMed

Chen, Lei; Zhang, Yu-Hang; Wang, ShaoPeng; Zhang, YunHua; Huang, Tao; Cai, Yu-Dong

2017-01-01

Identifying essential genes in a given organism is important for research on their fundamental roles in organism survival. Furthermore, if possible, uncovering the links between core functions or pathways with these essential genes will further help us obtain deep insight into the key roles of these genes. In this study, we investigated the essential and non-essential genes reported in a previous study and extracted gene ontology (GO) terms and biological pathways that are important for the determination of essential genes. Through the enrichment theory of GO and KEGG pathways, we encoded each essential/non-essential gene into a vector in which each component represented the relationship between the gene and one GO term or KEGG pathway. To analyze these relationships, the maximum relevance minimum redundancy (mRMR) was adopted. Then, the incremental feature selection (IFS) and support vector machine (SVM) were employed to extract important GO terms and KEGG pathways. A prediction model was built simultaneously using the extracted GO terms and KEGG pathways, which yielded nearly perfect performance, with a Matthews correlation coefficient of 0.951, for distinguishing essential and non-essential genes. To fully investigate the key factors influencing the fundamental roles of essential genes, the 21 most important GO terms and three KEGG pathways were analyzed in detail. In addition, several genes was provided in this study, which were predicted to be essential genes by our prediction model. We suggest that this study provides more functional and pathway information on the essential genes and provides a new way to investigate related problems.

Informational Support in Pediatric Oncology: Review of the Challenges Among Arab Families.

PubMed

Otmani, Naïma; Khattab, Mohammed

2016-11-18

Childhood cancer and its invasive treatment is a distressing life experience for the child and his family. Providing informational support is an essential part of community care, and defining parent's burden is an important part of this goal. However, providing such information can be particularly challenging in Arab countries where beliefs, traditions, religion, and socioeconomic factors influence parents' needs and their priorities of needs. This article presents a review of these specificities among Arab families. Implications of health-care providers are also discussed.

ASSESSING THE EFFECT OF HABITAT ALTERATION ON SHELLFISH POPULATIONS

EPA Science Inventory

Habitat provides a variety of life support functions for many species, such as providing shelter, substrate, food, and nursery areas. Habitat alteration is one of the most important causes of declines in ecological resources in North America, and habitats essential to the well b...

Reflecting on Quality Learning in a Student Writing Experience Supported by Technology.

ERIC Educational Resources Information Center

Ellis, Robert

With rapid developments in information technology in society being mirrored in the use of new learning technologies in universities, research into the quality of technologically-supported learning is essential. To date, research into new learning technologies has provided us with valuable knowledge that includes the theories behind their design,…

Student Teacher Perceptions of the Impact of Mentoring on Student Teaching

ERIC Educational Resources Information Center

Bird, Lori K.

2012-01-01

Mentoring is an essential component of the student teaching experience. The support provided by highly prepared and effective mentors contributes to the success of student teachers during this high stakes period of professional development. Findings from this mixed-methods study support five mentoring factors as valid and a useful framework for…

Beginning Teacher Success: An Investigation into the Feedback from Mentors of Formal Mentoring Programs

ERIC Educational Resources Information Center

Barrera, Arnold; Braley, Richard T.; Slate, John R.

2010-01-01

Teacher mentors of first-year teachers provided insight into those practices they viewed as essential for their success in the mentoring role. Specifically, they were queried about teacher involvement/support, staff development, administrative support and resource materials. Almost all of the mentor teachers believed a teacher mentoring program…

Caught on Video! Using Handheld Digital Video Cameras to Support Evidence-Based Reasoning

ERIC Educational Resources Information Center

Lottero-Perdue, Pamela S.; Nealy, Jennifer; Roland, Christine; Ryan, Amy

2011-01-01

Engaging elementary students in evidence-based reasoning is an essential aspect of science and engineering education. Evidence-based reasoning involves students making claims (i.e., answers to questions, or solutions to problems), providing evidence to support those claims, and articulating their reasoning to connect the evidence to the claim. In…

Eco-logical successes : fourth edition, March 2013

DOT National Transportation Integrated Search

2013-03-01

Infrastructure facilities, such as roadways, transit lines, and communication systems, provide vital services that support the healthy functioning of a community. While essential, sometimes the development of these facilities has negative environment...

US Army remotely piloted vehicle supporting technology program

NASA Technical Reports Server (NTRS)

Gossett, T. D.

1981-01-01

Essential technology programs that lead to the full scale engineering development of the Aquila Remotely Piloted Vehicle system for U.S. Army are described. The Aquila system uses a small recoverable and reusable RPV to provide target acquisition, designation, and aerial reconnaissance mission support for artillery and smart munitions. Developments that will provide growth capabilities to the Aquila RPV system, as well as future RPV mission concepts being considered by the U.S. Army are presented.

Understanding Older Adult's Perceptions of Factors that Support Trust in Human and Robot Care Providers.

PubMed

Stuck, Rachel E; Rogers, Wendy A

2017-06-01

As the population of older adults increase so will the need for care providers, both human and robot. Trust is a key aspect to establish and maintain a successful older adult-care provider relationship. However, due to trust volatility it is essential to understand it within specific contexts. This proposed mixed methods study will explore what dimensions of trust emerge as important within the human-human and human-robot dyads in older adults and care providers. First, this study will help identify key qualities that support trust in a care provider relationship. By understanding what older adults perceive as needing to trust humans and robots for various care tasks, we can begin to provide recommendations based on user expectations for design to support trust.

Commercial aviation : programs and options for providing air service to small communities : testimony before the Subcommittee on Aviation, Committee on Transportation and Infrastructure, U.S. House of Representatives

DOT National Transportation Integrated Search

2007-04-25

Congress established two key programs to help support air service to small communities the Essential Air Service (EAS) providing about $100 million in subsidies per year and the Small Community Air Service Development Program (SCASDP) that provide...

Facilitators and barriers to the increased supervisory role of senior charge nurses: a qualitative study.

PubMed

Rankin, J; McGuire, C; Matthews, L; Russell, M; Ray, D

2016-04-01

To explore the experiences of senior charge nurses provided with 'increased supervisory hours'. Designated supervisory time is essential for senior charge nurses to provide effective clinical leadership. It is important to explore the impact arises of such an increase. An online questionnaire collected exploratory data from senior charge nurses (n = 60). Semi-structured interviews gathered in-depth qualitative data (n = 12). Findings were analysed for common themes associated with implementation of the increased senior charge nurse supervisory role. The majority of senior charge nurses were unable to use their full allocation of supervisory time. They struggled to accomplish leadership goals because of managing staffing levels, increased workload, time constraints and limited support. Factors that facilitated the role included preparation and support, adequate staff capacity, effective leadership skills and availability of supervisory time. The senior charge nurses took pride in providing clinical leadership, promoting staff development and delivering patient care. Support, in terms of preparation, capacity building and ongoing mentoring, was a key factor for achieving senior charge nurse goals. Senior charge nurses should be supported to maximise supervisory time through the provision of an induction programme, formal coaching and ongoing training and development. Preparation and support is essential for senior charge nurses to deliver enhanced clinical leadership through increased supervisory time. © 2015 The Authors Journal of Nursing Management Published by John Wiley & Sons Ltd.

Mexican Americans on the Home Front: Community Organizations in Arizona during World War II.

ERIC Educational Resources Information Center

Marin, Christine

During World War II Arizona's Mexican-American communities organized their own patriotic activities and worked, in spite of racism, to support the war effort. In Phoenix the Lenadores del Mundo, an active fraternal society, began this effort by sponsoring a festival in January 1942. Such "mutualistas" provided an essential support system…

Initial Assessment for K-12 English Language Support in Six Countries: Revisiting the Validity-Reliability Paradox

ERIC Educational Resources Information Center

Sinclair, Jeanne; Lau, Clarissa

2018-01-01

It is common practice for K-12 schools to assess multilingual students' language proficiency to determine language support program placement. Because such programs can provide essential scaffolding, the policies guiding these assessments merit careful consideration. It is well accepted that quality assessments must be valid (representative of the…

Writing Skills of Hearing-Impaired Students Who Benefit from Support Services at Public Schools in Turkey

ERIC Educational Resources Information Center

Karasu, H. Pelin

2017-01-01

Support services provide an essential role for hearing-impaired students attending public schools, in terms of improving their language and academic skills. In this study, the writing skills of hearing-impaired students enrolled in public schools were evaluated, and the relationship between the writing scores, audiological variables and…

Peer-supported economic empowerment: A financial wellness intervention framework for people with psychiatric disabilities.

PubMed

Jiménez-Solomon, Oscar G; Méndez-Bustos, Pablo; Swarbrick, Margaret; Díaz, Samantha; Silva, Sissy; Kelley, Maura; Duke, Steve; Lewis-Fernández, Roberto

2016-09-01

People with psychiatric disabilities experience substantial economic exclusion, which hinders their ability to achieve recovery and wellness. The purpose of this article is to describe a framework for a peer-supported economic empowerment intervention grounded in empirical literature and designed to enhance financial wellness. The authors followed a 3-step process, including (a) an environmental scan of scientific literature, (b) a critical review of relevant conceptual frameworks, and (c) the design of an intervention logic framework based on (a) and (b), the programmatic experience of the authors, and input from peer providers. We identified 6 peer provider functions to support individuals with psychiatric disabilities to overcome economic inclusion barriers, achieve financial wellness goals, and lessen the psychosocial impact of poverty and dependency. These include (a) engaging individuals in culturally meaningful conversations about life dreams and financial goals, (b) inspiring individuals to reframe self-defeating narratives by sharing personal stories, (c) facilitating a financial wellness action plan, (d) coaching to develop essential financial skills, (e) supporting navigation and utilization of financial and asset-building services, and (f) fostering mutual emotional and social support to achieve financial wellness goals. Financial wellness requires capabilities that depend on gaining access to financial and asset-building supports, and not merely developing financial skills. The proposed framework outlines new roles and competencies for peer providers to help individuals build essential financial capabilities, and address social determinants of mental health and disability. Research is currently underway to pilot-test and refine peer-supported economic empowerment strategies. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Segmenting healthcare terminology users: a strategic approach to large scale evolutionary development.

PubMed

Price, C; Briggs, K; Brown, P J

1999-01-01

Healthcare terminologies have become larger and more complex, aiming to support a diverse range of functions across the whole spectrum of healthcare activity. Prioritization of development, implementation and evaluation can be achieved by regarding the "terminology" as an integrated system of content-based and functional components. Matching these components to target segments within the healthcare community, supports a strategic approach to evolutionary development and provides essential product differentiation to enable terminology providers and systems suppliers to focus on end-user requirements.

Orbit determination software development for microprocessor based systems: Evaluation and recommendations

NASA Technical Reports Server (NTRS)

Shenitz, C. M.; Mcgarry, F. E.; Tasaki, K. K.

1980-01-01

A guide is presented for National Aeronautics and Space Administration management personnel who stand to benefit from the lessons learned in developing microprocessor-based flight dynamics software systems. The essential functional characteristics of microprocessors are presented. The relevant areas of system support software are examined, as are the distinguishing characteristics of flight dynamics software. Design examples are provided to illustrate the major points presented, and actual development experience obtained in this area is provided as evidence to support the conclusions reached.

Interim Stabilization Equipment Essential and Support Drawing Plan

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

KOCH, M.R.

The purpose of this document is to list the Interim Stabilization equipment drawings that are classified as Essential or Support drawings. Essential Drawings: Those drawings identified by the facility staff as necessary to directly support the safe operation of the facility or equipment. Support Drawings: Those drawings identified by the facility staff that further describe the design details of structures, systems or components shown on essential drawings.

Battlespace awareness and the Australian Army battlefield command support system

NASA Astrophysics Data System (ADS)

Gaertner, Paul S.; Slade, Mark; Bowden, Fred; Stagg, Bradley; Huf, Samuel

2000-08-01

Effective battlespace awareness is essential for any defence operation; this is especially true in the increasingly complex and dynamic land component of the military environment. Because of its relatively small force size dispersed piece-wise across a large and largely vacant landmass, the Defence of Australia presents a somewhat unique challenge for the development of systems that support command decision-making. The intent of this paper is to first examine the digitisation effort under way in Australia and describe the Army Battlefield Command Support System (BCSS) being developed for use in the tactical arena. BCSS is essentially a suite of commercial-off-the-shelf and government-off-the-shelf software components provided via a standard operating environment to aid decision-making. Then, we present the development of a Tactical Land C4I Assessment Capability (TLCAC) synthetic environment which is being used to undertake controlled performance evaluations of the various elements of the BCSS suite and provide impact assessments of new technological advances. The TLCAC provides a capacity to assess in near real-time Brigade and below level command post exercise activities. That is, when deployed it provides a mechanism to automatically collect command and control and manoeuvre data, which can aid in the after action review process.

38 CFR 61.80 - General operation requirements for supportive housing and service centers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... provided to permit use of essential electrical appliances while assuring safety from fire; (10) All food preparation areas must contain suitable space and equipment to store, prepare, and serve food in a sanitary... program's ability to provide a successful outcome for veterans. (7) Corrective Action(s): When necessary...

38 CFR 61.80 - General operation requirements for supportive housing and service centers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... provided to permit use of essential electrical appliances while assuring safety from fire; (10) All food preparation areas must contain suitable space and equipment to store, prepare, and serve food in a sanitary... program's ability to provide a successful outcome for veterans. (7) Corrective Action(s): When necessary...

Changing office practice and health care systems to facilitate diabetes self-management.

PubMed

Funnell, Martha M; Anderson, Robert M

2003-04-01

Diabetes is a self-managed disease for which patients provide 99% of their own care. For patients to succeed as diabetes self-managers, they need office practices and health care systems that can prepare and support them in their diabetes self-management efforts over the long term. In order to provide effective diabetes education and ongoing support, office practices and health care systems will have to fundamentally redefine the roles of health professionals and patients with diabetes, and redesign practices and systems to allow for effective long-term self-management education and support. Although it is difficult for both people and systems to change, change is essential if we are going to provide self-management support for the majority of patients suffering from this serious chronic disease.

ASR Technology for Children with Dyslexia: Enabling Immediate Intervention to Support Reading in Bahasa Melayu

ERIC Educational Resources Information Center

Husni, Husniza; Jamaludin, Zulikha

2009-01-01

Reading is an essential skill towards literacy development, and should be provided so that children can master the skill at their early ages. For dyslexic children, mastering the skill is a challenge. It has been widely agreed that the theory behind such difficulties in reading for dyslexic lies in the phonological-core deficits. Support has been…

Handbook of Response to Intervention: The Science and Practice of Multi-Tiered Systems of Support, 2nd Edition

ERIC Educational Resources Information Center

Jimerson, Shane R., Ed.; Burns, Matthew K., Ed.; VanDerHeyden, Amanda M., Ed.

2016-01-01

The second edition of this essential handbook provides a comprehensive, updated overview of the science that informs best practices for the implementation of response to intervention (RTI) processes within Multi-Tiered Systems of Support (MTSS) to facilitate the academic success of all students. The volume includes insights from leading scholars…

A Study of Novice Teachers: Challenges and Supports in the First Years

ERIC Educational Resources Information Center

Fantilli, Robert D.; McDougall, Douglas E.

2009-01-01

In recent years, it has been reported that an alarming number of teachers are leaving the profession in the first three years after graduation from a pre-service program. This phenomenon is common in North America and it is essential that educators identify the challenges surrounding new teachers and provide supports to assist them. The vast…

What's at Stake in the Lives of People with Intellectual Disability? Part I: The Power of Naming, Defining, Diagnosing, Classifying, and Planning Supports

ERIC Educational Resources Information Center

Schalock, Robert L.; Luckasson, Ruth

2013-01-01

This article focuses on the power of naming, defining, diagnosing, classifying, and planning supports for people with intellectual disability. The article summarizes current thinking regarding these five functions, states the essential question addressed by the respective function, and provides an overview of the high stakes involved for people…

Quick release engine cylinder

DOEpatents

Sunnarborg, Duane A.

2000-01-01

A quick release engine cylinder allows optical access to an essentially unaltered combustion chamber, is suitable for use with actual combustion processes, and is amenable to rapid and repeated disassembly and cleaning. A cylinder member, adapted to constrain a piston to a defined path through the cylinder member, sealingly engages a cylinder head to provide a production-like combustion chamber. A support member mounts with the cylinder member. The support-to-cylinder mounting allows two relationships therebetween. In the first mounting relationship, the support engages the cylinder member and restrains the cylinder against the head. In the second mounting relationship, the cylinder member can pass through the support member, moving away from the head and providing access to the piston-top and head.

Essentials of building a career in nursing research.

PubMed

Cleary, Michelle; Sayers, Jan; Watson, Roger

2016-07-01

Nursing research is fundamental to driving evidence-based practice and achieving safe outcomes for patients. Underpinning the discussion in this paper are nurse researchers who thought strategically during their undergraduate and postgraduate studies to build a body of credible research influencing patient outcomes and, in so doing, establish their careers. To provide an overview of some of the career essentials that support a transition in role for the beginner or emerging researcher, otherwise known as the early career researcher. Early career researchers need to acquire research competencies, to get involved in research teams, and to understand the research landscape and the various associated subtleties/vagaries and career trajectories. This is fundamental for establishing their credibility as researchers, and enabling them to undertake research that will influence policy and practice. Establishing a research career is challenging, and takes time, effort, patience, perseverance and commitment. For beginner researchers, collegial support and mentoring are essential to support a viable, professional, sustainable, enquiring profession, and a satisfying career. Building individual capabilities and collaborative research teams together is fundamental to research success in adapting to new roles and workplaces.

The potential of Origanum vulgare L. (Lamiaceae) essential oil in inhibiting the growth of some food-related Aspergillus species

PubMed Central

Carmo, Egberto Santos; de Oliveira Lima, Edeltrudes; de Souza, Evandro Leite

2008-01-01

Origanum vulgare L. (Lamiaceae) has been currently known for their interesting antimicrobial activity being regarded as alternative antimicrobial for use is food conservation systems. This study aimed to evaluate the effectiveness of O. vulgare essential oil in inhibiting the growth of some food-related Aspergillus species (A. flavus, A. parasiticus, A. terreus, A. ochraceus, A. fumigatus and A. niger). The essential oil revealed a strong anti-Aspergillus property providing an inhibition of all assayed mould strains. MIC values were between 80 and 20 μL/mL being found a MIC50 of 40 μL/mL. The essential oil at concentration of 80 and 40 μL/mL provided a fungicidal effect on A. flavus, A. fumigatus and A. niger noted by a total inhibition of the radial mycelial growth along 14 days of interaction. In addition, the essential oil was able to inhibit the mould spores germination when assayed at concentrations of 80 and 40 μL/mL. Our results showed the interesting anti-Aspergillus activity of O. vulgare essential oil supporting their possible use as anti-mould compound in food conservation. PMID:24031231

Making sense of HUSK: practice implications for social change initiatives.

PubMed

McBeath, Bowen

2015-01-01

As an exemplar of bottom-up progressive social experimentation, HUSK provides opportunities to examine how innovative practice is supported and challenged in bureaucratic settings. In this analysis the author uses a sensemaking lens to identify critical issues and questions for those seeking to promote progressive change initiative in social welfare systems. Findings identify essential organizational and managerial supports needed to support service user voice and participation and reinforce the importance of reflexivity in practice and research.

OPTIMIZING BMP PLACEMENT AT WATERSHED-SCALE USING SUSTAIN

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate alternative plans for environmental quality restoration and protection needs in urban and developing areas. A watershed-scale decision-support system, based on cost optimization, provides an essential tool to suppo...

HABITAT RELATIONSHIPS OF WATERFOWL WINTERING IN NARRAGANSTT BAY

EPA Science Inventory

Coastal marine habitats often provide essential structure and life support functions for estuarine-dependent wildlife such as wading birds, small mammals, and waterfowl. Unfortunately, these areas are increasingly being lost or degraded by watershed development and human disturb...

U.S. EPA's Watershed Management Research Activities

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate alternative plans for environmental quality restoration and protection needs in urban and developing areas. A watershed-scale decision-support system, based on cost optimization, provides an essential tool to suppo...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT TENANT PARTICIPATION AND TENANT OPPORTUNITIES IN PUBLIC HOUSING Family Investment... expanded services essential to providing families in public housing with better access to educational and..., and assistance in the attainment of certificates of high school equivalency); (e) Business...

Nursing teams: behind the charts.

PubMed

Bae, Sung-Heui; Farasat, Alireza; Nikolaev, Alex; Seo, Jin Young; Foltz-Ramos, Kelly; Fabry, Donna; Castner, Jessica

2017-07-01

To examine the nature and characteristics of both received and provided mutual support in a social network within an acute care hospital unit. Current evidence regarding the social network in the health care workforce reveals the nature of social ties. Most studies of social network-related support that measured the characteristics of social support used self-reported perception from workers receiving support. There is a gap in studies that focus on back-up behaviour. The evaluation included a social network analysis of a nursing unit employing 54 staff members. A 12 item electronic survey was administered. Descriptive statistics were calculated using the Statistical Package for the Social Sciences. Social network analyses were carried out using ucinet, r 3.2.3 and gephi. Based on the study findings, as providers of mutual support the nursing staff claimed to give their peers more help than these peers gave them credit for. Those who worked overtime provided more mutual support. Mutual support is a key teamwork characteristic, essential to quality and safety in hospital nursing teams that can be evaluated using social network analysis. Because of a discrepancy regarding receiving and providing help, examining both receiver and provider networks is a superior approach to understanding mutual support. © 2017 John Wiley & Sons Ltd.

Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice.

PubMed

Young, Susan; Guo, Kristina L

2016-01-01

The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

A Context-Aware Ubiquitous Learning Approach for Providing Instant Learning Support in Personal Computer Assembly Activities

ERIC Educational Resources Information Center

Hsu, Ching-Kun; Hwang, Gwo-Jen

2014-01-01

Personal computer assembly courses have been recognized as being essential in helping students understand computer structure as well as the functionality of each computer component. In this study, a context-aware ubiquitous learning approach is proposed for providing instant assistance to individual students in the learning activity of a…

Obstacles and Supports Related to the Use of Educational Technologies: The Role of Technological Expertise, Gender, and Age

ERIC Educational Resources Information Center

Lane, Cara A.; Lyle, Henry F.

2011-01-01

In order for institutions of higher education to provide essential technology resources and encourage the adoption of educational technologies, it is vital to gather information about the barriers their users encounter and the supports they find most helpful. The purpose of this study is to better understand how differences in user traits (e.g.,…

DoD Product Line Practice Workshop Report

DTIC Science & Technology

1998-05-01

capability. The essential enterprise management practices include ensuring sound business goals providing an appropriate funding model performing...business. This way requires vision and explicit support at the organizational level. There must be an explicit funding model to support the development...the same group seems to work best in smaller organizations. A funding model for core asset development also needs to be developed because the core

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.

Overview of open resources to support automated structure verification and elucidation

EPA Science Inventory

Cheminformatics methods form an essential basis for providing analytical scientists with access to data, algorithms and workflows. There are an increasing number of free online databases (compound databases, spectral libraries, data repositories) and a rich collection of software...

The Potential Contribution of Advanced Imaging Techniques to Developmental Neurotoxicity Risk Assessment

EPA Science Inventory

Neuropathologic assessment provides critical data essential to developmental neurotoxicity risk assessment. There are a number of objectives in conducting a neuropathologic assessment to effectively support risk assessment. These include a comprehensive assessment of the adult an...

Peer support for postpartum depression: volunteers' perceptions, recruitment strategies and training from a randomized controlled trial

PubMed Central

Dennis, Cindy-Lee

2013-01-01

A randomized controlled trial evaluated the effect of telephone-based peer support (mother-to-mother) on preventing postpartum depression among high-risk mothers. This paper reports volunteers' perceptions, which showed that peer support is an effective preventative intervention. Two-hundred and five (205) volunteers were recruited and trained to provide peer support to 349 mothers randomized to the intervention group. Volunteers' perceptions were measured at 12 weeks using the Peer Volunteer Experience Questionnaire, completed by 69% (121) of the 175 volunteers who provided support to at least one mother. Large majorities felt that the training session had prepared them for their role (94.2%), that volunteering did not interfere with their lives (81.8%) and that providing support helped them grow as individuals (87.8%). Over 90% stated that they would become a peer volunteer again, given the opportunity. Recruitment and retention of effective volunteers is essential to the success of any peer-support intervention. Results from this study can assist clinicians and program planners to provide effective training, sufficient on-going support and evaluation and appropriate matching of volunteers to mothers who desire peer support and are at high risk of postpartum depression. PMID:22388589

Making Boundaries Great Again: Essentialism and Support for Boundary-Enhancing Initiatives.

PubMed

Roberts, Steven O; Ho, Arnold K; Rhodes, Marjorie; Gelman, Susan A

2017-12-01

Psychological essentialism entails a focus on category boundaries (e.g., categorizing people as men or women) and an increase in the conceptual distance between those boundaries (e.g., accentuating the differences between men and women). Across eight studies, we demonstrate that essentialism additionally entails an increase in support for boundary-enhancing legislation, policies, and social services, and that it does so under conditions that disadvantage social groups, as well as conditions that benefit them. First, individual differences in essentialism were associated with support for legislation mandating that transgender people use restrooms corresponding with their biological sex, and with support for the boundary-enhancing policies of the 2016 then-presumptive Republican presidential nominee (i.e., Donald Trump). Second, essentialism was associated with support for same-gender classrooms designed to promote student learning, as well as support for services designed to benefit LGBTQ (lesbian, gay, bisexual, transgender, queer) individuals. These findings demonstrate the boundary-enhancing implications of essentialism and their social significance.

Making drugs accessible.

PubMed

1999-01-01

Making drugs accessible for common HIV-associated illnesses in West Africa is discussed. HIV-positive people in Ouagadougou, Burkina Faso, could not afford drugs for treating their illnesses; thus, volunteers from La Bergerie-FUC, a Christian organization, have established a day care center for HIV-positive people. A French church supplies the drugs; oral rehydration salts are provided through the Ministry of Health. Since the organization did not have enough drugs to meet the needs of all its patients, two strategies were developed to improve its drug supply. The first strategy was to raise money to buy drugs through the support of a local NGO, the Initiative Privee et Communautaire de lutte contre le SIDA (IPC). IPC initially refused to support them, but, eventually agreed to fund drug purchasing as a pilot project. The second strategy was to look at ways of reducing the cost of drugs, which resulted in a list of essential drugs for HIV-associated infections. The list was approved by Care and Support Committee of the national AIDS program for use by other organizations. The organizations have created a national network to improve the delivery of community-based care and support services in Burkina Faso. Recently, the national AIDS program has asked this network to help them change the national essential drugs list to include essential drugs for treating common HIV-associated infections.

How do line managers experience and handle the return to work of employees on sick leave due to work-related stress? A one-year follow-up study.

PubMed

Ladegaard, Yun; Skakon, Janne; Elrond, Andreas Friis; Netterstrøm, Bo

2017-08-28

To examine how line managers experience and manage the return to work process of employees on sick leave due to work-related stress and to identify supportive and inhibiting factors. Semi-structured interviews with 15 line managers who have had employees on sick leave due to work-related stress. The grounded theory approach was employed. Even though managers may accept the overall concept of work-related stress, they focus on personality and individual circumstances when an employee is sick-listed due to work-related stress. The lack of a common understanding of stress creates room for this focus. Line managers experience cross-pressure, discrepancies between strategic and human-relationship perspectives and a lack of organizational support in the return to work process. Organizations should aim to provide support for line managers. Research-based knowledge and guidelines on work-related stress and return to work process are essential, as is the involvement of coworkers. A commonly accepted definition of stress and a systematic risk assessment is also important. Cross-pressure on line managers should be minimized and room for adequate preventive actions should be provided as such an approach could support both the return to work process and the implementation of important interventions in the work environment. Implication for rehabilitation Organizations should aim to provide support for line managers handling the return to work process. Cross-pressure on line managers should be minimized and adequate preventive actions should be provided in relation to the return to work process. Research-based knowledge and guidelines on work-related stress and return to work are essential. A common and formal definition of stress should be emphasized in the workplace.

Performance of National Maps of Watershed Integrity at Watershed Scales

EPA Science Inventory

Watershed integrity, the capacity of a watershed to support and maintain ecological processes essential to the sustainability of services provided to society, can be influenced by a range of landscape and in-stream factors. Ecological response data from four intensively monitored...

The Essential Supports for School Improvement. Research Report

ERIC Educational Resources Information Center

Sebring, Penny Bender; Allensworth, Elaine; Bryk, Anthony S.; Easton, John Q.; Luppescu, Stuart

2006-01-01

This report sets forth a framework of essential supports and contextual resources for school improvement, examines empirical evidence on its key elements and how they link to improvements in student learning, and investigates how a school's essential supports interact with community context to affect student learning. The purpose of this research…

HIV-positive mothers in Viet Nam: using their status to build support groups and access essential services.

PubMed

Oosterhoff, Pauline; Anh, Nguyen Thu; Yen, Pham Ngoc; Wright, Pamela; Hardon, Anita

2008-11-01

Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2004, and a sister group begun in 2005 in Thai Nguyen province. From April 2004 to early 2007, we carried out semi-structured interviews with 275 health care workers and 153 HIV-positive women and members of their families, as well as participant observation of group meetings and activities. Sunflowers have successfully organised themselves to access vital social, medical and economic support and services for themselves, their children and partners. They gained self-confidence, and learned to communicate with their peers and voice their needs to service providers. Based on personal development plans, they have accessed other state services, such as loans, job counselling and legal advice. They have also gained access to school and treatment for their children, who had previously been excluded. Although the women were vulnerable to HIV as wives and mothers, motherhood also provided them with social status and an identity they used to help build organisations and develop strategies to access the essential services that they and their families need.

Analysis of Ten Reverse Engineering Tools

NASA Astrophysics Data System (ADS)

Koskinen, Jussi; Lehmonen, Tero

Reverse engineering tools can be used in satisfying the information needs of software maintainers. Especially in case of maintaining large-scale legacy systems tool support is essential. Reverse engineering tools provide various kinds of capabilities to provide the needed information to the tool user. In this paper we analyze the provided capabilities in terms of four aspects: provided data structures, visualization mechanisms, information request specification mechanisms, and navigation features. We provide a compact analysis of ten representative reverse engineering tools for supporting C, C++ or Java: Eclipse Java Development Tools, Wind River Workbench (for C and C++), Understand (for C++), Imagix 4D, Creole, Javadoc, Javasrc, Source Navigator, Doxygen, and HyperSoft. The results of the study supplement the earlier findings in this important area.

A model for the electronic support of practice-based research networks.

PubMed

Peterson, Kevin A; Delaney, Brendan C; Arvanitis, Theodoros N; Taweel, Adel; Sandberg, Elisabeth A; Speedie, Stuart; Richard Hobbs, F D

2012-01-01

The principal goal of the electronic Primary Care Research Network (ePCRN) is to enable the development of an electronic infrastructure to support clinical research activities in primary care practice-based research networks (PBRNs). We describe the model that the ePCRN developed to enhance the growth and to expand the reach of PBRN research. Use cases and activity diagrams were developed from interviews with key informants from 11 PBRNs from the United States and United Kingdom. Discrete functions were identified and aggregated into logical components. Interaction diagrams were created, and an overall composite diagram was constructed describing the proposed software behavior. Software for each component was written and aggregated, and the resulting prototype application was pilot tested for feasibility. A practical model was then created by separating application activities into distinct software packages based on existing PBRN business rules, hardware requirements, network requirements, and security concerns. We present an information architecture that provides for essential interactions, activities, data flows, and structural elements necessary for providing support for PBRN translational research activities. The model describes research information exchange between investigators and clusters of independent data sites supported by a contracted research director. The model was designed to support recruitment for clinical trials, collection of aggregated anonymous data, and retrieval of identifiable data from previously consented patients across hundreds of practices. The proposed model advances our understanding of the fundamental roles and activities of PBRNs and defines the information exchange commonly used by PBRNs to successfully engage community health care clinicians in translational research activities. By describing the network architecture in a language familiar to that used by software developers, the model provides an important foundation for the development of electronic support for essential PBRN research activities.

Community resources support adherence to treatment for childhood cancer in El Salvador.

PubMed

Rossell, Nuria; Salaverria, Carmen; Hernandez, Angelica; Alabi, Soad; Vasquez, Roberto; Bonilla, Miguel; Lam, Catherine G; Ribeiro, Raul; Reis, Ria

2018-01-01

In order to reduce nonadherence and treatment abandonment of children with cancer in El Salvador, institutions located nearby the patients' homes were involved to provide support. Methodological approach: Health clinics and municipality offices in the patients' communities were asked to assist families who were not promptly located after missing hospital appointments, or those whose financial limitations were likely to impede continuation of treatment. Data was collected about the number of contacted institutions, the nature of help provided, staff's time investments, and parents' perceptions about the intervention. Local institutions (133 from 206 contacts) conducted home visits (83), and/or provided parents with money (55) or transportation (60). Parents found this support essential for continuing the treatment but they also encountered challenges regarding local institutions' inconsistencies. Nonadherence and abandonment decreased. Economic burden was reduced on both the families and the hospital. Involvement of external institutions might become regular practice to support families of children with cancer.

A feature dictionary supporting a multi-domain medical knowledge base.

PubMed

Naeymi-Rad, F

1989-01-01

Because different terminology is used by physicians of different specialties in different locations to refer to the same feature (signs, symptoms, test results), it is essential that our knowledge development tools provide a means to access a common pool of terms. This paper discusses the design of an online medical dictionary that provides a solution to this problem for developers of multi-domain knowledge bases for MEDAS (Medical Emergency Decision Assistance System). Our Feature Dictionary supports phrase equivalents for features, feature interactions, feature classifications, and translations to the binary features generated by the expert during knowledge creation. It is also used in the conversion of a domain knowledge to the database used by the MEDAS inference diagnostic sessions. The Feature Dictionary also provides capabilities for complex queries across multiple domains using the supported relations. The Feature Dictionary supports three methods for feature representation: (1) for binary features, (2) for continuous valued features, and (3) for derived features.

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea

PubMed Central

Martin, Janet; Tau, Goa; Cherian, Meena Nathan; Vergel de Dios, Jennifer; Mills, David; Fitzpatrick, Jane; Adu-Krow, William; Cheng, Davy

2015-01-01

Objective To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG. Design Cross-sectional survey. Setting Hospitals and health facilities in PNG. Participants 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. Outcome measures The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment. Results While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services. Conclusions Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. PMID:26674504

Requirements for clinical information modelling tools.

PubMed

Moreno-Conde, Alberto; Jódar-Sánchez, Francisco; Kalra, Dipak

2015-07-01

This study proposes consensus requirements for clinical information modelling tools that can support modelling tasks in medium/large scale institutions. Rather than identify which functionalities are currently available in existing tools, the study has focused on functionalities that should be covered in order to provide guidance about how to evolve the existing tools. After identifying a set of 56 requirements for clinical information modelling tools based on a literature review and interviews with experts, a classical Delphi study methodology was applied to conduct a two round survey in order to classify them as essential or recommended. Essential requirements are those that must be met by any tool that claims to be suitable for clinical information modelling, and if we one day have a certified tools list, any tool that does not meet essential criteria would be excluded. Recommended requirements are those more advanced requirements that may be met by tools offering a superior product or only needed in certain modelling situations. According to the answers provided by 57 experts from 14 different countries, we found a high level of agreement to enable the study to identify 20 essential and 21 recommended requirements for these tools. It is expected that this list of identified requirements will guide developers on the inclusion of new basic and advanced functionalities that have strong support by end users. This list could also guide regulators in order to identify requirements that could be demanded of tools adopted within their institutions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effect of an essential oil mixture on skin reactions in women undergoing radiotherapy for breast cancer: a pilot study.

PubMed

Halm, Margo A; Baker, Clarice; Harshe, Val

2014-12-01

This pilot study compared the effects of an essential oil mixture versus standard care on skin reactions in breast cancer patients receiving radiation. Using an experimental design, 24 patients were randomized to standard care (i.e., RadiaPlexRx™ ointment) or an essential oil mixture. Products were applied topically three times a day until 1 month postradiation. Weekly skin assessments were recorded and women completed patient satisfaction and quality of life (QOL) instruments at 3-, 6-, and 10-week intervals. No significant differences were found for skin, QOL, or patient satisfaction at interim or follow-up time points. Effect sizes were as follows: skin = .01 to .07 (small-medium effect); QOL = .01 to .04 (small effect); patient satisfaction = .02 (small effect). The essential oil mixture did not provide a better skin protectant effect than standard care. These findings suggest the essential oil mixture is equivalent to RadiaPlexRx, a common product used as standard care since it has been shown to be effective in protecting skin from radiation. Thus, this pilot provides evidence to support botanical or nonpharmaceutical options for women during radiotherapy for breast cancer. © The Author(s) 2014.

Tier II Interventions within the Framework of School-Wide Positive Behavior Support: Essential Features for Design, Implementation, and Maintenance.

PubMed

Anderson, Cynthia M; Borgmeier, Chris

2010-01-01

To meet the complex social behavioral and academic needs of all students, schools benefit from having available multiple evidence-based interventions of varying intensity. School-wide positive behavior support provides a framework within which a continuum of evidence-based interventions can be implemented in a school. This framework includes three levels or tiers of intervention; Tier I (primary or universal), Tier II (secondary or targeted), and Tier III (tertiary or individualized) supports. In this paper we review the logic behind school-wide positive behavior support and then focus on Tier II interventions, as this level of support has received the least attention in the literature. We delineate the key features of Tier II interventions as implemented within school-wide positive behavior support, provide guidelines for matching Tier II interventions to school and student needs, and describe how schools plan for implementation and maintenance of selected interventions.

Aging Water Infrastructure Research Program Innovation & Research for the 21st Century

EPA Science Inventory

The U.S. infrastructure is critical for providing essential services: protect public health and the environment and support and sustain our economy. Significant investment in water infrastructure: over 16,000 WWTPs serving 190 million people; about 54,000 community water syste...

29 CFR 1902.40 - Informal hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... conducted under this section shall be legislative in type. However, fairness may require an opportunity for... informal and legislative in type, this section is intended to provide more than the bare essentials of... written recommendations with supporting reasons and any additional data, views, and arguments from any...

Seeing Public Engagement Differently

ERIC Educational Resources Information Center

Willis, Jason

2010-01-01

The economic recession has had a profound effect on the ability of state and local governments to provide essential services to their communities--especially education. Stories about increased class sizes, personnel layoffs, and dwindling support for programs outside core classroom instruction have flooded newspapers around the country. Despite…

Enhancing bird banding information sharing across the western hemishpere

USGS Publications Warehouse

Rojo, A.; Berlanga, H.; Howes, L.; Tomosy, M.

2007-01-01

Bird banding and marking provide indispensable tools for ornithological research, management, and conservation of migratory birds and their habitats along migratory routes, breeding and non-breeding grounds. With the growing interest in international coordination of tracking bird movements, coordination amongst developing and existing programs is essential for effective data management. The North American Bird Banding Program (Canadian Bird Banding Office and U.S. Bird Banding Laboratory and the Mexican government) has been working to enhance collaboration with other Western Hemisphere countries to establish a voluntary bird banding communication network. This network addresses challenges, such as: demonstrating how sharing banding expertise and information management can support the stewardship of Western Hemisphere migratory birds, ensuring that valuable banding and encounter data are captured and shared. With increasing numbers of international scientific and conservation initiatives, bird banding and marking programs must provide essential international coordination functions as well as support local activities by facilitating access to bands, training, data management and encounter reporting.

A national database for essential drugs in South Africa.

PubMed

Zweygarth, M; Summers, R S

2000-06-01

In the process of drafting standard treatment guidelines for adults and children at hospital level, the Secretariat of the National Essential Drugs List Committee made use of a database designed with technical support from the School of Pharmacy, MEDUNSA. The database links the current 697 drugs on the Essential Drugs List with Standard Treatment Guidelines for over 400 conditions. It served to streamline the inclusion of different drugs and dosage forms in the various guidelines, and provided concise, updated information to other departments involved in drug procurement. From information on drug prices and morbidity, it can also be used to calculate drug consumption and cost estimates and compare them with actual figures.

Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya when No Anesthetist is Available: An Analysis of 1216 Consecutive Operative Procedures.

PubMed

Burke, Thomas F; Suarez, Sebastian; Sessler, Daniel I; Senay, Ayla; Yusufali, Taha; Masaki, Charles; Guha, Moytrayee; Rogo, Debora; Jani, Pankaj; Nelson, Brett D; Rogo, Khama

2017-12-01

Lack of access to emergency and essential surgery is widespread in low- and middle-income countries. Scarce anesthesia services contribute to this unmet need. The aim of this study was to evaluate the safety and feasibility of the Every Second Matters for Emergency and Essential Surgery-Ketamine (ESM-Ketamine) package for emergency and essential procedures when no anesthetist was available. From November 2013 to September 2017, the ESM-Ketamine package was used for patients requiring emergency or life-improving surgeries in fifteen selected facilities across Kenya when no anesthetist was available. A mixed-methods approach was used to assess safety and feasibility of the ESM-Ketamine package, including demand, acceptability, and practicality. The primary outcome was ketamine-related adverse events. Key-informant interviews captured perceptions of providers, hospital administrators, and surgeons/proceduralists. Non-anesthetist mid-level providers used ESM-Ketamine for 1216 surgical procedures across the fifteen study facilities. The median ketamine dose was 2.1 mg/kg. Brief (<30 s) oxygen desaturations occurred in 39 patients (3%), and prolonged (>30 s) oxygen desaturations occurred in seven patients (0.6%). There were 157 (13%) reported cases of hallucinations and agitation which were treated with diazepam. All patients recovered uneventfully, and no ketamine-related deaths were reported. Twenty-seven key-informant interviews showed strong support for the program with four main themes: financial considerations, provision of services, staff impact, and scaling considerations. The ESM-Ketamine package appears safe and feasible and is capable of expanding access to emergency and essential surgeries in rural Kenya when no anesthetist is available.

De Novo Sequencing and Analysis of Lemongrass Transcriptome Provide First Insights into the Essential Oil Biosynthesis of Aromatic Grasses.

PubMed

Meena, Seema; Kumar, Sarma R; Venkata Rao, D K; Dwivedi, Varun; Shilpashree, H B; Rastogi, Shubhra; Shasany, Ajit K; Nagegowda, Dinesh A

2016-01-01

Aromatic grasses of the genus Cymbopogon (Poaceae family) represent unique group of plants that produce diverse composition of monoterpene rich essential oils, which have great value in flavor, fragrance, cosmetic, and aromatherapy industries. Despite the commercial importance of these natural aromatic oils, their biosynthesis at the molecular level remains unexplored. As the first step toward understanding the essential oil biosynthesis, we performed de novo transcriptome assembly and analysis of C. flexuosus (lemongrass) by employing Illumina sequencing. Mining of transcriptome data and subsequent phylogenetic analysis led to identification of terpene synthases, pyrophosphatases, alcohol dehydrogenases, aldo-keto reductases, carotenoid cleavage dioxygenases, alcohol acetyltransferases, and aldehyde dehydrogenases, which are potentially involved in essential oil biosynthesis. Comparative essential oil profiling and mRNA expression analysis in three Cymbopogon species (C. flexuosus, aldehyde type; C. martinii, alcohol type; and C. winterianus, intermediate type) with varying essential oil composition indicated the involvement of identified candidate genes in the formation of alcohols, aldehydes, and acetates. Molecular modeling and docking further supported the role of identified protein sequences in aroma formation in Cymbopogon. Also, simple sequence repeats were found in the transcriptome with many linked to terpene pathway genes including the genes potentially involved in aroma biosynthesis. This work provides the first insights into the essential oil biosynthesis of aromatic grasses, and the identified candidate genes and markers can be a great resource for biotechnological and molecular breeding approaches to modulate the essential oil composition.

De Novo Sequencing and Analysis of Lemongrass Transcriptome Provide First Insights into the Essential Oil Biosynthesis of Aromatic Grasses

PubMed Central

Meena, Seema; Kumar, Sarma R.; Venkata Rao, D. K.; Dwivedi, Varun; Shilpashree, H. B.; Rastogi, Shubhra; Shasany, Ajit K.; Nagegowda, Dinesh A.

2016-01-01

Aromatic grasses of the genus Cymbopogon (Poaceae family) represent unique group of plants that produce diverse composition of monoterpene rich essential oils, which have great value in flavor, fragrance, cosmetic, and aromatherapy industries. Despite the commercial importance of these natural aromatic oils, their biosynthesis at the molecular level remains unexplored. As the first step toward understanding the essential oil biosynthesis, we performed de novo transcriptome assembly and analysis of C. flexuosus (lemongrass) by employing Illumina sequencing. Mining of transcriptome data and subsequent phylogenetic analysis led to identification of terpene synthases, pyrophosphatases, alcohol dehydrogenases, aldo-keto reductases, carotenoid cleavage dioxygenases, alcohol acetyltransferases, and aldehyde dehydrogenases, which are potentially involved in essential oil biosynthesis. Comparative essential oil profiling and mRNA expression analysis in three Cymbopogon species (C. flexuosus, aldehyde type; C. martinii, alcohol type; and C. winterianus, intermediate type) with varying essential oil composition indicated the involvement of identified candidate genes in the formation of alcohols, aldehydes, and acetates. Molecular modeling and docking further supported the role of identified protein sequences in aroma formation in Cymbopogon. Also, simple sequence repeats were found in the transcriptome with many linked to terpene pathway genes including the genes potentially involved in aroma biosynthesis. This work provides the first insights into the essential oil biosynthesis of aromatic grasses, and the identified candidate genes and markers can be a great resource for biotechnological and molecular breeding approaches to modulate the essential oil composition. PMID:27516768

The Essential Genome of Escherichia coli K-12.

PubMed

Goodall, Emily C A; Robinson, Ashley; Johnston, Iain G; Jabbari, Sara; Turner, Keith A; Cunningham, Adam F; Lund, Peter A; Cole, Jeffrey A; Henderson, Ian R

2018-02-20

Transposon-directed insertion site sequencing (TraDIS) is a high-throughput method coupling transposon mutagenesis with short-fragment DNA sequencing. It is commonly used to identify essential genes. Single gene deletion libraries are considered the gold standard for identifying essential genes. Currently, the TraDIS method has not been benchmarked against such libraries, and therefore, it remains unclear whether the two methodologies are comparable. To address this, a high-density transposon library was constructed in Escherichia coli K-12. Essential genes predicted from sequencing of this library were compared to existing essential gene databases. To decrease false-positive identification of essential genes, statistical data analysis included corrections for both gene length and genome length. Through this analysis, new essential genes and genes previously incorrectly designated essential were identified. We show that manual analysis of TraDIS data reveals novel features that would not have been detected by statistical analysis alone. Examples include short essential regions within genes, orientation-dependent effects, and fine-resolution identification of genome and protein features. Recognition of these insertion profiles in transposon mutagenesis data sets will assist genome annotation of less well characterized genomes and provides new insights into bacterial physiology and biochemistry. IMPORTANCE Incentives to define lists of genes that are essential for bacterial survival include the identification of potential targets for antibacterial drug development, genes required for rapid growth for exploitation in biotechnology, and discovery of new biochemical pathways. To identify essential genes in Escherichia coli , we constructed a transposon mutant library of unprecedented density. Initial automated analysis of the resulting data revealed many discrepancies compared to the literature. We now report more extensive statistical analysis supported by both literature searches and detailed inspection of high-density TraDIS sequencing data for each putative essential gene for the E. coli model laboratory organism. This paper is important because it provides a better understanding of the essential genes of E. coli , reveals the limitations of relying on automated analysis alone, and provides a new standard for the analysis of TraDIS data. Copyright © 2018 Goodall et al.

Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings.

PubMed

Kumar, Somesh; Yadav, Vikas; Balasubramaniam, Sudharsanam; Jain, Yashpal; Joshi, Chandra Shekhar; Saran, Kailash; Sood, Bulbul

2016-11-08

India accounts for 27 % of world's neonatal deaths. Although more Indian women deliver in facilities currently than a decade ago, early neonatal mortality has not declined, likely because of insufficient quality of care. The WHO Safe Childbirth Checklist (SCC) was developed to support health workers to perform essential practices known to reduce preventable maternal and new-born deaths around the time of childbirth. Despite promising early research many outstanding questions remain about effectiveness of the SCC in low-resource settings. In collaboration with the Ministry of Health SCC was modified for Indian context and introduced in 101 intervention facilities in Rajasthan, India and 99 facilities served as comparison to study if it reduces mortality. This Quasi experimental Observational intervention-comparison was embedded in this larger program to test whether a program for introduction of SCC with simple implementation package was associated with increased adherence to 28 evidence-based practices. This study was conducted in 8 intervention and 8 comparison sites. Program interventions to promote appropriate use of the SCC included orienting providers to the checklist, modest modifications of the SCC to promote provider uptake and accountability, ensuring availability of essential supplies, and providing supportive supervision for helping providers in using the SCC. The SCC was used by providers in 86 % of 240 deliveries observed in the eight intervention facilities. Providers in the intervention group significantly adhered to practices included in the SCC than providers in the comparison group controlling for baseline scores and confounders. Women delivering in the intervention facilities received on an average 11.5 more of the 28 practices included compared with women in the comparison facilities. For selected practices provider performance in the intervention group increased as much as 93 % than comparison sites. Use of the SCC and provider performance of best practices increased in intervention facilities reflecting improvement in quality of facility childbirth care for women and new-born in low resource settings.

ANTIMICROBIAL ACTIVITY OF BURSERA MORELENSIS RAMÍREZ ESSENTIAL OIL.

PubMed

M, Canales-Martinez; C R, Rivera-Yañez; J, Salas-Oropeza; H R, Lopez; M, Jimenez-Estrada; R, Rosas-Lopez; D A, Duran; C, Flores; L B, Hernandez; M A, Rodriguez-Monroy

2017-01-01

Bursera morelensis , known as "Aceitillo", is an endemic tree of Mexico. Infusions made from the bark of this species have been used for the treatment of skin infections and for their wound healing properties. In this work, we present the results of a phytochemical and antimicrobial investigation of the essential oil of B. morelensis . The essential oil was obtained by a steam distillation method and analyzed using GC-MS. The antibacterial and antifungal activities were evaluated. GC-MS of the essential oil demonstrated the presence of 28 compounds. The principal compound of the essential oil was a-Phellandrene (32.69%). The essential oil had antibacterial activity against Gram positive and negative strains. The most sensitive strains were S. pneumoniae , V. cholerae (cc) and E. coli (MIC 0.125 mg/mL, MBC 0.25 mg/mL). The essential oil was bactericidal for V. cholera (cc). The essential oil inhibited all the filamentous fungi. F. monilifome (IC 50 = 2.27 mg/mL) was the most sensitive fungal strain. This work provides evidence that confirms the antimicrobial activity of the B. morelensis essential oil and this is a scientific support about of traditional uses of this species.

ANTIMICROBIAL ACTIVITY OF BURSERA MORELENSIS RAMÍREZ ESSENTIAL OIL

PubMed Central

M., Canales-Martinez; C.R., Rivera-Yañez; J., Salas-Oropeza; H.R., Lopez; M., Jimenez-Estrada; R., Rosas-Lopez; D.A., Duran; C., Flores; L.B., Hernandez; M.A., Rodriguez-Monroy

2017-01-01

Background: Bursera morelensis, known as “Aceitillo”, is an endemic tree of Mexico. Infusions made from the bark of this species have been used for the treatment of skin infections and for their wound healing properties. In this work, we present the results of a phytochemical and antimicrobial investigation of the essential oil of B. morelensis. Materials and Methods: The essential oil was obtained by a steam distillation method and analyzed using GC-MS. The antibacterial and antifungal activities were evaluated. Results: GC-MS of the essential oil demonstrated the presence of 28 compounds. The principal compound of the essential oil was a-Phellandrene (32.69%). The essential oil had antibacterial activity against Gram positive and negative strains. The most sensitive strains were S. pneumoniae, V. cholerae (cc) and E. coli (MIC 0.125 mg/mL, MBC 0.25 mg/mL). The essential oil was bactericidal for V. cholera (cc). The essential oil inhibited all the filamentous fungi. F. monilifome (IC50 = 2.27 mg/mL) was the most sensitive fungal strain. Conclusions: This work provides evidence that confirms the antimicrobial activity of the B. morelensis essential oil and this is a scientific support about of traditional uses of this species. PMID:28480418

CrossTalk: The Journal of Defense Software Engineering. Volume 21, Number 3

DTIC Science & Technology

2008-03-01

describes essentials for requirements development and management. In addi- tion to providing training, eLearning and consulting services, she speaks at and...information, support sense- making, enable collaborative decision making, and effect changes in the physical environment. For example, the Global ...across layers, which enables effective use of resources and helps enforce security and confiden- tiality policies. Global Data Space DDS provides a

National Consumer and Financial Literacy Framework

ERIC Educational Resources Information Center

Ministerial Council for Education, Early Childhood Development and Youth Affairs (NJ1), 2011

2011-01-01

This document is a revised version of the National Consumer and Financial Literacy Framework (the Framework) originally developed in 2005. It articulates a rationale for consumer and financial education in Australian schools; describes essential consumer and financial capabilities that will support lifelong learning; and provides guidance on how…

Cloud-Based Virtual Laboratory for Network Security Education

ERIC Educational Resources Information Center

Xu, Le; Huang, Dijiang; Tsai, Wei-Tek

2014-01-01

Hands-on experiments are essential for computer network security education. Existing laboratory solutions usually require significant effort to build, configure, and maintain and often do not support reconfigurability, flexibility, and scalability. This paper presents a cloud-based virtual laboratory education platform called V-Lab that provides a…

Instituting the Updated CPR Protocol: The Team Physician's Role.

ERIC Educational Resources Information Center

Araujo, David

1994-01-01

Summarizes recommendations from the 1992 National Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care. Because team physicians may have to provide basic life support for athletes or spectators, knowing current (CPR) protocol is essential in developing emergency response plans and training personnel. Practice removing…

Collaborative Writing Support Tools on the Cloud

ERIC Educational Resources Information Center

Calvo, R. A.; O'Rourke, S. T.; Jones, J.; Yacef, K.; Reimann, P.

2011-01-01

Academic writing, individual or collaborative, is an essential skill for today's graduates. Unfortunately, managing writing activities and providing feedback to students is very labor intensive and academics often opt out of including such learning experiences in their teaching. We describe the architecture for a new collaborative writing support…

Essential science for understanding risks from radiation for airline passengers and crews

NASA Astrophysics Data System (ADS)

Knipp, Delores J.

2017-04-01

This commentary addresses the essential science and return-on-investment related to radiation risks for airline passengers and crews. The focus is on two recent NASA efforts to obtain data on radiation at and above commercial flight altitudes. Given that cosmic ray fluxes will likely be the highest since the dawn of the aviation age during the upcoming solar minimum, measuring high-altitude radiation dose and turning those data into useful information for aviation operators, schedulers, and frequent flyers will provide support for key decisions.

A Medical Decision Support System for the Space Station Health Maintenance Facility

PubMed Central

Ostler, David V.; Gardner, Reed M.; Logan, James S.

1988-01-01

NASA is developing a Health Maintenance Facility (HMF) to provide the equipment and supplies necessary to deliver medical care in the Space Station. An essential part of the Health Maintenance Facility is a computerized Medical Decision Support System (MDSS) that will enhance the ability of the medical officer (“paramedic” or “physician”) to maintain the crew's health, and to provide emergency medical care. The computer system has four major functions: 1) collect and integrate medical information into an electronic medical record from Space Station medical officers, HMF instrumentation, and exercise equipment; 2) provide an integrated medical record and medical reference information management system; 3) manage inventory for logistical support of supplies and secure pharmaceuticals; 4) supply audio and electronic mail communications between the medical officer and ground based flight surgeons. ImagesFigure 1

Specifications of Standards in Systems and Synthetic Biology: Status and Developments in 2017.

PubMed

Schreiber, Falk; Bader, Gary D; Gleeson, Padraig; Golebiewski, Martin; Hucka, Michael; Keating, Sarah M; Novère, Nicolas Le; Myers, Chris; Nickerson, David; Sommer, Björn; Waltemath, Dagmar

2018-03-29

Standards are essential to the advancement of Systems and Synthetic Biology. COMBINE provides a formal body and a centralised platform to help develop and disseminate relevant standards and related resources. The regular special issue of the Journal of Integrative Bioinformatics aims to support the exchange, distribution and archiving of these standards by providing unified, easily citable access. This paper provides an overview of existing COMBINE standards and presents developments of the last year.

Working to End Family Homelessness. Annual Report

ERIC Educational Resources Information Center

National Center on Family Homelessness (NJ1), 2012

2012-01-01

The National Center on Family Homelessness is determined to end family homelessness. Sheltering families provides a temporary safe haven. Connecting families to permanent housing, essential services, and critical supports can change their lives forever. Through research the Center learns what families need to rebound from the housing, economic,…

Content-Specific Source Encoding in the Human Medial Temporal Lobe

ERIC Educational Resources Information Center

Awipi, T.; Davachi, L.

2008-01-01

Although the medial temporal lobe (MTL) is known to be essential for episodic encoding, the contributions of individual MTL subregions remain unclear. Data from recognition memory studies have provided evidence that the hippocampus supports relational encoding important for later episodic recollection, whereas the perirhinal cortex has been linked…

South Dakota Student Learning Objectives Handbook

ERIC Educational Resources Information Center

Gill, Matt; Outka, Janeen; McCorkle, Mary

2015-01-01

Student growth is one of two essential components of South Dakota's Teacher and Principal Effectiveness Systems. In the state systems, student growth is defined as a positive change in student achievement between two or more points in time. "The South Dakota SLO Handbook" provides support and guidance to public schools and school…

Social and Emotional Learning in the Classroom: Promoting Mental Health and Academic Success

ERIC Educational Resources Information Center

Merrell, Kenneth W.; Gueldner, Barbara A.

2010-01-01

This highly engaging, eminently practical book provides essential resources for implementing social and emotional learning (SEL) in any K-12 setting. Numerous vivid examples illustrate the nuts and bolts of this increasingly influential approach to supporting students' mental health, behavior, and academic performance. Helpful reproducibles are…

The Serrano Problem: An Analysis of Equalization of Public School Support in California.

ERIC Educational Resources Information Center

Lindman, Erick L.

The Serrano case controversy raises the fundamental question: Do differences in school district per pupil expenditures represent cost differences incurred in providing essentially equivalent programs, or do they represent substantial differences in educational offerings? Although the answer is debatable, the California legislature increased…

Using Education Diplomacy to Help 15 Learning Champions Rethink Educational Assessment

ERIC Educational Resources Information Center

Anderson, Kate

2018-01-01

Learning assessment is essential for education systems to provide quality and equitable education. Education partners, both national and international, are supporting education systems around the world in their efforts to develop and implement holistic learning assessment strategies and mechanisms. In many cases, examining how learning is being…

Focus in High School Mathematics: Statistics and Probability

ERIC Educational Resources Information Center

National Council of Teachers of Mathematics, 2009

2009-01-01

Reasoning about and making sense of statistics and probability are essential to students' future success. This volume belongs to a series that supports National Council of Teachers of Mathematics' (NCTM's) "Focus in High School Mathematics: Reasoning and Sense Making" by providing additional guidance for making reasoning and sense making part of…

Education Facilities Sector-Specific Plan: An Annex to the Government Facilities Sector-Specific Plan

ERIC Educational Resources Information Center

US Department of Homeland Security, 2010

2010-01-01

Critical infrastructure and key resources (CIKR) provide the essential services that support basic elements of American society. Compromise of these CIKR could disrupt key government and industry activities, facilities, and systems, producing cascading effects throughout the Nation's economy and society and profoundly affecting the national…

Improving Teacher Practices Using Microteaching: Planful Video Recording and Constructive Feedback

ERIC Educational Resources Information Center

Ostrosky, Michaelene M.; Mouzourou, Chryso; Danner, Natalie; Zaghlawan, Hasan Y.

2013-01-01

When teacher preparation is disconnected from classroom practice, preservice teachers are left to try to make this connection without the guidance and support of skilled mentors. Practicum or field experiences are essential for effective personnel preparation. Practicum experiences can provide situated learning for preservice teachers to…

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea.

PubMed

Martin, Janet; Tau, Goa; Cherian, Meena Nathan; Vergel de Dios, Jennifer; Mills, David; Fitzpatrick, Jane; Adu-Krow, William; Cheng, Davy

2015-12-16

To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG. Cross-sectional survey. Hospitals and health facilities in PNG. 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment. While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services. Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Caregiving: The impact on emotional support for single women.

PubMed

Burnley, C S

1987-01-01

Even though filial caregivers are typically daughters rather than sons, examinations of caregiving have not adequately considered the impact of gender and marital status differences on the support systems that mediate the strain of caring. Because of competing demands on time and energy, caregivers make many changes in their personal activities while maintaining work and immediate family responsibilities. The friendships that provide emotional support for singles are perceived as less important than familial relationships. Therefore, the assumption is made that the single adult daughter has less to give up as compared to her married siblings. The parallel emotional support systems of the married and single caregivers go unrecognized. This study of never-married women over age 30 reveals that these caregivers essentially foreclosed social relationships in order to provide care. Copyright © 1987. Published by Elsevier Inc.

National Labs and Nuclear Emergency Response

NASA Astrophysics Data System (ADS)

Budil, Kimberly

2015-04-01

The DOE national laboratories, and in particular the three NNSA national security laboratories, have long supported a broad suite of national nuclear security missions for the U.S. government. The capabilities, infrastructure and base of expertise developed to support the U.S. nuclear weapons stockpile have been applied to such challenges as stemming nuclear proliferation, understanding the nuclear capabilities of adversaries, and assessing and countering nuclear threats including essential support to nuclear emergency response. This talk will discuss the programs that are underway at the laboratories and the essential role that science and technology plays therein. Nuclear scientists provide expertise, fundamental understanding of nuclear materials, processes and signatures, and tools and technologies to aid in the identification and mitigation of nuclear threats as well as consequence management. This talk will also discuss the importance of direct engagement with the response community, which helps to shape research priorities and to enable development of useful tools and techniques for responders working in the field. National Labs and Nuclear Emergency Response.

Supportive Care Treatment Guidelines: Value, Limitations, and Opportunities

PubMed Central

Peterson, Douglas E.; Bensadoun, Rene-Jean; Lalla, Rajesh V.; McGuire, Deborah B.

2013-01-01

Evidence-based guidelines in clinical oncology practice are now prominent, with emphasis on clinical, health outcome and economic perspectives. Given the complexity of cancer management, a multidisciplinary approach is essential. Evidence-based guidelines to address supportive cancer care have merged expert opinion, systematic evaluation of clinical and research data, and meta-analyses of clinical trials. Production of supportive care guidelines by the interdisciplinary team is dependent on sufficient high-quality research studies. Once published, it is essential they be customized at institutional and national levels. Implementation in clinical practice is perhaps the greatest challenge. Optimal management occurs through integration of country-specific issues, including care access, healthcare resources, information technology, and national coordination of healthcare practices. The purpose of this article is to: (1) provide an overview of interdisciplinary cancer management using evidence-based guidelines; (2) delineate the theory and practice of guideline dissemination, utilization and outcome assessment; and (3) recommend future research strategies to maximize guidelines use in clinical practice. PMID:21600365

Metal Patch Antenna

NASA Technical Reports Server (NTRS)

Chamberlain, Neil F. (Inventor); Zawadzki, Mark S. (Inventor); Hodges, Richard E. (Inventor)

2012-01-01

Disclosed herein is a patch antenna comprises a planar conductive patch attached to a ground plane by a support member, and a probe connector in electrical communication with the conductive patch arranged to conduct electromagnetic energy to or from the conductive patch, wherein the conductive patch is disposed essentially parallel to the ground plane and is separated from the ground plane by a spacing distance; wherein the support member comprises a plurality of sides disposed about a central axis oriented perpendicular to the conductive patch and the ground plane; wherein the conductive patch is solely supported above the ground plane by the support member; and wherein the support member provides electrical communication between the planer conductive patch and the ground plane.

Supporting Patient Care in the Emergency Department with a Computerized Whiteboard System

PubMed Central

Aronsky, Dominik; Jones, Ian; Lanaghan, Kevin; Slovis, Corey M.

2008-01-01

Efficient information management and communication within the emergency department (ED) is essential to providing timely and high-quality patient care. The ED whiteboard (census board) usually serves as an ED’s central access point for operational and patient-related information. This article describes the design, functionality, and experiences with a computerized ED whiteboard, which has the ability to display relevant operational and patient-related information in real time. Embedded functionality, additional whiteboard views, and the integration with ED and institutional information system components, such as the computerized patient record or the provider order entry system, provide rapid access to more detailed information. As an information center, the computerized whiteboard supports our ED environment not only for providing patient care, but also for operational, educational, and research activities. PMID:18096913

Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet

PubMed Central

Price, Charles T; Langford, Joshua R; Liporace, Frank A

2012-01-01

Osteoporosis and low bone mineral density affect millions of Americans. The majority of adults in North America have insufficient intake of vitamin D and calcium along with inadequate exercise. Physicians are aware that vitamin D, calcium and exercise are essential for maintenance of bone health. Physicians are less likely to be aware that dietary insufficiencies of magnesium, silicon, Vitamin K, and boron are also widely prevalent, and each of these essential nutrients is an important contributor to bone health. In addition, specific nutritional factors may improve calcium metabolism and bone formation. It is the authors’ opinion that nutritional supplements should attempt to provide ample, but not excessive, amounts of factors that are frequently insufficient in the typical American diet. In contrast to dietary insufficiencies, several nutrients that support bone health are readily available in the average American diet. These include zinc, manganese, and copper which may have adverse effects at higher levels of intake. Some multivitamins and bone support products provide additional quantities of nutrients that may be unnecessary or potentially harmful. The purpose of this paper is to identify specific nutritional components of bone health, the effects on bone, the level of availability in the average American diet, and the implications of supplementation for each nutritional component. A summary of recommended dietary supplementation is included. PMID:22523525

The relationship between women's experiences of mistreatment at facilities during childbirth, types of support received and person providing the support in Lucknow, India.

PubMed

Diamond-Smith, Nadia; Sudhinaraset, May; Melo, Jason; Murthy, Nirmala

2016-09-01

a growing body of literature has highlighted the prevalence of mistreatment that women experience around the globe during childbirth, including verbal and physical abuse, neglect, lack of support, and disrespect. Much of this has been qualitative. Research around the world suggests that support during childbirth can improve health outcomes and behaviours, and improve experiences. Support can be instrumental, informational, or emotional, and can be provided by a variety of people including family (husbands, mothers) or health providers of various professional levels. This study explores women's reported experiences of mistreatment during childbirth quantitatively, and how these varied by specific types of support available and provided by specific individuals. participants were women age 16-30 who had delivered infants in a health facility in the previous five years and were living in slums of Lucknow India. Data were collected on their experiences of mistreatment, the types of support they received, and who provided that support. women who reported lack of support were more likely to report mistreatment. Lack of support in regards to discussions with providers and provider information were most strongly associated with a higher mistreatment score. Women who received any type of support from their husband or a health worker were significantly more likely to report lower mistreatment scores. Receiving informational support from a mother/mother-in-law or emotional support from a health worker was also associated with lower mistreatment scores. However, receiving emotional support from a friend/neighbour/other family member was associated with a higher mistreatment score. women rely on different people to provide different types of support during childbirth in this setting. Some of these individuals provide specific types of support that ultimately improve a woman's overall experience of her childbirth. Interventions aiming to reduce mistreatment to women during childbirth should consider the important role of increasing support for women, and who might be the most appropriate person to provide the most essential types of support through this process. Copyright © 2016. Published by Elsevier Ltd.

Promising Practices in the Preparation of Special Educators to Provide Reading Instruction

ERIC Educational Resources Information Center

Sayeski, Kristin L.; Gormley Budin, Shannon E.; Bennett, Katie

2015-01-01

The majority of students with disabilities require support in the area of reading. Given the importance of reading instruction, it is essential that special education teacher preparation programs prepare candidates who are knowledgeable about reading development and skilled in the delivery of reading instruction. The purpose of this article is…

Annual Report. 2009-2010 Fiscal Year. Building Capacity for Literacy and Essential Skills

ERIC Educational Resources Information Center

Movement for Canadian Literacy, 2010

2010-01-01

For over 30 years, Movement for Canadian Literacy (MCL) has provided a forum and voice for literacy organizations, practitioners and learners across the country. In partnership with its member literacy coalitions, learner representatives from every province and territory and other key stakeholders, MCL has supported the literacy and essential…

To Win the Game, Know the Rules and Legitimize the Players: Disciplinary Literacy and Multilingual Learners

ERIC Educational Resources Information Center

Hickey, Pamela J.; Lewis, Tarie

2015-01-01

Effective disciplinary literacy instruction is an essential element in the education of multilingual learners. In this article, we provide an overview of disciplinary literacy as well as instructional approaches that support meaningful pedagogy for these students. We recognize that multilingual learners are already skilled at negotiating language…

Rethinking edTPA: The Use of InTASC Principles and Standards

ERIC Educational Resources Information Center

Kuo, Nai-Cheng

2018-01-01

The Interstate Teacher Assessment and Support Consortium (InTASC) Model Core Teaching Standards and Learning Progressions for Teachers 1.0, developed by the Council of Chief State School Officers (CCSSO, 2013) in the United States, provide a set of expectations for essential knowledge, critical disposition, and performance needed for high-quality…

Supporting Refugee Children in 21st Century Britain: A Compendium of Essential Information.

ERIC Educational Resources Information Center

Rutter, Jill

This book provides information on the most recent groups of refugee children in British schools, including children from Albania, Eastern European Roma, the former Soviet Union, Iraq, Kurdistan, Algeria, Colombia, Ecuador, Bolivia, Kenya, Nigeria, and many other countries. Because educational provisions for students from refugee communities have…

From Prioritizing Objects to Prioritizing Cues: A Developmental Shift for Cognitive Control

ERIC Educational Resources Information Center

Chevalier, Nicolas; Dauvier, Bruno; Blaye, Agnès

2018-01-01

Emerging cognitive control supports increasingly adaptive behaviors and predicts life success, while low cognitive control is a major risk factor during childhood. It is therefore essential to understand how it develops. The present study provides evidence for an age-related shift in the type of information that children prioritize in their…

Developing and Sustaining a Healthy School Community: Essential Elements Identified by School Health Champions

ERIC Educational Resources Information Center

Stolp, Sean; Wilkins, Emma; Raine, Kim D.

2015-01-01

Background: Comprehensive School Health (CSH) approaches to developing a healthy school community can be effective in supporting chronic disease prevention while positively impacting on student behaviour and academic performance. Although a CSH framework provides principles for action, there is a lack of evidence regarding the processes that best…

Early Literacy Intervention for Preschoolers Who Need Tier 3 Support

ERIC Educational Resources Information Center

Kaminski, Ruth A.; Powell-Smith, Kelly A.

2017-01-01

Phonemic awareness has been consistently identified as an essential skill for as well as an important predictor of later reading achievement. Children who lack these early literacy skills at kindergarten entry are more likely to demonstrate both short- and long-term reading difficulties. Despite the importance of providing intervention early,…

Nurses' Perceptions of Nursing Care Documentation in the Electronic Health Record

ERIC Educational Resources Information Center

Jensen, Tracey A.

2013-01-01

Electronic health records (EHRs) will soon become the standard for documenting nursing care. The EHR holds the promise of rapid access to complete records of a patient's encounter with the healthcare system. It is the expectation that healthcare providers input essential data that communicates important patient information to support quality…

The President's Emergency Plan for AIDS Relief: Report on Education

ERIC Educational Resources Information Center

US Department of State, 2006

2006-01-01

For too many children, education has been a casualty of the HIV/AIDS pandemic. Yet schooling remains an essential element of a robust individual and societal future, and partnerships with the education sector provide important opportunities to fight back against the pandemic. The United States Government (USG) supports efforts to address the…

From Parents to Partners: Building a Family-Centered Early Childhood Program

ERIC Educational Resources Information Center

Keyser, Janis

2006-01-01

Partnering with parents is essential if an early childhood program is to succeed. "From Parents to Partners" explores the reasons and methods for developing ongoing partnerships with parents and other family members. It also provides the tools and strategies needed to build the communication and support networks within which these partnerships…

Library Public Relations: Recent Articles on Marketing and Branding in University Libraries

ERIC Educational Resources Information Center

Matuozzi, Robert N.

2009-01-01

Though the core mission of a university library--to provide essential support for teaching and research remains unchanged--the library cannot escape budgetary constraints. It has to compete for resources with other departments and programs in the university. Times are hard, with some states currently reporting unprecedented budget deficits with…

Abbreviated Military Decision Making for Brigade Combat Teams

DTIC Science & Technology

2001-06-01

manual, The Enlighted Eye. The current study is field focused, includes self as an instrument, is essentially interpretive in scope, focuses on details...decision making performance deteriorated when more rather than less information was provided.”51 Even under normal circumstances, current technology ...Direct Military Support (10) / Chapter 3 / 12 Critical Technology (3

Delay effects in the human sensory system during balancing.

PubMed

Stepan, Gabor

2009-03-28

Mechanical models of human self-balancing often use the Newtonian equations of inverted pendula. While these mathematical models are precise enough on the mechanical side, the ways humans balance themselves are still quite unexplored on the control side. Time delays in the sensory and motoric neural pathways give essential limitations to the stabilization of the human body as a multiple inverted pendulum. The sensory systems supporting each other provide the necessary signals for these control tasks; but the more complicated the system is, the larger delay is introduced. Human ageing as well as our actual physical and mental state affects the time delays in the neural system, and the mechanical structure of the human body also changes in a large range during our lives. The human balancing organ, the labyrinth, and the vision system essentially adapted to these relatively large time delays and parameter regions occurring during balancing. The analytical study of the simplified large-scale time-delayed models of balancing provides a Newtonian insight into the functioning of these organs that may also serve as a basis to support theories and hypotheses on balancing and vision.

Developing leadership talent: a statewide nurse leader mentorship program.

PubMed

Rich, Mary; Kempin, Bettyann; Loughlin, Mary Jo; Vitale, Tracy R; Wurmser, Theresa; Thrall, Terese Hudson

2015-02-01

Nurse leaders continue to seek support programs essential for advancement to senior roles. Providing such support presents a challenge for the future of nursing in the state of New Jersey and on a national level. This article discusses the creation of a mentorship program by the Organization of Nurse Executives of New Jersey (ONE NJ). In recognition of the program, which has contributed to the advancement of New Jersey nursing leadership, the ONE NJ received the 2014 American Organization of Nurse Executives Chapter Achievement Award.

Proceedings of the Annual Conference on Ada (Trademark) Technology (2nd) Held at Hampton, Virginia on March 27, 28, 1984.

DTIC Science & Technology

1984-03-01

evaluation of powerful support environments are essential if we are to maximize Lanauage Definition the productivity of programmers. CENVTACS provided...quality Policy and Objectives Ada support environment which includes a rich set of powerful tools (in addition to a compiler) The DOD has established Ada...to be easy to learn and easy to use. It will be powerful , efficient, and The MAPSE Command Language (MCL) friendly. This paper describes how these

Chronology: MSFC Space Shuttle program development, assembly, and testing major events (1969 - April, 1981)

NASA Technical Reports Server (NTRS)

Whalen, Jessie E. (Compiler); Mckinley, Sarah L. (Compiler); Gates, Thomas G. (Compiler)

1988-01-01

Listings of major events directly related to the Space Shuttle Program at Marshall Space Flight Center (MSFC) are presented. This information will provide the researcher with a means of following the chronological progression of the program. The products that the historians have prepared are intended to provide supportive research essential to the writing of formal narrative histories of Marshall's contributions to the Space Shuttle and Space Station.

Coastal Research Center Woods Hole Oceanographic Institution Report for the Period March 1986-July 1988

DTIC Science & Technology

1989-03-01

providing instrumentation, supplies, ship time and travel that are essential before a thesis project can be formulated. In the past we have successfully...Between Hytperiid Amphi- pods and salps Dean M. Jacobson Department/Advisor: Department of Biology/D. Anderson Degree/Date: Ph.D./February 1987...Research Center often provides partial support in the form of travel , publication or organizational expenses for symposia and workshops in Woods Hole or

Information and research: an essential partnership

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

Oen, C.J.; White, M.G.; Dunaway, P.B.

Information support is provided to the Nevada Applied Ecology Group (NAEG) through the Ecological Sciences Information Center (ESIC) at Oak Ridge National Laboratory to offer an effective, easy-to-use link between the individual researcher and the literature relevant to his work. Information within the interest areas defined by NAEG administration is identified and entered into a computerized system that provides rapid, accurate retrieval. The primary topics are the environmental aspects of the transuranic elements. (auth)

DOC/WSNSO (Department of Commerce/Weather Service Nuclear Support Office) operational support to Federal Radiological Monitoring and Assessment Center

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

Mueller, P.

1989-01-01

The National Weather Service (NWS) is an agency of the Department of Commerce. The NWS has hundreds of weather offices throughout the United States. The Weather Service Nuclear Support Office (WSNSO) is a highly specialized unit of NWS that provides direct support to the U.S. Department of Energy's (DOE's) underground nuclear testing program. The WSNSO has been associated with the DOE for >33 yr. As a result of the unique relationship with the DOE, all WSNSO emergency response meteorologists and meteorological technicians are allowed access to classified material. Meteorological phenomena play a significant role during a Federal Radiological Monitoring andmore » Assessment Center (FRMAC) event, and WSNSO meteorologists provide direct support to ARAC. The marriage of state-of-the-art computer systems together with proven technology provides the on-scene WSNSO meteorologist with essentially a portable fully equipped, fully functional, advanced NWS weather station. The WSNSO's emergency response personnel and hardware are at the ready and can be mobilized within 2 h. WSNSO can provide on-scene weather forecasts and critical weather data collection whenever and wherever necessary.« less

Factors affecting nurse retention at an academic Magnet® hospital.

PubMed

Buffington, Annsley; Zwink, Jennifer; Fink, Regina; Devine, Deborah; Sanders, Carolyn

2012-05-01

: The aim of this study was to examine the factors affecting the retention of registered nurses (RNs) and validate the revised Casey-Fink Nurse Retention Survey (2009). : Creating an organizational culture of retention may reduce nurse turnover. Focusing on why nurses leave and identifying factors why nurses stay are essential. : A descriptive survey design gathered data from RNs with 1 or more years of experience providing direct patient care and employed in inpatient/ambulatory settings in an acute care, academic, Magnet hospital. : There were no statistically significant relationships between nurse respondents' perceptions of work environment/support/encouragement and age or years of experience. However, there were significant differences between inpatient and ambulatory nurse responses in several key areas including job satisfaction, mentorship, and educational support. Overall, nurses reported feeling a lack of support and recognition from managers. Results provide evidence to support improved strategies to foster nurse retention.

Holism, health and data - managing the person-centred digital haystack.

PubMed

Rigby, Michael

2010-01-01

There is currently very legitimate pressure to change the function of health information systems to more explicitly serve and support the individual. Concurrently other support services to health, including condition monitoring, social care and intelligent housing, add to the complexity of patient health related data. A paradigm shift is needed, to recognize that many agencies and systems outside as well as within the health sector all work to support the citizen's health, yet the essential integrated view is not being provided, even though much needed not least by the citizen and their agents. Broker technologies can enable this new paradigm. Moreover, a move to identifying the patient's appointments and support services would enable a daily life dimension to be given due weight, and would recognize the patient's viewpoint in wanting to live an ordered life, not one subservient and reactive to the delivery of care by providers.

Supporting aspartate biosynthesis is an essential function of respiration in proliferating cells

PubMed Central

Sullivan, Lucas B.; Gui, Dan Y.; Hosios, Aaron M.; Bush, Lauren N.; Freinkman, Elizaveta; Vander Heiden, Matthew G.

2015-01-01

Summary Mitochondrial respiration is important for cell proliferation, however the specific metabolic requirements fulfilled by respiration to support proliferation have not been defined. Here we show that a major role of respiration in proliferating cells is to provide electron acceptors for aspartate synthesis. This finding is consistent with the observation that cells lacking a functional respiratory chain are auxotrophic for pyruvate, which serves as an exogenous electron acceptor. Further, the pyruvate requirement can be fulfilled with an alternative electron acceptor, alpha-ketobutyrate, which provides cells neither carbon nor ATP. Alpha-ketobutyrate restores proliferation when respiration is inhibited, suggesting that an alternative electron acceptor can substitute for respiration to support proliferation. We find that electron acceptors are limiting for producing aspartate, and supplying aspartate enables proliferation of respiration deficient cells in the absence of exogenous electron acceptors. Together, these data argue a major function of respiration in proliferating cells is to support aspartate synthesis. PMID:26232225

Investing in soils as an infrastructure to maintain and enhance food water and carbon services

NASA Astrophysics Data System (ADS)

Davies, Jessica

2017-04-01

Soils are a life support system for global society and our planet. In addition to providing the vast majority of our food; soils regulate water quality and quantity reducing the risk of floods, droughts and pollution; and as the largest store of carbon in the earth system they are critical to climate change. By providing these multiple essential services, soils act a natural form of infrastructure that is critical to supporting both rural and urban communities and economies. Can natural infrastructure and natural capital concepts be used to motivate and enable investment and regulation of soils for purposes such as soil carbon sequestration? What scientific knowledge and tools would we need to support soil infrastructure decision making - in policy arenas and elsewhere? This poster will present progress from a new research project supported by the UK research council (EP/N030532/1) that addresses these questions.

How Past Loss of Control Accidents May Inform Safety Cases for Advanced Control Systems on Commercial Aircraft

NASA Technical Reports Server (NTRS)

Holloway, C. M.; Johnson, C. W.

2008-01-01

This paper describes five loss of control accidents involving commercial aircraft, and derives from those accidents three principles to consider when developing a potential safety case for an advanced flight control system for commercial aircraft. One, among the foundational evidence needed to support a safety case is the availability to the control system of accurate and timely information about the status and health of relevant systems and components. Two, an essential argument to be sustained in the safety case is that pilots are provided with adequate information about the control system to enable them to understand the capabilities that it provides. Three, another essential argument is that the advanced control system will not perform less safely than a good pilot.

From smallpox eradication to contemporary global health initiatives: enhancing human capacity towards a global public health goal.

PubMed

Tarantola, Daniel; Foster, Stanley O

2011-12-30

The eradication of smallpox owes its success first and foremost to the thousands of lay health workers and community members who, throughout the campaign and across continents, took on the roles of advocates, educators, vaccinators, care providers and contributors to epidemic surveillance and containment. Bangladesh provides a good example where smallpox eradication and the capacity enhancement needed to achieve this goal resulted in a two-way mutually beneficial process. Smallpox-dedicated staff provided community members with information guidance, support and tools. In turn, communities not only created the enabling environment for smallpox program staff to perform their work but acquired the capacity to perform essential eradication tasks. Contemporary global health programmes can learn much from these core lessons including: the pivotal importance of supporting community aspirations, capacity and resilience; the critical need to enhance commitment, capacity and accountability across the workforce; and the high value of attentive human resources management and support. We owe to subsequent global disease control, elimination and eradication ventures recognition of the need for social and behavioural science to inform public health strategies; the essential roles that civil society organizations and public-private partnerships can play in public health discourse and action; the overall necessity of investing in broad-based health system strengthening; and the utility of applying human rights principles, norms and standards to public health policy and practice. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

In Situ Resource Utilization Technology Research and Facilities Supporting the NASA's Human Systems Research and Technology Life Support Program

NASA Technical Reports Server (NTRS)

Schlagheck, Ronald A.; Sibille, Laurent; Sacksteder, Kurt; Owens, Chuck

2005-01-01

The NASA Microgravity Science program has transitioned research required in support of NASA s Vision for Space Exploration. Research disciplines including the Materials Science, Fluid Physics and Combustion Science are now being applied toward projects with application in the planetary utilization and transformation of space resources. The scientific and engineering competencies and infrastructure in these traditional fields developed at multiple NASA Centers and by external research partners provide essential capabilities to support the agency s new exploration thrusts including In-Situ Resource Utilization (ISRU). Among the technologies essential to human space exploration, the production of life support consumables, especially oxygen and; radiation shielding; and the harvesting of potentially available water are realistically achieved for long-duration crewed missions only through the use of ISRU. Ongoing research in the physical sciences have produced a body of knowledge relevant to the extraction of oxygen from lunar and planetary regolith and associated reduction of metals and silicon for use meeting manufacturing and repair requirements. Activities being conducted and facilities used in support of various ISRU projects at the Glenn Research Center and Marshall Space Flight Center will be described. The presentation will inform the community of these new research capabilities, opportunities, and challenges to utilize their materials, fluids and combustion science expertise and capabilities to support the vision for space exploration.

Selecting essential information for biosurveillance--a multi-criteria decision analysis.

PubMed

Generous, Nicholas; Margevicius, Kristen J; Taylor-McCabe, Kirsten J; Brown, Mac; Daniel, W Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

2014-01-01

The National Strategy for Biosurveillance defines biosurveillance as "the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels." However, the strategy does not specify how "essential information" is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being "essential". The question of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of "essential information" for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system.

Safe motherhood professional responsibility, notes from the World Congress of Obstetrics and Gynaecology in Rio de Janeiro.

PubMed

Huezo, C

1989-04-01

Maternal mortality and morbidity are community diseases which need to be addressed mainly at the community level. As was noted in the 1988 World Congress of Obstetrics and Gynaecology, obstetricians and gynecologists have a social responsibility to promote women's health, with the 1st step being prevention of mortality and morbidity. 2 important facets of prevention are good family planning education and services to prevent high-risk pregnancies and adequate obstetric care. The General Assembly of the International Federation of Gynaecology and Obstetrics, which preceded the Congress, urged governments to ensure adequate nutrition, education and health care for girls; support to family planning within the context of maternal and child health; and expansion of the coverage and improvement of the quality of maternity services. The General Assembly requested its member associations: 1) to advocate and support promotion of women's health and social status and to support governments in establishing national committees involving all relevant sectors of society; 2) to support governments in their efforts to rationalize the allocation of resources to provide essential care for every woman; 3) to provide governments with the necessary technical support in their efforts to expand the availability of essential elements of obstetric care and the necessary technologies associated with them; 4) to promote and support the involvement of obstetricians in action-oriented research aimed at developing and testing innovative approaches to the delivery of maternity care services, including their cost effectiveness; and 5) to act as the focal point for rallying other professional associations and non-governmental organizations, and to collaborate with women's groups for the cause of safe motherhood and improving the health of women in general.

Creating an inclusive leisure space: strategies used to engage children with and without disabilities in the arts-mediated program Spiral Garden.

PubMed

Smart, Eric; Edwards, Brydne; Kingsnorth, Shauna; Sheffe, Sarah; Curran, C J; Pinto, Madhu; Crossman, Shannon; King, Gillian

2018-01-01

This article describes how service providers use a set of practical strategies to create an inclusive leisure space in Spiral Garden, an arts-mediated outdoor summer day program for children with and without disabilities. This study was guided by an interpretive qualitative approach. Fourteen Spiral Garden service providers participated in semi-structured interviews. Nine had extensive experience with the program and had been present during key phases of program development spanning over a 26-year period and five were service providers during the summer of 2013. Transcript data were analyzed using inductive thematic analysis. The analysis produced eight strategies organized under three larger categories that service providers perceived to be essential in creating an inclusive leisure space: (1) engaging children in collective experiences; (2) encouraging peer interactions and friendships; and (3) facilitating collaborative child-directed experiences. Service providers working across different inclusive settings can use findings from this study to contribute to program design and implementation. Presented strategies enable children to experience opportunities for spontaneous free play, individualized structured support, and meaningful social participation. Overall, service providers are encouraged to enhance supportive child and service provider relationships and reciprocal child and environment relationships in group-based programs. Implications for Rehabilitation Exploring and facilitating reciprocal relationships between children and their environment is essential to creating inclusive leisure spaces. Transforming program intentions of meaningful social participation into practice requires learning about and affecting change in children's individual social contexts. Service providers can engage themselves as full participants in inclusive leisure spaces through playful negotiations, internal reflections, and artistic expressions.

Clinical decision support: effectiveness in improving quality processes and clinical outcomes and factors that may influence success.

PubMed

Murphy, Elizabeth V

2014-06-01

The use of electronic health records has skyrocketed following the 2009 HITECH Act, which provides financial incentives to health care providers for the "meaningful use" of electronic medical record systems. An important component of the "Meaningful Use" legislation is the integration of Clinical Decision Support Systems (CDSS) into the computerized record, providing up-to-date medical knowledge and evidence-based guidance to the physician at the point of care. As reimbursement is increasingly tied to process and clinical outcomes, CDSS will be integral to future medical practice. Studies of CDSS indicate improvement in preventive services, appropriate care, and clinical and cost outcomes with strong evidence for CDSS effectiveness in process measures. Increasing provider adherence to CDSS recommendations is essential in improving CDSS effectiveness, and factors that influence adherence are currently under study.

Improvement of force health protection through preventive medicine oversight of contractor support.

PubMed

Mower, Scott A

2009-01-01

Unprecedented numbers of contractors are used throughout the Iraq theater of operations to alleviate military manpower shortages. At virtually every major forward operating base, US-based contractors perform the preponderance of essential life support services. At more remote sites, local national contractors are increasingly relied upon to maintain chemical latrines, remove trash, deliver bulk water, and execute other janitorial functions. Vigorous oversight of contractor performance is essential to ensure services are delivered according to specified standards. Poor oversight can increase the risk of criminal activities, permit substandard performance, elevate disease and nonbattle injury rates, degrade morale, and diminish Soldier readiness. As the principal force health protection proponents in the Department of Defense, preventive medicine units must be tightly integrated into the oversight processes. This article defines the force health protection implications associated with service contracts and provide recommendations for strengthening preventive medicine's oversight role.

Physician leadership is essential to the survival of teaching hospitals.

PubMed

Schwartz, R W; Pogge, C

2000-06-01

Academic medical centers (AMCs) face severe financial constraints because they must now compete directly with private providers that focus exclusively on cost-effective healthcare delivery. Educational and research capacities developed at AMCs have been supported by government and third party payers, but government support is diminishing. Physicians are ill-equipped to respond to market pressures. Analyses of cultural change and restructuring in corporate giants such as Greyhound, IBM and FedEx are relevant to teaching hospitals. To succeed, organizations must flatten hierarchy, empower staff, train leaders, and mobilize intellectual capital. Effective leadership is essential. Physicians must educate themselves on forces impacting the AMC, understand changes needed in the structure and processes of AMC governance and acquire competencies for leadership and management if AMCs are to survive and thrive. Surgeons should acquire competencies that will enable them to become leaders in the process of AMC transformation.

The Impact of Childhood Trauma on Brain Development: A Literature Review and Supporting Handouts

ERIC Educational Resources Information Center

Kirouac, Samantha; McBride, Dawn Lorraine

2009-01-01

This project provides a comprehensive overview of the research literature on the brain and how trauma impacts brain development, structures, and functioning. A basic exploration of childhood trauma is outlined in this project, as it is essential in making associations and connections to brain development. Childhood trauma is processed in the…

Strong School-Community Partnerships in Inclusive Schools Are "Part of the Fabric of the School... We Count on Them"

ERIC Educational Resources Information Center

Gross, Judith M. S.; Haines, Shana J.; Hill, Cokethea; Francis, Grace L.; Blue-Banning, Martha; Turnbull, Ann P.

2015-01-01

School-community partnerships play an essential role in successful schools, often providing supports and resources to meet staff, family, and student needs that go beyond what is typically available through school. Reciprocally, community partners benefit from their relationships with schools, including learning about schools' inclusive culture.…

Palliative Care.

PubMed

Swetz, Keith M; Kamal, Arif H

2018-03-06

Palliative care prioritizes symptom management and quality of life throughout the course of serious illness. Regardless of whether care is inpatient or outpatient, primary or subspecialty, a solid understanding of the basics of effective communication, symptom management, and end-of-life care is crucial. This article reviews these essentials and provides an overview of current evidence to support patient-centered palliative care.

Becoming Political, Too: New Readings and Writings on the Politics of Literacy Education.

ERIC Educational Resources Information Center

Shannon, Patrick, Ed.

This collection of 20 essays on topics vital to literacy education, a follow-up to "Becoming Political," aims to be essential reading for anyone wishing to understand the past, present, and likely future of literacy education. The essays provide equal parts of theory, strategy, and hope for all who are interested in supporting literacies…

If You Would Preserve the Management Team, You Must Pitch In and Do Your Part. The Endpaper.

ERIC Educational Resources Information Center

Cole, James E.

1983-01-01

Nine ways for school executives to provide essential support for their superintendent's concept of the management team are: (1) speaking positively about the superintendent when talking to teachers, parents, students, and members of the community; (2) keeping the superintendent informed of events, achievements, and problems; (3) seeking the…

Benchmarking and Accreditation Goals Support the Value of an Undergraduate Business Law Core Course

ERIC Educational Resources Information Center

O'Brien, Christine Neylon; Powers, Richard E.; Wesner, Thomas L.

2018-01-01

This article provides information about the value of a core course in business law and why it remains essential to business education. It goes on to identify highly ranked undergraduate business programs that require one or more business law courses. Using "Business Week" and "US News and World Report" to identify top…

Nursing Minimum Data Set for School Nursing Practice. Position Statement. Revised

ERIC Educational Resources Information Center

Denehy, Janice

2012-01-01

It is the position of the National Association of School Nurses (NASN) to support the collection of essential nursing data as listed in the Nursing Minimum Data Set (NMDS). The NMDS provides a basic structure to identify the data needed to delineate nursing care delivered to clients as well as relevant characteristics of those clients. Structure…

Power in a Union

ERIC Educational Resources Information Center

Johnson, Pam

2009-01-01

The work unions do in providing and supporting learning for their members rarely makes the news headlines, but it will be essential if people are to engage those workers who most need to acquire new and better skills to cope in the economic downturn. In this article, the author talks about the power in a union and describes UNISON, a comparatively…

Crisis Preparedness: Leadership for IT Disaster Recovery. Backgrounder Brief. CoSN Essential Leadership Skills Series

ERIC Educational Resources Information Center

Consortium for School Networking (NJ1), 2006

2006-01-01

When there is the unexpected disaster of any kind, school personnel, students, parents and communities expect to rely on communication and critical services such as payroll and access to student information the district provides and therefore the technology that supports them. Disaster recovery of IT-related operations and information is critical…

Developing Successful Collaborative Working Practices for Children with Speech and Language Difficulties: A Pilot Study

ERIC Educational Resources Information Center

Paradice, Ruth; Bailey-Wood, Nicola; Davies, Kate; Solomon, Marion

2007-01-01

The importance of collaborative practice between those who provide services to children with special educational needs is now regarded as essential and is supported strongly by the UK government. However, joint working is often difficult to implement, despite the goodwill of all involved. This paper describes a pilot study aimed at developing…

Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes.

PubMed

Frazer, Kate; Connolly, Michael; Naughton, Corina; Kow, Veronica

2014-07-01

Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports. The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme. Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students. The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical teaching and support for learners in the practice environment.

PubMed

McBrien, Barry

The purpose of planned clinical experience for students of nursing is primarily to provide students with the opportunity to develop their clinical skills, integrate theory and practice, and assist with their socialization into nursing. Nursing, in the main, is a practice-based profession. To this extent, it is essential that nurse education continues to have a strong practical element despite its full integration into higher education institutions (Department of Health, 1999). However, providing adequate support and supervision for learners is challenging. Undoubtedly, exacerbated by increasing numbers of learners, staff shortages and mentors training deficits. This article aims to critically analyse several strategies, which can be used to promote clinical learning.

Home-Care-Aides Voices from the Field: Job Experiences of Personal Support Specialists—the Maine Home Care Worker Retention Study

PubMed Central

Ashley, Alison; Butler, Sandra S.; Fishwick, Nancy

2010-01-01

In response to a rapidly aging population that is living longer with more chronic health needs, increased recruitment and successful retention of home care aides is essential. Insight into the job experiences of Personal Support Specialists is provided through the qualitative findings from a mixed-method mail survey (n=131). Workers described reasons why they do their jobs (feeling rewarded, valuing helping and being energized by homecare work) as well as the challenges they face providing homecare (low wages; along with a lack of benefits, respect and recognition). Both short and longer term recommendations are formulated based on workers’ narrative responses. PMID:20592538

Sensory Response of Transplanted Astrocytes in Adult Mammalian Cortex In Vivo

PubMed Central

Zhang, Kuan; Chen, Chunhai; Yang, Zhiqi; He, Wenjing; Liao, Xiang; Ma, Qinlong; Deng, Ping; Lu, Jian; Li, Jingcheng; Wang, Meng; Li, Mingli; Zheng, Lianghong; Zhou, Zhuan; Sun, Wei; Wang, Liting; Jia, Hongbo; Yu, Zhengping; Zhou, Zhou; Chen, Xiaowei

2016-01-01

Glial precursor transplantation provides a potential therapy for brain disorders. Before its clinical application, experimental evidence needs to indicate that engrafted glial cells are functionally incorporated into the existing circuits and become essential partners of neurons for executing fundamental brain functions. While previous experiments supporting for their functional integration have been obtained under in vitro conditions using slice preparations, in vivo evidence for such integration is still lacking. Here, we utilized in vivo two-photon Ca2+ imaging along with immunohistochemistry, fluorescent indicator labeling-based axon tracing and correlated light/electron microscopy to analyze the profiles and the functional status of glial precursor cell-derived astrocytes in adult mouse neocortex. We show that after being transplanted into somatosensory cortex, precursor-derived astrocytes are able to survive for more than a year and respond with Ca2+ signals to sensory stimulation. These sensory-evoked responses are mediated by functionally-expressed nicotinic receptors and newly-established synaptic contacts with the host cholinergic afferents. Our results provide in vivo evidence for a functional integration of transplanted astrocytes into adult mammalian neocortex, representing a proof-of-principle for sensory cortex remodeling through addition of essential neural elements. Moreover, we provide strong support for the use of glial precursor transplantation to understand glia-related neural development in vivo. PMID:27405333

Reforming funding for chronic illness: Medicare-CDM.

PubMed

Swerissen, Hal; Taylor, Michael J

2008-02-01

Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

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.

Position of the American Dietetic Association: Promoting and supporting breastfeeding.

PubMed

James, Delores C S; Dobson, Brenda

2005-05-01

It is the position of the American Dietetic Association (ADA) that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources. ADA emphasizes the essential role of dietetics professionals in promoting and supporting breastfeeding by providing up-to-date, practical information to pregnant and postpartum women, involving family and friends in breastfeeding education and counseling, removing institutional barriers to breastfeeding, collaborating with community organizations and others who promote and support breastfeeding, and advocating for policies that position breastfeeding as the norm for infant feeding. ADA also emphasizes its own role by providing up-to-date information to the public, encouraging empirical research, providing continuing education opportunities, providing cultural sensitivity and cultural competence training to dietetics professionals, and encouraging universities to review and update undergraduate and graduate training programs.

20 CFR 416.1220 - Property essential to self-support; general.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Property essential to self-support; general. 416.1220 Section 416.1220 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY...-support; general. When counting the value of resources an individual (and spouse, if any) has, the value...

Sexual health for people with intellectual disability.

PubMed

Eastgate, Gillian

2008-01-01

People with intellectual disability experience the same range of sexual needs and desires as other people. However, they experience many difficulties meeting their needs. They may be discouraged from relieving sexual tension by masturbating. They face a high risk of sexual abuse. They are likely not to be offered the full range of choices for contraception and sexual health screening. Poor education and social isolation may increase their risk of committing sexual offences. However, with appropriate education and good social support, people with intellectual disability are capable of safe, constructive sexual expression and healthy relationships. Providing such support is an essential part of supporting people with intellectual disability.

Jamaican families.

PubMed

Miner, Dianne Cooney

2003-01-01

The study of the family in the Caribbean originated with European scholars who assumed the universality of the patriarchal nuclear family and the primacy of this structure to the healthy functioning of society. Matrifocal Caribbean families thus were seen as chaotic and disorganized and inadequate to perform the essential tasks of the social system. This article provides a more current discussion of the Jamaican family. It argues that its structure is the result of the agency and adaptation of its members and not the root cause of the increasing marginalization of peoples in the developing world. The article focuses on families living in poverty and how the family structure supports essential family functions, adaptations, and survival.

Kinetic modeling of plant metabolism and its predictive power: peppermint essential oil biosynthesis as an example.

PubMed

Lange, Bernd Markus; Rios-Estepa, Rigoberto

2014-01-01

The integration of mathematical modeling with analytical experimentation in an iterative fashion is a powerful approach to advance our understanding of the architecture and regulation of metabolic networks. Ultimately, such knowledge is highly valuable to support efforts aimed at modulating flux through target pathways by molecular breeding and/or metabolic engineering. In this article we describe a kinetic mathematical model of peppermint essential oil biosynthesis, a pathway that has been studied extensively for more than two decades. Modeling assumptions and approximations are described in detail. We provide step-by-step instructions on how to run simulations of dynamic changes in pathway metabolites concentrations.

Rapid visual perception of interracial crowds: Racial category learning from emotional segregation.

PubMed

Lamer, Sarah Ariel; Sweeny, Timothy D; Dyer, Michael Louis; Weisbuch, Max

2018-05-01

Drawing from research on social identity and ensemble coding, we theorize that crowd perception provides a powerful mechanism for social category learning. Crowds include allegiances that may be distinguished by visual cues to shared behavior and mental states, providing perceivers with direct information about social groups and thus a basis for learning social categories. Here, emotion expressions signaled group membership: to the extent that a crowd exhibited emotional segregation (i.e., was segregated into emotional subgroups), a visible characteristic (race) that incidentally distinguished emotional subgroups was expected to support categorical distinctions. Participants were randomly assigned to view interracial crowds in which emotion differences between (black vs. white) subgroups were either small (control condition) or large (emotional segregation condition). On each trial, participants saw crowds of 12 faces (6 black, 6 white) for roughly 300 ms and were asked to estimate the average emotion of the entire crowd. After all trials, participants completed a racial categorization task and self-report measure of race essentialism. As predicted, participants exposed to emotional segregation (vs. control) exhibited stronger racial category boundaries and stronger race essentialism. Furthermore, such effects accrued via ensemble coding, a visual mechanism that summarizes perceptual information: emotional segregation strengthened participants' racial category boundaries to the extent that segregation limited participants' abilities to integrate emotion across racial subgroups. Together with evidence that people observe emotional segregation in natural environments, these findings suggest that crowd perception mechanisms support racial category boundaries and race essentialism. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Biomedical informatics and translational medicine.

PubMed

Sarkar, Indra Neil

2010-02-26

Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams.

Rural maternity care.

PubMed

Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

2012-10-01

To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in rural settings. Remuneration models should facilitate interprofessional collaboration. 9. Practitioners skilled in neonatal resuscitation and newborn care are essential to rural maternity care. 10. Training of rural maternity health care providers should include collaborative practice as well as the necessary clinical skills and competencies. Sites must be developed and supported to train midwives, nurses, and physicians and provide them with the skills necessary for rural maternity care. Training in rural and northern settings must be supported. 11. Generalist skills in maternity care, surgery, and anaesthesia are valued and should be supported in training programs in family medicine, surgery, and anaesthesia as well as nursing and midwifery. 12. All physicians and nurses should be exposed to maternity care in their training, and basic competencies should be met. 13. Quality improvement and outcome monitoring should be integral to all maternity care systems. 14. Support must be provided for ongoing, collaborative, interprofessional, and locally provided continuing education and patient safety programs.

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness that is knowledgeable of potential and current conditions, possible impacts on populations and infrastructure, and other key information. E-DECIDER and the Clearinghouse have worked together to address many of these issues and challenges to deliver interoperable, authoritative decision support products.

FY 2014 LDRD Annual Report Project Summaries

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

Tomchak, Dena

The FY 2014 Laboratory Directed Research and Development (LDRD) Annual Report is a compendium of the diverse research performed to develop and ensure the INL's technical capabilities can support future DOE missions and national research priorities. LDRD is essential to INL - it provides a means for the laboratory to pursue novel scientific and engineering research in areas that are deemed too basic or risky for programmatic investments. This research enahnces technical capabilities at the laboratory, providing scientific and engineering staff with opportunities for skill building and partnership development.

Seismology in Lebanon

NASA Astrophysics Data System (ADS)

Hamilton, Robert M.; Rouhbon, Badaovi

During the last several years, while civil war raged in Lebanon, the Bhannes seismograph station near Beirut continued to operate and provide seismograms and phase readings on a regular basis.Seismologists around the world owe gratitude to Charles Tabet, an employee of both the Lebanon National Council for Scientific Research (NCSR) and the American University of Beirut, for his daily dedication to maintaining the station's operations. In addition, Iskandar Sursock, also of the NCSR, has provided essential support and personal resources to continue the seismological program in Lebanon.

Clinical Decision Support: Effectiveness in Improving Quality Processes and Clinical Outcomes and Factors That May Influence Success

PubMed Central

Murphy, Elizabeth V.

2014-01-01

The use of electronic health records has skyrocketed following the 2009 HITECH Act, which provides financial incentives to health care providers for the “meaningful use” of electronic medical record systems. An important component of the “Meaningful Use” legislation is the integration of Clinical Decision Support Systems (CDSS) into the computerized record, providing up-to-date medical knowledge and evidence-based guidance to the physician at the point of care. As reimbursement is increasingly tied to process and clinical outcomes, CDSS will be integral to future medical practice. Studies of CDSS indicate improvement in preventive services, appropriate care, and clinical and cost outcomes with strong evidence for CDSS effectiveness in process measures. Increasing provider adherence to CDSS recommendations is essential in improving CDSS effectiveness, and factors that influence adherence are currently under study. PMID:24910564

Tucking the Pigeons up Your Sleeve: Ten Personae Teach One Nonfiction Course

ERIC Educational Resources Information Center

Sunstein, Bonnie S.

2010-01-01

Nonfiction writing, as defined by the author, is the mix of art, craft, and information, put together by writers who let readers know they are interested in a topic, and who speculate about what that interest or topic might mean. In this article, the author introduces ten imagined colleagues who provide essential support for the teaching of…

Criterion 4: Conservation and maintenance of soil and water resources

Treesearch

Stephen R. Shifley; Francisco X. Aguilar; Nianfu Song; Susan I. Stewart; David J. Nowak; Dale D. Gormanson; W. Keith Moser; Sherri Wormstead; Eric J. Greenfield

2012-01-01

Soils are the fundamental resource enabling land to provide a wide array of benefits. Both humans and wildlife rely on soils for the production of life-sustaining nourishment and shelter. Soil is important to society because it supports plants that supply food, fibers, drugs, and other essentials and because it filters water and recycles wastes.The factors that affect...

Handbook of Institutional Advancement. A Practical Guide to College and University Relations, Fund Raising, Alumni Relations, Government Relations, Publications, and Executive Management for Continued Advancement.

ERIC Educational Resources Information Center

Rowland, A. Westley, Ed.

The guide's purpose is to provide administrators with essential information that will maintain public confidence in higher education and ensure continued financial support. Six major aspects of institutional advancement are considered: (1) institutional relation (programs to improve communication and understanding among students, administrators,…

Pathways to Thinking: Strategies for Developing Independent Learners K-8. Expanded Professional Version.

ERIC Educational Resources Information Center

Ross, Elinor Parry

Learning how to think is essential for children to grow into responsible citizens and contribute to society. Schools need curricula that support a variety of thinking strategies as students read, write, and study content-area subjects, and learn to evaluate and manage what they do. This book for teachers provides a framework for creating a…

An Evaluation of a Computer-Based Videotext Information Delivery System for Farmers: The Green Thumb Project.

ERIC Educational Resources Information Center

Warner, Paul D.; Clearfield, Frank

The Green Thumb Project was designed to test the feasibility of operating a computerized system for disseminating weather, market, and other agricultural production and management information on a day-to-day basis; to develop a prototype software support system for the test; and to provide essential project information on conduct of the test to…

Dune Management Challenges on Developed Coasts

DTIC Science & Technology

2016-10-01

provide essential ecosys- tem services, including habitat for en- dangered species such as piping plovers, sites of high tourism value, groundwater...maintaining the physical environment’s ability to support urban, commercial, and tourism uses, can lead to management approaches which do not...Beach nourishment and restoration is also valued by many stakeholders who recognize that tourism can decline where beach widths have decreased

For All Our Daughters: How Mentoring Helps Young Women and Girls Master the Art of Growing Up.

ERIC Educational Resources Information Center

Echevarria, Pegine

As girls face the serious emotional, physical, and developmental challenges during youth and adolescence, external support from a nonparental female role model is an essential, and too frequently ignored, requirement for healthy development. This book presents a process for mentoring young women and girls by providing guidance in five areas:…

Canadian Federal Support for Climate Change and Health Research Compared With the Risks Posed

PubMed Central

Smith, Tanya R.; Berrang-Ford, Lea

2011-01-01

For emerging public health risks such as climate change, the Canadian federal government has a mandate to provide information and resources to protect citizens' health. Research is a key component of this mandate and is essential if Canada is to moderate the health effects of a changing climate. We assessed whether federal support for climate change and health research is consistent with the risks posed. We audited projects receiving federal support between 1999 and 2009, representing an investment of Can$16 million in 105 projects. Although funding has increased in recent years, it remains inadequate, with negligible focus on vulnerable populations, limited research on adaptation, and volatility in funding allocations. A federal strategy to guide research support is overdue. PMID:21490335

[Education reform with the support of the faculty--introduction of a supplementary education program including teacher support and individual guidance].

PubMed

Wada, Keiji; Yoshimura, Teruki

2015-01-01

  To deal with declining levels of academic ability and motivation among students (a situation attributable to fewer high school graduates, a greater number of universities, and the diversification of entrance examination methods), one must comprehend the conditions of faculties collectively, and take appropriate measures. Using the results of examinations carried out in each grade as indices, we examined levels of academic ability and established various support programs based on the results. Basic chemistry, biology, and physics courses were designed to help first-year students acquire essential academic skills. For second, third, and fourth-year students, two types of support programs were implemented: supplementary instruction to help students improve their understanding of basic topics in pharmaceutical sciences, and an e-learning system to promote self-study, requiring minimal assistance from teachers. Although educational benefits were observed in many students, the number of learners whose understanding failed to improve as a result of the support programs continued to increase. Consequently, The Support Section for Pharmaceutical Education opened in October 2011 to address these concerns. The support section functions mainly to provide individual assistance to students who lack strong academic abilities, and provides teachers with information useful for educational reform. Here, we describe the educational support provided by our faculty and its effectiveness.

Perceptions on evaluative and formative functions of external supervision of Rwandan primary healthcare facilities: A qualitative study.

PubMed

Schriver, Michael; Cubaka, Vincent Kalumire; Itangishaka, Sylvere; Nyirazinyoye, Laetitia; Kallestrup, Per

2018-01-01

External supervision of primary healthcare facilities in low- and middle-income countries often has a managerial main purpose in which the role of support for professional development is unclear. To explore how Rwandan primary healthcare supervisors and providers (supervisees) perceive evaluative and formative functions of external supervision. Qualitative, exploratory study. Focus group discussions: three with supervisors, three with providers, and one mixed (n = 31). Findings were discussed with individual and groups of supervisors and providers. Evaluative activities occupied providers' understanding of supervision, including checking, correcting, marking and performance-based financing. These were presented as sources of motivation, that in self-determination theory indicate introjected regulation. Supervisors preferred to highlight their role in formative supervision, which may mask their own and providers' uncontested accounts that systematic performance evaluations predominated supervisors' work. Providers strongly requested larger focus on formative and supportive functions, voiced as well by most supervisors. Impact of performance evaluation on motivation and professional development is discussed. While external supervisors intended to support providers' professional development, our findings indicate serious problems with this in a context of frequent evaluations and performance marking. Separating the role of supporter and evaluator does not appear as the simple solution. If external supervision is to improve health care services, it is essential that supervisors and health centre managers are competent to support providers in a way that transparently accounts for various performance pressures. This includes delivery of proper formative supervision with useful feedback, maintaining an effective supervisory relationship, as well as ensuring providers are aware of the purpose and content of evaluative and formative supervision functions.

Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings.

PubMed

Amano, Koji; Morita, Tatsuya; Miyamoto, Jiro; Uno, Teruaki; Katayama, Hirofumi; Tatara, Ryohei

2018-03-05

Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia. A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: non-cachexia/pre-cachexia (32.7%) and cachexia/refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were "when anorexia, weight loss, and muscle weakness become apparent" (48.6%) and "nutritional support team" (67.3%), respectively. The top three beliefs of nutritional treatments were "I do not wish to receive tube feeding" (78.6%), "parenteral nutrition and hydration are essential" (60.7%), and "parenteral hydration is essential" (59.6%). Patients with cancer cachexia expressed a greater need for nutritional support. They wished to receive nutritional support from medical staff when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Most patients wished to receive parenteral nutrition and hydration.

From the Office of the National Coordinator: the strategy for advancing the exchange of health information.

PubMed

Williams, Claudia; Mostashari, Farzad; Mertz, Kory; Hogin, Emily; Atwal, Parmeeth

2012-03-01

Electronic health information exchange addresses a critical need in the US health care system to have information follow patients to support patient care. Today little information is shared electronically, leaving doctors without the information they need to provide the best care. With payment reforms providing a strong business driver, the demand for health information exchange is poised to grow. The Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, has led the process of establishing the essential building blocks that will support health information exchange. Over the coming year, this office will develop additional policies and standards that will make information exchange easier and cheaper and facilitate its use on a broader scale.

Development of a balance, safe mobility and falls management programme for people with multiple sclerosis.

PubMed

Gunn, Hilary; Endacott, Ruth; Haas, Bernhard; Marsden, Jonathan; Freeman, Jennifer

2017-08-07

To utilise stakeholder input to inform the structure, format and approach of a multiple sclerosis (MS) balance, safe mobility and falls management programme. Using a three-round nominal group technique, participants individually rated their agreement with 20 trigger statements, followed by a facilitated group discussion and re-rating. Three mixed groups included service users (n = 15) and providers (n = 19). Quantitative analysis determined agreement, whilst qualitative responses were analysed thematically. Median scores for each of the 20 trigger statements did not change significantly over sequential rounds, however, deviations around the medians indicated more agreement amongst participants over time. Key recommendations were: Aims and approach: The programme should be tailored to the needs of people with MS. Falls and participation-based outcomes are equally important. Structure and format: The programme should balance expected burden and anticipated benefit, moving away from models requiring weekly attendance and promoting and supporting self-efficacy. Optimising engagement: Support to maintain engagement and intensity of practice over the long term is essential. Sustainability: Adequate funding is necessary. Staff should have MS specific knowledge and experience. Participants collaboratively identified critical components of a MS balance, safe mobility and falls management programme. They also highlighted the importance of a collaborative, user-centred, MS-specific approach. Implications for Rehabilitation People with multiple sclerosis need condition-specific interventions focussed on maximising balance and safe mobility and reducing falls. Programme design should support self-efficacy and flexible engagement. Adequate support and funding are seen as essential by both service users and providers.

Measurement-based care for refractory depression: a clinical decision support model for clinical research and practice.

PubMed

Trivedi, Madhukar H; Daly, Ella J

2007-05-01

Despite years of antidepressant drug development and patient and provider education, suboptimal medication dosing and duration of exposure resulting in incomplete remission of symptoms remains the norm in the treatment of depression. Additionally, since no one treatment is effective for all patients, optimal implementation focusing on the measurement of symptoms, side effects, and function is essential to determine effective sequential treatment approaches. There is a need for a paradigm shift in how clinical decision making is incorporated into clinical practice and for a move away from the trial-and-error approach that currently determines the "next best" treatment. This paper describes how our experience with the Texas Medication Algorithm Project (TMAP) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial has confirmed the need for easy-to-use clinical support systems to ensure fidelity to guidelines. To further enhance guideline fidelity, we have developed an electronic decision support system that provides critical feedback and guidance at the point of patient care. We believe that a measurement-based care (MBC) approach is essential to any decision support system, allowing physicians to individualize and adapt decisions about patient care based on symptom progress, tolerability of medication, and dose optimization. We also believe that successful integration of sequential algorithms with MBC into real-world clinics will facilitate change that will endure and improve patient outcomes. Although we use major depression to illustrate our approach, the issues addressed are applicable to other chronic psychiatric conditions including comorbid depression and substance use disorder as well as other medical illnesses.

Measurement-Based Care for Refractory Depression: A Clinical Decision Support Model for Clinical Research and Practice

PubMed Central

Trivedi, Madhukar H.; Daly, Ella J.

2009-01-01

Despite years of antidepressant drug development and patient and provider education, suboptimal medication dosing and duration of exposure resulting in incomplete remission of symptoms remains the norm in the treatment of depression. Additionally, since no one treatment is effective for all patients, optimal implementation focusing on the measurement of symptoms, side effects, and function is essential to determine effective sequential treatment approaches. There is a need for a paradigm shift in how clinical decision making is incorporated into clinical practice and for a move away from the trial-and-error approach that currently determines the “next best” treatment. This paper describes how our experience with the Texas Medication Algorithm Project (TMAP) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial has confirmed the need for easy-to-use clinical support systems to ensure fidelity to guidelines. To further enhance guideline fidelity, we have developed an electronic decision support system that provides critical feedback and guidance at the point of patient care. We believe that a measurement-based care (MBC) approach is essential to any decision support system, allowing physicians to individualize and adapt decisions about patient care based on symptom progress, tolerability of medication, and dose optimization. We also believe that successful integration of sequential algorithms with MBC into real-world clinics will facilitate change that will endure and improve patient outcomes. Although we use major depression to illustrate our approach, the issues addressed are applicable to other chronic psychiatric conditions including comorbid depression and substance use disorder as well as other medical illnesses. PMID:17320312

Medical-School Partnership in Guiding Return to School Following Mild Traumatic Brain Injury in Youth

PubMed Central

Gioia, Gerard A.

2015-01-01

Mild traumatic brain injury (mTBI) is recognized as a prevalent and significant risk concern for youth. Appropriate school return is particularly challenging. The medical and school systems must be prepared partners to support the school return of the student with mTBI. Medical providers must be trained in assessment and management skills with a focused understanding of school demands. Schools must develop policies and procedures to prepare staff to support a gradual return process with the necessary academic accommodations. Ongoing communication between the family, student, school, and medical provider is essential to supporting recovery. A systematic gradual return to school process is proposed including levels of recommended activity and criteria for advancement. Targets for intervention are described with associated strategies for supporting recovery. A ten element PACE model for activity-exertion management is introduced to manage symptom exacerbation. A strong medical-school partnership will maximize outcomes for students with mTBI. PMID:25535055

Airborne Tactical Intent-Based Conflict Resolution Capability

NASA Technical Reports Server (NTRS)

Wing, David J.; Vivona, Robert A.; Roscoe, David A.

2009-01-01

Trajectory-based operations with self-separation involve the aircraft taking the primary role in the management of its own trajectory in the presence of other traffic. In this role, the flight crew assumes the responsibility for ensuring that the aircraft remains separated from all other aircraft by at least a minimum separation standard. These operations are enabled by cooperative airborne surveillance and by airborne automation systems that provide essential monitoring and decision support functions for the flight crew. An airborne automation system developed and used by NASA for research investigations of required functionality is the Autonomous Operations Planner. It supports the flight crew in managing their trajectory when responsible for self-separation by providing monitoring and decision support functions for both strategic and tactical flight modes. The paper focuses on the latter of these modes by describing a capability for tactical intent-based conflict resolution and its role in a comprehensive suite of automation functions supporting trajectory-based operations with self-separation.

Supporting Aspartate Biosynthesis Is an Essential Function of Respiration in Proliferating Cells.

PubMed

Sullivan, Lucas B; Gui, Dan Y; Hosios, Aaron M; Bush, Lauren N; Freinkman, Elizaveta; Vander Heiden, Matthew G

2015-07-30

Mitochondrial respiration is important for cell proliferation; however, the specific metabolic requirements fulfilled by respiration to support proliferation have not been defined. Here, we show that a major role of respiration in proliferating cells is to provide electron acceptors for aspartate synthesis. This finding is consistent with the observation that cells lacking a functional respiratory chain are auxotrophic for pyruvate, which serves as an exogenous electron acceptor. Further, the pyruvate requirement can be fulfilled with an alternative electron acceptor, alpha-ketobutyrate, which provides cells neither carbon nor ATP. Alpha-ketobutyrate restores proliferation when respiration is inhibited, suggesting that an alternative electron acceptor can substitute for respiration to support proliferation. We find that electron acceptors are limiting for producing aspartate, and supplying aspartate enables proliferation of respiration deficient cells in the absence of exogenous electron acceptors. Together, these data argue a major function of respiration in proliferating cells is to support aspartate synthesis. Copyright © 2015 Elsevier Inc. All rights reserved.

The use of tobacco tax revenues to fund the Guam Cancer Registry: A double win for cancer control.

PubMed

David, Annette M; Haddock, Robert L; Bordallo, Renata; Dirige, Janet T; Mery, Les

2017-06-01

Cancer registries that provide reliable data on cancer incidence, mortality and burden are essential to cancer control. However, establishing sustainable local funding mechanisms to support cancer registries remains a challenge in many countries. Guam, an unincorporated Territory of the United States of America in the Western Pacific, enacted a bill that raised tobacco taxes, and earmarked a percentage of tobacco tax revenues to support its Cancer Registry. This provided a reliable funding stream for the Registry, allowing for continued staffing and capacity building; at the same time, youth tobacco consumption decreased following the tax increase. Linking tobacco tax revenues to cancer registry support is a feasible strategy with a double benefit: higher tobacco prices from higher tobacco taxes reduce tobacco-related cancer risk while assuring the long-term viability of systematic cancer data collection and dissemination.

The use of tobacco tax revenues to fund the Guam Cancer Registry: A double win for cancer control

PubMed Central

David, Annette M.; Haddock, Robert L; Bordallo, Renata; Dirige, Janet T.; Mery, Les

2017-01-01

Cancer registries that provide reliable data on cancer incidence, mortality and burden are essential to cancer control. However, establishing sustainable local funding mechanisms to support cancer registries remains a challenge in many countries. Guam, an unincorporated Territory of the United States of America in the Western Pacific, enacted a bill that raised tobacco taxes, and earmarked a percentage of tobacco tax revenues to support its Cancer Registry. This provided a reliable funding stream for the Registry, allowing for continued staffing and capacity building; at the same time, youth tobacco consumption decreased following the tax increase. Linking tobacco tax revenues to cancer registry support is a feasible strategy with a double benefit: higher tobacco prices from higher tobacco taxes reduce tobacco-related cancer risk while assuring the long-term viability of systematic cancer data collection and dissemination. PMID:29130031

A two-stage clinical decision support system for early recognition and stratification of patients with sepsis: an observational cohort study.

PubMed

Amland, Robert C; Lyons, Jason J; Greene, Tracy L; Haley, James M

2015-10-01

To examine the diagnostic accuracy of a two-stage clinical decision support system for early recognition and stratification of patients with sepsis. Observational cohort study employing a two-stage sepsis clinical decision support to recognise and stratify patients with sepsis. The stage one component was comprised of a cloud-based clinical decision support with 24/7 surveillance to detect patients at risk of sepsis. The cloud-based clinical decision support delivered notifications to the patients' designated nurse, who then electronically contacted a provider. The second stage component comprised a sepsis screening and stratification form integrated into the patient electronic health record, essentially an evidence-based decision aid, used by providers to assess patients at bedside. Urban, 284 acute bed community hospital in the USA; 16,000 hospitalisations annually. Data on 2620 adult patients were collected retrospectively in 2014 after the clinical decision support was implemented. 'Suspected infection' was the established gold standard to assess clinical decision support clinimetric performance. A sepsis alert activated on 417 (16%) of 2620 adult patients hospitalised. Applying 'suspected infection' as standard, the patient population characteristics showed 72% sensitivity and 73% positive predictive value. A postalert screening conducted by providers at bedside of 417 patients achieved 81% sensitivity and 94% positive predictive value. Providers documented against 89% patients with an alert activated by clinical decision support and completed 75% of bedside screening and stratification of patients with sepsis within one hour from notification. A clinical decision support binary alarm system with cross-checking functionality improves early recognition and facilitates stratification of patients with sepsis.

Social Support and Women Living With Breast Cancer in the South of Thailand.

PubMed

Suwankhong, Dusanee; Liamputtong, Pranee

2016-01-01

To discuss social support among women with breast cancer in rural communities in southern Thailand. Qualitative research that allowed researchers to understand the lived experiences of women living with breast cancer and social support. In-depth interviewing and drawing methods were adopted with 20 women with breast cancer. Thematic analysis was employed to analyze the data. Most women with breast cancer received three types of social support: emotional support, tangible support, and informational support. Most support came from family members and relatives. Religion was also a form of social support for women. Many women, however, received insufficient social support from healthcare providers. This reduced their capacity to manage their illness, thus impacting their well-being. Various forms of support are essential for women with breast cancer so that they can better cope with their condition. Nurses and other health professionals are an important source of social support for women with breast cancer. Through having an understanding of and being sensitive to these women's experiences, culture, and challenges, nurses and healthcare professionals can provide more individualized support and care to women during a vulnerable period of their life. We contend that the cultural perspectives of patients are crucial in nursing science. Nurses need to appreciate the importance of culture for the support of patients with breast cancer. © 2015 Sigma Theta Tau International.

Software development environments: Status and trends

NASA Technical Reports Server (NTRS)

Duffel, Larry E.

1988-01-01

Currently software engineers are the essential integrating factors tying several components together. The components consist of process, methods, computers, tools, support environments, and software engineers. The engineers today empower the tools versus the tools empowering the engineers. Some of the issues in software engineering are quality, managing the software engineering process, and productivity. A strategy to accomplish this is to promote the evolution of software engineering from an ad hoc, labor intensive activity to a managed, technology supported discipline. This strategy may be implemented by putting the process under management control, adopting appropriate methods, inserting the technology that provides automated support for the process and methods, collecting automated tools into an integrated environment and educating the personnel.

Advancing Autonomous Operations Technologies for NASA Missions

NASA Technical Reports Server (NTRS)

Cruzen, Craig; Thompson, Jerry Todd

2013-01-01

This paper discusses the importance of implementing advanced autonomous technologies supporting operations of future NASA missions. The ability for crewed, uncrewed and even ground support systems to be capable of mission support without external interaction or control has become essential as space exploration moves further out into the solar system. The push to develop and utilize autonomous technologies for NASA mission operations stems in part from the need to reduce operations cost while improving and increasing capability and safety. This paper will provide examples of autonomous technologies currently in use at NASA and will identify opportunities to advance existing autonomous technologies that will enhance mission success by reducing operations cost, ameliorating inefficiencies, and mitigating catastrophic anomalies.

Advancing Autonomous Operations Technologies for NASA Missions

NASA Technical Reports Server (NTRS)

Cruzen, Craig; Thompson, Jerry T.

2013-01-01

This paper discusses the importance of implementing advanced autonomous technologies supporting operations of future NASA missions. The ability for crewed, uncrewed and even ground support systems to be capable of mission support without external interaction or control has become essential as space exploration moves further out into the solar system. The push to develop and utilize autonomous technologies for NASA mission operations stems in part from the need to reduce cost while improving and increasing capability and safety. This paper will provide examples of autonomous technologies currently in use at NASA and will identify opportunities to advance existing autonomous technologies that will enhance mission success by reducing cost, ameliorating inefficiencies, and mitigating catastrophic anomalies

Blood pressure (BP) control and perceived family support in patients with essential hypertension seen at a primary care clinic in Western Nigeria.

PubMed

Ojo, Oluwaseun S; Malomo, Sunday O; Sogunle, Peter T

2016-01-01

Nonadherence to therapeutic plans has been reported among hypertensive patients. Researchers have also shown that adherence to therapeutic plans improves if motivation in the form of social support is provided. There is a dearth of local studies that explore the influence of family support on treatment outcomes of hypertensive patients. The aim of the study was to determine the relationship between BP control and perceived family support in patients with essential hypertension seen at a primary care setting in Western Nigeria. This was a cross-sectional hospital-based study. Systematic random sampling technique was used in selecting 360 hypertensive respondents between April and July 2013. Data were collected through a pretested interviewer-administered questionnaire and a standardized tool, Perceived Social Support Family Scale, which measured the respondents' level of perceived family support. Statistical Package for Social Sciences (SPSS) version 17.0 was used to analyze data. The majority of the respondents were middle-aged (61.1%) and female (59.4%). Blood pressure (BP) was controlled in 46.4% of the respondents. Most of the respondents (79.4%) had "strong" perceived family support. Strong perceived family support (odds ratio [OR] 4.778, 95% confidence interval [CI] =2.569-8.887) and female gender (OR 1.838, 95% CI = 1.177-2.869) were independent predictors of controlled BP. The proportion of hypertensive patients with optimal BP control is low in this practice setting. The positive association between BP control and perceived family support emphasizes the need for physicians to reflect on the available family support when managing hypertensive patients.

Social support and coping means: the lived experiences of Northeastern Thai women with breast cancer.

PubMed

Dumrongpanapakorn, Phensiri; Liamputtong, Pranee

2017-10-01

Social support plays a critical role in how women living with breast cancer deal with their diagnosis and treatment. This article discusses the meanings of breast cancer and the experiences of social support among women living with breast cancer in Northeastern Thailand (Isan). In-depth interviews were conducted with 18 women with breast cancer. Data were analysed using the thematic analysis method. Being diagnosed with breast cancer can be a traumatic experience. However, many women with breast cancer managed to deal with their illnesses and treatments and this was based largely on social support they received. Available support from family members, friends, neighbours, religion and health care professionals was essential for them to deal with their breast cancer. Social support was an important component for the provision of good care for these women and women living with breast cancer. Although medical treatments were essential for breast cancer, social support could enhance the effectiveness of the treatments as it helped women to have positive perspectives about their health conditions and to better deal with their illnesses. Our findings are useful for sensitive health promotion for women with breast cancer in Thailand and elsewhere. Social support should be modified to meet the woman's individual needs. Health professionals are an important source of social support for women with breast cancer. Having an understanding and being sensitive to these women's experiences and challenges means that health care professionals can provide more individualised support and care to women during their vulnerable period of life. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Direct-to-Consumer Racial Admixture Tests and Beliefs About Essential Racial Differences

PubMed Central

Phelan, Jo C.; Link, Bruce G.; Zelner, Sarah; Yang, Lawrence H.

2015-01-01

Although at first relatively disinterested in race, modern genomic research has increasingly turned attention to racial variations. We examine a prominent example of this focus—direct-to-consumer racial admixture tests—and ask how information about the methods and results of these tests in news media may affect beliefs in racial differences. The reification hypothesis proposes that by emphasizing a genetic basis for race, thereby reifying race as a biological reality, the tests increase beliefs that whites and blacks are essentially different. The challenge hypothesis suggests that by describing differences between racial groups as continua rather than sharp demarcations, the results produced by admixture tests break down racial categories and reduce beliefs in racial differences. A nationally representative survey experiment (N = 526) provided clear support for the reification hypothesis. The results suggest that an unintended consequence of the genomic revolution may be to reinvigorate age-old beliefs in essential racial differences. PMID:25870464

Bergamot Essential Oil Attenuates Anxiety-Like Behaviour in Rats.

PubMed

Rombolà, Laura; Tridico, Laura; Scuteri, Damiana; Sakurada, Tsukasa; Sakurada, Shinobu; Mizoguchi, Hirokazu; Avato, Pinarosa; Corasaniti, Maria Tiziana; Bagetta, Giacinto; Morrone, Luigi Antonio

2017-04-11

Preclinical studies have recently highlighted that bergamot essential oil (BEO) is endowed with remarkable neurobiolological effects. BEO can affect synaptic transmission, modulate electroencephalographic activity and it showed neuroprotective and analgesic properties. The phytocomplex, along with other essential oils, is also widely used in aromatherapy to minimize symptoms of stress-induced anxiety and mild mood disorders. However, only limited preclinical evidences are actually available. This study examined the anxiolytic/sedative-like effects of BEO using an open field task (OFT), an elevated plus-maze task (EPM), and a forced swimming task (FST) in rats. This study further compared behavioural effects of BEO to those of the benzodiazepine diazepam. Analysis of data suggests that BEO induces anxiolytic-like/relaxant effects in animal behavioural tasks not superimposable to those of the DZP. The present observations provide further insight to the pharmacological profile of BEO and support its rational use in aromatherapy.

Demonstration of Essential Reliability Services by a 300-MW Solar Photovoltaic Power Plant

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

Loutan, Clyde; Klauer, Peter; Chowdhury, Sirajul

The California Independent System Operator (CAISO), First Solar, and the National Renewable Energy Laboratory (NREL) conducted a demonstration project on a large utility-scale photovoltaic (PV) power plant in California to test its ability to provide essential ancillary services to the electric grid. With increasing shares of solar- and wind-generated energy on the electric grid, traditional generation resources equipped with automatic governor control (AGC) and automatic voltage regulation controls -- specifically, fossil thermal -- are being displaced. The deployment of utility-scale, grid-friendly PV power plants that incorporate advanced capabilities to support grid stability and reliability is essential for the large-scale integrationmore » of PV generation into the electric power grid, among other technical requirements. A typical PV power plant consists of multiple power electronic inverters and can contribute to grid stability and reliability through sophisticated 'grid-friendly' controls. In this way, PV power plants can be used to mitigate the impact of variability on the grid, a role typically reserved for conventional generators. In August 2016, testing was completed on First Solar's 300-MW PV power plant, and a large amount of test data was produced and analyzed that demonstrates the ability of PV power plants to use grid-friendly controls to provide essential reliability services. These data showed how the development of advanced power controls can enable PV to become a provider of a wide range of grid services, including spinning reserves, load following, voltage support, ramping, frequency response, variability smoothing, and frequency regulation to power quality. Specifically, the tests conducted included various forms of active power control such as AGC and frequency regulation; droop response; and reactive power, voltage, and power factor controls. This project demonstrated that advanced power electronics and solar generation can be controlled to contribute to system-wide reliability. It was shown that the First Solar plant can provide essential reliability services related to different forms of active and reactive power controls, including plant participation in AGC, primary frequency control, ramp rate control, and voltage regulation. For AGC participation in particular, by comparing the PV plant testing results to the typical performance of individual conventional technologies, we showed that regulation accuracy by the PV plant is 24-30 points better than fast gas turbine technologies. The plant's ability to provide volt-ampere reactive control during periods of extremely low power generation was demonstrated as well. The project team developed a pioneering demonstration concept and test plan to show how various types of active and reactive power controls can leverage PV generation's value from being a simple variable energy resource to a resource that provides a wide range of ancillary services. With this project's approach to a holistic demonstration on an actual, large, utility-scale, operational PV power plant and dissemination of the obtained results, the team sought to close some gaps in perspectives that exist among various stakeholders in California and nationwide by providing real test data.« less

Workflow management in large distributed systems

NASA Astrophysics Data System (ADS)

Legrand, I.; Newman, H.; Voicu, R.; Dobre, C.; Grigoras, C.

2011-12-01

The MonALISA (Monitoring Agents using a Large Integrated Services Architecture) framework provides a distributed service system capable of controlling and optimizing large-scale, data-intensive applications. An essential part of managing large-scale, distributed data-processing facilities is a monitoring system for computing facilities, storage, networks, and the very large number of applications running on these systems in near realtime. All this monitoring information gathered for all the subsystems is essential for developing the required higher-level services—the components that provide decision support and some degree of automated decisions—and for maintaining and optimizing workflow in large-scale distributed systems. These management and global optimization functions are performed by higher-level agent-based services. We present several applications of MonALISA's higher-level services including optimized dynamic routing, control, data-transfer scheduling, distributed job scheduling, dynamic allocation of storage resource to running jobs and automated management of remote services among a large set of grid facilities.

Manufactured soils for plant growth at a lunar base

NASA Technical Reports Server (NTRS)

Ming, Douglas W.

1989-01-01

Advantages and disadvantages of synthetic soils are discussed. It is pointed out that synthetic soils may provide the proper physical and chemical properties necessary to maximize plant growth, such as a toxic-free composition and cation exchange capacities. The importance of nutrient retention, aeration, moisture retention, and mechanical support as qualities for synthetic soils are stressed. Zeoponics, or the cultivation of plants in zeolite substrates that both contain essential plant-growth cations on their exchange sites and have minor amounts of mineral phases and/or anion-exchange resins that supply essential plant growth ions, is discussed. It is suggested that synthetic zeolites at lunar bases could provide adsorption media for separation of various gases, act as catalysts and as molecular sieves, and serve as cation exchangers in sewage-effluent treatment, radioactive-waste disposal, and pollution control. A flow chart of a potential zeoponics system illustrates this process.

Ethics: an essential dimension of soliciting philanthropic gifts from donors.

PubMed

Chervenak, Frank A; McCullough, Laurence B; Fraley, Milinda; Golding, Joe

2010-12-01

Obstetrics and gynecology continues to experience fiscal pressures that challenge its core missions. In such an increasingly economically unforgiving environment, philanthropy will become a major source of revenue. This article provides ethical guidance for seeking philanthropic gifts by translating ethical theory into practice. The basis for this guidance is an account of the ethics of philanthropy that identifies both its consequentialist and deontologic components and shows their relevance to the ethical significance of donors' motivations and directiveness. The prevention of abuse of vulnerable donors and of distortions of the physician-patient relationship is emphasized. Ethics is an essential component of the responsible solicitation of philanthropic support from donors. Copyright © 2010 Mosby, Inc. All rights reserved.

Center for Nanoscale Science and Technology

National Institute of Standards and Technology Data Gateway

NIST Center for Nanoscale Science and Technology (Program website, free access)   Currently there is no database matching your keyword search, but the NIST Center for Nanoscale Science and Technology website may be of interest. The Center for Nanoscale Science and Technology enables science and industry by providing essential measurement methods, instrumentation, and standards to support all phases of nanotechnology development, from discovery to production.

The Importance of Morphemic Awareness to Reading Achievement and the Potential of Signing Morphemes to Supporting Reading Development

ERIC Educational Resources Information Center

Nielsen, Diane Corcoran; Luetke, Barbara; Stryker, Deborah S.

2011-01-01

The ability to access and understand the meaning of multi-morphemic words is essential for age-appropriate literacy growth as well as for achievement in other participants, such as science and social studies, which are so print-dependent. This paper provides a theoretical basis for focusing on the morphology of English when teaching students who…

Teacher Position in Spurring Value Based Education in Early Learning in Nairobi County, Kenya: Addressing Support of Values in School Environment

ERIC Educational Resources Information Center

Amollo, Odundo P.; Lilian, Ganira K.

2017-01-01

Value Based Education (VBE) is an essential element that impacts moral, ethical, cultural, social and spiritual ideals necessary for holistic development of children. Providing an education on values at an early age ensures that children are directed by these ideologies throughout life. Research indicates that children who adopt values at an early…

ISS Logistics Hardware Disposition and Metrics Validation

NASA Technical Reports Server (NTRS)

Rogers, Toneka R.

2010-01-01

I was assigned to the Logistics Division of the International Space Station (ISS)/Spacecraft Processing Directorate. The Division consists of eight NASA engineers and specialists that oversee the logistics portion of the Checkout, Assembly, and Payload Processing Services (CAPPS) contract. Boeing, their sub-contractors and the Boeing Prime contract out of Johnson Space Center, provide the Integrated Logistics Support for the ISS activities at Kennedy Space Center. Essentially they ensure that spares are available to support flight hardware processing and the associated ground support equipment (GSE). Boeing maintains a Depot for electrical, mechanical and structural modifications and/or repair capability as required. My assigned task was to learn project management techniques utilized by NASA and its' contractors to provide an efficient and effective logistics support infrastructure to the ISS program. Within the Space Station Processing Facility (SSPF) I was exposed to Logistics support components, such as, the NASA Spacecraft Services Depot (NSSD) capabilities, Mission Processing tools, techniques and Warehouse support issues, required for integrating Space Station elements at the Kennedy Space Center. I also supported the identification of near-term ISS Hardware and Ground Support Equipment (GSE) candidates for excessing/disposition prior to October 2010; and the validation of several Logistics Metrics used by the contractor to measure logistics support effectiveness.

Post-transcriptional trafficking and regulation of neuronal gene expression.

PubMed

Goldie, Belinda J; Cairns, Murray J

2012-02-01

Intracellular messenger RNA (mRNA) traffic and translation must be highly regulated, both temporally and spatially, within eukaryotic cells to support the complex functional partitioning. This capacity is essential in neurons because it provides a mechanism for rapid input-restricted activity-dependent protein synthesis in individual dendritic spines. While this feature is thought to be important for synaptic plasticity, the structures and mechanisms that support this capability are largely unknown. Certainly specialized RNA binding proteins and binding elements in the 3' untranslated region (UTR) of translationally regulated mRNA are important, but the subtlety and complexity of this system suggests that an intermediate "specificity" component is also involved. Small non-coding microRNA (miRNA) are essential for CNS development and may fulfill this role by acting as the guide strand for mediating complex patterns of post-transcriptional regulation. In this review we examine post-synaptic gene regulation, mRNA trafficking and the emerging role of post-transcriptional gene silencing in synaptic plasticity.

Neuropharmacology of the essential oil of bergamot.

PubMed

Bagetta, Giacinto; Morrone, Luigi Antonio; Rombolà, Laura; Amantea, Diana; Russo, Rossella; Berliocchi, Laura; Sakurada, Shinobu; Sakurada, Tsukasa; Rotiroti, Domenicantonio; Corasaniti, Maria Tiziana

2010-09-01

Bergamot (Citrus bergamia, Risso) is a fruit most knowledgeable for its essential oil (BEO) used in aromatherapy to minimize symptoms of stress-induced anxiety and mild mood disorders and cancer pain though the rational basis for such applications awaits to be discovered. The behavioural and EEG spectrum power effects of BEO correlate well with its exocytotic and carrier-mediated release of discrete amino acids endowed with neurotransmitter function in the mammalian hippocampus supporting the deduction that BEO is able to interfere with normal and pathological synaptic plasticity. The observed neuroprotection in the course of experimental brain ischemia and pain does support this view. In conclusion, the data yielded so far contribute to our understanding of the mode of action of this phytocomplex on nerve tissue under normal and pathological experimental conditions and provide a rational basis for the practical use of BEO in complementary medicine. The opening of a wide venue for future research and translation into clinical settings is also envisaged. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Smart telemedicine support for continuous glucose monitoring: the embryo of a future global agent for diabetes care.

PubMed

Rigla, Mercedes

2011-01-01

Although current systems for continuous glucose monitoring (CGM) are the result of progressive technological improvement, and although a beneficial effect on glucose control has been demonstrated, few patients are using them. Something similar has happened to telemedicine (TM); in spite of the long-term experience, which began in the early 1980s, no TM system has been widely adopted, and presential visits are still almost the only way diabetologists and patients communicate. The hypothesis developed in this article is that neither CGM nor TM will ever be routinely implemented separately, and their consideration as essential elements for standard diabetes care will one day come from their integration as parts of a telemedical monitoring platform. This platform, which should include artificial intelligence for giving decision support to patients and physicians, will represent the core of a more complex global agent for diabetes care, which will provide control algorithms and risk analysis among other essential functions. © 2010 Diabetes Technology Society.

Energetic particle flux experiment (IMP-F and G)

NASA Technical Reports Server (NTRS)

Anderson, K. A.

1972-01-01

The technical aspects of the University of California IMP-F experiment aboard the Explorer-34 and the University of California IMP-G (S1) and (S2) experiments aboard the Explorer-41. The experiment detectors and electronics are discussed for each experiment as well as the fabrication, preflight and post-flight history. A description of the ground support equipment is also given for each experiment. These three experiments were essentially all different. The IMP-G experiment was essentially the IMP-F experiment with the addition of four Geiger-Mueller detectors. The IMP-G (S-2) was a supplementary experiment and differed completely from the IMP-F and IMP-G experiments. It was concluded that the ground support equipment approach used for the IMP-F and IMP-G experiments where emphasis was placed on a thorough exercise and monitoring of the experiment operation during various testing phases provided a high degree of confidence and reliability in these experiments. No known electronic failures have occurred during the spacecraft lifetime although some detector problems were experienced.

Chinese proprietary herbal medicine listed in 'China national essential drug list' for common cold: a systematic literature review.

PubMed

Chen, Wei; Lewith, George; Wang, Li-qiong; Ren, Jun; Xiong, Wen-jing; Lu, Fang; Liu, Jian-ping

2014-01-01

Chinese proprietary herbal medicines (CPHMs) have long history in China for the treatment of common cold, and lots of them have been listed in the 'China national essential drug list' by the Chinese Ministry of Health. The aim of this review is to provide a well-round clinical evidence assessment on the potential benefits and harms of CPHMs for common cold based on a systematic literature search to justify their clinical use and recommendation. We searched CENTRAL, MEDLINE, EMBASE, SinoMed, CNKI, VIP, China Important Conference Papers Database, China Dissertation Database, and online clinical trial registry websites from their inception to 31 March 2013 for clinical studies of CPHMs listed in the 'China national essential drug list' for common cold. There was no restriction on study design. A total of 33 CPHMs were listed in 'China national essential drug list 2012' for the treatment of common cold but only 7 had supportive clinical evidences. A total of 6 randomised controlled trials (RCTs) and 7 case series (CSs) were included; no other study design was identified. All studies were conducted in China and published in Chinese between 1995 and 2012. All included studies had poor study design and methodological quality, and were graded as very low quality. The use of CPHMs for common cold is not supported by robust evidence. Further rigorous well designed placebo-controlled, randomized trials are needed to substantiate the clinical claims made for CPHMs.

The resources of Mars for human settlement

NASA Astrophysics Data System (ADS)

Meyer, T. R.; McKay, C. P.

1989-04-01

Spacecraft exploration of Marshas shown that the essential resources necessary for life support are present on the Martian surface. The key life-support compounds O2, N2, and H2O are available on Mars. The soil could be used as radiation shielding and could provide many useful industrial and construction materials. Compounds with high chemical energy, such as rocket fuels, can be manufactured in-situ on Mars. Solar power, and possibly wind power, are available and practical on Mars. Preliminary engineering studies indicate that fairly autonomous processes can be designed to extract and stockpile Martian consumables.

Friction Stir Welding: Standards and Specifications in Today's U.S. Manufacturing and Fabrication

NASA Technical Reports Server (NTRS)

Ding, Robert Jeffrey

2008-01-01

New welding and technology advancements are reflected in the friction stir welding (FSW) specifications used in the manufacturing sector. A lack of publicly available specifications as one of the reasons that the FSW process has not propagate through the manufacturing sectors. FSW specifications are an integral supporting document to the legal agreement written between two entities for deliverable items. Understanding the process and supporting specifications is essential for a successful FSW manufacturing operation. This viewgraph presentation provides an overview of current FSW standards in the industry and discusses elements common to weld specifications.

Biomedical Informatics for Computer-Aided Decision Support Systems: A Survey

PubMed Central

Belle, Ashwin; Kon, Mark A.; Najarian, Kayvan

2013-01-01

The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest. PMID:23431259

The resources of Mars for human settlement

NASA Technical Reports Server (NTRS)

Meyer, Thomas R.; Mckay, Christopher P.

1989-01-01

Spacecraft exploration of Marshas shown that the essential resources necessary for life support are present on the Martian surface. The key life-support compounds O2, N2, and H2O are available on Mars. The soil could be used as radiation shielding and could provide many useful industrial and construction materials. Compounds with high chemical energy, such as rocket fuels, can be manufactured in-situ on Mars. Solar power, and possibly wind power, are available and practical on Mars. Preliminary engineering studies indicate that fairly autonomous processes can be designed to extract and stockpile Martian consumables.

A national survey of program director opinions of core competencies and structure of hand surgery fellowship training.

PubMed

Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

2012-10-01

We assessed hand surgery program directors' opinions of essential components of hand surgery training and potential changes in the structure of hand surgery programs. We recruited all 74 program directors of Accreditation Council of Graduate Medical Education-accredited hand surgery fellowship programs to participate. We designed a web-based survey to assess program directors' support for changes in the structure of training programs and to assess opinions of components that are essential for graduates to be proficient. Respondents were asked to rate 9 general areas of practice, 97 knowledge topics, and 172 procedures. Each component was considered essential if 50% or more of respondents thought that graduates must be fully knowledgeable of the topic and be able to perform the procedure at the end of training. The response rate was 84% (n = 62). A minority of program directors (n = 15; 24%) supported creation of additional pathways for hand surgery training, and nearly three-quarters (n = 46; 74%) preferred a fellowship model to an integrated residency model. Most program directors (n = 40; 65%) thought that a 1-year fellowship was sufficient to train a competent hand surgeon. Wrist, distal radius/ulna, forearm, and peripheral nerve conditions were rated as essential areas of practice. Of the detailed components, 76 of 97 knowledge topics and 98 of 172 procedures were rated as essential. Only 48% respondents (n = 30) rated microsurgery as it relates to free tissue transfer as essential. However, small and large vessel laceration repairs were rated as essential by 92% (n = 57) and 77% (n = 48) of respondents, respectively. This study found resistance to prolonging the length of fellowship training and introduction of an integrated residency pathway. To train all hand surgeons in essential components of hand surgery, programs must individually evaluate exposure provided and find innovative ways to augment training when necessary. Studies of curriculum content in hand surgery affect the future scope of hand surgery practice and highlight areas in need of reform and enhancement. Copyright © 2012. Published by Elsevier Inc.

Evolutionary History of LINE-1 in the Major Clades of Placental Mammals

PubMed Central

Waters, Paul D.; Dobigny, Gauthier; Waddell, Peter J.; Robinson, Terence J.

2007-01-01

Background LINE-1 constitutes an important component of mammalian genomes. It has a dynamic evolutionary history characterized by the rise, fall and replacement of subfamilies. Most data concerning LINE-1 biology and evolution are derived from the human and mouse genomes and are often assumed to hold for all placentals. Methodology To examine LINE-1 relationships, sequences from the 3′ region of the reverse transcriptase from 21 species (representing 13 orders across Afrotheria, Xenarthra, Supraprimates and Laurasiatheria) were obtained from whole genome sequence assemblies, or by PCR with degenerate primers. These sequences were aligned and analysed. Principal Findings Our analysis reflects accepted placental relationships suggesting mostly lineage-specific LINE-1 families. The data provide clear support for several clades including Glires, Supraprimates, Laurasiatheria, Boreoeutheria, Xenarthra and Afrotheria. Within the afrotherian LINE-1 (AfroLINE) clade, our tree supports Paenungulata, Afroinsectivora and Afroinsectiphillia. Xenarthran LINE-1 (XenaLINE) falls sister to AfroLINE, providing some support for the Atlantogenata (Xenarthra+Afrotheria) hypothesis. Significance LINEs and SINEs make up approximately half of all placental genomes, so understanding their dynamics is an essential aspect of comparative genomics. Importantly, a tree of LINE-1 offers a different view of the root, as long edges (branches) such as that to marsupials are shortened and/or broken up. Additionally, a robust phylogeny of diverse LINE-1 is essential in testing that site-specific LINE-1 insertions, often regarded as homoplasy-free phylogenetic markers, are indeed unique and not convergent. PMID:17225861

Investing in the foundation of sustainable development: pathways to scale up for early childhood development

PubMed Central

Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan; Heymann, Jody; Boo, Florencia Lopez; Behrman, Jere R; Lu, Chunling; Lucas, Jane E; Perez-Escamilla, Rafael; Dua, Tarun; Bhutta, Zulfiqar A; Stenberg, Karin; Gertler, Paul; Darmstadt, Gary L

2018-01-01

Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals. PMID:27717610

Improved measurement for mothers, newborns and children in the era of the Sustainable Development Goals.

PubMed

Marchant, Tanya; Bryce, Jennifer; Victora, Cesar; Moran, Allisyn C; Claeson, Mariam; Requejo, Jennifer; Amouzou, Agbessi; Walker, Neff; Boerma, Ties; Grove, John

2016-06-01

An urgent priority in maternal, newborn and child health is to accelerate the scale-up of cost-effective essential interventions, especially during labor, the immediate postnatal period and for the treatment of serious infectious diseases and acute malnutrition.  Tracking intervention coverage is a key activity to support scale-up and in this paper we examine priorities in coverage measurement, distinguishing between essential interventions that can be measured now and those that require methodological development. We conceptualized a typology of indicators related to intervention coverage that distinguishes access to care from receipt of an intervention by the population in need.  We then built on documented evidence on coverage measurement to determine the status of indicators for essential interventions and to identify areas for development. Contact indicators from pregnancy to childhood were identified as current indicators for immediate use, but indicators reflecting the quality of care provided during these contacts need development. At each contact point, some essential interventions can be measured now, but the need for development of indicators predominates around interventions at the time of birth and interventions to treat infections. Addressing this need requires improvements in routine facility based data capture, methods for linking provider and community-based data, and improved guidance for effective coverage measurement that reflects the provision of high-quality care. Coverage indicators for some essential interventions can be measured accurately through household surveys and be used to track progress in maternal, newborn and child health.  Other essential interventions currently rely on contact indicators as proxies for coverage but urgent attention is needed to identify new measurement approaches that directly and reliably measure their effective coverage.

Biological and ecological science for Florida—The Sunshine State

USGS Publications Warehouse

,

2017-08-30

Florida is rich in sunshine and other natural resources essential to the State's economy. More than 100 million tourists visit Florida's beaches, wetlands, forests, oceans, lakes, and streams where they generate billions of dollars and sustain more than a million jobs. Florida also provides habitat for several thousand freshwater and marine fish, mammals, birds, and other wildlife that are viewed, hunted, or fished, or that provide valuable ecological services. Fertile soils and freshwater supplies support agriculture and forest industries and generate more than $8 billion of revenue annually and sustain thousands of jobs.

Laboratory Directed Research and Development FY-10 Annual Report

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

Dena Tomchak

2011-03-01

The FY 2010 Laboratory Directed Research and Development (LDRD) Annual Report is a compendium of the diverse research performed to develop and ensure the INL's technical capabilities can support the future DOE missions and national research priorities. LDRD is essential to the INL -- it provides a means for the laboratory to pursue novel scientific and engineering research in areas that are deemed too basic or risky for programmatic investments. This research enhances technical capabilities at the laboratory, providing scientific and engineering staff with opportunities for skill building and partnership development.

USGS research on Atlantic coral reef ecosystems

USGS Publications Warehouse

Kuffner, Ilsa B.; Yates, Kimberly K.; Zawada, David G.; Richey, Julie N.; Kellogg, Christina A.; Toth, Lauren T.

2015-10-23

Coral reefs are massive, biomineralized structures that protect coastal communities by acting as barriers to hazards such as hurricanes and tsunamis. They provide sand for beaches through the natural process of erosion, support tourism and recreational industries, and provide essential habitat for fisheries. The continuing global degradation of coral reef ecosystems is well documented. There is a need for focused, coordinated science to understand the complex physical and biological processes and interactions that are impacting the condition of coral reefs and their ability to respond to a changing environment.

The integrated microbial genome resource of analysis.

PubMed

Checcucci, Alice; Mengoni, Alessio

2015-01-01

Integrated Microbial Genomes and Metagenomes (IMG) is a biocomputational system that allows to provide information and support for annotation and comparative analysis of microbial genomes and metagenomes. IMG has been developed by the US Department of Energy (DOE)-Joint Genome Institute (JGI). IMG platform contains both draft and complete genomes, sequenced by Joint Genome Institute and other public and available genomes. Genomes of strains belonging to Archaea, Bacteria, and Eukarya domains are present as well as those of viruses and plasmids. Here, we provide some essential features of IMG system and case study for pangenome analysis.

Conceptual Framework for Developing a Diabetes Information Network.

PubMed

Riazi, Hossein; Langarizadeh, Mostafa; Larijani, Bagher; Shahmoradi, Leila

2016-06-01

To provide a conceptual framework for managing diabetic patient care, and creating an information network for clinical research. A wide range of information technology (IT) based interventions such as distance learning, diabetes registries, personal or electronic health record systems, clinical information systems, and clinical decision support systems have so far been used in supporting diabetic care. Previous studies demonstrated that IT could improve diabetes care at its different aspects. There is however no comprehensive conceptual framework that defines how different IT applications can support diverse aspects of this care. Therefore, a conceptual framework that combines different IT solutions into a wide information network for improving care processes and for research purposes is widely lacking. In this study we describe the theoretical underpin of a big project aiming at building a wide diabetic information network namely DIANET. A literature review and a survey of national programs and existing regulations for diabetes management was conducted in order to define different aspects of diabetic care that should be supported by IT solutions. Both qualitative and quantitative research methods were used in this study. In addition to the results of a previous systematic literature review, two brainstorming and three expert panel sessions were conducted to identify requirements of a comprehensive information technology solution. Based on these inputs, the requirements for creating a diabetes information network were identified and used to create a questionnaire based on 9-point Likert scale. The questionnaire was finalized after removing some items based on calculated content validity ratio and content validity index coefficients. Cronbach's alpha reliability coefficient was also calculated (αTotal= 0.98, P<0.05, CI=0.95). The final questionnaire was containing 45 items. It was sent to 13 clinicians at two diabetes clinics of endocrine and metabolism research institute in order to assess the necessity level of the requirements for diabetes information network conceptual framework. The questionnaires were returned by 10 clinicians. Each requirement item was labeled as essential, semi-essential, or non-essential based on the mean of its scores. All requirement items were identified as essential or semi-essential. Thus, all of them were used to build the conceptual framework. The requirements were allocated into 11 groups each one representing a module in the conceptual framework. Each module was described separately. We proposed a conceptual framework for supporting diabetes care and research. Integrating different and heterogeneous clinical information systems of healthcare facilities and creating a comprehensive diabetics data warehouse for research purposes, would be possible by using the DIANET framework.

Australian midwifery students and the continuity of care experience--getting it right.

PubMed

Sidebotham, Mary

2014-09-01

The evidence base supporting the value to be gained by women and babies from receiving continuity of care from a known midwife is growing; it is essential, therefore, that we nurture the future workforce to work within this model of care. The Australian National Midwifery Education Standards mandate that midwifery students provide continuity of care to 20 women as part of their practice requirements. The educational value to students and the degree of preparation this provides for future work patterns is well acknowledged. There is also growing evidence that women, too, benefit from having a student follow them through the pregnancy journey. This paper examines the experience of some students working within this model and comments on the importance of providing a flexible programme delivery model and supportive midwifery educators in order to sustain and develop this innovative approach to completing clinical practice requirements within a midwifery education programme.

Highly damped kinematic coupling for precision instruments

DOEpatents

Hale, Layton C.; Jensen, Steven A.

2001-01-01

A highly damped kinematic coupling for precision instruments. The kinematic coupling provides support while causing essentially no influence to its nature shape, with such influences coming, for example, from manufacturing tolerances, temperature changes, or ground motion. The coupling uses three ball-cone constraints, each combined with a released flexural degree of freedom. This arrangement enables a gain of higher load capacity and stiffness, but can also significantly reduce the friction level in proportion to the ball radius divided by the distance between the ball and the hinge axis. The blade flexures reduces somewhat the stiffness of the coupling and provides an ideal location to apply constrained-layer damping which is accomplished by attaching a viscoelastic layer and a constraining layer on opposite sides of each of the blade flexures. The three identical ball-cone flexures provide a damped coupling mechanism to kinematically support the projection optics system of the extreme ultraviolet lithography (EUVL) system, or other load-sensitive apparatus.

Noonan syndrome: clinical features, diagnosis, and management guidelines.

PubMed

Romano, Alicia A; Allanson, Judith E; Dahlgren, Jovanna; Gelb, Bruce D; Hall, Bryan; Pierpont, Mary Ella; Roberts, Amy E; Robinson, Wanda; Takemoto, Clifford M; Noonan, Jacqueline A

2010-10-01

Noonan syndrome (NS) is a common, clinically and genetically heterogeneous condition characterized by distinctive facial features, short stature, chest deformity, congenital heart disease, and other comorbidities. Gene mutations identified in individuals with the NS phenotype are involved in the Ras/MAPK (mitogen-activated protein kinase) signal transduction pathway and currently explain ∼61% of NS cases. Thus, NS frequently remains a clinical diagnosis. Because of the variability in presentation and the need for multidisciplinary care, it is essential that the condition be identified and managed comprehensively. The Noonan Syndrome Support Group (NSSG) is a nonprofit organization committed to providing support, current information, and understanding to those affected by NS. The NSSG convened a conference of health care providers, all involved in various aspects of NS, to develop these guidelines for use by pediatricians in the diagnosis and management of individuals with NS and to provide updated genetic findings.

The scientific argumentation profile of physics teacher candidate in Surabaya

NASA Astrophysics Data System (ADS)

Ain, T. N.; Wibowo, H. A. C.; Rohman, A.; Deta, U. A.

2018-03-01

The ability of scientific argumentation is an essential factor that must be mastered by physics teacher candidate as a requirement in explaining good and accurate scientific concepts. In the process of arguing, students develop explanations or persuade colleagues to support their hypotheses, express doubts, ask questions, relate alternative answers, and confirm what is unknown to develop the ability to provide rational and scientific explanations. The design of this research is descriptive qualitative with the subject of research is 20 undergraduate students of Physics Education Department in Surabaya. The research instrument consists of four casuistic questions related to the concept of kinematics. The argumentation pattern of physics teacher candidate is coded using Toulmin's argumentation pattern. The results show that the student’s ability in providing scientific argument is at the level of providing claims with the support of a weak warrant. The students are not able to provide excellent rebuttals. In each case given, the student can give a good claim statement in answering the questions. However, the concept used to support the claim is not correct. This case causes the warrant used to support the claim is weak. Students also do not analyse other facts that affect the system. Students have not reached a higher level because the understanding of physics is not deep enough.

A Study of Military-Civil Service Differences in Quality of Life

DTIC Science & Technology

1976-12-01

specialists -- men and women whose knowledge and skills are essential to the increasingly complex activities that support AF mission$ (Ai-- Force... essential support functions. They let military personne] concentrate fully on their primary ina lon of training to keep combat ready or reacting immediately...unification of military and civilian personnel nited in the study were: 1. The custom of dressing military in uniform when they are in GoR/sm/76D-11 essentially

Supporting the Essential Elements with CD-ROM Storybooks

ERIC Educational Resources Information Center

Pearman, Cathy J.; Lefever-Davis, Shirley

2006-01-01

CD-ROM storybooks can support the development of the five essential elements of reading instruction identified by The National Reading Panel: phonemic awareness, phonics, fluency, vocabulary, and comprehension. Specific features inherent in these texts, audio pronunciation of text, embedded vocabulary definitions and animated graphics can be used…

Organization-level principles and practices to support spiritual care at the end of life: a qualitative study.

PubMed

Holyoke, Paul; Stephenson, Barry

2017-04-11

Though most models of palliative care specifically include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families. Organizations often leave responsibility for such care with individual care providers, some of whom are comfortable with this role and well supported, others who are not. This study looked to hospice programs founded and operated on specific spiritual foundations to identify, if possible, organizational-level practices that support high-quality spiritual care that then might be applied in secular healthcare organizations. Forty-six digitally-recorded interviews were conducted with bereaved family members, care providers and administrators associated with four hospice organizations in North America, representing Buddhist, Catholic, Jewish, and Salvation Army faith traditions. The interviews were analyzed iteratively using the constant comparison method within a grounded theory approach. Nine Principles for organizational support for spiritual care emerged from the interviews. Three Principles identify where and how spiritual care fits with the other aspects of palliative care; three Principles guide the organizational approach to spiritual care, including considerations of assessment and of sacred places; and three Principles support the spiritual practice of care providers within the organizations. Organizational practices that illustrate each of the principles were provided by interviewees. These Principles, and the practices underlying them, could increase the quality of spiritual care offered by secular health care organizations at the end of life.

Essential qualities of children’s favorite places

NASA Astrophysics Data System (ADS)

Prakoso, S.

2018-03-01

This paper builds on an existential-phenomenology framework to better understand the essential qualities of children’s favorite places. Based on grounded theory, this study focused on the everyday life experiences of 25 children (14 girls and 11 boys), aged 9–12 years and living in Jakarta, whose housing environments reflected various spatial qualities. The results showed that all children reported having one or more favorite places. Despite differences in type, scale, form, and location of children’s favorite places, each existential place was a supportive urban space conceived, perceived, and lived through the meaning and symbolic use given to it by a child. The essential qualities of children’s favorite places were accessibility, a location within route from home to other destinations (such as a friend’s house or school), and a space providing a sense of comfort, security, and social affiliation, as well as experiences that were restorative, personal, sensory, and materialistic. This study may have implications for the design of urban places that foster the formation of children’s favorite spaces by taking into account these essential qualities of children’s lived-existential spaces.

Essential drugs production in Brazil, Russia, India, China and South Africa (BRICS): opportunities and challenges.

PubMed

Ezziane, Zoheir

2014-12-01

The objective of this work is to elucidate various essential drugs in the Brazil, Russia, India, China and South Africa (BRICS) countries. It discusses the opportunities and challenges of the existing biotech infrastructure and the production of drugs and vaccines in member states of the BRICS. This research is based on a systematic literature review between the years 2000 and 2014 of documents retrieved from the databases Embase, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organizations, research institutions and philanthropic organizations. Findings vary from one member state to another. These include useful comparison between the BRICS countries in terms of pharmaceuticals expenditure versus total health expenditure, local manufacturing of drugs/vaccines using technology and know-how transferred from developed countries, and biotech entrepreneurial collaborations under the umbrella of the BRICS region. This study concludes by providing recommendations to support more of inter collaborations among the BRICS countries as well as between BRICS and many developing countries to shrink drug production costs. In addition, this collaboration would also culminate in reaching out to poor countries that are not able to provide their communities and patients with cost-effective essential medicines.

Essential drugs production in Brazil, Russia, India, China and South Africa (BRICS): opportunities and challenges

PubMed Central

Ezziane, Zoheir

2014-01-01

The objective of this work is to elucidate various essential drugs in the Brazil, Russia, India, China and South Africa (BRICS) countries. It discusses the opportunities and challenges of the existing biotech infrastructure and the production of drugs and vaccines in member states of the BRICS. This research is based on a systematic literature review between the years 2000 and 2014 of documents retrieved from the databases Embase, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organizations, research institutions and philanthropic organizations. Findings vary from one member state to another. These include useful comparison between the BRICS countries in terms of pharmaceuticals expenditure versus total health expenditure, local manufacturing of drugs/vaccines using technology and know-how transferred from developed countries, and biotech entrepreneurial collaborations under the umbrella of the BRICS region. This study concludes by providing recommendations to support more of inter collaborations among the BRICS countries as well as between BRICS and many developing countries to shrink drug production costs. In addition, this collaboration would also culminate in reaching out to poor countries that are not able to provide their communities and patients with cost-effective essential medicines. PMID:25489593

Always Strategic: Jointly Essential Landpower

DTIC Science & Technology

2015-02-01

United States Army War College’s lines of effort to educate strategic leaders and provide well-being education and support by developing self ...wartime mobilization, there is no doubt that it cannot properly be assessed as being even some- what equal in national cultural esteem to the military...apparent- ly more than marginally like ideas, such as seapower, airpower, and cyberpower. For obvious, and indeed all but self -evident reasons with

Leg ulcer assessment techniques in a remote rural area.

PubMed

Graham, Julia

Community-based leg ulcer clinics are a cost-effective and efficient way of managing patients with leg ulcers in the community (Blair et al, 1988; Moffatt and Oldroyd, 1994). According to the Scottish Clinical Standards for Vascular Services (NHS Quality Improvement Scotland, 2003): 'It is essential that all vascular patients are seen by a nurse with vascular expertise, who is able to provide information, support and health promotion advice'.

[Psychological specificities of living donor kidney transplantation].

PubMed

Papeloux-Heitzmann, Élodie

2016-12-01

For people with end-stage kidney disease, a transplant is the promise of a future without dialysis. Living donor kidney transplantation comprises many specificities and is distinct from cadaveric donor transplantation. Some psychological aspects explain these specificities. They may be subconscious and difficult to access, but it is essential to decipher them in order to adapt the support provided to these people. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Engineering With Nature Geographic Project Mapping Tool (EWN ProMap)

DTIC Science & Technology

2015-07-01

EWN ProMap database provides numerous case studies for infrastructure projects such as breakwaters, river engineering dikes, and seawalls that have...the EWN Project Mapping Tool (EWN ProMap) is to assist users in their search for case study information that can be valuable for developing EWN ideas...Essential elements of EWN include: (1) using science and engineering to produce operational efficiencies supporting sustainable delivery of

Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

PubMed

Paxton, Avery B; Pickering, Emily A; Adler, Alyssa M; Taylor, J Christopher; Peterson, Charles H

2017-01-01

Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH), special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of reefs on the seafloor so that all EFH across a wide range of habitat complexity may be accurately identified and properly managed.

Implementing a Breastfeeding Toolkit for Nursing Education.

PubMed

Folker-Maglaya, Catherine; Pylman, Maureen E; Couch, Kimberly A; Spatz, Diane L; Marzalik, Penny R

All health professional organizations recommend exclusive breastfeeding for at least 6 months, with continued breastfeeding for 1 year or more after birth. Women cite lack of support from health professionals as a barrier to breastfeeding. Meanwhile, breastfeeding education is not considered essential to basic nursing education and students are not adequately prepared to support breastfeeding women. Therefore, a toolkit of comprehensive evidence-based breastfeeding educational materials was developed to provide essential breastfeeding knowledge. A study was performed to determine the effectiveness of the breastfeeding toolkit education in an associate degree nursing program. A pretest/posttest survey design with intervention and comparison groups was used. One hundred fourteen students completed pre- and posttests. Student knowledge was measured using a 12-item survey derived with minor modifications from Marzalik's 2004 instrument measuring breastfeeding knowledge. When pre- and posttests scores were compared within groups, both groups' knowledge scores increased. A change score was calculated with a significantly higher mean score for the intervention group. When regression analysis was used to control for the pretest score, belonging to the intervention group increased student scores but not significantly. The toolkit was developed to provide a curriculum that demonstrates enhanced learning to prepare nursing students for practice. The toolkit could be used in other settings, such as to educate staff nurses working with childbearing families.

Taphonomic evidence for high-speed adapted fins in thunniform ichthyosaurs.

PubMed

Lingham-Soliar, Theagarten; Plodowski, Gerhard

2007-01-01

Ichthyosaurs have been compared with the fast-swimming thunniform groups of marine vertebrates, tuna, lamnid sharks, and dolphins, based on similarity of shape of the body and locomotory organs. In addition to shape, high-tensile stiffness of the control surfaces has been shown to be essential in maximizing hydrodynamic efficiency in extant thunniform swimmers. To date, there has been no evidence of a stiffening support system for the dorsal fin and dorsal lobe of the caudal fin in ichthyosaurs, the sole stiffening structure of the ventral lobe being an extension of the vertebral column along its leading edge. Stenopterygius SMF 457 is arguably the best soft-tissue preserved ichthyosaur specimen known. Here, we examine soft-tissue preservation in this specimen in the control surfaces and provide the first evidence of a complex architecture of stiff fibers in the dorsal and caudal fins. We find by comparisons and by analogy that these fibers provided a remarkable mechanism for high tensile stiffness and efficiency of the locomotory organs virtually identical to that of the great white shark, Carcharodon carcharias. It is the first mechanostructural study of the control surfaces of a Jurassic ichthyosaur that adds essential evidence in support of the view that these forms were high-speed thunniform swimmers.

Taphonomic evidence for high-speed adapted fins in thunniform ichthyosaurs

NASA Astrophysics Data System (ADS)

Lingham-Soliar, Theagarten; Plodowski, Gerhard

2007-01-01

Ichthyosaurs have been compared with the fast-swimming thunniform groups of marine vertebrates, tuna, lamnid sharks, and dolphins, based on similarity of shape of the body and locomotory organs. In addition to shape, high-tensile stiffness of the control surfaces has been shown to be essential in maximizing hydrodynamic efficiency in extant thunniform swimmers. To date, there has been no evidence of a stiffening support system for the dorsal fin and dorsal lobe of the caudal fin in ichthyosaurs, the sole stiffening structure of the ventral lobe being an extension of the vertebral column along its leading edge. Stenopterygius SMF 457 is arguably the best soft-tissue preserved ichthyosaur specimen known. Here, we examine soft-tissue preservation in this specimen in the control surfaces and provide the first evidence of a complex architecture of stiff fibers in the dorsal and caudal fins. We find by comparisons and by analogy that these fibers provided a remarkable mechanism for high tensile stiffness and efficiency of the locomotory organs virtually identical to that of the great white shark, Carcharodon carcharias. It is the first mechanostructural study of the control surfaces of a Jurassic ichthyosaur that adds essential evidence in support of the view that these forms were high-speed thunniform swimmers.

Supporting Online Learners: Blending High-Tech with High-Touch

ERIC Educational Resources Information Center

Dolan, Sean; Donohue, Chip; Holstrom, Lisa; Pernell, Latonia; Sachdev, Anu

2009-01-01

Effective and easily accessible student support services are essential to the success of adult learners. A student-centered approach is especially important in the design and delivery of online courses, professional certificates, and degree programs for early childhood professionals. A student-first approach is essential for non-traditional adult…

20 CFR 416.1157 - Support and maintenance assistance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... which an SSI claimant lives or an SSI claimant's ineligible spouse, parent, sponsor (or the sponsor's spouse) of an alien, or essential person. Private nonprofit agency means a religious, charitable... spouse) if you are an alien, or an essential person. We also do not consider certain support and...

The resources of Mars for human settlement.

PubMed

Meyer, T R; McKay, C P

1989-01-01

Spacecraft exploration of Mars has shown that the essential resources necessary for life support are present on the martian surface. The key life-support compounds O2, N2, and H2O are available on Mars. The soil could be used as radiation shielding and could provide many useful industrial and construction materials. Compounds with high chemical energy, such as rocket fuels, can be manufactured in-situ on Mars. Solar power, and possibly wind power, are available and practical on Mars. Preliminary engineering studies indicate that fairly autonomous processes can be designed to extract and stockpile Martian consumables. The ability to utilize these materials in support of a human exploration effort allows missions that are more robust and economical than would otherwise be possible.

Patient-oriented Computerized Clinical Guidelines for Mobile Decision Support in Gestational Diabetes.

PubMed

García-Sáez, Gema; Rigla, Mercedes; Martínez-Sarriegui, Iñaki; Shalom, Erez; Peleg, Mor; Broens, Tom; Pons, Belén; Caballero-Ruíz, Estefanía; Gómez, Enrique J; Hernando, M Elena

2014-03-01

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients' self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient's access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients' personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients' acceptance of the whole system. © 2014 Diabetes Technology Society.

Some Consequences of Thermosolutal Convection: The Grain Structure of Castings

NASA Technical Reports Server (NTRS)

Hansen, G.; Hellawell, A.; Lu, S. Z.; Steube, R. S.

1996-01-01

The essential principles of thermosolutal convection are outlined, and how convection provides a transport mechanism between the mushy region of a casting and the open bulk liquid is illustrated. The convective flow patterns which develop assist in heat exchange and macroscopic solute segregation during solidification; they also provide a mechanism for the transport of dendritic fragments from the mushy region into the bulk liquid. Surviving fragments become nuclei for equiaxed grains and so lead to blocking of the parental columnar, dendritic growth front from which they originated. The physical steps in such a sequence are considered and some experimental data are provided to support the argument.

Social support and support groups among people with HIV/AIDS in Ghana.

PubMed

Abrefa-Gyan, Tina; Wu, Liyun; Lewis, Marilyn W

2016-01-01

HIV/AIDS, a chronic burden in Ghana, poses social and health outcome concerns to those infected. Examining the Medical Outcome Study Social Support Survey (MOS-SSS) instrument among 300 Ghanaians from a cross-sectional design, Principal Component Analysis yielded four factors (positive interaction, trust building, information giving, and essential support), which accounted for 85.73% of the total variance in the MOS-SSS. A logistic regression analysis showed that essential support was the strongest predictor of the length of time an individual stayed in the support group, whereas positive interaction indicated negative association. The study's implications for policy, research, and practice were discussed.

The impact of maths support tutorials on mathematics confidence and academic performance in a cohort of HE Animal Science students

PubMed Central

Amory, Jonathan

2014-01-01

Students embarking on a bioscience degree course, such as Animal Science, often do not have sufficient experience in mathematics. However, mathematics forms an essential and integral part of any bioscience degree and is essential to enhance employability. This paper presents the findings of a project looking at the effect of mathematics tutorials on a cohort of first year animal science and management students. The results of a questionnaire, focus group discussions and academic performance analysis indicate that small group tutorials enhance students’ confidence in maths and improve students’ academic performance. Furthermore, student feedback on the tutorial programme provides a deeper insight into student experiences and the value students assign to the tutorials. PMID:25024925

Informatics: essential infrastructure for quality assessment and improvement in nursing.

PubMed Central

Henry, S B

1995-01-01

In recent decades there have been major advances in the creation and implementation of information technologies and in the development of measures of health care quality. The premise of this article is that informatics provides essential infrastructure for quality assessment and improvement in nursing. In this context, the term quality assessment and improvement comprises both short-term processes such as continuous quality improvement (CQI) and long-term outcomes management. This premise is supported by 1) presentation of a historical perspective on quality assessment and improvement; 2) delineation of the types of data required for quality assessment and improvement; and 3) description of the current and potential uses of information technology in the acquisition, storage, transformation, and presentation of quality data, information, and knowledge. PMID:7614118

The impact of maths support tutorials on mathematics confidence and academic performance in a cohort of HE Animal Science students.

PubMed

van Veggel, Nieky; Amory, Jonathan

2014-01-01

Students embarking on a bioscience degree course, such as Animal Science, often do not have sufficient experience in mathematics. However, mathematics forms an essential and integral part of any bioscience degree and is essential to enhance employability. This paper presents the findings of a project looking at the effect of mathematics tutorials on a cohort of first year animal science and management students. The results of a questionnaire, focus group discussions and academic performance analysis indicate that small group tutorials enhance students' confidence in maths and improve students' academic performance. Furthermore, student feedback on the tutorial programme provides a deeper insight into student experiences and the value students assign to the tutorials.

Filling in the gaps: reporting of concurrent supportive care therapies in breast cancer chemotherapy trials.

PubMed

Freedman, Orit; Amir, Eitan; Zimmermann, Camilla; Clemons, Mark

2011-03-01

Supportive care interventions can have a substantial impact on side effects of chemotherapy. Consequently, accurate reporting of such interventions is essential when interpreting clinical trial results. This study determined the prevalence and quality of reporting of supportive care treatment for common chemotherapy-induced toxicities in phase III, breast cancer chemotherapy trials. A systematic review of phase III trials of breast cancer trials incorporating chemotherapy published in the last 5 years was undertaken. Trials were identified through MEDLINE, EMBASE, BIOSIS, and the Cochrane Library. Supportive treatments evaluated were use of antiemetics, colony-stimulating growth factors, and antibiotics. Reporting quality was rated as "good", "fair", "poor", or "absent" using predetermined criteria. Sixty-two trials met inclusion criteria. In 41 studies (66%), details regarding prophylactic antiemetic treatment were not provided. Growth factor use was not reported in 20 trials (32%). Instructions for the use of prophylactic antibiotics were absent in 45 trials (72%). There are significant deficiencies in reporting of use of prophylactic supportive care agents in breast cancer trials. Omission of supportive care instructions may impact substantially on patient management and health care system expenditure. Recommendations for the type, dose, and frequency of supportive care drugs should be provided and reported on in trials.

Surviving the wait: defining support while awaiting breast cancer surgery.

PubMed

Dickerson, Suzanne S; Alqaissi, Nesreen; Underhill, Meghan; Lally, Robin M

2011-07-01

This paper is a report of a descriptive study of the common meanings, shared experiences and practices of social support of women within the days between breast cancer diagnosis and treatment initiation. Support needs, types of social support and support outcomes during and after breast cancer treatment have been explored worldwide. However, to promote women's psychological wellbeing it is essential to understand how women define support in the highly stressful period initially following diagnosis. Secondary analysis of narrative texts using interpretive phenomenology from 18 women in the Midwestern United States newly diagnosed with breast cancer who were interviewed in 2005 for a study of women's pretreatment thought processes. 'Surviving the wait for surgery by balancing support needs to maintain a hopeful outlook' was the overarching pattern linking six other related themes: (1) controlling access to information for self and to others, (2) knowing which supportive network members to access, (3) controlling anxiety through distraction to maintain hope while waiting, (4) being in good hands and comfortable with decision (provider support), (5) protecting others through concealment and being strong to maintain hope and (6) accepting care from others vs. maintaining a nurturing role. Implications for nurses working with women in the days following breast cancer diagnosis include assessing women's definitions and availability of support; respecting varied needs for informational support; providing a supportive clinical environment; educating clinicians, family and friends regarding unsupportive responses within the cultural context and validating women's control and balancing of support needs. © 2011 Blackwell Publishing Ltd.

Designing Targeted Educational Voucher Schemes for the Poor in Developing Countries

NASA Astrophysics Data System (ADS)

Shafiq, M. Najeeb

2010-02-01

A targeted educational voucher scheme (TEVS) is often proposed for the poor in developing countries. Essentially, TEVS involves issuing vouchers to poor households, thus enabling them to pay tuition and fees for their children's schooling at participating non-public schools. However, little is known about TEVS' design in developing countries. This article provides the foundation for constructing a TEVS and conducting subsequent scientific evaluations to support, modify or oppose such a system. Specifically, this article uses three policy instruments to design a TEVS: regulation, support services and finance. Regulation here refers to the rules that must be adhered to by participating households, children and schools. Support services refer to services facilitating the participation of children, households, schools, and financial and political supporters. Finance refers to the value of each voucher, total TEVS costs and sources of finance.

Self-Assessment Methods in Writing Instruction: A Conceptual Framework, Successful Practices and Essential Strategies

ERIC Educational Resources Information Center

Nielsen, Kristen

2014-01-01

Student writing achievement is essential to lifelong learner success, but supporting writing can be challenging for teachers. Several large-scale analyses of publications on writing have called for further study of instructional methods, as the current literature does not sufficiently address the need to support best teaching practices.…

Mentors' Views of Factors Essential for the Success of Beginning Teachers

ERIC Educational Resources Information Center

Barrera, Arnold; Braley, Richard; Slate, John R.

2008-01-01

The views of 46 mentors of first-year teachers were obtained regarding practices that they viewed as essential for their success in mentoring teachers. Specifically, they were queried about teacher involvement/support, staff development, administrative support, and resource materials. Almost all of the mentor teachers believed a teacher-mentoring…

Cultural, ethical, and spiritual competencies of health care providers responding to a catastrophic event.

PubMed

Jose, Mini M

2010-12-01

Compassion is a language that is understood across cultures, religions, and nations. Being compassionate and empathetic is a basic responsibility of health care providers responding to disasters. Compassion and empathy cannot be operationalized unless providers show culturally competent, ethically right, and spiritually caring behavior. In addition to being accepting of cultures other than their own, providers must read literature and familiarize themselves with the predominant cultures of the affected population. Ethically right decision making is essentially an act of balancing the risks and benefits to the entire society. Spiritual care is an important dimension of total health, and therefore recognition and resolution of the spiritual needs of disaster victims is an essential role of health care providers. Disaster management is teamwork and therefore requires that health care providers draw on the expertise and support of other team members; coordinating efforts with local religious, social governmental organizations, and NGOs to deal with the intangible effects of the cultural and spiritual impact of a disaster and to prevent further demoralization of the affected community is imperative. Disasters occur, and the only thing that can ameliorate their devastating effects is to improve disaster preparedness and respond collectively and courageously to every catastrophic event. Published by Elsevier Inc.

The role of peer support in diabetes care and self-management.

PubMed

Brownson, Carol A; Heisler, Michele

2009-03-01

In light of the growing prevalence and healthcare costs of diabetes mellitus, it is critically important for healthcare providers to improve the efficiency and effectiveness of their diabetes care. A key element of effective disease management for diabetes is support for patient self-management. Barriers to care exist for both patients and healthcare systems. As a result, many people with diabetes do not get the care and support needed to successfully manage their diabetes.Disease management approaches that incorporate peer support may be a promising way to help provide self-management support to patients with diabetes. Trained peers provide emotional support, instrumental (tangible or material) support, education, and skills training to those they serve, and outreach and care coordination for provider systems. They play a unique role that complements and supports clinical care.To describe how peers are currently supporting diabetes care, a number of databases were searched for studies describing the roles of peers using relevant key words. This paper reviews current literature that describes the roles and duties of peers in interventions to improve diabetes care, with a focus on their contributions to six essential elements of self-management support: (i) access to regular, high-quality clinical care; (ii) an individualized approach to assessment and treatment; (iii) patient-centered collaborative goal setting; (iv) education and skills training; (v) ongoing follow-up and support; and (vi) linkages to community resources.Peers worked under a variety of titles, which did not define their duties. The scope of their work ranged from assisting health professionals to playing a central role in care. Providing education and follow-up support were the two most common roles. In all but one study, these roles were carried out during face-to-face contact, most frequently in community sites.A growing body of literature supports the value of peer models for diabetes management. Additional research can answer remaining questions related to such issues as cost effectiveness, sustainability, integration of peers into health and social service delivery systems, and recruitment, training, and support of peers. Continuing to develop and evaluate innovative models for more effectively mobilizing and integrating peers into diabetes care has great potential for improving diabetes outcomes worldwide.

Cloud-based mobility management in heterogeneous wireless networks

NASA Astrophysics Data System (ADS)

Kravchuk, Serhii; Minochkin, Dmytro; Omiotek, Zbigniew; Bainazarov, Ulan; Weryńska-Bieniasz, RóŻa; Iskakova, Aigul

2017-08-01

Mobility management is the key feature that supports the roaming of users between different systems. Handover is the essential aspect in the development of solutions supporting mobility scenarios. The handover process becomes more complex in a heterogeneous environment compared to the homogeneous one. Seamlessness and reduction of delay in servicing the handover calls, which can reduce the handover dropping probability, also require complex algorithms to provide a desired QoS for mobile users. A challenging problem to increase the scalability and availability of handover decision mechanisms is discussed. The aim of the paper is to propose cloud based handover as a service concept to cope with the challenges that arise.

The Astroculture (tm)-1 experiment on the USML-1 mission

NASA Technical Reports Server (NTRS)

Tibbitts, Theodore; Bula, R. J.; Morrow, R. C.

1994-01-01

Permanent human presence in space will require a life support system that minimizes athe need for resupply of consumables from Earth resources. Plants that convert radiant energy to chemical energy via photosynthesis are a key component of a bioregenerative life support system. Providing the proper root environment for plants in reduced gravity is an essential aspect of the development of facilities for growing plants in a space environment. The ASTROCULTURE(TM)-1 experiment, included in the USML-1 mission, successfully demonstrated the ability of the Wisconsin Center for Space Automation and Robotics porous tube water delivery system to control water movement through a rooting matrix in a microgravity environment.

[Support for families through a Disability Resource Unit].

PubMed

Micaëlli, Delphine

The Disability Resource Unit of the mother and infant welfare protection centre aims to facilitate the care of children with a disability in day care centres or at school. Thanks to the creation of a doctor-children's nurse partnership, the unit provides families with personalised support. Listening, availability and empathy are essential in order to meet as best as possible the specific needs of the child and the parents' expectations. Interview with Véronique Labidoire, child care worker and technical advisor in the Disability Resource Unit of the Gironde's mother and infant welfare protection centre. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Approaches to resource recovery in controlled ecological life support systems

NASA Technical Reports Server (NTRS)

Bubenheim, D. L.; Wydeven, T.

1994-01-01

Recovery of resources from waste streams in a space habitat is essential to minimize the resupply burden and achieve self sufficiency. The ultimate goal of a Controlled Ecological Life Support System (CELSS) is to achieve the greatest practical level of mass recycle and provide self sufficiency and safety for humans. Several mission scenarios leading to the ultimate application could employ CELSS component technologies or subsystems with initial emphasis on recycle of the largest mass components of the waste stream. Candidate physical/chemical and biological processes for resource recovery from liquid and solid waste streams are discussed and the current fundamental recovery potentials are estimated.

Chinese Proprietary Herbal Medicine Listed in ‘China National Essential Drug List’ for Common Cold: A Systematic Literature Review

PubMed Central

Chen, Wei; Lewith, George; Wang, Li-qiong; Ren, Jun; Xiong, Wen-jing; Lu, Fang; Liu, Jian-ping

2014-01-01

Objective Chinese proprietary herbal medicines (CPHMs) have long history in China for the treatment of common cold, and lots of them have been listed in the ‘China national essential drug list’ by the Chinese Ministry of Health. The aim of this review is to provide a well-round clinical evidence assessment on the potential benefits and harms of CPHMs for common cold based on a systematic literature search to justify their clinical use and recommendation. Methods We searched CENTRAL, MEDLINE, EMBASE, SinoMed, CNKI, VIP, China Important Conference Papers Database, China Dissertation Database, and online clinical trial registry websites from their inception to 31 March 2013 for clinical studies of CPHMs listed in the ‘China national essential drug list’ for common cold. There was no restriction on study design. Results A total of 33 CPHMs were listed in ‘China national essential drug list 2012’ for the treatment of common cold but only 7 had supportive clinical evidences. A total of 6 randomised controlled trials (RCTs) and 7 case series (CSs) were included; no other study design was identified. All studies were conducted in China and published in Chinese between 1995 and 2012. All included studies had poor study design and methodological quality, and were graded as very low quality. Conclusions The use of CPHMs for common cold is not supported by robust evidence. Further rigorous well designed placebo-controlled, randomized trials are needed to substantiate the clinical claims made for CPHMs. PMID:25329481

Selecting Essential Information for Biosurveillance—A Multi-Criteria Decision Analysis

PubMed Central

Generous, Nicholas; Margevicius, Kristen J.; Taylor-McCabe, Kirsten J.; Brown, Mac; Daniel, W. Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

2014-01-01

The National Strategy for Biosurveillancedefines biosurveillance as “the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels.” However, the strategy does not specify how “essential information” is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being “essential”. Thequestion of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of “essential information” for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system. PMID:24489748

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

An assessment of the quality of care for children in eighteen randomly selected district and sub-district hospitals in Bangladesh

PubMed Central

2012-01-01

Background Quality hospital care is important in ensuring that the needs of severely ill children are met to avert child mortality. However, the quality of hospital care for children in developing countries has often been found poor. As the first step of a country road map for improving hospital care for children, we assessed the baseline situation with respect to the quality of care provided to children under-five years age in district and sub-district level hospitals in Bangladesh. Methods Using adapted World Health Organization (WHO) hospital assessment tools and standards, an assessment of 18 randomly selected district (n=6) and sub-district (n=12) hospitals was undertaken. Teams of trained assessors used direct case observation, record review, interviews, and Management Information System (MIS) data to assess the quality of clinical case management and monitoring; infrastructure, processes and hospital administration; essential hospital and laboratory supports, drugs and equipment. Results Findings demonstrate that the overall quality of care provided in these hospitals was poor. No hospital had a functioning triage system to prioritise those children most in need of immediate care. Laboratory supports and essential equipment were deficient. Only one hospital had all of the essential drugs for paediatric care. Less than a third of hospitals had a back-up power supply, and just under half had functioning arrangements for safe-drinking water. Clinical case management was found to be sub-optimal for prevalent illnesses, as was the quality of neonatal care. Conclusion Action is needed to improve the quality of paediatric care in hospital settings in Bangladesh, with a particular need to invest in improving newborn care. PMID:23268650

Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations.

PubMed

Osso, Diane; Kanani, Nehal

2013-02-01

Antiseptic mouth rinses are widely recommended and marketed to improve oral health. This article summarizes current studies on the comparative effectiveness of selected antiseptic mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily exposure, including salivary flow rate, oral cancer and wear of composite restorations. Electronic database searches were conducted using Google Scholar and PubMed to identify articles comparing the effectiveness of 4 commercially marketed antiseptic mouth rinses differing in active ingredients (0.12% chlorhexidine gluconate, essential oils (menthol, thymol and eucalyptol) and methyl salicylate, 0.7% cetylpyridinium chloride and 20% aloe vera gel) for controlling plaque and gingivitis. Criteria for inclusion included controlled clinical trials and systematic reviews appearing in English language publications evaluating the comparative effectiveness of the mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily usage. The majority of studies have shown mouth rinses containing chlorhexidine gluconate or essential oils and methyl salicylate provide clinically significant anti-gingivitis and anti-plaque benefits. Cetylpyridinium chloride has been found to provide only limited clinical benefits compared to inactive control mouth rinse. Inadequate evidence is available to evaluate the clinical effectiveness of aloe vera gel. Chlorhexidine, essential oils and cetylpyridinium have been found to be safe. However, limited data are available on the effects of the mouth rinse on wear patterns of dental restorations. Studies reviewed reported no significant difference in salivary flow rate related to alcohol based mouth rinse. Research supports the effectiveness of antiseptic mouth rinses in reducing plaque and gingivitis as an adjunct to home care. Insufficient evidence is available to support the claim that oral antiseptics can reduce the risk of developing periodontitis or the rate of progression of periodontitis.

Evaluation of a Potential for Enhancing the Decision Support System of the Interagency Modeling and Atmospheric Assessment Center with NASA Earth Science Research Results

NASA Technical Reports Server (NTRS)

Blonski, Slawomir; Berglund, Judith; Spruce, Joseph P.; McKellip, Rodney; Jasinski, Michael; Borak, Jordan; Lundquist, Julie

2007-01-01

NASA's objective for the Applied Sciences Program of the Science Mission Directorate is to expand and accelerate the realization of economic and societal benefits from Earth science, information, and technology. This objective is accomplished by using a systems approach to facilitate the incorporation of Earth observations and predictions into the decision-support tools used by partner organizations to provide essential services to society. The services include management of forest fires, coastal zones, agriculture, weather prediction, hazard mitigation, aviation safety, and homeland security. In this way, NASA's long-term research programs yield near-term, practical benefits to society. The Applied Sciences Program relies heavily on forging partnerships with other Federal agencies to accomplish its objectives. NASA chooses to partner with agencies that have existing connections with end-users, information infrastructure already in place, and decision support systems that can be enhanced by the Earth science information that NASA is uniquely poised to provide (NASA, 2004).

Virtual memory support for distributed computing environments using a shared data object model

NASA Astrophysics Data System (ADS)

Huang, F.; Bacon, J.; Mapp, G.

1995-12-01

Conventional storage management systems provide one interface for accessing memory segments and another for accessing secondary storage objects. This hinders application programming and affects overall system performance due to mandatory data copying and user/kernel boundary crossings, which in the microkernel case may involve context switches. Memory-mapping techniques may be used to provide programmers with a unified view of the storage system. This paper extends such techniques to support a shared data object model for distributed computing environments in which good support for coherence and synchronization is essential. The approach is based on a microkernel, typed memory objects, and integrated coherence control. A microkernel architecture is used to support multiple coherence protocols and the addition of new protocols. Memory objects are typed and applications can choose the most suitable protocols for different types of object to avoid protocol mismatch. Low-level coherence control is integrated with high-level concurrency control so that the number of messages required to maintain memory coherence is reduced and system-wide synchronization is realized without severely impacting the system performance. These features together contribute a novel approach to the support for flexible coherence under application control.

[The needs of children in a context of violence within the family].

PubMed

Sadlier, Karen

Intimate partner violence has a significant impact on children, who are caught up in a conflict of loyalty with regard to their parents. Their development can be compromised in these situations. It is essential to meet the specific needs of these children, notably by enabling them to express their emotions, while providing them with a safe environment and adapted support. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

[The physical impact of pregnancy on a teenager].

PubMed

Audinet, Corinne

2016-01-01

Pregnancy in a teenager may be an expression of her angst. From a lack of contraception or its failure, to the desire to be pregnant, she may be expressing her wish to acquire the status of an adult or to offset depression and anxiety resulting from abandonment. The situation is further compounded by the physical changes she undergoes. Providing the teenager with global support is essential. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A Knowledge-based System for Estimating Incident Clearance Duration for Maryland : I-95 a Case Study for the Project of MD-17-SHA/UM/4-19 : “Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment”

DOT National Transportation Integrated Search

2017-12-01

For the incident response operations to be appreciated by the general public, it is essential that responsible highway agencies be capable of providing the estimated clearance duration of a detected incident at the level sufficiently reliable for mot...

Smart Materials and Structures-Smart Wing. Volumes 1, 2, 3 and 4

DTIC Science & Technology

1998-12-01

repeatable fashion when heat is applied. Therefore, once the pre-twist is successfully applied and the tube is installed in the model, heating the...modules were operated and calibrated online by the PSI 8400 Control System. Because the transducer modules are extremely sensitive to temperature, a...again substantiates that adaptive features tend to support each other, though not necessarily in a completely linear fashion , and essentially provide a

Demonstration of Human-Autonomy Teaming Principles

NASA Technical Reports Server (NTRS)

Shively, Robert Jay

2016-01-01

Known problems with automation include lack of mode awareness, automation brittleness, and risk of miscalibrated trust. Human-Autonomy Teaming (HAT) is essential for improving these problems. We have identified some critical components of HAT and ran a part-task study to introduce these components to a ground station that supports flight following of multiple aircraft. Our goal was to demonstrate, evaluate, and refine HAT principles. This presentation provides a brief summary of the study and initial findings.

Scoping review of resources for integrating evidence-based supported employment into spinal cord injury rehabilitation.

PubMed

Cotner, Bridget A; Ottomanelli, Lisa; Keleher, Virginia; Dirk, Lynn

2018-02-27

Individual placement and support (IPS), an evidence-based supported employment (SE) program, has helped Veterans with spinal cord injury (SCI) receiving care in the Veterans Health Administration to obtain work. To facilitate integration of IPS into SCI rehabilitation, resources are needed. A scoping review was conducted to identify tools and resources suitable for providers of SCI care. Applying a modified version of Arksey and O'Malley's framework, a scoping review of literature on SE tools or resources was conducted. The original review focused on resources published between 2002 and 2015 and available in English. Prior to publication an updated review through 2017 was conducted. From 1822 tools and resources identified in the initial review, 24 met criteria for inclusion and were evaluated by an advisory panel of experts, who selected 16 tools that addressed five topics: IPS in SCI (n = 2) orientation to SCI (n = 3); IPS SE (n = 7), job accommodations (n = 2), and benefits planning (n = 2). The updated review yielded no tools or resources that met inclusion criteria. Despite few resources to guide implementation of IPS in SCI, 16 essential resources were identified that, combined into a toolkit, may facilitate translation of IPS in SCI from research to clinical care. Implications for rehabilitation The toolkit consists of 16 essential resources and is currently available online to all persons involved in spinal cord injury rehabilitation to educate them about this effective means of assisting persons with spinal cord injury to find employment and to facilitate translation of individual placement and support in spinal cord injury from research to clinical care. While expert-informed, the toolkit is being field tested with both clinical and vocational providers to facilitate the adoption of individual placement and support by spinal cord injury rehabilitation programs. The revised version will be made available online.

Terrestrial essential climate variables (ECVs) at a glance

USGS Publications Warehouse

Stitt, Susan; Dwyer, John; Dye, Dennis; Josberger, Edward

2011-01-01

The Global Terrestrial Observing System, Global Climate Observing System, World Meteorological Organization, and Committee on Earth Observation Satellites all support consistent global land observations and measurements. To accomplish this goal, the Global Terrestrial Observing System defined 'essential climate variables' as measurements of atmosphere, oceans, and land that are technically and economically feasible for systematic observation and that are needed to meet the United Nations Framework Convention on Climate Change and requirements of the Intergovernmental Panel on Climate Change. The following are the climate variables defined by the Global Terrestrial Observing System that relate to terrestrial measurements. Several of them are currently measured most appropriately by in-place observations, whereas others are suitable for measurement by remote sensing technologies. The U.S. Geological Survey is the steward of the Landsat archive, satellite imagery collected from 1972 to the present, that provides a potential basis for deriving long-term, global-scale, accurate, timely and consistent measurements of many of these essential climate variables.

An evidence based approach to undergraduate physical assessment practicum course development.

PubMed

Anderson, Brenda; Nix, Elizabeth; Norman, Bilinda; McPike, H Dawn

2014-05-01

Physical assessment is an important component of professional nursing practice. New nurse graduates experience difficulty transitioning the traditional head to toe physical assessment into real world nursing practice. This study was conducted to provide current data concerning physical assessment competencies utilized consistently by registered nurses. This quantitative study used a 126 item survey mailed to 900 Registered Nurses. Participants used a Likert-type scale to report frequency of use for physical assessment competencies. Thirty seven competencies were determined to be essential components of the physical assessment, 18 were determined supplemental, and 71 were determined to be non-essential. Transition of the new graduate nurse into professional practice can be enhanced by focusing content in physical assessment practicum courses on the essential competencies of physical assessment. Faculty for the university has analyzed data from this study to support evidence based changes to the undergraduate nursing program physical assessment practicum course. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessment of antinociceptive, antipyretic and antimicrobial activity of Piper cubeba L. essential oil in animal models.

PubMed

Mothana, Ramzi; Alsaid, Mansour; Khaled, Jamal M; Alharbi, Naiyf S; Alatar, Abdulrahman; Raish, Mohammad; Al-Yahya, Mohammed; Rafatullah, Syed; Parvez, Mohammad Khalid; Ahamad, Syed Rizwan

2016-03-01

This study was designed to investigate the possible antiniciceptive, antipyretic and antimicrobial activities of the essential oil obtained from the fruits of Piper Cubeba (L.). To assess the antinociceptive and antipyretic activities, three doses (150, 300 and 600 mg/kg, i.p.) were tested in acetic acid-induced abdominal writhing, tail flick reaction and hot-plate and Brewer's yeast-induced hyperpyrexia test models in animals. Moreover, the antimicrobial activity was examined using agar diffusion method and broth micro-dilution assay for minimum inhibitory concentrations (MIC). The Piper Cubeba essential oil (PCEO) showed a marked antinociception (17, 30 and 54%) and an increase in reaction time in mice in the flick tailed and hot-plate tests. The brewer's yeast induced hyperpyrexia was decreased in a dose dependent manner. PCEO also exhibited a strong antimicrobial potential. These findings confirm the traditional analgesic indications of P. cubeba oil and provide persuasive evidence and support its use in Arab traditional medicine.

Frankincense Essential Oil as a Supportive Therapy for Cancer-Related Fatigue: A Case Study.

PubMed

Reis, Debra; Jones, Tisha Throne

Fatigue experienced by patients diagnosed with cancer can be debilitating and can be challenging to manage. The use of supportive therapies such as essential oils is gaining popularity among patients diagnosed with cancer. This article describes one patient's experience using frankincense (Boswellia carterii) essential oil to help in the management of her fatigue. The topical application of the frankincense helped to take her fatigue from being barely able to lift her head to being able to do some basic activities of daily living.

Investing in the foundation of sustainable development: pathways to scale up for early childhood development.

PubMed

Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan; Heymann, Jody; Boo, Florencia Lopez; Behrman, Jere R; Lu, Chunling; Lucas, Jane E; Perez-Escamilla, Rafael; Dua, Tarun; Bhutta, Zulfiqar A; Stenberg, Karin; Gertler, Paul; Darmstadt, Gary L

2017-01-07

Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Distinct roles of autophagy-dependent and -independent functions of FIP200 revealed by generation and analysis of a mutant knock-in mouse model

PubMed Central

Chen, Song; Wang, Chenran; Yeo, Syn; Liang, Chun-Chi; Okamoto, Takako; Sun, Shaogang; Wen, Jian; Guan, Jun-Lin

2016-01-01

Autophagy is an evolutionarily conserved cellular process controlled through a set of essential autophagy genes (Atgs). However, there is increasing evidence that most, if not all, Atgs also possess functions independent of their requirement in canonical autophagy, making it difficult to distinguish the contributions of autophagy-dependent or -independent functions of a particular Atg to various biological processes. To distinguish these functions for FIP200 (FAK family-interacting protein of 200 kDa), an Atg in autophagy induction, we examined FIP200 interaction with its autophagy partner, Atg13. We found that residues 582–585 (LQFL) in FIP200 are required for interaction with Atg13, and mutation of these residues to AAAA (designated the FIP200-4A mutant) abolished its canonical autophagy function in vitro. Furthermore, we created a FIP200-4A mutant knock-in mouse model and found that specifically blocking FIP200 interaction with Atg13 abolishes autophagy in vivo, providing direct support for the essential role of the ULK1/Atg13/FIP200/Atg101 complex in the process beyond previous studies relying on the complete knockout of individual components. Analysis of the new mouse model showed that nonautophagic functions of FIP200 are sufficient to fully support embryogenesis by maintaining a protective role in TNFα-induced apoptosis. However, FIP200-mediated canonical autophagy is required to support neonatal survival and tumor cell growth. These studies provide the first genetic evidence linking an Atg's autophagy and nonautophagic functions to different biological processes in vivo. PMID:27013233

Seeking a balance between employment and the care of an ageing parent.

PubMed

Eldh, Ann Catrine; Carlsson, Eva

2011-06-01

A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities. To elucidate the experience of providing informal care to an ageing parent while managing the responsibilities of a working life. Narrative interviews were performed with 11 persons with experience of the phenomenon. Transcribed interviews were analysed with phenomenological hermeneutics. Informed consent was given prior to the interviews. The study was approved by a research ethics committee. Providing informal care to an ageing parent while also pursuing a working life implies seeking balance: a balance between providing support to the parent's needs and one's responsibilities at work. Being employed supports this balance as it provides both fulfilment and refuge. Being capable of managing both roles grants a sense of satisfaction, supporting one's sense of balance in life. The balance can be supported by sharing the responsibility of caring for the ageing parent with others. Despite perceived saturation and an effort to provide for the possibility to consider internal consistency, the findings should be considered as a contribution to the understanding of the phenomenon, as experienced by individuals in their life world. It is essential to recognise the impact that providing care for an ageing parent may have on the lives of a growing number of people, particularly if they have employment responsibilities. Acknowledgement by others supports one's ability to attain balance; as co-workers and managers, we can acknowledge the efforts of an informal caregiver and as health care staff recognise the valuable contribution made by people in mid-life who provide informal care for their ageing parents. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

Stopping the culture of workplace incivility in nursing.

PubMed

Khadjehturian, Rachele E

2012-12-01

Workplace incivility (WI) continues to hamper professional nursing practice, patient care, and the health of nurses who encounter this phenomenon in their workplace. This article provides an exemplar of WI experienced by a new nurse when a more seasoned nurse uses humiliation, intimidation, and angry verbal abuse to accuse the novice nurse in the presence of coworkers and patients that she failed to provide essential nursing care to a challenging patient. Nurses are reminded that open communication among coworkers will help minimize the occurrence of WI, encourage a supportive milieu in the unit, and ensure the safety of patients, family, and staff.

Developing Essential Understanding of Rational Numbers for Teaching Mathematics in Grades 3-5. Essential Understandings

ERIC Educational Resources Information Center

Clarke, Carne; Fisher, William; Marks, Rick; Ross, Sharon; Zbiek, Rose Mary

2010-01-01

This book focuses on essential knowledge for teachers about rational numbers. It is organized around four big ideas, supported by multiple smaller, interconnected ideas--essential understandings. Taking teachers beyond a simple introduction to rational numbers, the book will broaden and deepen their mathematical understanding of one of the most…

A Study of Business Incubators: Models, Best Practices, and Recommendations for NASA and Florida

NASA Technical Reports Server (NTRS)

1997-01-01

This study was conducted to provide NASA-Kennedy Space Center with information and recommendations to support establishing one or more technology-based business incubators In Florida. The study involved assembling information about incubators: why they succeed, why they fail, how they are organized, and what services they provide. Consequently, this study focuses on widely-recognized "best practices," needed to establish successful technology- based business incubators. The findings are used to optimize the design and implementation of one or more technology-based business incubators to be established in Florida. Recommendations reflect both the essential characteristics of successful incubators and the optimal business demographics in Florida. Appendix A provides a fuller description of the objectives of the study. Technology-based business incubators are an increasing catalyst of new business development across the USi Incubators focus on providing entrepreneurs and small start-up firms with a wide array of support services necessary to bring forth new products and processes based on technologies developed in the nation's federal and private laboratories and universities. Appendix B provides extensive discussion of findings relative to technology- based business incubators.

A quality management systems approach for CD4 testing in resource-poor settings.

PubMed

Westerman, Larry E; Kohatsu, Luciana; Ortiz, Astrid; McClain, Bernice; Kaplan, Jonathan; Spira, Thomas; Marston, Barbara; Jani, Ilesh V; Nkengasong, John; Parsons, Linda M

2010-10-01

Quality assurance (QA) is a systematic process to monitor and improve clinical laboratory practices. The fundamental components of a laboratory QA program include providing a functional and safe laboratory environment, trained and competent personnel, maintained equipment, adequate supplies and reagents, testing of appropriate specimens, internal monitoring of quality, accurate reporting, and external quality assessments. These components are necessary to provide accurate and precise CD4 T-cell counts, an essential test to evaluate start of and monitor effectiveness of antiretroviral therapy for HIV-infected patients. In recent years, CD4 testing has expanded dramatically in resource-limited settings. Information on a CD4 QA program as described in this article will provide guidelines not only for clinical laboratory staff but also for managers of programs responsible for supporting CD4 testing. All agencies involved in implementing CD4 testing must understand the needs of the laboratory and provide advocacy, guidance, and financial support to established CD4 testing sites and programs. This article describes and explains the procedures that must be put in place to provide reliable CD4 determinations in a variety of settings.

Facilitation of learning: part 2.

PubMed

Warburton, Tyler; Houghton, Trish; Barry, Debbie

2016-04-27

The previous article in this series of 11, Facilitation of learning: part 1, reviewed learning theories and how they relate to clinical practice. Developing an understanding of these theories is essential for mentors and practice teachers to enable them to deliver evidence-based learning support. This is important given that effective learning support is dependent on an educator who possesses knowledge of their specialist area as well as the relevent tools and methods to support learning. The second domain of the Nursing and Midwifery Council's Standards to Support Learning and Assessment in Practice relates to the facilitation of learning. To fulfil this domain, mentors and practice teachers are required to demonstrate their ability to recognise the needs of learners and provide appropriate support to meet those needs. This article expands on some of the discussions from part 1 of this article and considers these from a practical perspective, in addition to introducing some of the tools that can be used to support learning.

Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang.

PubMed

Moss, Mark; Hewitt, Steven; Moss, Lucy; Wesnes, Keith

2008-01-01

This study provides further evidence for the impact of the aromas of plant essential oils on aspects of cognition and mood in healthy participants. One hundred and forty-four volunteers were randomly assigned to conditions of ylang-ylang aroma, peppermint aroma, or no aroma control. Cognitive performance was assessed using the Cognitive Drug Research computerized assessment battery, with mood scales completed before and after cognitive testing. The analysis of the data revealed significant differences between conditions on a number of the factors underpinning the tests that constitute the battery. Peppermint was found to enhance memory whereas ylang-ylang impaired it, and lengthened processing speed. In terms of subjective mood peppermint increased alertness and ylang-ylang decreased it, but significantly increased calmness. These results provide support for the contention that the aromas of essential oils can produce significant and idiosyncratic effects on both subjective and objective assessments of aspects of human behavior. They are discussed with reference to possible pharmacological and psychological modes of influence.

Using Student-Produced Video to Validate Head-to-Toe Assessment Performance.

PubMed

Purpora, Christina; Prion, Susan

2018-03-01

This study explored third-semester baccalaureate nursing students' perceptions of the value of using student-produced video as an approach for learning head-to-toe assessment, an essential clinical nursing skill taught in the classroom. A cognitive apprenticeship model guided the study. The researchers developed a 34-item survey. A convenience sample of 72 students enrolled in an applied assessment and nursing fundamentals course at a university in the western United States provided the data. Most students reported a videotaping process that worked, supportive faculty, valuable faculty review of their work, confidence, a sense of performance independence, the ability to identify normal assessment findings, and few barriers to learning. The results suggested that a student-produced video approach to learning head-to-toe assessment was effective. Further, the study demonstrated how to leverage available instructional technology to provide meaningful, personalized instruction and feedback to students about an essential nursing skill. [J Nurs Educ. 2018;57(3):154-158.]. Copyright 2018, SLACK Incorporated.

Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013.

PubMed

Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard

2014-10-31

This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.

U.S. Geological Survey Mineral Resources Program - Science Supporting Mineral Resource Stewardship

USGS Publications Warehouse

Kropschot, S.J.

2007-01-01

The United States is the world's largest user of mineral resources. We use them to build our homes and cities, fertilize our food crops, and create wealth that allows us to buy goods and services. Individuals rarely use nonfuel mineral resources in their natural state - we buy light bulbs, not the silica, soda ash, lime, coal, salt, tungsten, copper, nickel, molybdenum, iron, manganese, aluminum, and zinc used to convert electricity into light. The USGS Mineral Resources Program (MRP) is the sole Federal source of scientific information and unbiased research on nonfuel mineral potential, production, and consumption, as well as on the environmental effects of minerals. The MRP also provides baseline geochemical, geophysical, and mineral-deposit data used to understand environmental issues related to extraction and use of mineral resources. Understanding how minerals, water, plants, and organisms interact contributes to our understanding of the environment, which is essential for maintaining human and ecosystem health. To support creation of economic and national security policies in a global context, MRP collects and analyzes data on essential mineral commodities from around the world.

Determining business models for financial sustainability in regional health information organizations (RHIOs): a review.

PubMed

Maffei, Roxana; Burciago, Daniel; Dunn, Kim

2009-10-01

Regional health information organizations (RHIOs) have the potential to alleviate today's health care problems by granting providers access to a supported body of clinical information for all patients in a given region. While the promise of and enthusiasm for RHIOs is immense, the issue of their financial sustainability remains unclear. It has been said that the business model supporting a regional or national health information network is as essential, if not more essential, than the technology that makes it feasible. Currently, there is a clear lack of concrete business models implemented in RHIOs' projects. This article reports the results of a literature review of the current status of the adaptation and implementation of business models by RHIOs for successful financial sustainability. Based on the review, this article also attempts to evaluate the existing financial situation of RHIOs to determine and recommend the best models of economic sustainability. Significant findings include RHIOs' present financial environment, planning, and self-sustainability methods. Future studies will be needed as RHIOs continue to grow and move toward the implementation phase of their development.

Policy content and stakeholder network analysis for infant and young child feeding in Bangladesh.

PubMed

Rasheed, Sabrina; Roy, Swapan Kumar; Das, Susmita; Chowdhury, Syeda Nafisa; Iqbal, Mohammad; Akter, Syeda Mahsina; Jahan, Khurshid; Uddin, Shahadat; Thow, Anne Marie

2017-06-13

Appropriate infant and young child feeding (IYCF) practices are essential for nutrition of infants and young children. Bangladesh has one of the highest levels of malnutrition globally along with sub-optimal IYCF practices. A supportive policy environment is essential to ensure that effective IYCF interventions are scaled up. The objectives of our study were to assess the support for IYCF in the national policy environment through policy analysis and stakeholder analysis and in so doing identify opportunities to strengthen the policy environment. We used a matrix developed by SAIFRN (the South Asian Infant Feeding Research Network) to systematically identify supportive national policies, plans and guidelines for IYCF. We adapted narrative synthesis and descriptive approaches to analyze policy content, based on four themes with a focus on support for mothers. We conducted three Net-Map interviews to identify stakeholders who influenced the policies and programs related to IYCF. We identified 19 national policy documents relevant to IYCF. Overall, there was good level of support for IYCF practices at policy level - particularly regarding general support for IYCF and provision of information to mothers - but these were not consistently supported at implementation level, particularly regarding specificity and population coverage. We identified gaps regarding the training of health workers, capacity building, the monitoring and targeting of vulnerable mothers and providing an enabling environment to mothers, specifically with respect to maternity leave for working women. Urban populations and providers outside the public sector remained uncovered by policy. Our stakeholder analysis identified government entities such as the National Nutrition Service, as the most influential in terms of both technical and funding support as they had the mandate for formulation and implementation of policies and national programs. Stakeholders from different sectors played important roles, demonstrating the salience of IYCF. Although there is strong supportive policy environment for IYCF, it is important that policies cover all populations. Our analysis indicated that opportunities to strengthen the policy environment include: expanding population coverage, increasing inter-sector coordination, improving translation of policy objectives to implementation-level documents, and the engagement of non-public sectors. In addition, we recommend explicit strategies to engage diverse stakeholders in the formulation and implementation of IYCF policies.

“That’s True Love:” Lived Experiences of Puerto Rican Perinatally HIV-Infected Youth within Their Families’ Context

PubMed Central

Silva-Suárez, Georgina; Bastida, Elena; Rabionet, Silvia E.; Beck-Sagué, Consuelo; Febo, Irma; Zorrilla, Carmen D.

2015-01-01

The burden of HIV affects not only HIV-infected patients but also their families and caregivers. It is also known that family support is crucial for people living with HIV. A qualitative study was conducted to explore the life experiences, within the family context, of perinatally HIV-infected (pHIV-I) youth in Puerto Rico. Twenty in-depth interviews were performed and audio-recorded. Within the family context, study participants experienced acceptance, love and support but also stigma and discrimination. They reported that family is an essential component in their lives and treatment. Losing one or both parents at a young age was considered more difficult than having HIV. Most participants who lost their parents lived with other family members. This was a challenging situation for both pHIV-I youth and their caregivers. Participants described their healthcare providers as part of their families and would like to keep in touch as they transition to adult care. Despite the challenges, participants expressed a desire to have children. Services targeted to this population should stress social support, incorporate family members into the medical process, provide special guidance and support while transitioning to adult care, and provide them with the latest information regarding HIV and reproductive options. PMID:26703639

Perceptions on evaluative and formative functions of external supervision of Rwandan primary healthcare facilities: A qualitative study

PubMed Central

Schriver, Michael; Cubaka, Vincent Kalumire; Itangishaka, Sylvere; Nyirazinyoye, Laetitia; Kallestrup, Per

2018-01-01

Background External supervision of primary healthcare facilities in low- and middle-income countries often has a managerial main purpose in which the role of support for professional development is unclear. Aim To explore how Rwandan primary healthcare supervisors and providers (supervisees) perceive evaluative and formative functions of external supervision. Design Qualitative, exploratory study. Data Focus group discussions: three with supervisors, three with providers, and one mixed (n = 31). Findings were discussed with individual and groups of supervisors and providers. Results Evaluative activities occupied providers’ understanding of supervision, including checking, correcting, marking and performance-based financing. These were presented as sources of motivation, that in self-determination theory indicate introjected regulation. Supervisors preferred to highlight their role in formative supervision, which may mask their own and providers’ uncontested accounts that systematic performance evaluations predominated supervisors’ work. Providers strongly requested larger focus on formative and supportive functions, voiced as well by most supervisors. Impact of performance evaluation on motivation and professional development is discussed. Conclusion While external supervisors intended to support providers’ professional development, our findings indicate serious problems with this in a context of frequent evaluations and performance marking. Separating the role of supporter and evaluator does not appear as the simple solution. If external supervision is to improve health care services, it is essential that supervisors and health centre managers are competent to support providers in a way that transparently accounts for various performance pressures. This includes delivery of proper formative supervision with useful feedback, maintaining an effective supervisory relationship, as well as ensuring providers are aware of the purpose and content of evaluative and formative supervision functions. PMID:29462144

Essential oil of lavender in anxiety disorders: Ready for prime time?

PubMed Central

2017-01-01

Anxiety disorders are some of the most common psychiatric disorders, with potentially debilitating consequences on individual function. Existing pharmacotherapies for anxiety disorders are limited by delay to therapeutic effect, dependence, tolerance, withdrawal, and abuse potential. Therefore, safe and evidence-based complementary or alternative therapies may be important allies in the care of patients with anxiety disorders. Essential oils are lipophilic and concentrated botanical extracts that exhibit many properties of drugs, although they are not Food and Drug Administration approved and have limitations characteristic of herbal preparations. Lavender essential oil has an extensive anecdotal history of anxiolytic benefit that has recently been supported by clinical efficacy studies. The 2 primary terpenoid constituents of lavender essential oil, linalool and linalyl acetate, may produce an anxiolytic effect in combination via inhibition of voltage-gated calcium channels, reduction of 5HT1A receptor activity, and increased parasympathetic tone. The objectives of this article are to provide a brief overview of lavender oil in aromatherapy, explore variability in the constituents of lavender oil, summarize its pharmacology and safety profile, as well as describe its body of research that has been conducted for anxiety.

[Electronic data processing-assisted high dosage therapy with stem cell transplantation at the Donauspital].

PubMed

Habertheuer, K H; Kier, P; Ruckser, R; Scherz, M; Höniger, S; Sebesta, C; Tiefengraber, E; Schmid, A; Mandl, A; Sterz, M

1995-01-01

Organization of high dose chemotherapy with stem cell transplantation essentially requires EDV-support. "ONCOBASE" has been adapted into the Donauspital network on May 1, 1992. We report about the 2-year clinical experience with ONCOBASE: 1. ONCOBASE effectively supports communication between the ward, ambulance and hospital pharmacy (where all cytostatics are prepared). 2. ONCOBASE provides better surveillance concerning all therapeutic procedures including cytostatic drugs and supportive therapies. 3. ONCOBASE allows the generation of medical letters which include all drugs and supportive therapies delivered. 4. Since ONCOBASE is a database program, all informations concerning the patients are registered. These include cumulative drug doses, information on side effects, blood cell kinetics after previous therapies, kinetics of tumor markers and results of further examinations. 5. ONCOBASE permits rapid data exchange with other hospital networks using the communication data record governed by the "Arbeitskreis für EDV der deutschen Gesellschaft für Hämatoonkologie".

Nutritional support of children in the intensive care unit.

PubMed Central

Seashore, J. H.

1984-01-01

Nutritional support is an integral and essential part of the management of 5-10 percent of hospitalized children. Children in the intensive care unit are particularly likely to develop malnutrition because of the nature and duration of their illness, and their inability to eat by mouth. This article reviews the physiology of starvation and the development of malnutrition in children. A method of estimating the nutritional requirements of children is presented. The techniques of nutritional support, including enteral, peripheral, and central parenteral nutrition are discussed in detail. Appropriate formulas are given for different age groups. Electrolyte, vitamin, and mineral supplements are discussed. Guidelines are provided for choosing between peripheral and central total parenteral nutrition. A monitoring protocol is suggested and complications of nutritional therapy are reviewed. Safe and effective nutritional support requires considerable investment of time and effort by members of the nutrition team. PMID:6433586

A study of electro-mechanical and infrastructure instrumentation facilities in environmental laboratory.

PubMed

Dhawangale, R M; Kawale, S M; Waghmare, Maya; Pandya, G H; Kondawar, V K

2006-01-01

Environmental laboratories carry out measurement and analysis of a number of physical, chemical and biological parameters. Each parameter requires some sort of instrument for its determination. Providing efficient instrumentation services to various departments of the Institute is an stupendous task. Instrumentation services in the form of installation, operation, repair and maintenanace of electro-mechanical equipment requires an in-depth experience and knowledge of the working, fabrication, design and repair of similar type of instruments so that the need of space, installation pre-requisites, budget constraints, availability of essential spares parts could be assessed. The paper discusses the operation of an environmental instrument repairs and maintenance, and audio-visual facilities. Suggestions for drafting of the proper specifications for procurement of laboratory equipments, such as ovens, furnaces, refrigerators, blowers, audio visual aids, and spares and accessories are given in this paper. The paper also gives the detailed information on various aspects that are needed for checking and testing of the equipment against specification before putting it in operational use. Development of a preventive maintenance program involving QC checks and keeping an inventory of essential spares required are also discussed in this paper. It is felt that such services are essential in providing smooth support to carry out research and development activities of the Institute.

[Good practices with tinnitus in adult].

PubMed

Le Pajolec, Christine; Ohresser, Martine; Nevoux, Jérome

2017-11-01

The interrogation is essential to trace the genesis of the tinnitus and to appreciate its repercussion. Clinical examination should look for a local, vascular or cervical cause. The ENT consultation with audiogram and tinnitus evaluation is essential to know the characteristics of the tinnitus and to consider the treatment. If tinnitus is accompanied by a decrease in hearing, then wearing hearing aids can correct deafness and decrease the tinnitus. The psychological impact of tinnitus must always be taken into account and the use of a multidisciplinary team is an interesting solution. Medical treatments are not very effective; on the other hand psychotherapies (CBT, TRT and sophrology) bring a real improvement. The doctor's speech must always be supportive and provide therapeutic hope. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Person-Centered Care: A Definition and Essential Elements.

PubMed

2016-01-01

Improving healthcare safety, quality, and coordination, as well as quality of life, are important aims of caring for older adults with multiple chronic conditions and/or functional limitations. Person-centered care is an approach to meeting these aims, but there are no standardized, agreed-upon parameters for delivering such care. The SCAN Foundation charged a team from the American Geriatrics Society (AGS) in collaboration with a research and clinical team from the Keck School of Medicine of the University of Southern California to provide the evidence base to support a definition of person-centered care and its essential elements. An interprofessional panel of experts in person-centered care principles and practices that the AGS convened developed this statement. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

From paperwork to parenting: experiences of professional staff in student support.

PubMed

Hu, Wendy C Y; Flynn, Eleanor; Mann, Rebecca; Woodward-Kron, Robyn

2017-03-01

For academic staff, responding to student concerns is an important responsibility. Professional staff, or non-academic staff who do administrative work in medical schools, are often the first to be approached by students, yet there is little research on how they manage student issues. Informed by the conceptual framework of emotional labour, we examined the experiences of professional staff, aiming to identify theoretical and practical insights for improving the provision of student support. We examined the scope of support provided, the impact of providing this support on staff and how these impacts can be managed. Professional staff at two medical schools were invited to participate in semi-structured qualitative interviews. Interviews were transcribed and independently analysed for emergent themes. Data analysis continued with purposive sampling for maximum variation until thematic saturation was reached. Findings were returned to participants in writing and via oral presentations for member checking and refinement. Twenty-two female staff from clinical, teaching and commercial backgrounds at nine urban and rural teaching sites were interviewed. Participants described providing support for diverse concerns, from routine requests to life-threatening emergencies. Four major themes emerged: firstly, all described roles consistent with emotional labour. Secondly, student support was regarded as informal work, and not well recognised or defined. Consequently, many drew upon their personal orientation to provide support. Finally, we identified both positive and negative personal impacts, including ongoing distress after critical events. Professional staff perform a range of student support work, leading to emotional, personal and work impacts. In turn, they need support, recognition and training in this essential but under-recognised role. Emotional labour offers a conceptual framework for understanding the gendered nature and impact of this work and how it may be managed. We suggest practical strategies for promoting positive and preventing negative effects on staff from supporting medical students. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

The assessment on impact of essential drugs policy on primary health care system in rural areas of Shandong Province policy and regulation division of the Health Department of Shandong Province.

PubMed

Li, Zhuge; Shu, Defeng; Xia, Mei; Gao, Dehai; Lu, Dan; Huang, Ning; Tian, Xiaoqing; An, Limei; Li, Shixue; Li, Sheng

2015-01-01

At present, China has achieved an initial establishment and gradual implementation of a framework for national essential drugs policy. With the further implementation of the national essential drugs policy, it is not clear how the policy works, whether it achieves the original intention of essential drugs policy, and what impact essential drugs policy exerts on the primary health care system. In view of it, we conducted a field research on sample areas of Shandong Province to understand the conditions of the implementation of the essential drugs policy in Shandong Province. From three perspectives of medical institutions, patients and medical staff, this thesis analyzes the impact of essential drugs policy on village-level and township-level health service system, summarizes the effectiveness of implementing essential drugs policy, discovers the problems of various aspects and conducts an in-depth analysis of the causes, and puts forward feasible suggestions to provide reference for improving the essential drugs policy. The assessment results show that the implementation of essential drugs policy in Shandong Province has played a positive role in promoting the sound development of the primary health care system, changed the situation of covering hospital expenses with medicine revenue in the past, contributed to the return of medical institutions to public welfare, and reduced the patient's economic burden of disease. But there emerge many problems as follows: impact on the doctor's diagnosis and treatment due to incompleteness of drug types, and distribution not in place, patient loss and operational difficulty of village clinic. Thus, this thesis makes recommendations of drugs catalog formulation, drug procurement, sales and use, and meanwhile points out that the supporting financial compensation policy and performance appraisal policy and other measures in place are a prerequisite for a positive role of essential drugs policy.

Making avian influenza vaccines available, an industry point of view (IFAH).

PubMed

van Aarle, P

2006-01-01

Vaccination against avian influenza (AI) has proved to be an efficient tool in the reduction of virus excretion and in increasing the threshold for infection. Vaccination in outbreaks, as part of a complete programme, has proved to be an essential component of control and eradication programmes. Avian influenza is a serious threat to public health. In contingency plans for outbreaks of highly pathogenic AI (HPAI), the option of emergency vaccination, using inactivated or recombinant vaccines, should be considered. The availability of suitable vaccines has to be ensured in 'peace time' in a contract for a vaccine or antigen bank. Unlike the human influenza vaccines, poultry AI vaccines have proved to provide protection against a wide range of strains within the same H-subtype. However, in case new H5 or H7 strains emerge in poultry, there is no regulatory guideline to support a swift reaction by the vaccine industry. Production of HPAI virus should take place in facilities with a Biosafety Level 3 (BSL3) to safeguard containment of virus and to prevent infection of manufacturing staff. Vaccine strains for inactivated vaccines should preferably be low pathogenicity AI (LPAI). In a new outbreak, it is essential to determine early which vaccine strain will provide protection against the field virus. Sequencing does not predict the protective capacity of vaccines. Challenge studies, providing essential information, take too much time and can be carried out only in BSL3 facilities. Serological matching of vaccine and field strains would provide a faster system. It is recommended that a matching system be developed and validated.

Essential interventions: implementation strategies and proposed packages of care

PubMed Central

2014-01-01

In an effort to accelerate progress towards achieving Millennium Development Goal (MDG) 4 and 5, provision of essential reproductive, maternal, newborn and child health (RMNCH) interventions is being considered. Not only should a state-of-the-art approach be taken for services delivered to the mother, neonate and to the child, but services must also be deployed across the household to hospital continuum of care approach and in the form of packages. The paper proposed several packages for improved maternal, newborn and child health that can be delivered across RMNCH continuum of care. These packages include: supportive care package for women to promote awareness related to healthy pre-pregnancy and pregnancy interventions; nutritional support package for mother to improve supplementation of essential nutrients and micronutrients; antenatal care package to detect, treat and manage infectious and noninfectious diseases and promote immunization; high risk care package to manage preeclampsia and eclampsia in pregnancy; childbirth package to promote support during labor and importance of skilled birth attendance during labor; essential newborn care package to support healthy newborn care practices; and child health care package to prevent and manage infections. This paper further discussed the implementation strategies for employing these interventions at scale. PMID:25178110

Space construction data base

NASA Technical Reports Server (NTRS)

1979-01-01

Construction of large systems in space is a technology requiring the development of construction methods to deploy, assemble, and fabricate the elements comprising such systems. A construction method is comprised of all essential functions and operations and related support equipment necessary to accomplish a specific construction task in a particular way. The data base objective is to provide to the designers of large space systems a compendium of the various space construction methods which could have application to their projects.

Biomass growth restriction in a packed bed reactor

DOEpatents

Griffith, William L.; Compere, Alicia L.

1978-01-01

When carrying out continuous biologically catalyzed reactions with anaerobic microorganisms attached to a support in an upflow packed bed column, growth of the microorganisms is restricted to prevent the microorganisms from plugging the column by limiting the availability of an essential nutrient and/or by the presence of predatory protozoa which consume the anaerobic microorganisms. A membrane disruptive detergent may be provided in the column to lyse dead microorganisms to make them available as nutrients for live microorganisms.

I need to know! Timely accessing of perioperative user manuals.

PubMed

Landreneau, Raphael

2010-12-01

Ready access to equipment or product information is essential for the safe operation of the many items that a perioperative nurse is asked to use, troubleshoot, or maintain. One institution's solution for making manufacturer information available in the practice setting was to create a facility intranet site dedicated to OR equipment manuals. This site provides information access to perioperative nurses and support staff members and, ultimately, helps improve patient care. Published by Elsevier Inc. All rights reserved.

Providing a healthy work environment for nurses: the influence on retention.

PubMed

Cohen, Jayne; Stuenkel, Diane; Nguyen, Quyen

2009-01-01

Differences in registered nurses' (RNs) perceptions of their work environment were measured with the Insel and Moos' Work Environment Scale to identify factors in the work environment that may influence retention. Statistically significant differences for perceptions of supervisor support and innovation were found between those RNs who left their unit or hospital during a 24-month period and those who stayed. Implementing strategies to promote retention of RNs to ensure safe, quality patient care is essential.

Ground-truthing electrical resistivity methods in support of submarine groundwater discharge studies: Examples from Hawaii, Washington, and California

USGS Publications Warehouse

Johnson, Cordell; Swarzenski, Peter W.; Richardson, Christina M.; Smith, Christopher G.; Kroeger, Kevin D.; Ganguli, Priya M.

2015-01-01

Rigorous ground-truthing at each field site showed that multi-channel electrcial resistivity techniques can reproduce the scales and dynamics of a seepage field when such data are correctly collected, and when the model inversions are tuned to field site characteristics. Such information can provide a unique perspective on the scales and dynamics of exchange processes within a coastal aquifer—information essential to scientists and resource managers alike.

Phoenix: SOA based information management services

NASA Astrophysics Data System (ADS)

Grant, Rob; Combs, Vaughn; Hanna, Jim; Lipa, Brian; Reilly, Jim

2009-05-01

The Air Force Research Laboratory (AFRL) has developed a reference set of Information Management (IM) Services that will provide an essential piece of the envisioned final Net-Centric IM solution for the Department of Defense (DoD). These IM Services will provide mission critical functionality to enable seamless interoperability between existing and future DoD systems and services while maintaining a highly available IM capability across the wide spectrum of differing scalability and performance requirements. AFRL designed this set of IM Services for integration with other DoD and commercial SOA environments. The services developed will provide capabilities for information submission, information brokering and discovery, repository, query, type management, dissemination, session management, authorization, service brokering and event notification. In addition, the IM services support common information models that facilitate the management and dissemination of information consistent with client needs and established policy. The services support flexible and extensible definitions of session, service, and channel contexts that enable the application of Quality of Service (QoS) and security policies at many levels within the SOA.

Stepping Stones to Research: Providing Pipelines from Middle School through PhD

NASA Astrophysics Data System (ADS)

Noel-Storr, Jacob; Baum, S. A.; RIT Insight Lab SSR Team; Carlson CenterImaging Science Faculty, Chester F.

2014-01-01

We present a decade's worth of strategies designed to promote and provide "Stepping Stones to Research" to provide a realistic pipeline of educational opportunities, with multiple gateways and exit points, for students moving towards STEM careers along the "STEM pipeline". We also illustrate how the Stepping Stones are designed to incidentally co-inside with related external opportunities through which we can also guide and support our mentees on their paths. We present programs such as middle school family science programs, high school research opportunities, high school internships, undergraduate research pathways, research experiences for undergraduates, and other opportunities. We will highlight the presentations being made at this very meeting -- from the first presentation of a high school student, to a dissertation presentation of a PhD graduate -- that have benefited from this stepping stone principle. We also reflect on the essential nature of building a "researcher-trust", even as a young student, of advocates and mentors who can support the continuation of a scientific career.

Bioregenerative life-support systems

NASA Technical Reports Server (NTRS)

Mitchell, C. A.

1994-01-01

Long-duration future habitation of space involving great distances from Earth and/or large crew sizes (eg, lunar outpost, Mars base) will require a controlled ecological life-support system (CELSS) to simultaneously revitalize atmosphere (liberate oxygen and fix carbon dioxide), purify water (via transpiration), and generate human food (for a vegetarian diet). Photosynthetic higher plants and algae will provide the essential functions of biomass productivity in a CELSS, and a combination of physicochemical and bioregenerative processes will be used to regenerate renewable resources from waste materials. Crop selection criteria for a CELSS include nutritional use characteristics as well as horticultural characteristics. Cereals, legumes, and oilseed crops are used to provide the major macronutrients for the CELSS diet. A National Aeronautics and Space Administration (NASA) Specialized Center of Research and Training (NSCORT) was established at Purdue University to establish proof of the concept of the sustainability of a CELSS. The Biosphere 2 project in Arizona is providing a model for predicted and unpredicted situations that arise as a result of closure in a complex natural ecosystem.

A Systematic Process for Developing High Quality SaaS Cloud Services

NASA Astrophysics Data System (ADS)

La, Hyun Jung; Kim, Soo Dong

Software-as-a-Service (SaaS) is a type of cloud service which provides software functionality through Internet. Its benefits are well received in academia and industry. To fully utilize the benefits, there should be effective methodologies to support the development of SaaS services which provide high reusability and applicability. Conventional approaches such as object-oriented methods do not effectively support SaaS-specific engineering activities such as modeling common features, variability, and designing quality services. In this paper, we present a systematic process for developing high quality SaaS and highlight the essentiality of commonality and variability (C&V) modeling to maximize the reusability. We first define criteria for designing the process model and provide a theoretical foundation for SaaS; its meta-model and C&V model. We clarify the notion of commonality and variability in SaaS, and propose a SaaS development process which is accompanied with engineering instructions. Using the proposed process, SaaS services with high quality can be effectively developed.

End of Life Care Policy for the Dying: Consensus Position Statement of Indian Association of Palliative Care

PubMed Central

Macaden, Stanley C; Salins, Naveen; Muckaden, Maryann; Kulkarni, Priyadarshini; Joad, Anjum; Nirabhawane, Vivek; Simha, Srinagesh

2014-01-01

EXECUTIVE SUMMARY Purpose: To develop an End of Life Care (EOLC) Policy for patients who are dying with an advanced life limiting illness. To improve the quality of care of the dying by limiting unnecessary therapeutic medical interventions, providing access to trained palliative care providers, ensuring availability of essential medications for pain and symptom control and improving awareness of EOLC issues through education initiatives. Evidence: A review of Country reports, observational studies and key surveys demonstrates that EOLC in India is delivered ineffectively, with a majority of the Indian population dying with no access to palliative care at end of life and essential medications for pain and symptom control. Limited awareness of EOLC among public and health care providers, lack of EOLC education, absent EOLC policy and ambiguous legal standpoint are some of the major barriers in effective EOLC delivery. Recommendations: Access to receive good palliative and EOLC is a human right. All patients are entitled to a dignified death. Government of India (GOI) to take urgent steps towards a legislation supporting good EOLC, and all hospitals and health care institutions to have a working EOLC policyProviding a comprehensive care process that minimizes physical and non physical symptoms in the end of life phase and ensuring access to essential medications for pain and symptom controlPalliative care and EOLC to be part of all hospital and community/home based programsStandards of palliative and EOLC as established by appropriate authorities and Indian Association of Palliative Care (IAPC) met and standards accredited and monitored by national and international accreditation bodiesAll health care providers with direct patient contact are urged to undergo EOLC certification, and EOLC training should be incorporated into the curriculum of health care education. PMID:25191002

Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.

PubMed

2012-07-20

This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.

What evidence and support do state-level public health practitioners need to address obesity prevention.

PubMed

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

Supporting the Evaluation and Implementation of Musculoskeletal Models of Care: A Globally Informed Framework for Judging Readiness and Success.

PubMed

Briggs, Andrew M; Jordan, Joanne E; Jennings, Matthew; Speerin, Robyn; Bragge, Peter; Chua, Jason; Woolf, Anthony D; Slater, Helen

2017-04-01

To develop a globally informed framework to evaluate readiness for implementation and success after implementation of musculoskeletal models of care (MOCs). Three phases were undertaken: 1) a qualitative study with 27 Australian subject matter experts (SMEs) to develop a draft framework; 2) an eDelphi study with an international panel of 93 SMEs across 30 nations to evaluate face validity, and refine and establish consensus on the framework components; and 3) translation of the framework into a user-focused resource and evaluation of its acceptability with the eDelphi panel. A comprehensive evaluation framework was developed for judging the readiness and success of musculoskeletal MOCs. The framework consists of 9 domains, with each domain containing a number of themes underpinned by detailed elements. In the first Delphi round, scores of "partly agree" or "completely agree" with the draft framework ranged 96.7%-100%. In the second round, "essential" scores ranged 58.6%-98.9%, resulting in 14 of 34 themes being classified as essential. SMEs strongly agreed or agreed that the final framework was useful (98.8%), usable (95.1%), credible (100%) and appealing (93.9%). Overall, 96.3% strongly supported or supported the final structure of the framework as it was presented, while 100%, 96.3%, and 100% strongly supported or supported the content within the readiness, initiating implementation, and success streams, respectively. An empirically derived framework to evaluate the readiness and success of musculoskeletal MOCs was strongly supported by an international panel of SMEs. The framework provides an important internationally applicable benchmark for the development, implementation, and evaluation of musculoskeletal MOCs. © 2016, American College of Rheumatology.

Supporting Cross-Organizational Process Control

NASA Astrophysics Data System (ADS)

Angelov, Samuil; Vonk, Jochem; Vidyasankar, Krishnamurthy; Grefen, Paul

E-contracts express the rights and obligations of parties through a formal, digital representation of the contract provisions. In process intensive relationships, e-contracts contain business processes that a party promises to perform for the counter party, optionally allowing monitoring of the execution of the promised processes. In this paper, we describe an approach in which the counter party is allowed to control the process execution. This approach will lead to more flexible and efficient business relations which are essential in the context of modern, highly dynamic and complex collaborations among companies. We present a specification of the process controls available to the consumer and their support in the private process specification of the provider.

Status of the Superconducting Insertion Device Control at TLS

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

Hu, K. H.; Wang, C. J.; Lee, Demi

2007-01-19

Superconducting insertion devices are installed at Taiwan Light Source to meet the rapidly growing demand of X-ray users. A control system supports the operation of all these superconducting insertion devices. Control system coordinates the operation of the main power supply and the trimming power supply to charge/discharge the magnet and provide essential interlock protection for the coils and vacuum ducts. Quench protection and various cryogenic interlocks are designed to prevent damage to the magnet. A friendly user interface supports routine operation. Various applications are also developed to aid the operation of these insertion devices. Design consideration and details of themore » implementation will be summarized in this report.« less

Space Suit Spins

NASA Technical Reports Server (NTRS)

2005-01-01

Space is a hostile environment where astronauts combat extreme temperatures, dangerous radiation, and a near-breathless vacuum. Life support in these unforgiving circumstances is crucial and complex, and failure is not an option for the devices meant to keep astronauts safe in an environment that presents constant opposition. A space suit must meet stringent requirements for life support. The suit has to be made of durable material to withstand the impact of space debris and protect against radiation. It must provide essential oxygen, pressure, heating, and cooling while retaining mobility and dexterity. It is not a simple article of clothing but rather a complex modern armor that the space explorers must don if they are to continue exploring the heavens

Content validity of the DSM-IV borderline and narcissistic personality disorder criteria sets.

PubMed

Blais, M A; Hilsenroth, M J; Castlebury, F D

1997-01-01

This study sought to empirically evaluate the content validity of the newly revised DSM-IV narcissistic personality disorder (NPD) and borderline personality disorder (BPD) criteria sets. Using the essential features of each disorder as construct definitions, factor analysis was used to determine how adequately the criteria sets covered the constructs. In addition, this empirical investigation sought to: 1) help define the dimensions underlying these polythetic disorders; 2) identify core features of each diagnosis; and 3) highlight the characteristics that may be most useful in diagnosing these two disorders. Ninety-one outpatients meeting DSM-IV criteria for a personality disorder (PD) were identified through a retrospective analysis of chart information. Records of these 91 patients were independently rated on all of the BPD and NPD symptom criteria for the DSM-IV. Acceptable interrater reliability (kappa estimates) was obtained for both presence or absence of a PD and symptom criteria for BPD and NPD. The factor analysis, performed separately for each disorder, identified a three-factor solution for both the DSM-IV BPD and NPD criteria sets. The results of this study provide strong support for the content validity of the NPD criteria set and moderate support for the content validly of the BPD criteria set. Three domains were found to comprise the BPD criteria set, with the essential features of interpersonal and identity instability forming one domain, and impulsivity and affective instability each identified as separate domains. Factor analysis of the NPD criteria set found three factors basically corresponding to the essential features of grandiosity, lack of empathy, and need for admiration. Therefore, the NPD criteria set adequately covers the essential or defining features of the disorder.

Regulation of Sulphur Assimilation Is Essential for Virulence and Affects Iron Homeostasis of the Human-Pathogenic Mould Aspergillus fumigatus

PubMed Central

Amich, Jorge; Schafferer, Lukas; Haas, Hubertus; Krappmann, Sven

2013-01-01

Sulphur is an essential element that all pathogens have to absorb from their surroundings in order to grow inside their infected host. Despite its importance, the relevance of sulphur assimilation in fungal virulence is largely unexplored. Here we report a role of the bZIP transcription factor MetR in sulphur assimilation and virulence of the human pathogen Aspergillus fumigatus. The MetR regulator is essential for growth on a variety of sulphur sources; remarkably, it is fundamental for assimilation of inorganic S-sources but dispensable for utilization of methionine. Accordingly, it strongly supports expression of genes directly related to inorganic sulphur assimilation but not of genes connected to methionine metabolism. On a broader scale, MetR orchestrates the comprehensive transcriptional adaptation to sulphur-starving conditions as demonstrated by digital gene expression analysis. Surprisingly, A. fumigatus is able to utilize volatile sulphur compounds produced by its methionine catabolism, a process that has not been described before and that is MetR-dependent. The A. fumigatus MetR transcriptional activator is important for virulence in both leukopenic mice and an alternative mini-host model of aspergillosis, as it was essential for the development of pulmonary aspergillosis and supported the systemic dissemination of the fungus. MetR action under sulphur-starving conditions is further required for proper iron regulation, which links regulation of sulphur metabolism to iron homeostasis and demonstrates an unprecedented regulatory crosstalk. Taken together, this study provides evidence that regulation of sulphur assimilation is not only crucial for A. fumigatus virulence but also affects the balance of iron in this prime opportunistic pathogen. PMID:24009505

Regulation of sulphur assimilation is essential for virulence and affects iron homeostasis of the human-pathogenic mould Aspergillus fumigatus.

PubMed

Amich, Jorge; Schafferer, Lukas; Haas, Hubertus; Krappmann, Sven

2013-01-01

Sulphur is an essential element that all pathogens have to absorb from their surroundings in order to grow inside their infected host. Despite its importance, the relevance of sulphur assimilation in fungal virulence is largely unexplored. Here we report a role of the bZIP transcription factor MetR in sulphur assimilation and virulence of the human pathogen Aspergillus fumigatus. The MetR regulator is essential for growth on a variety of sulphur sources; remarkably, it is fundamental for assimilation of inorganic S-sources but dispensable for utilization of methionine. Accordingly, it strongly supports expression of genes directly related to inorganic sulphur assimilation but not of genes connected to methionine metabolism. On a broader scale, MetR orchestrates the comprehensive transcriptional adaptation to sulphur-starving conditions as demonstrated by digital gene expression analysis. Surprisingly, A. fumigatus is able to utilize volatile sulphur compounds produced by its methionine catabolism, a process that has not been described before and that is MetR-dependent. The A. fumigatus MetR transcriptional activator is important for virulence in both leukopenic mice and an alternative mini-host model of aspergillosis, as it was essential for the development of pulmonary aspergillosis and supported the systemic dissemination of the fungus. MetR action under sulphur-starving conditions is further required for proper iron regulation, which links regulation of sulphur metabolism to iron homeostasis and demonstrates an unprecedented regulatory crosstalk. Taken together, this study provides evidence that regulation of sulphur assimilation is not only crucial for A. fumigatus virulence but also affects the balance of iron in this prime opportunistic pathogen.

The Hawke's Bay Condom Card Scheme: a qualitative study of the views of service providers on increased, discreet access for youth to free condoms.

PubMed

Ryder, Hollie; Aspden, Trudi; Sheridan, Janie

2015-12-01

The incidence of sexually transmitted infections and unplanned pregnancies in adolescence is of concern. The Hawke's Bay District Health Board, New Zealand, set up a pilot condom card scheme ('the Scheme') to allow 13- to 24-year-olds, deemed suitable for the Scheme, to access free condoms from pharmacies on presentation of a Condom Card. Our study explored the views of service providers of a pilot Condom Card Scheme. Qualitative interviews were conducted with 17 service providers (nurses, pharmacists, pharmacy staff) between February and April 2013. Our findings showed that the Scheme was viewed positively by service providers, who indicated almost universal support for the Scheme to continue. However, participants noted a perceived lack of advertising, low number of sites for collection of condoms, lack of flexibility of the Scheme's criteria relating to who could access the scheme and issues with some pharmacy service providers, all of which led to a number of recommendations for improving the Scheme. The views of service providers indicate broad support for the continuation of the Scheme. Canvassing young people's suggestions for improving the Scheme is also essential. © 2015 Royal Pharmaceutical Society.

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.

LDRD 2016 Annual Report: Laboratory Directed Research and Development Program Activities

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

Hatton, D.

Each year, Brookhaven National Laboratory (BNL) is required to provide a program description and overview of its Laboratory Directed Research and Development Program (LDRD) to the Department of Energy (DOE) in accordance with DOE Order 413.2C dated October 22, 2015. This report provides a detailed look at the scientific and technical activities for each of the LDRD projects funded by BNL in FY 2016, as required. In FY 2016, the BNL LDRD Program funded 48 projects, 21 of which were new starts, at a total cost of $11.5M. The investments that BNL makes in its LDRD program support the Laboratory’smore » strategic goals. BNL has identified four Critical Outcomes that define the Laboratory’s scientific future and that will enable it to realize its overall vision. Two operational Critical Outcomes address essential operational support for that future: renewal of the BNL campus; and safe, efficient laboratory operations.« less

Interdisciplinary Guidelines for Care of Women Presenting to the Emergency Department With Pregnancy Loss.

PubMed

Catlin, Anita

In April 2016, the National Perinatal Association and Kaiser Permanente Northern California Nursing Research Community Benefits Grant sponsored an interdisciplinary summit to explore the needs of women who present with actual or potential pregnancy loss to the emergency department (ED). Thirty-two experts in the field of pregnancy loss, 17 of whom represented their professional organizations, participated. These experts, which included nurses, physicians, social workers, counselors, authors, and parents, worked together to create guidelines for care of women with a pregnancy loss in the ED. Recommendations for ED healthcare providers are included. Emergency department personnel agreed that improvements in care could be offered and were willing to endorse education for their staff. The guidelines delineate how to better provide physical, emotional, and bereavement support at any stage of gestational loss. Administrative support for policies in the ED is essential to ensure the delivery of family-centered, culturally sensitive practices when a pregnancy ends.

Leadership and characteristics of nonprofit mental health peer-run organizations nationwide.

PubMed

Ostrow, Laysha; Hayes, Stephania L

2015-04-01

Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N=380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow.

Using PVM to host CLIPS in distributed environments

NASA Technical Reports Server (NTRS)

Myers, Leonard; Pohl, Kym

1994-01-01

It is relatively easy to enhance CLIPS (C Language Integrated Production System) to support multiple expert systems running in a distributed environment with heterogeneous machines. The task is minimized by using the PVM (Parallel Virtual Machine) code from Oak Ridge Labs to provide the distributed utility. PVM is a library of C and FORTRAN subprograms that supports distributive computing on many different UNIX platforms. A PVM deamon is easily installed on each CPU that enters the virtual machine environment. Any user with rsh or rexec access to a machine can use the one PVM deamon to obtain a generous set of distributed facilities. The ready availability of both CLIPS and PVM makes the combination of software particularly attractive for budget conscious experimentation of heterogeneous distributive computing with multiple CLIPS executables. This paper presents a design that is sufficient to provide essential message passing functions in CLIPS and enable the full range of PVM facilities.

Statewide health information: a tool for improving hospital accountability.

PubMed

Epstein, M H; Kurtzig, B S

1994-07-01

By early 1994, 38 states had invested in data collection, analysis, and dissemination on the use, cost, effectiveness, and performance of hospitals. States use these data to control costs, encourage prudent purchasing, monitor effectiveness and outcomes of health care, guide health policy, and promote informed decision making. Experience in several states suggests that public release of hospital-specific data influences hospital performance. The value of state data organizations' databases to address issues of quality and accountability can be strengthened by ensuring the stability and growth of statewide health information systems, supporting research on information dissemination techniques, and promoting comparisons among hospitals. Information to measure provider performance must be placed in the public domain--to help ensure prudent and cost-effective health care purchasing and to give providers comparable information for improvement of care. State-level health databases are an essential component of the information infrastructure needed to support health reform.

Cancer risk management decision making for BRCA+ women.

PubMed

Leonarczyk, Terri Jabaley; Mawn, Barbara E

2015-01-01

Women with pathogenic BRCA genetic mutations face high risks for cancer development. Estimates vary among mutation carriers, with lifetime risks ranging from 41% to 90% for breast cancer and 8% to 62% for ovarian cancer. Cancer risk management options for BRCA mutation positive (BRCA+) women have life-altering implications. This qualitative, phenomenological study explored the experience of cancer risk management decision making for women who are unaffected carriers of a BRCA mutation (previvors). Fifteen previvors recruited from Facing Our Risk of Cancer Empowered (FORCE), an online informational and support group, were interviewed. Findings consisted of four major themes: the early previvor experience, intense emotional upheaval; the decisional journey, navigating a personal plan for survival; lack of knowledge and experience among health care providers; and support is essential. Findings highlight the different decisional perspectives of previvors based on age and individual factors and the need for increased competence among health care providers. © The Author(s) 2014.

Assessing young children's intention-reading in authentic communicative contexts: preliminary evidence and clinical utility.

PubMed

Greenslade, Kathryn J; Coggins, Truman E

2014-01-01

Identifying what a communication partner is looking at (referential intention) and why (social intention) is essential to successful social communication, and may be challenging for children with social communication deficits. This study explores a clinical task that assesses these intention-reading abilities within an authentic context. To gather evidence of the task's reliability and validity, and to discuss its clinical utility. The intention-reading task was administered to twenty 4-7-year-olds with typical development (TD) and ten with autism spectrum disorder (ASD). Task items were embedded in an authentic activity, and they targeted the child's ability to identify the examiner's referential and social intentions, which were communicated through joint attention behaviours. Reliability and construct validity evidence were addressed using established psychometric methods. Reliability and validity evidence supported the use of task scores for identifying children whose intention-reading warranted concern. Evidence supported the reliability of task administration and coding, and item-level codes were highly consistent with overall task performance. Supporting task validity, group differences aligned with predictions, with children with ASD exhibiting poorer and more variable task scores than children with TD. Also, as predicted, task scores correlated significantly with verbal mental age and ratings of parental concerns regarding social communication abilities. The evidence provides preliminary support for the reliability and validity of the clinical task's scores in assessing young children's real-time intention-reading abilities, which are essential for successful interactions in school and beyond. © 2014 Royal College of Speech and Language Therapists.

14 CFR 272.9 - Selection of a carrier to provide essential air service and payment of compensation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.9 Selection of a carrier to provide essential air service and... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Selection of a carrier to provide essential...

Working relationships between obstetric care staff and their managers: a critical incident analysis.

PubMed

Chipeta, Effie; Bradley, Susan; Chimwaza-Manda, Wanangwa; McAuliffe, Eilish

2016-08-26

Malawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi's disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers. A qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres' providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software. Poor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers' lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post. Positive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers' job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi.

The relationship between leadership support, workplace health promotion and employee wellbeing in South Africa.

PubMed

Milner, Karen; Greyling, Michael; Goetzel, Ron; Da Silva, Roseanne; Kolbe-Alexander, Tracey; Patel, Deepak; Nossel, Craig; Beckowski, Megan

2015-09-01

Leadership support has been identified as an essential component of successful workplace health promotion (WHP) programs. However, there is little research in this area and even less theoretical conceptualization on ways in which leadership support for WHP is related to improved employee wellbeing. In this paper, we developed and tested a model of leadership support for WHP and employee wellbeing outcomes using employer and employee data gathered from 71 South African organizations. A theoretical model based on social exchange theory was developed. It was hypothesized that perceptions of company commitment to health promotion mediates the relationship between leadership support, the provision of WHP facilities and employee wellbeing. A hierarchical structural equation modeling technique was used to test the model. We determined that leaders' support for WHP was important insofar as they also provided health promotion facilities to their employees. No direct relationship was found between leadership support alone and employee wellbeing. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Providing Effective Speech-Language Pathology Group Treatment in the Comprehensive Inpatient Rehabilitation Setting.

PubMed

Baron, Christine; Holcombe, Molly; van der Stelt, Candace

2018-02-01

Group treatment is an integral part of speech-language pathology (SLP) practice. The majority of SLP literature concerns group treatment provided in outpatient settings. This article describes the goals, procedures, and benefits of providing quality SLP group therapy in the comprehensive inpatient rehabilitation (CIR) setting. Effective CIR groups must be designed with attention to type and severity of communication impairment, as well physical stamina of group members. Group leaders need to target individualized patient goals while creating a challenging, complex, and dynamic group context that supports participation by all group members. Direct patient-to-patient interaction is fostered as much as possible. Peer feedback supports goal acquisition by fellow group members. The rich, complex group context fosters improved insight, initiation, social connectedness, and generalization of communication skills. Group treatment provides a unique type of treatment not easily replicated with individual treatment. SLP group treatment in a CIR is an essential component of an intensive, high-quality program. Continued advocacy for group therapy provision and research into its efficacy and effectiveness are warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The California Seafloor and Coastal Mapping Program – Providing science and geospatial data for California's State Waters

USGS Publications Warehouse

Johnson, Samuel Y.; Cochrane, Guy R.; Golden, Nadine; Dartnell, Peter; Hartwell, Stephen; Cochran, Susan; Watt, Janet

2017-01-01

The California Seafloor and Coastal Mapping Program (CSCMP) is a collaborative effort to develop comprehensive bathymetric, geologic, and habitat maps and data for California's State Waters. CSCMP began in 2007 when the California Ocean Protection Council (OPC) and the National Oceanic and Atmospheric Administration (NOAA) allocated funding for high-resolution bathymetric mapping, largely to support the California Marine Life Protection Act and to update nautical charts. Collaboration and support from the U.S. Geological Survey and other partners has led to development and dissemination of one of the world's largest seafloor-mapping datasets. CSCMP provides essential science and data for ocean and coastal management, stimulates and enables research, and raises public education and awareness of coastal and ocean issues. Specific applications include:•Delineation and designation of marine protected areas•Characterization and modeling of benthic habitats and ecosystems•Updating nautical charts•Earthquake hazard assessments•Tsunami hazard assessments•Planning offshore infrastructure•Providing baselines for monitoring change•Input to models of sediment transport, coastal erosion, and coastal flooding•Regional sediment management•Understanding coastal aquifers•Providing geospatial data for emergency response

ATDM LANL FleCSI: Topology and Execution Framework

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

Bergen, Benjamin Karl

FleCSI is a compile-time configurable C++ framework designed to support multi-physics application development. As such, FleCSI attempts to provide a very general set of infrastructure design patterns that can be specialized and extended to suit the needs of a broad variety of solver and data requirements. This means that FleCSI is potentially useful to many different ECP projects. Current support includes multidimensional mesh topology, mesh geometry, and mesh adjacency information, n-dimensional hashed-tree data structures, graph partitioning interfaces, and dependency closures (to identify data dependencies between distributed-memory address spaces). FleCSI introduces a functional programming model with control, execution, and data abstractionsmore » that are consistent with state-of-the-art task-based runtimes such as Legion and Charm++. The model also provides support for fine-grained, data-parallel execution with backend support for runtimes such as OpenMP and C++17. The FleCSI abstraction layer provides the developer with insulation from the underlying runtimes, while allowing support for multiple runtime systems, including conventional models like asynchronous MPI. The intent is to give developers a concrete set of user-friendly programming tools that can be used now, while allowing flexibility in choosing runtime implementations and optimizations that can be applied to architectures and runtimes that arise in the future. This project is essential to the ECP Ristra Next-Generation Code project, part of ASC ATDM, because it provides a hierarchically parallel programming model that is consistent with the design of modern system architectures, but which allows for the straightforward expression of algorithmic parallelism in a portably performant manner.« less

Expanding the (kaleido)scope: exploring current literature trends for translating electroencephalography (EEG) based brain-computer interfaces for motor rehabilitation in children

NASA Astrophysics Data System (ADS)

Kinney-Lang, E.; Auyeung, B.; Escudero, J.

2016-12-01

Rehabilitation applications using brain-computer interfaces (BCI) have recently shown encouraging results for motor recovery. Effective BCI neurorehabilitation has been shown to exploit neuroplastic properties of the brain through mental imagery tasks. However, these applications and results are currently restricted to adults. A systematic search reveals there is essentially no literature describing motor rehabilitative BCI applications that use electroencephalograms (EEG) in children, despite advances in such applications with adults. Further inspection highlights limited literature pursuing research in the field, especially outside of neurofeedback paradigms. Then the question naturally arises, do current literature trends indicate that EEG based BCI motor rehabilitation applications could be translated to children? To provide further evidence beyond the available literature for this particular topic, we present an exploratory survey examining some of the indirect literature related to motor rehabilitation BCI in children. Our goal is to establish if evidence in the related literature supports research on this topic and if the related studies can help explain the dearth of current research in this area. The investigation found positive literature trends in the indirect studies which support translating these BCI applications to children and provide insight into potential pitfalls perhaps responsible for the limited literature. Careful consideration of these pitfalls in conjunction with support from the literature emphasize that fully realized motor rehabilitation BCI applications for children are feasible and would be beneficial. • BCI intervention has improved motor recovery in adult patients and offer supplementary rehabilitation options to patients. • A systematic literature search revealed that essentially no research has been conducted bringing motor rehabilitation BCI applications to children, despite advances in BCI. • Indirect studies discovered from the systematic literature search, i.e. neurorehabilitation in children via BCI for autism spectrum disorder, provide insight into translating motor rehabilitation BCI applications to children. • Translating BCI applications to children is a relevant, important area of research which is relatively barren.

Expanding the (kaleido)scope: exploring current literature trends for translating electroencephalography (EEG) based brain-computer interfaces for motor rehabilitation in children.

PubMed

Kinney-Lang, E; Auyeung, B; Escudero, J

2016-12-01

Rehabilitation applications using brain-computer interfaces (BCI) have recently shown encouraging results for motor recovery. Effective BCI neurorehabilitation has been shown to exploit neuroplastic properties of the brain through mental imagery tasks. However, these applications and results are currently restricted to adults. A systematic search reveals there is essentially no literature describing motor rehabilitative BCI applications that use electroencephalograms (EEG) in children, despite advances in such applications with adults. Further inspection highlights limited literature pursuing research in the field, especially outside of neurofeedback paradigms. Then the question naturally arises, do current literature trends indicate that EEG based BCI motor rehabilitation applications could be translated to children? To provide further evidence beyond the available literature for this particular topic, we present an exploratory survey examining some of the indirect literature related to motor rehabilitation BCI in children. Our goal is to establish if evidence in the related literature supports research on this topic and if the related studies can help explain the dearth of current research in this area. The investigation found positive literature trends in the indirect studies which support translating these BCI applications to children and provide insight into potential pitfalls perhaps responsible for the limited literature. Careful consideration of these pitfalls in conjunction with support from the literature emphasize that fully realized motor rehabilitation BCI applications for children are feasible and would be beneficial. •  BCI intervention has improved motor recovery in adult patients and offer supplementary rehabilitation options to patients. •  A systematic literature search revealed that essentially no research has been conducted bringing motor rehabilitation BCI applications to children, despite advances in BCI. •  Indirect studies discovered from the systematic literature search, i.e. neurorehabilitation in children via BCI for autism spectrum disorder, provide insight into translating motor rehabilitation BCI applications to children. •  Translating BCI applications to children is a relevant, important area of research which is relatively barren.

Preparation and Support of Patients through the Transplant Process: Understanding the Recipients' Perspectives

PubMed Central

Mauthner, Oliver; De Luca, Enza; Poole, Jennifer; Gewarges, Mena; Abbey, Susan E.; Shildrick, Margrit; Ross, Heather

2012-01-01

Preparation for heart transplant commonly includes booklets, instructional videos, personalized teaching sessions, and mentorship. This paper explores heart transplant recipients' thoughts on their preparation and support through the transplant process. Twenty-five interviews were audio-/videotaped capturing voice and body language and transcribed verbatim. Coding addressed language, bodily gesture, volume, and tone in keeping with our visual methodology. Recipients reported that only someone who had a transplant truly understands the experience. As participants face illness and life-altering experiences, maintaining a positive attitude and hope is essential to coping well. Healthcare professionals provide ongoing care and reassurance about recipients' medical status. Mentors, family members, and close friends play vital roles in supporting recipients. Participants reported that only heart transplant recipients understood the experience, the hope, and ultimately the suffering associated with living with another persons' heart. Attention needs to be focused not solely on the use of teaching modalities, but also on the development of innovative support networks. This will promote patient and caregiver engagement in self-management. Enhancing clinicians' knowledge of the existential aspects of transplantation will provide them with a nuanced understanding of the patients' experience, which will ultimately enhance their ability to better prepare and support patients and their caregivers. PMID:23125923

An in-country model of workforce support for trained mid-level eye care workers in Papua New Guinea and Pacific Islands.

PubMed

Brûlé, Julie; Tousignant, Benoit; Nicholls, Graeme; Pearce, Matthew G

2017-08-11

To alleviate the significant burden of vision impairment and blindness in low-resource settings, addressing the shortage in human resources in eye care is one of the fundamental strategies. With its postgraduate training programmes, The Fred Hollows Foundation New Zealand (FHFNZ) aims to increase workforce capacity in the Pacific Island countries and territories and Papua New Guinea. This paper presents an in-country model to offer support to graduates, an essential element to retain them in the workforce and ensure they are able to perform the tasks they were trained to do. FHFNZ has designed a workforce support programme employing a standardised process, allowing comparable reporting and providing data for FHFNZ to evaluate its training programmes, outputs as well as professional recognition and integration in the workplace.

[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.

Supportive Care: Integration of Patient-Centered Kidney Care to Manage Symptoms and Geriatric Syndromes

PubMed Central

Jassal, Sarbjit Vanita

2016-01-01

Dialysis care is often associated with poor outcomes including low quality of life (QOL). To improve patient-reported outcomes, incorporation of the patient’s needs and perspective into the medical care they receive is essential. This article provides a framework to help clinicians integrate symptom assessment and other measures such as QOL and frailty scores into a clinical approach to the contemporary supportive care of patients with advanced CKD. This approach involves (1) defining our understanding of kidney supportive care, patient-centered dialysis, and palliative dialysis; (2) understanding and recognizing common symptoms associated with advanced CKD; (3) discussing the concepts of physical function, frailty, and QOL and their role in CKD; and (4) identifying the structural and process barriers that may arise when patient-centered dialysis is being introduced into clinical practice. PMID:27510454

Mapping the literature of transcultural nursing*

PubMed Central

Murphy, Sharon C.

2006-01-01

Overview: No bibliometric studies of the literature of the field of transcultural nursing have been published. This paper describes a citation analysis as part of the project undertaken by the Nursing and Allied Health Resources Section of the Medical Library Association to map the literature of nursing. Objective: The purpose of this study was to identify the core literature and determine which databases provided the most complete access to the transcultural nursing literature. Methods: Cited references from essential source journals were analyzed for a three-year period. Eight major databases were compared for indexing coverage of the identified core list of journals. Results: This study identifies 138 core journals. Transcultural nursing relies on journal literature from associated health sciences fields in addition to nursing. Books provide an important format. Nearly all cited references were from the previous 18 years. In comparing indexing coverage among 8 major databases, 3 databases rose to the top. Conclusions: No single database can claim comprehensive indexing coverage for this broad field. It is essential to search multiple databases. Based on this study, PubMed/MEDLINE, Social Sciences Citation Index, and CINAHL provide the best coverage. Collections supporting transcultural nursing require robust access to literature beyond nursing publications. PMID:16710461

Advancing Precambrian palaeomagnetism with the PALEOMAGIA and PINT(QPI) databases

PubMed Central

Veikkolainen, Toni H.; Biggin, Andrew J.; Pesonen, Lauri J.; Evans, David A.; Jarboe, Nicholas A.

2017-01-01

State-of-the-art measurements of the direction and intensity of Earth’s ancient magnetic field have made important contributions to our understanding of the geology and palaeogeography of Precambrian Earth. The PALEOMAGIA and PINT(QPI) databases provide thorough public collections of important palaeomagnetic data of this kind. They comprise more than 4,100 observations in total and have been essential in supporting our international collaborative efforts to understand Earth's magnetic history on a timescale far longer than that of the present Phanerozoic Eon. Here, we provide an overview of the technical structure and applications of both databases, paying particular attention to recent improvements and discoveries. PMID:28534869

Advancing Precambrian palaeomagnetism with the PALEOMAGIA and PINT(QPI) databases.

PubMed

Veikkolainen, Toni H; Biggin, Andrew J; Pesonen, Lauri J; Evans, David A; Jarboe, Nicholas A

2017-05-23

State-of-the-art measurements of the direction and intensity of Earth's ancient magnetic field have made important contributions to our understanding of the geology and palaeogeography of Precambrian Earth. The PALEOMAGIA and PINT( QPI ) databases provide thorough public collections of important palaeomagnetic data of this kind. They comprise more than 4,100 observations in total and have been essential in supporting our international collaborative efforts to understand Earth's magnetic history on a timescale far longer than that of the present Phanerozoic Eon. Here, we provide an overview of the technical structure and applications of both databases, paying particular attention to recent improvements and discoveries.

Influences of VSAT network on the economical and industrial development

NASA Astrophysics Data System (ADS)

Lancrenon, B.; Lorent, P.

1990-10-01

The adaptable, rapidly assembled and operational VSAT (very small aperature terminal) satellite network is a tool which rapidly provides essential digital infrastructure for business communication networks in order to support and stimulate the development of modern industry. A market analysis is given for VSATs, discussing such topics as applications of the product, retail and distribution, banking finance, and manufacturing industry. The centralized booking of the tourism transport sector is also investigated. The network including the earth stations, the satellite, the systems aspects, and the network management is described in detail and diagrams are provided. Some estimates of space channel cost per year are given.

Psychosocial issues for children and adolescents with chronic illness: self-esteem, school functioning and sports participation.

PubMed

Vitulano, Lawrence A

2003-07-01

Self-esteem, school functioning, and sports participation are among the most significant psychosocial issues that affect children and adolescents with chronic illness. Although these capacities are essential components of development for all children, they present special concerns for children with limitations of health. Parents, teachers, and coaches play important roles in providing normalizing and gratifying opportunities for children who struggle to be competent and accepted by their peers. Much can be done to provide chronically ill children with experiences and support that will allow them to grow up happier, feel better about themselves, and enjoy more success.

Adolescent substance involvement use and abuse.

PubMed

Monasterio, Erica B

2014-09-01

Substance use in adolescence is common, but not all use indicates a substance use disorder. The primary care provider has an essential role in screening for substance involvement, assessing the level of substance use and its impact on function, and engaging in a brief intervention to encourage and support behavioral change related to substance use. This article summarizes the literature on adolescent vulnerability to substance use disorders and their impact on adolescent health and well-being. Practical concrete suggestions for approaches to screening, brief interventions, and referral to treatment provide a stepwise approach to adolescent substance use assessment and intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

Care Offered by an Information-Rich Pediatric Acute Illness Connected Care Model.

PubMed

McConnochie, Kenneth M; Wood, Nancy E; Alarie, Carol; Ronis, Sarah

2016-06-01

Prevailing regulatory and financing issues constrain dissemination of connected care despite evidence supporting acceptability, effectiveness, and efficiency. In this analysis we describe care provided over a 12-year period by Health-e-Access, an evidence-based, information-rich, connected care model designed to serve children with acute illness. We demonstrate the broad clinical capacity of this care model and key components imparting this capacity. Since 2001, Health-e-Access has been used in childcare, elementary schools, neighborhood after-hours sites, and a school for children with severe disabilities in Rochester, NY. With Health-e-Access, videoconference (preferably) or telephone enables parent, patient, and provider engagement. Technology includes the capacity for acquisition and exchange of a broad range of clinical observations, qualifying Health-e-Access as an information-rich model and differentiating it from multiple other connected care models commonly labeled telemedicine. Primary diagnoses recorded for completed visits were classified according to resources (technology, personnel, examination type) required to complete encounters appropriately. Among 13,812 Health-e-Access visits initiated through June 2013, 98.2% were completed. Capacity for ear-nose-throat examination and close inspection of eye and skin were sufficient to identify positive findings supporting 95.2% of primary diagnoses. Videoconference and stethoscope were considered essential for observations required to rule out serious conditions often presenting in similar fashion to these 95%. Health-e-Access included technology essential for establishing diagnoses, ruling out more serious conditions, and identifying problems beyond its scope. Regulations enabling and financing incentivizing replication of similar connected care models would benefit families and communities substantially. Observations challenge regulatory bodies and payers to support connected health services of comparable value.

[Technology in the nurse-patient relationship in diabetology, a true metronome?].

PubMed

Desserprix, Agnès

2016-03-01

Technology is evolving to keep pace with patients' and caregivers' needs and advances in research. In diabetology, this progress concerns administration systems, the devices for monitoring blood sugar levels, accessories and technical support, and provides hope for tomorrow. In this context, it is essential that the patient remains at the centre of the nurse-patient relationship and that technology remains simply a source of reference points and comfort. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A broadband polarization-insensitive cloak based on mode conversion

PubMed Central

Gu, Chendong; Xu, Yadong; Li, Sucheng; Lu, Weixin; Li, Jensen; Chen, Huanyang; Hou, Bo

2015-01-01

In this work, we demonstrate an one-dimensional cloak consisting of parallel-plated waveguide with two slabs of gradient index metamaterials attached to its metallic walls. In it objects are hidden without limitation of polarizations, and good performance is observed for a broadband of frequencies. The experiments at microwave frequencies are carried out, supporting the theoretical results very well. The essential principle behind the proposed cloaking device is based on mode conversion, which provides a new strategy to manipulate wave propagation. PMID:26175114

Concurrency in product realization

NASA Astrophysics Data System (ADS)

Kelly, Michael J.

1994-03-01

Technology per se does not provide a competitive advantage. Timely exploitation of technology is what gives the competitive edge, and this demands a major shift in the product development process and management of the industrial enterprise. `Teaming to win' is more than a management theme; it is the disciplined engineering practice that is essential to success in today's global marketplace. Teaming supports the concurrent engineering practices required to integrate the activities of people responsible for product realization through achievement of shorter development cycles, lower costs, and defect-free products.

Brief encounters: what do primary care professionals contribute to peoples' self-care support network for long-term conditions? A mixed methods study.

PubMed

Rogers, Anne; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Blickem, Christian

2016-02-17

Primary care professionals are presumed to play a central role in delivering long-term condition management. However the value of their contribution relative to other sources of support in the life worlds of patients has been less acknowledged. Here we explore the value of primary care professionals in people's personal communities of support for long-term condition management. A mixed methods survey with nested qualitative study designed to identify relationships and social network member's (SNM) contributions to the support work of managing a long-term condition conducted in 2010 in the North West of England. Through engagement with a concentric circles diagram three hundred participants identified 2544 network members who contributed to illness management. The results demonstrated how primary care professionals are involved relative to others in ongoing self-care management. Primary care professionals constituted 15.5 % of overall network members involved in chronic illness work. Their contribution was identified as being related to illness specific work providing less in terms of emotional work than close family members or pets and little to everyday work. The qualitative accounts suggested that primary care professionals are valued mainly for access to medication and nurses for informational and monitoring activities. Overall primary care is perceived as providing less input in terms of extended self-management support than the current literature on policy and practice suggests. Thus primary care professionals can be described as providing 'minimally provided support'. This sense of a 'minimally' provided input reinforces limited expectations and value about what primary care professionals can provide in terms of support for long-term condition management. Primary care was perceived as having an essential but limited role in making a contribution to support work for long-term conditions. This coalesces with evidence of a restricted capacity of primary care to take on the work load of self-management support work. There is a need to prioritise exploring the means by which extended self-care support could be enhanced out-with primary care. Central to this is building a system capable of engaging network capacity to mobilise resources for self-management support from open settings and the broader community.

Workplace breastfeeding support for hospital employees.

PubMed

Dodgson, Joan E; Chee, Yuet-Oi; Yap, Tian Sew

2004-07-01

Breastfeeding initiation rates have been steadily rising in Hong Kong, but most employed women wean prior to returning to work. While health care providers promote breastfeeding, women receive little support from employers. A few health care facilities offer some workplace breastfeeding support, but little is known about the specific types and amount of support that are offered. This paper reports a study whose aim was to describe workplace supports available to breastfeeding women employed by hospitals that provide maternity services in Hong Kong, and to determine if differences in workplace supports exist based on the hospitals' numbers of employees or funding source. In late 2001, a cross-sectional survey was completed by nurse managers or lactation consultants most knowledgeable about supports to breastfeeding employees in 19 hospitals. The number of workplace breastfeeding supports or Breastfeeding Support Score (M = 7.47; sd = 3.37) varied considerably. Mean Breastfeeding Support Score for government-funded hospitals was significantly higher (t = 2.31; P = 0.03) than for private hospitals. Of the 14 hospitals that had a designated space for using a breast pump, only five (26.3%) had a private room with a door that locked. Only two hospitals (11.1%) allowed employees to take breaks as needed to use a pump; employees in 10 (55.6%) had to use their meal and regular break times. Hospitals having a hospital-wide committee that addressed workplace breastfeeding issues had a more supportive environment for breastfeeding employees. Although all surveyed hospitals returned the questionnaire, the sample size was small. It was difficult to ensure accuracy and to differentiate subtle variations in the services provided using a self-report survey. Facilitating continued breastfeeding after employees' return to work requires that employers understand the needs of breastfeeding employees. Policy at the level of the employer and government is an essential component of creating a supportive environment.

Facilitation of self-transcendence in a breast cancer support group.

PubMed

Coward, D D

1998-01-01

To examine the feasibility and patterns of effectiveness of a breast cancer support group intervention specifically designed to facilitate self-transcendence views and perspectives that would enhance emotional and physical well-being. Pre-experimental design pilot intervention study with a quantitative approach to data analysis. Survivor-established breast cancer resource center in Austin, TX. Women with recently diagnosed breast cancer (N = 16) participating in 90-minute support group sessions that met weekly for eight weeks. Theory-driven support group intervention facilitated by an oncology clinical nurse specialist, a psychotherapist, and a breast cancer survivor. Activities planned for individual sessions were based on self-transcendence theory, cancer support group literature, and the facilitators' extensive previous support group experience. Self-transcendence, emotional well-being, physical well-being. Good networking, coordination, and follow-up were essential for participant recruitment and retention throughout the intervention period. Although specific theory-driven activities were planned for group sessions, facilitators maintained flexibility in meeting immediate concerns of the participants. Relationships among participants' scores on study variables indicated an association between self-transcendence and emotional well-being. Scores on self-transcendence and well-being variables at the end of the intervention increased from baseline, but only functional performance status, mood state, and satisfaction with life reached statistical significance. The pilot study was invaluable in providing direction for the conduct of future experimental studies. Provides preliminary support for the use of theory-driven activities for promotion of self-transcendence views and behaviors within a cancer support group setting.

Reconstruction and Validation of a Genome-Scale Metabolic Model for the Filamentous Fungus Neurospora crassa Using FARM

PubMed Central

Hood, Heather M.; Ocasio, Linda R.; Sachs, Matthew S.; Galagan, James E.

2013-01-01

The filamentous fungus Neurospora crassa played a central role in the development of twentieth-century genetics, biochemistry and molecular biology, and continues to serve as a model organism for eukaryotic biology. Here, we have reconstructed a genome-scale model of its metabolism. This model consists of 836 metabolic genes, 257 pathways, 6 cellular compartments, and is supported by extensive manual curation of 491 literature citations. To aid our reconstruction, we developed three optimization-based algorithms, which together comprise Fast Automated Reconstruction of Metabolism (FARM). These algorithms are: LInear MEtabolite Dilution Flux Balance Analysis (limed-FBA), which predicts flux while linearly accounting for metabolite dilution; One-step functional Pruning (OnePrune), which removes blocked reactions with a single compact linear program; and Consistent Reproduction Of growth/no-growth Phenotype (CROP), which reconciles differences between in silico and experimental gene essentiality faster than previous approaches. Against an independent test set of more than 300 essential/non-essential genes that were not used to train the model, the model displays 93% sensitivity and specificity. We also used the model to simulate the biochemical genetics experiments originally performed on Neurospora by comprehensively predicting nutrient rescue of essential genes and synthetic lethal interactions, and we provide detailed pathway-based mechanistic explanations of our predictions. Our model provides a reliable computational framework for the integration and interpretation of ongoing experimental efforts in Neurospora, and we anticipate that our methods will substantially reduce the manual effort required to develop high-quality genome-scale metabolic models for other organisms. PMID:23935467

NASA Integrated Network COOP

NASA Technical Reports Server (NTRS)

Anderson, Michael L.; Wright, Nathaniel; Tai, Wallace

2012-01-01

Natural disasters, terrorist attacks, civil unrest, and other events have the potential of disrupting mission-essential operations in any space communications network. NASA's Space Communications and Navigation office (SCaN) is in the process of studying options for integrating the three existing NASA network elements, the Deep Space Network, the Near Earth Network, and the Space Network, into a single integrated network with common services and interfaces. The need to maintain Continuity of Operations (COOP) after a disastrous event has a direct impact on the future network design and operations concepts. The SCaN Integrated Network will provide support to a variety of user missions. The missions have diverse requirements and include anything from earth based platforms to planetary missions and rovers. It is presumed that an integrated network, with common interfaces and processes, provides an inherent advantage to COOP in that multiple elements and networks can provide cross-support in a seamless manner. The results of trade studies support this assumption but also show that centralization as a means of achieving integration can result in single points of failure that must be mitigated. The cost to provide this mitigation can be substantial. In support of this effort, the team evaluated the current approaches to COOP, developed multiple potential approaches to COOP in a future integrated network, evaluated the interdependencies of the various approaches to the various network control and operations options, and did a best value assessment of the options. The paper will describe the trade space, the study methods, and results of the study.

Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship

PubMed Central

Pickering, Emily A.; Adler, Alyssa M.; Taylor, J. Christopher; Peterson, Charles H.

2017-01-01

Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH), special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of reefs on the seafloor so that all EFH across a wide range of habitat complexity may be accurately identified and properly managed. PMID:28873447

Integrative Genomics Viewer (IGV): high-performance genomics data visualization and exploration

PubMed Central

Thorvaldsdóttir, Helga; Mesirov, Jill P.

2013-01-01

Data visualization is an essential component of genomic data analysis. However, the size and diversity of the data sets produced by today’s sequencing and array-based profiling methods present major challenges to visualization tools. The Integrative Genomics Viewer (IGV) is a high-performance viewer that efficiently handles large heterogeneous data sets, while providing a smooth and intuitive user experience at all levels of genome resolution. A key characteristic of IGV is its focus on the integrative nature of genomic studies, with support for both array-based and next-generation sequencing data, and the integration of clinical and phenotypic data. Although IGV is often used to view genomic data from public sources, its primary emphasis is to support researchers who wish to visualize and explore their own data sets or those from colleagues. To that end, IGV supports flexible loading of local and remote data sets, and is optimized to provide high-performance data visualization and exploration on standard desktop systems. IGV is freely available for download from http://www.broadinstitute.org/igv, under a GNU LGPL open-source license. PMID:22517427

Integrative Genomics Viewer (IGV): high-performance genomics data visualization and exploration.

PubMed

Thorvaldsdóttir, Helga; Robinson, James T; Mesirov, Jill P

2013-03-01

Data visualization is an essential component of genomic data analysis. However, the size and diversity of the data sets produced by today's sequencing and array-based profiling methods present major challenges to visualization tools. The Integrative Genomics Viewer (IGV) is a high-performance viewer that efficiently handles large heterogeneous data sets, while providing a smooth and intuitive user experience at all levels of genome resolution. A key characteristic of IGV is its focus on the integrative nature of genomic studies, with support for both array-based and next-generation sequencing data, and the integration of clinical and phenotypic data. Although IGV is often used to view genomic data from public sources, its primary emphasis is to support researchers who wish to visualize and explore their own data sets or those from colleagues. To that end, IGV supports flexible loading of local and remote data sets, and is optimized to provide high-performance data visualization and exploration on standard desktop systems. IGV is freely available for download from http://www.broadinstitute.org/igv, under a GNU LGPL open-source license.

Cultural events provided by employer and occupational wellbeing of employees: A cross-sectional study among hospital nurses.

PubMed

Tuisku, Katinka; Pulkki-Råback, Laura; Virtanen, Marianna

2016-09-27

Occupational well-being in health care is essential for the quality of care and productivity. Some of the major challenges facing hospital nurses are the personnel turnover, emotional loading and health care reforms. After primary occupational safety and risk management, complementary positive health promotion approaches with cultural interventions can be experimented. To examine the association between well-being indicators of hospital nurses and their participation in cultural events provided by the employer (theater, concerts, exhibitions, museums, sight-seeing, and musicals) during past 6 months. Subjective well-being was measured by work engagement, workplace support for new ideas, work satisfaction and experienced stress. A dose-dependent association was found between participation in cultural events and positive psychology parameters of occupational well-being (support for new ideas and work engagement), but the experience of stress was unrelated to participation in cultural events. Collective participation has a positive covariant effect on work engagement and seems to mediate the innovative work climate measured by workplace support for new ideas. Collective cultural events for employees may promote positive aspects of occupational wellbeing.

Modifying the Human-Machine Interface Based on Quantitative Measurements of the Level of Awareness

NASA Technical Reports Server (NTRS)

Freund, Louis E.; Knapp, Benjamin

1999-01-01

This project got underway without funding approved during the summer of 1998. The initial project steps were to identify previously published work in the fields of error classification systems, physiological measurements of awareness, and related topics. This agenda was modified at the request of NASA Ames in August, 1998 to include supporting the new Cargo Air Association (CAA) evaluation of the Human Factors related to the ADS-B technology. Additional funding was promised to fully support both efforts. Work on library research ended in the late Fall, 1998 when the SJSU project directors were informed that NASA would not be adding to the initial funding of the research project as had been initially committed. However, NASA did provide additional funding for the CAA project activity. NASA elected to leave the research grant in place to provide a pathway for the CAA project funding to SJSU (San Jose State University) to support Dr. Freund's work on the CAA tasks. Dr. Knapp essentially terminated his involvement with the project at this time.

Watershed System Model: The Essentials to Model Complex Human-Nature System at the River Basin Scale

NASA Astrophysics Data System (ADS)

Li, Xin; Cheng, Guodong; Lin, Hui; Cai, Ximing; Fang, Miao; Ge, Yingchun; Hu, Xiaoli; Chen, Min; Li, Weiyue

2018-03-01

Watershed system models are urgently needed to understand complex watershed systems and to support integrated river basin management. Early watershed modeling efforts focused on the representation of hydrologic processes, while the next-generation watershed models should represent the coevolution of the water-land-air-plant-human nexus in a watershed and provide capability of decision-making support. We propose a new modeling framework and discuss the know-how approach to incorporate emerging knowledge into integrated models through data exchange interfaces. We argue that the modeling environment is a useful tool to enable effective model integration, as well as create domain-specific models of river basin systems. The grand challenges in developing next-generation watershed system models include but are not limited to providing an overarching framework for linking natural and social sciences, building a scientifically based decision support system, quantifying and controlling uncertainties, and taking advantage of new technologies and new findings in the various disciplines of watershed science. The eventual goal is to build transdisciplinary, scientifically sound, and scale-explicit watershed system models that are to be codesigned by multidisciplinary communities.

Precepting 101: Teaching Strategies and Tips for Success for Preceptors.

PubMed

Lazarus, Judy

2016-11-01

The current shortage of certified nurse-midwives and certified midwives willing to serve as preceptors for midwifery education programs limits the number of students accepted into education programs. Preceptors are an essential link between academic programs and clinical practice and are indispensable to the growth of the midwifery profession. Preceptors create a safe environment for learning and teach adult learners through a variety of clinical teaching strategies. Novice preceptors need training and support to learn a new role, and experienced preceptors desire continued support and training. Before starting, preceptors need to identify sources of support and mentoring as well as understand the academic program's expectations for the student. This article draws on the clinical education literature to describe approaches to teaching all types of students. Practical strategies for integrating all levels of students into busy clinical settings are identified. Two approaches for clinical teaching, the Five Minute Preceptor and SNAPPS, are discussed in detail. Strategies for providing effective feedback and approaches to student evaluation are provided. © 2016 by the American College of Nurse-Midwives.

Nurses and computers. An international perspective on nurses' requirements.

PubMed

Bond, Carol S

2007-01-01

This paper reports the findings from a Florence Nightingale Foundation Travel Scholarship undertaken by the author in the spring of 2006. The aim of the visit was to explore nurses' attitudes towards, and experiences of, using computers in their practice, and the requirements that they have to encourage, promote and support them in using ICT. Nurses were found to be using computers mainly for carrying out administrative tasks, such as updating records, rather than as information tools to support evidence based practice, or patient information needs. Nurses discussed the systems they used, the equipment provided, and their skills, or more often their lack of skills. The need for support was a frequent comment, most nurses feeling that it was essential that help was available at the point of need, and that it was provided by someone, preferably a nurse, who understood the work context. Three groups of nurses were identified. Engagers; Worried Willing and Resisters. The report concludes that pre-registration education has a responsibility to seek to ensure that newly qualified nurses enter practice as engagers.

A comprehensive infectious disease management system.

PubMed

Marcu, Alex; Farley, John D

2009-01-01

An efficient electronic management system is now an essential tool for the successful management and monitoring of those affected by communicable infectious diseases (Human Immunodeficiency Virus - HIV, hepatitis C - HEP C) during the course of the treatment. The current methods which depend heavily on manual collecting, compiling and disseminating treatment information are labor-intensive and time consuming. Clinics specialized in the treatment of infectious diseases use a mix of electronic systems that fail to interact with each other, result in data duplication, and do not support treatment of the patient as a whole. The purpose of the Infectious Disease Management System is to reduce the administrative overhead associated with data collection and analysis while providing correlation abilities and decision support in accordance with defined treatment guidelines. This Infectious Disease Management System was developed to: Ensure cost effectiveness by means of low software licensing costs, Introduce a centralized mechanism of collecting and monitoring all infectious disease management data, Automate electronic retrieval of laboratory findings, Introduce a decision support mechanism as per treatment guidelines, Seamlessly integrate of application modules, Provide comprehensive reporting capabilities, Maintain a high level of user friendliness.

Primary care providers and medical homes for individuals with spina bifida.

PubMed

Walker, William O

2008-01-01

The contributions of primary care providers to the successful care of children with spina bifida cannot be underestimated. Overcoming systemic barriers to their integration into a comprehensive care system is essential. By providing routine and disability specific care through the structure of a Medical Home, they are often the first line resource and support for individuals and their families. The Medical Home model encourages primary care providers to facilitate discussions on topics as varied as education and employment. Knowledge of specific medical issues unique to this population allows the primary care provider to complement the efforts of other specialty clinics and providers in often neglected areas such as sexual health, obesity and latex sensitization. As individuals with spina bifida live into adulthood, and access to traditional multidisciplinary care models evolves, these skills will take on increasing importance within the scope of providing comprehensive and coordinated care.

Anaerobic utilization of essential oils by denitrifying bacteria.

PubMed

Harder, J; Heyen, U; Probian, C; Foss, S

2000-01-01

Plant volatile organic compounds are a major carbon source in nature. We studied the degradability of these substances by anaerobic microorganisms in enrichment cultures with representative essential oils as organic substrates and nitrate as electron acceptor. Lemon and pine needle oil supported microbial growth in the presence of pure oil, whereas parsley seed, camphor, sage, fennel, and mint oil supported growth only when the essential oils were dissolved in an overlying phase of 2,2,4,4,6,8,8-heptamethylnonane. Thyme oil did not support denitrification. Analyses of the microbially degraded oils revealed the disappearance of monoterpenes, of several monoterpenoids, and of methoxy-propenyl-benzenes, including apiole and myristicin. Most-probable-number determinations for denitrifying communities in sewage sludge and forest soil yielded 10(6) to 10(7) monoterpene-utilizing cells ml(-1), representing 0.7 to 100% of the total cultivable nitrate-reducing microorganisms. The utilization of essential oils together with the common occurrence of this metabolic trait are indications for an environmentally important, but currently unexplored anaerobic turnover of plant volatile organic compounds in soil.

Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study.

PubMed

Blusi, Madeleine; Kristiansen, Lisbeth; Jong, Mats

2015-09-01

Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers. © 2014 John Wiley & Sons Ltd.

Acquired RhD mosaicism identifies fibrotic transformation of thrombopoietin receptor-mutated essential thrombocythemia.

PubMed

Montemayor-Garcia, Celina; Coward, Rebecca; Albitar, Maher; Udani, Rupa; Jain, Prachi; Koklanaris, Eleftheria; Battiwalla, Minoo; Keel, Siobán; Klein, Harvey G; Barrett, A John; Ito, Sawa

2017-09-01

Acquired copy-neutral loss of heterozygosity has been described in myeloid malignant progression with an otherwise normal karyotype. A 65-year-old woman with MPL-mutated essential thrombocythemia and progression to myelofibrosis was noted upon routine pretransplant testing to have mixed field reactivity with anti-D and an historic discrepancy in RhD type. The patient had never received transfusions or transplantation. Gel immunoagglutination revealed group A red blood cells and a mixed-field reaction for the D phenotype, with a predominant D-negative population and a small subset of circulating red blood cells carrying the D antigen. Subsequent genomic microarray single nucleotide polymorphism profiling revealed copy-neutral loss of heterozygosity of chromosome 1 p36.33-p34.2, a known molecular mechanism underlying fibrotic progression of MPL-mutated essential thrombocythemia. The chromosomal region affected by this copy-neutral loss of heterozygosity encompassed the RHD, RHCE, and MPL genes. We propose a model of chronological molecular events that is supported by RHD zygosity assays in peripheral lymphoid and myeloid-derived cells. Copy-neutral loss of heterozygosity events that lead to clonal selection and myeloid malignant progression may also affect the expression of adjacent unrelated genes, including those encoding for blood group antigens. Detection of mixed-field reactions and investigation of discrepant blood typing results are important for proper transfusion support of these patients and can provide useful surrogate markers of myeloproliferative disease progression. © 2017 AABB.

Fire flood method for recovering petroleum from oil reservoirs of low permeability and temperature

DOEpatents

Kamath, Krishna

1984-08-14

The present invention is directed to a method of enhanced oil recovery by fire flooding petroleum reservoirs characterized by a temperature of less than the critical temperature of carbon dioxide, a pore pressure greater than the saturated vapor pressure of carbon dioxide at said temperature (87.7.degree. F. at 1070 psia), and a permeability in the range of about 20 to 100 millidarcies. The in situ combustion of petroleum in the reservoir is provided by injecting into the reservoir a combustion supporting medium consisting essentially of oxygen, ozone, or a combination thereof. The heat of combustion and the products of this combustion which consist essentially of gaseous carbon dioxide and water vapor sufficiently decrease the viscosity of oil adjacent to fire front to form an oil bank which moves through the reservoir towards a recovery well ahead of the fire front. The gaseous carbon dioxide and the water vapor are driven into the reservoir ahead of the fire front by pressure at the injection well. As the gaseous carbon dioxide cools to less than about 88.degree. F. it is converted to liquid which is dissolved in the oil bank for further increasing the mobility thereof. By using essentially pure oxygen, ozone, or a combination thereof as the combustion supporting medium in these reservoirs the permeability requirements of the reservoirs are significantly decreased since the liquid carbon dioxide requires substantially less voidage volume than that required for gaseous combustion products.

Patients' experiences of information and support during the first six months after heart or lung transplantation.

PubMed

Ivarsson, Bodil; Ekmehag, Björn; Sjöberg, Trygve

2013-08-01

Heart or lung recipients are taught about a new lifestyle, risk factors, medication, food restrictions and exercise so they can take an active role and responsibility for disease management after transplantation. However, little is known about patients' experiences of information and support in these situations. The aim of the study was to illuminate how patients, six months after a heart or lung transplantation, experienced the information and support they received in connection with the transplantation. Sixteen patients were included in the study, and interviews were analysed using a qualitative content analysis method. The findings are presented in three themes: Alternating between gratitude and satisfaction and resignation, Striving to follow treatment strategies and Returning to a relatively normal life. The patients expressed gratitude when their health improved markedly but resignation when complications or side effects occurred due to the lack of information and support they received. Healthcare professionals can make specific improvements in the information they provide to patients to increase their preparedness. Information and support should be provided regularly so as to avoid non-adherence to essential guidelines. To return to a normal life, patients need support from healthcare organizations, families, employers and society in general. These findings should be taken into account in the clinical management of transplant patients, particularly those with dependent children or failing social networks.

Development of guidelines for tertiary education institutions to assist them in supporting students with a mental illness: a Delphi consensus study with Australian professionals and consumers.

PubMed

Reavley, Nicola J; Ross, Anna M; Killackey, Eoin; Jorm, Anthony F

2013-01-01

Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students' academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts. Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers) were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals). 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation. Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to inform policy and practice in tertiary institutions.

Development of guidelines for tertiary education institutions to assist them in supporting students with a mental illness: a Delphi consensus study with Australian professionals and consumers

PubMed Central

Ross, Anna M.; Killackey, Eoin; Jorm, Anthony F.

2013-01-01

Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students’ academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts. Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers) were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals). 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation. Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to inform policy and practice in tertiary institutions. PMID:23638380

Discharge planning for a patient with a new ostomy: best practice for clinicians.

PubMed

Prinz, Anita; Colwell, Janice C; Cross, Heidi H; Mantel, Janet; Perkins, Jacqueline; Walker, Cynthia A

2015-01-01

A comprehensive discharge plan for a patient with a new stoma is needed to ensure the individual receives the necessary ostomy education prior to discharge. The plan should include teaching basic skills and providing information about how to manage the ostomy (ie, emptying and changing the pouch, how to order supplies, available manufacturers, dietary/fluid guidelines, potential complications, medications, and managing gas and odor), assisting with transitions in care, and providing information about resources for support and assistance. The purpose of this best practice guideline is to provide clinicians with a brief overview of the essential elements that should be included in the discharge plan to facilitate patient education and the transition of care from hospital to home.

Digital technology and clinical decision making in depression treatment: Current findings and future opportunities.

PubMed

Hallgren, Kevin A; Bauer, Amy M; Atkins, David C

2017-06-01

Clinical decision making encompasses a broad set of processes that contribute to the effectiveness of depression treatments. There is emerging interest in using digital technologies to support effective and efficient clinical decision making. In this paper, we provide "snapshots" of research and current directions on ways that digital technologies can support clinical decision making in depression treatment. Practical facets of clinical decision making are reviewed, then research, design, and implementation opportunities where technology can potentially enhance clinical decision making are outlined. Discussions of these opportunities are organized around three established movements designed to enhance clinical decision making for depression treatment, including measurement-based care, integrated care, and personalized medicine. Research, design, and implementation efforts may support clinical decision making for depression by (1) improving tools to incorporate depression symptom data into existing electronic health record systems, (2) enhancing measurement of treatment fidelity and treatment processes, (3) harnessing smartphone and biosensor data to inform clinical decision making, (4) enhancing tools that support communication and care coordination between patients and providers and within provider teams, and (5) leveraging treatment and outcome data from electronic health record systems to support personalized depression treatment. The current climate of rapid changes in both healthcare and digital technologies facilitates an urgent need for research, design, and implementation of digital technologies that explicitly support clinical decision making. Ensuring that such tools are efficient, effective, and usable in frontline treatment settings will be essential for their success and will require engagement of stakeholders from multiple domains. © 2017 Wiley Periodicals, Inc.

Strategies to support engagement and continuity of activity during mealtimes for families living with dementia; a qualitative study.

PubMed

Keller, Heather H; Martin, Lori Schindel; Dupuis, Sherry; Reimer, Holly; Genoe, Rebecca

2015-10-09

Mealtimes are an essential part of living and quality of life for everyone, including persons living with dementia. A longitudinal qualitative study provided understanding of the meaning of mealtimes for persons with dementia and their family care partners. Strategies were specifically described by families to support meaningful mealtimes. The purpose of this manuscript is to describe the strategies devised and used by these families living with dementia. A longitudinal qualitative study was undertaken to explore the meaning and experience of mealtimes for families living with dementia over a three-year period. 27 families [older person with dementia and at least one family care partner] were originally recruited from the community of South-Western Ontario. Individual and dyad interviews were conducted each year. Digitally recorded transcripts were analyzed using grounded theory methodology. Strategies were identified and categorized. Strategies to support quality mealtimes were devised by families as they adapted to their evolving lives. General strategies such as living in the moment, as well as strategies specific to maintaining social engagement and continuity of mealtime activities were reported. In addition to nutritional benefit, family mealtimes provide important opportunities for persons with dementia and their family care partners to socially engage and continue meaningful roles. Strategies identified by participants provide a basis for further education and support to families living with dementia.

Perspectives of Youth in Foster Care on Essential Ingredients for Promoting Self-determination and Successful Transition to Adult Life: My Life Model.

PubMed

Powers, Laurie E; Fullerton, Ann; Schmidt, Jessica; Geenen, Sarah; Oberweiser-Kennedy, Molly; Dohn, JoAnn; Nelson, May; Iavanditti, Rosemary; Blakeslee, Jennifer

2018-02-01

Research clearly documents the serious challenges and poor outcomes experienced by many young people exiting foster care, as well as compounded disparities for the high percentage of youth in care who are identified with disabilities and/or mental health challenges. However, very little research has been conducted to specify or validate effective models for improving the transition trajectories of youth exiting care. Evidence suggests the My Life self-determination enhancement model offers a promising approach for supporting youths' self-determined and positive transition to adulthood. The model includes youth-directed, experientially oriented coaching in the application of self-determination skills to achieve youth-identified transition goals, coupled with peer mentoring workshops that provide opportunities for learning, networking and fun. This in depth qualitative study of 10 youth who completed the My Life intervention focused on investigating coaching and mentoring elements and processes that youth participants identify as most important to their success, with the intention of informing the further development of youth-directed approaches to supporting young people who are transitioning to adulthood. Themes emerged around the centrality of youth self-direction, important processes in the coaching relationship, the essential value of experiential activities and self-determination skill development, and peer mentoring experiences that youth identified as fostering their success. Implications are discussed for research and practice in supporting youth exiting foster care.

Essential conditions for the implementation of comprehensive school health to achieve changes in school culture and improvements in health behaviours of students.

PubMed

Storey, Kate E; Montemurro, Genevieve; Flynn, Jenn; Schwartz, Marg; Wright, Erin; Osler, Jill; Veugelers, Paul J; Roberts, Erica

2016-11-02

Comprehensive School Health (CSH) is an internationally recognized framework that holistically addresses school health by transforming the school culture. It has been shown to be effective in enhancing health behaviours among students while also improving educational outcomes. Despite this effectiveness, there is a need to focus on how CSH is implemented. Previous studies have attempted to uncover the conditions necessary for successful operationalization, but none have described them in relation to a proven best practice model of implementation that has demonstrated positive changes to school culture and improvements in health behaviours. The purpose of this research was to identify the essential conditions of CSH implementation utilizing secondary analysis of qualitative interview data, incorporating a multitude of stakeholder perspectives. This included inductive content analysis of teacher (n = 45), principal (n = 46), and school health facilitator (n = 34) viewpoints, all of whom were employed within successful CSH project schools in Alberta, Canada between 2008 and 2013. Many themes were identified, here called conditions, that were divided into two categories: 'core conditions' (students as change agents, school-specific autonomy, demonstrated administrative leadership, dedicated champion to engage school staff, community support, evidence, professional development) and 'contextual conditions' (time, funding and project supports, readiness and prior community connectivity). Core conditions were defined as those conditions necessary for CSH to be successfully implemented, whereas contextual conditions had a great degree of influence on the ability for the core conditions to be obtained. Together, and in consideration of already established 'process conditions' developed by APPLE Schools (assess, vision, prioritize; develop and implement an action plan; monitor, evaluate, celebrate), these represent the essential conditions of successful CSH implementation. Overall, the present research contributes to the evidence-base of CSH implementation, ultimately helping to shape its optimization by providing school communities with a set of understandable essential conditions for CSH implementation. Such research is important as it helps to support and bolster the CSH framework that has been shown to improve the education, health, and well-being of school-aged children.

Interdependence and dynamics of essential services in an extensive risk context: a case study in Montserrat, West Indies

NASA Astrophysics Data System (ADS)

Sword-Daniels, V. L.; Rossetto, T.; Wilson, T. M.; Sargeant, S.

2015-05-01

The essential services that support urban living are complex and interdependent, and their disruption in disasters directly affects society. Yet there are few empirical studies to inform our understanding of the vulnerabilities and resilience of complex infrastructure systems in disasters. This research takes a systems thinking approach to explore the dynamic behaviour of a network of essential services, in the presence and absence of volcanic ashfall hazards in Montserrat, West Indies. Adopting a case study methodology and qualitative methods to gather empirical data, we centre the study on the healthcare system and its interconnected network of essential services. We identify different types of relationship between sectors and develop a new interdependence classification system for analysis. Relationships are further categorised by hazard conditions, for use in extensive risk contexts. During heightened volcanic activity, relationships between systems transform in both number and type: connections increase across the network by 41%, and adapt to increase cooperation and information sharing. Interconnections add capacities to the network, increasing the resilience of prioritised sectors. This in-depth and context-specific approach provides a new methodology for studying the dynamics of infrastructure interdependence in an extensive risk context, and can be adapted for use in other hazard contexts.

Interdependence and dynamics of essential services in an extensive risk context: a case study in Montserrat, West Indies

NASA Astrophysics Data System (ADS)

Sword-Daniels, V. L.; Rossetto, T.; Wilson, T. M.; Sargeant, S.

2015-02-01

The essential services that support urban living are complex and interdependent, and their disruption in disasters directly affects society. Yet there are few empirical studies to inform our understanding of the vulnerabilities and resilience of complex infrastructure systems in disasters. This research takes a systems thinking approach to explore the dynamic behaviour of a network of essential services, in the presence and absence of volcanic ashfall hazards in Montserrat, West Indies. Adopting a case study methodology and qualitative methods to gather empirical data we centre the study on the healthcare system and its interconnected network of essential services. We identify different types of relationship between sectors and develop a new interdependence classification system for analysis. Relationships are further categorised by hazard condition, for use in extensive risk contexts. During heightened volcanic activity, relationships between systems transform in both number and type: connections increase across the network by 41%, and adapt to increase cooperation and information sharing. Interconnections add capacities to the network, increasing the resilience of prioritised sectors. This in-depth and context-specific approach provides a new methodology for studying the dynamics of infrastructure interdependence in an extensive risk context, and can be adapted for use in other hazard contexts.

Determination of the protease cleavage site repertoire—The RNase H but not the RT domain is essential for foamy viral protease activity

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

Spannaus, Ralf; Bodem, Jochen, E-mail: Jochen.Bodem@vim.uni-wuerzburg.de

2014-04-15

In contrast to orthoretroviruses, the foamy virus protease is only active as a protease-reverse transcriptase fusion protein and requires viral RNA for activation. Maturation of foamy viral proteins seems to be restricted to a single cleavage site in Gag and Pol. We provide evidence that unprocessed Gag is required for optimal infectivity, which is unique among retroviruses. Analyses of the cleavage site sequences of the Gag and Pol cleavage sites revealed a high similarity compared to those of Lentiviruses. We show that positions P2' and P2 are invariant and that Gag and Pol cleavage sites are processed with similar efficiencies.more » The RNase H domain is essential for protease activity, but can functionally be substituted by RNase H domains of other retroviruses. Thus, the RNase H domain might be involved in the stabilization of the protease dimer, while the RT domain is essential for RNA dependent protease activation. - Highlights: • Unprocessed Gag is required for optimal infectivity of foamy viruses. • Positions P2 and P2' are invariant in the foamy viral cleavage sites. • The RNaseH domain is essential for protease activity. • The RNaseH domains of other retroviruses support foamy viral protease activity.« less

TURKISH VERSION QUALITY OF LIFE IN ESSENTIAL TREMOR QUESTIONNAIRE (QUEST): VALIDITY AND RELIABILITY STUDY.

PubMed

Güler, Sibel; Turan, F Nesrin

2015-09-30

Our aim was to translate the Quality of Life in Essential Tremor Questionnaire (QUEST) advanced by Troster (2005) and to analyse the validity and reliability of this questionnaire. Two hundred twelve consecutive patients with essential tremor (ET) and forty-three control subjects were included in the study. Permission for the translation and validation of the QUEST scale was obtained. The translation was performed according to the guidelines provided by the publisher. After the translation, the final version of the scale was administered to both groups to determine its reliability and validity. The QUEST Physical, Psychosocial, communication, Hobbies/leisure and Work/finance scores were 0.967, 0.968, 0.933, 0.964 and 0.925, respectively. There were good correlations between each of the QUEST scores that were indicative of good internal consistency. Additionally, we observed that all of the QUEST scores were most strongly related to the right and left arms (p=0.0001). However, we observed that all of the QUEST scores were weakly related to the voice, head and right leg (p=0.0001). These findings support the notion that the Turkish version of the Quality of Life in Essential Tremor (QUEST) questionnaire is a valid and reliable tool for the assessment of the quality of life of patients with ET.

Sensitive voltammetric determination of thymol in essential oil of Carum copticum seeds using boron-doped diamond electrode.

PubMed

Stanković, Dalibor M

2015-10-01

Essential oil of Carum copticum seeds, obtained from a local shop, was extracted and content of thymol was analyzed using square-wave voltammetry at boron-doped diamond electrode. The effect of various parameters, such as pH of supporting electrolyte and square-wave voltammetric parameters (modulation amplitude and frequency), was examined. In Britton-Robinson buffer solution (pH 4), thymol provided a single and oval-shaped irreversible oxidation peak at +1.13 V versus silver/silver chloride potassium electrode (3M). Under optimal experimental conditions, a plot of peak height against concentration of thymol was found to be linear over the range of 4 to 100μM consisting of two linear ranges: from 4 to 20μM (R(2)=0.9964) and from 20 to 100μM (R(2)=0.9993). The effect of potential interferences such as p-cymene and γ-terpinene (major components in essential oil of C. copticum seeds) was evaluated. Thus, the proposed method displays a sufficient selectivity toward thymol with a detection limit of 3.9μM, and it was successfully applied for the determination of thymol in essential oil of C. copticum seeds. The Prussian blue method was used for validation of the proposed electroanalytical method. Copyright © 2015 Elsevier Inc. All rights reserved.

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

Supporting Families to Support Students

ERIC Educational Resources Information Center

Kelly, John; Rossen, Eric; Cowan, Katherine C.

2018-01-01

Collaboration between students' families and the school is an essential component to promoting student mental and behavioral health. Many schools structure their mental health services using a Multi-Tiered System of Supports that offers three different tiers of support from universal supports to personalized help for students with serious…

Ventromedial Hypothalamus and the Generation of Aggression

PubMed Central

Hashikawa, Yoshiko; Hashikawa, Koichi; Falkner, Annegret L.; Lin, Dayu

2017-01-01

Aggression is a costly behavior, sometimes with severe consequences including death. Yet aggression is prevalent across animal species ranging from insects to humans, demonstrating its essential role in the survival of individuals and groups. The question of how the brain decides when to generate this costly behavior has intrigued neuroscientists for over a century and has led to the identification of relevant neural substrates. Various lesion and electric stimulation experiments have revealed that the hypothalamus, an ancient structure situated deep in the brain, is essential for expressing aggressive behaviors. More recently, studies using precise circuit manipulation tools have identified a small subnucleus in the medial hypothalamus, the ventrolateral part of the ventromedial hypothalamus (VMHvl), as a key structure for driving both aggression and aggression-seeking behaviors. Here, we provide an updated summary of the evidence that supports a role of the VMHvl in aggressive behaviors. We will consider our recent findings detailing the physiological response properties of populations of VMHvl cells during aggressive behaviors and provide new understanding regarding the role of the VMHvl embedded within the larger whole-brain circuit for social sensation and action. PMID:29375329

Measuring nursing essential contributions to quality patient care outcomes.

PubMed

Wolgast, Kelly A; Taylor, Katherine; Garcia, Dawn; Watkins, Miko

2011-01-01

Workload Management System for Nursing (WMSN) is a core Army Medical Department business system that has provided near real-time, comprehensive nursing workload and manpower data for decision making at all levels for over 25 years. The Army Manpower Requirements and Documentation Agency populates data from WMSN into the Manpower Staffing Standards System (Inpatient module within Automated Staffing Assessment Model). The current system, Workload Management System for Nursing Internet (WMSNi), is an interim solution that requires additional functionalities for modernization and integration at the enterprise level. The expanding missions and approved requirements for WMSNi support strategic initiatives on the Army Medical Command balanced scorecard and require continued sustainment for multiple personnel and manpower business processes for both inpatient and outpatient nursing care. This system is currently being leveraged by the TRICARE Management Activity as an interim multiservice solution, and is being used at 24 Army medical treatment facilities. The evidenced-based information provided to Army decision makers through the methods used in the WMSNi will be essential across the Army Medical Command throughout the system's life cycle.

Data Fusion for Earth Science Remote Sensing

NASA Technical Reports Server (NTRS)

Braverman, Amy

2007-01-01

Beginning in 2004, NASA has supported the development of an international network of ground-based remote sensing installations for the measurement of greenhouse gas columns. This collaboration has been successful and is currently used in both carbon cycle investigations and in the efforts to validate the GOSAT space-based column observations of CO2 and CH4. With the support of a grant, this research group has established a network of ground-based column observations that provide an essential link between the satellite observations of CO2, CO, and CH4 and the extensive global in situ surface network. The Total Carbon Column Observing Network (TCCON) was established in 2004. At the time of this report seven sites, employing modern instrumentation, were operational or were expected to be shortly. TCCON is expected to expand. In addition to providing the most direct means of tying the in situ and remote sensing data sets together, TCCON provides a means of testing the retrieval algorithms of SCIAMACHY and GOSAT over the broadest variation in atmospheric state. TCCON provides a critically maintained and long timescale record for identification of temporal drift and spatial bias in the calibration of the space-based sensors. Finally, the global observations from TCCON are improving our understanding of how to use column observations to provide robust estimates of surface exchange of C02 and CH4 in advance of the launch of OCO and GOSAT. TCCON data are being used to better understand the impact of both regional fluxes and long-range transport on gradients in the C02 column. Such knowledge is essential for identifying the tools required to best use the space-based observations. The technical approach and methodology of retrieving greenhouse gas columns from near-IR solar spectra, data quality and process control are described. Additionally, the impact of and relevance to NASA of TCCON and satellite validation and carbon science are addressed.

Saving mothers and newborns in communities: strengthening community midwives to provide high quality essential newborn and maternal care in Baluchistan, Pakistan in a financially sustainable manner.

PubMed

Mumtaz, Zubia; Cutherell, Andrea; Bhatti, Afshan

2014-04-06

To address it's persistently high maternal mortality rate of 276/100,000 live births, the government of Pakistan created a new cadre of community based midwives (CMW). One expectation is that CMWs will improve access to maternal health services for underserved women. Recent research shows the CMWs have largely failed to establish midwifery practices, because CMW's lack of skills, both clinical and entrepreneurial and funds necessary to develop their practice infrastructure and logistics. Communities also lack trust in their competence to conduct safe births. To address these issues, the Saving Mothers and Newborn (SMNC) intervention will implement three key elements to support the CMWs to establish their private practices: (1) upgrade CMW clinical skills (2) provide business-skills training and small loans (3) generate demand for CMW services using cellular phone SMS technology and existing women's support groups. This 3-year project aims to investigate whether CMWs enrolled in this initiative are providing the essential maternal and newborn health care to women and children living in districts of Quetta, and Gwadar in a financially self-sustaining manner. Specifically the research will use quasi-experimental impact assessment to document whether the SMNC initiative is having an impact on CMW services uptake, financial analysis to assess if the initiative enabled CMWs to develop financially self-sustainable practices and observation methods to assess the quality of care the CMWs are providing. A key element of the SMNC initiative - the provision of business skills training and loans to establish private practices - is an innovative initiative in Pakistan and little is known about its effectiveness. This research will provide emperic evidence of the effectiveness of the intervention as well as contribute to the body of evidence around potential solutions to improve sustainable coverage of high impact Maternal, Neonatal and Child Health interventions in vulnerable populations living in remote rural areas.

Antispasmodic activity of essential oil from Lippia dulcis Trev.

PubMed

Görnemann, T; Nayal, R; Pertz, H H; Melzig, M F

2008-04-17

To investigate the essential oil of Lippia dulcis Trev. (Verbenaceae) that is traditionally used in the treatment of cough, colds, bronchitis, asthma, and colic in Middle America for antispasmodic activity. We used a porcine bronchial bioassay to study contractile responses to carbachol and histamine in the absence or presence of the essential oil. The essential oil showed anti-histaminergic and anti-cholinergic activities at 100 microg/ml. The anti-histaminergic and anti-cholinergic activities of the essential oil of Lippia dulcis support the rational use of the plant or plant extracts to treat bronchospasm.

Validation of Essential Acoustic Parameters for Highly Urgent In-Vehicle Collision Warnings.

PubMed

Lewis, Bridget A; Eisert, Jesse L; Baldwin, Carryl L

2018-03-01

Objective The aim of this study was to validate the importance of key acoustic criteria for use as in-vehicle forward collision warning (FCW) systems. Background Despite recent advances in vehicle safety, automobile crashes remain one of the leading causes of death. As automation allows for more control of noncritical functions by the vehicle, the potential for disengagement and distraction from the driving task also increases. It is, therefore, as important as ever that in-vehicle safety-critical interfaces are intuitive and unambiguous, promoting effective collision avoidance responses upon first exposure even under divided-attention conditions. Method The current study used a driving simulator to assess the effectiveness of two warnings, one that met all essential acoustic parameters, one that met only some essential parameters, and a no-warning control in the context of a lead vehicle-following task in conjunction with a cognitive distractor task and collision event. Results Participants receiving an FCW comprising five essential acoustic components had improved collision avoidance responses relative to a no-warning condition and an FCW missing essential elements on their first exposure. Responses to a consistently good warning (GMU Prime) improved with subsequent exposures, whereas continued exposure to the less optimal FCW (GMU Sub-Prime) resulted in poorer performance even relative to receiving no warning at all. Conclusions This study provides support for previous warning design studies and for the validity of five key acoustic parameters essential for the design of effective in-vehicle FCWs. Application Results from this study have implications for the design of auditory FCWs and in-vehicle display design.

A framework for institutionalizing quality assurance.

PubMed

Silimperi, Diana R; Franco, Lynne Miller; Veldhuyzen van Zanten, Tisna; MacAulay, Catherine

2002-12-01

To develop a framework to support the institutionalization of quality assurance (QA). The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.

Global and national laboratory networks support high quality surveillance for measles and rubella.

PubMed

Xu, Wenbo; Zhang, Yan; Wang, Huiling; Zhu, Zhen; Mao, Naiying; Mulders, Mick N; Rota, Paul A

2017-05-01

Laboratory networks are an essential component of disease surveillance systems because they provide accurate and timely confirmation of infection. WHO coordinates global laboratory surveillance of vaccine preventable diseases, including measles and rubella. The more than 700 laboratories within the WHO Global Measles and Rubella Laboratory Network (GMRLN) supports surveillance for measles, rubella and congenial rubella syndrome in 191 counties. This paper describes the overall structure and function of the GMRLN and highlights the largest of the national laboratory networks, the China Measles and Rubella Laboratory Network. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Biogeochemical evidence for subsurface hydrocarbon occurrence, Recluse oil field, Wyoming; preliminary results

USGS Publications Warehouse

Dalziel, Mary C.; Donovan, Terrence J.

1980-01-01

Anomalously high manganese-to-iron ratios occurring in pine needles and sage leaves over the Recluse oil field, Wyoming, suggest effects of petroleum microseepage on the plants. This conclusion is supported by iron and manganese concentrations in soils and carbon and oxygen isotope ratios in rock samples. Seeping hydrocarbons provided reducing conditions sufficient to enable divalent iron and manganese to be organically complexed or adsorbed on solids in the soils. These bound or adsorped elements in the divalent state are essential to plants, and the plants readily assimilate them. The magnitude of the plant anomalies, combined with the supportive isotopic and chemical evidence confirming petroleum leakage, makes a strong case for the use of plants as a biogeochemical prospecting tool.

Modelling and Decision Support of Clinical Pathways

NASA Astrophysics Data System (ADS)

Gabriel, Roland; Lux, Thomas

The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

Clinical Use of an Enterprise Data Warehouse

PubMed Central

Evans, R. Scott; Lloyd, James F.; Pierce, Lee A.

2012-01-01

The enormous amount of data being collected by electronic medical records (EMR) has found additional value when integrated and stored in data warehouses. The enterprise data warehouse (EDW) allows all data from an organization with numerous inpatient and outpatient facilities to be integrated and analyzed. We have found the EDW at Intermountain Healthcare to not only be an essential tool for management and strategic decision making, but also for patient specific clinical decision support. This paper presents the structure and two case studies of a framework that has provided us the ability to create a number of decision support applications that are dependent on the integration of previous enterprise-wide data in addition to a patient’s current information in the EMR. PMID:23304288

Austerity and the "sector-wide approach" to health: The Mozambique experience.

PubMed

Pfeiffer, James; Gimbel, Sarah; Chilundo, Baltazar; Gloyd, Stephen; Chapman, Rachel; Sherr, Kenneth

2017-08-01

Fiscal austerity policies imposed by the IMF have reduced investments in social services, leaving post-independence nations like Mozambique struggling to recover from civil war and high disease burden. By 2000, a sector-wide approach (SWAp) was promoted to maximize aid effectiveness. 'Like-minded' bilateral donors, from Europe and Canada, promoted a unified approach to health sector support focusing on joint planning, common basket funding, and streamlined monitoring and evaluation to improve sector coordination, amplify country ownership, and build sustainable health systems. Notable donors - including US government and the Global Fund - did not participate in the SWAp, and increased vertical funding weakened the SWAp in favor of non-governmental organizations (NGOs). In spite of some success in harmonizing aid to the health sector, the SWAp experience in Mozambique demonstrates how continued austerity regimes that severely constrain public spending will continue to undermine health system strengthening in Africa, even in the midst of high levels of foreign aid with the ostensible purpose of strengthening those systems. The SWAp story provides a poignant illustration of how continued austerity will impede progress toward Sustainable Development Goal 3 (SDG 3); "Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". However, the SWAp continues to offer an alternative model to health system support that can provide a foundation for resistance to renewed austerity measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Spine Trauma as a Component of Essential Neurosurgery: An Outcomes Analysis from Cambodia.

PubMed

Chua, Michelle H; Hong, Raksmey; Rydeth, Tytim; Vycheth, Iv; Nang, Sam; Vuthy, Din; Park, Kee B

2018-06-01

In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The aim of this study was to review outcomes from operative management of spine trauma at a resource-limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (American Spinal Injury Association A or American Spinal Injury Association B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016. Surgical treatment was provided to 277 patients with cervical or thoracolumbar spine trauma, including 36 facet dislocations and 135 thoracolumbar burst fractures at a cost of $100-$280 per surgery. Six patients (2.2%) required treatment for postoperative wound infection. Reoperation was performed in 8 patients (2.9%) for wrong-level surgery. Failure of short-segment pedicle screw fixation was discovered in 4 patients (7.0%). Neurologic improvement was reported by 64 patients (65.3%) with incomplete spinal cord injury and available long-term follow-up. Affordable neurosurgical care can be provided in a safe and sustainable manner to patients with traumatic spine and spinal cord injuries in resource-limited communities. This supports the call for essential neurosurgery to be made available around the world to individuals from all socioeconomic strata. Copyright © 2018 Elsevier Inc. All rights reserved.

Treatment of essential tremor with arotinolol.

PubMed

Kuroda, Y; Kakigi, R; Shibasaki, H

1988-04-01

We investigated the effect of arotinolol, a new peripherally acting beta-adrenergic blocker, in 15 patients with essential tremor. The patients received 30 mg per day of arotinolol for 8 weeks. Accelerometer readings showed a significant reduction in amplitude of postural tremor after treatment. Action tremor also improved to essentially the same degree as postural tremor. The present findings support the view that the therapeutic effect of beta-blockers in essential tremor is mediated by peripheral beta-adrenergic receptors.

Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness.

PubMed

Ferranti, Jeffrey M; Langman, Matthew K; Tanaka, David; McCall, Jonathan; Ahmad, Asif

2010-01-01

Healthcare is increasingly dependent upon information technology (IT), but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality, and financial effectiveness. Moreover, hospitals have lagged in adopting thoughtful analytic approaches that would allow operational leaders and providers to capitalize upon existing data stores. In this manuscript, we propose a fundamental re-evaluation of strategic IT investments in healthcare, with the goal of increasing efficiency, reducing costs, and improving outcomes through the targeted application of health analytics. We also present three case studies that illustrate the use of health analytics to leverage pre-existing data resources to support improvements in patient safety and quality of care, to increase the accuracy of billing and collection, and support emerging health issues. We believe that such active investment in health analytics will prove essential to realizing the full promise of investments in electronic clinical systems.

The state of research into children with cancer across Europe: new policies for a new decade

PubMed Central

Pritchard-Jones, K; Lewison, G; Camporesi, S; Vassal, G; Ladenstein, R; Benoit, Y; Predojevic, JS; Sterba, J; Stary, J; Eckschlager, T; Schroeder, H; Doz, F; Creutzig, U; Klingebiel, T; Kosmidis, HV; Garami, M; Pieters, R; O’Meara, A; Dini, G; Riccardi, R; Rascon, J; Rageliene, L; Calvagna, V; Czauderna, P; Kowalczyk, JR; Gil-da-Costa, MJ; Norton, L; Pereira, F; Janic, D; Puskacova, J; Jazbec, J; Canete, A; Hjorth, L; Ljungman, G; Kutluk, T; Morland, B; Stevens, M; Walker, D; Sullivan, R

2011-01-01

Overcoming childhood cancers is critically dependent on the state of research. Understanding how, with whom and what the research community is doing with childhood cancers is essential for ensuring the evidence-based policies at national and European level to support children, their families and researchers. As part of the European Union funded EUROCANCERCOMS project to study and integrate cancer communications across Europe, we have carried out new research into the state of research in childhood cancers. We are very grateful for all the support we have received from colleagues in the European paediatric oncology community, and in particular from Edel Fitzgerald and Samira Essiaf from the SIOP Europe office. This report and the evidence-based policies that arise from it come at a important junction for Europe and its Member States. They provide a timely reminder that research into childhood cancers is critical and needs sustainable long-term support. PMID:22276053

Facilities and support systems for a 90-day test of a regenerative life support system

NASA Technical Reports Server (NTRS)

Malin, R. L.

1972-01-01

A 90-day test is reported of a regenerative life support system which was completed in a space station simulator. The long duration of the test and the fact that it was manned, imposed rigid reliability and safety requirements on the facility. Where adequate reliability could not be built into essential facility systems, either backup systems or components were provided. Awareness was intensified by: (1) placing signs on every piece of equipment that could affect the test, (2) painting switches on all breaker panels a bright contrasting color, (3) restricting access to the test control area, and (4) informing personnel in the facility (other than test personnel) of test activities. It is concluded that the basic facility is satisfactory for conducting long-duration manned tests, and it is recommended that all monitor and alarm functions be integrated into a single operation.

R&D to Market Success: BTO-Supported Technologies Commercialized from 2010-2015

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

None, None

2017-04-01

Technology commercialization plays an essential role in almost every facet of the U.S. economy. It spurs private sector funding that supports innovative breakthroughs, drives growth through increased productivity and product development, increases American competitiveness, and creates domestic jobs. The BTO Technology Commercialization report is an annual publication offering the latest information on successfully commercialized technologies resulting in part from BTO’s research partnerships. This report defines a “commercialized technology” as a process, technique, design, machine, tool, material, or software that was developed with funds provided at least in part by BTO, and that has resulted in domestic sales or is inmore » use in the U.S. This definition also applies to open-source software products developed with support from BTO, all of which are currently distributed freely but are actively used for commercial purposes.« less

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

Crossing the quality chasm: the role of information technology departments.

PubMed

Weir, Charlene R; Hicken, Bret L; Rappaport, Hank Steven; Nebeker, Jonathan R

2006-01-01

Integrating information technology (IT) into medical settings is considered essential to transforming hospitals into 21st-century health care institutions. Yet the role of IT departments in maximizing the effectiveness of information systems is not well understood. This article reports a 3-round Delphi panel of Veterans Administration personnel experienced with provider order entry electronic systems. In round 1, 35 administrative, clinical, and IT personnel answered 10 open-ended questions about IT strategies and structures that best support successful transformation. In round 2, panelists rated item importance and ranked proposed strategies. In round 3, panelists received aggregate feedback and rerated the items. Four domains emerged from round 1: IT organization, IT performance monitoring, user-support activities, and core IT responsibilities (eg, computer security, training). In rounds 2 and 3, IT performance monitoring was rated the most important, closely followed by clinical support. Strategies associated with each domain are identified and discussed.

Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness

PubMed Central

Langman, Matthew K; Tanaka, David; McCall, Jonathan; Ahmad, Asif

2010-01-01

Healthcare is increasingly dependent upon information technology (IT), but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality, and financial effectiveness. Moreover, hospitals have lagged in adopting thoughtful analytic approaches that would allow operational leaders and providers to capitalize upon existing data stores. In this manuscript, we propose a fundamental re-evaluation of strategic IT investments in healthcare, with the goal of increasing efficiency, reducing costs, and improving outcomes through the targeted application of health analytics. We also present three case studies that illustrate the use of health analytics to leverage pre-existing data resources to support improvements in patient safety and quality of care, to increase the accuracy of billing and collection, and support emerging health issues. We believe that such active investment in health analytics will prove essential to realizing the full promise of investments in electronic clinical systems. PMID:20190055

Principles to Products: Toward Realizing MOS 2.0

NASA Technical Reports Server (NTRS)

Bindschadler, Duane L.; Delp, Christopher L.

2012-01-01

This is a report on the Operations Revitalization Initiative, part of the ongoing NASA-funded Advanced Multi-Mission Operations Systems (AMMOS) program. We are implementing products that significantly improve efficiency and effectiveness of Mission Operations Systems (MOS) for deep-space missions. We take a multi-mission approach, in keeping with our organization's charter to "provide multi-mission tools and services that enable mission customers to operate at a lower total cost to NASA." Focusing first on architectural fundamentals of the MOS, we review the effort's progress. In particular, we note the use of stakeholder interactions and consideration of past lessons learned to motivate a set of Principles that guide the evolution of the AMMOS. Thus guided, we have created essential patterns and connections (detailed in companion papers) that are explicitly modeled and support elaboration at multiple levels of detail (system, sub-system, element...) throughout a MOS. This architecture is realized in design and implementation products that provide lifecycle support to a Mission at the system and subsystem level. The products include adaptable multi-mission engineering documentation that describes essentials such as operational concepts and scenarios, requirements, interfaces and agreements, information models, and mission operations processes. Because we have adopted a model-based system engineering method, these documents and their contents are meaningfully related to one another and to the system model. This means they are both more rigorous and reusable (from mission to mission) than standard system engineering products. The use of models also enables detailed, early (e.g., formulation phase) insight into the impact of changes (e.g., to interfaces or to software) that is rigorous and complete, allowing better decisions on cost or technical trades. Finally, our work provides clear and rigorous specification of operations needs to software developers, further enabling significant gains in productivity.

Social Network Structures of Breast Cancer Patients and the Contributing Role of Patient Navigators.

PubMed

Gunn, Christine M; Parker, Victoria A; Bak, Sharon M; Ko, Naomi; Nelson, Kerrie P; Battaglia, Tracy A

2017-08-01

Minority women in the U.S. continue to experience inferior breast cancer outcomes compared with white women, in part due to delays in care delivery. Emerging cancer care delivery models like patient navigation focus on social barriers, but evidence demonstrating how these models increase social capital is lacking. This pilot study describes the social networks of newly diagnosed breast cancer patients and explores the contributing role of patient navigators. Twenty-five women completed a one hour interview about their social networks related to cancer care support. Network metrics identified important structural attributes and influential individuals. Bivariate associations between network metrics, type of network, and whether the network included a navigator were measured. Secondary analyses explored associations between network structures and clinical outcomes. We identified three types of networks: kin-based, role and/or affect-based, or heterogeneous. Network metrics did not vary significantly by network type. There was a low prevalence of navigators included in the support networks (25%). Network density scores were significantly higher in those networks without a navigator. Network metrics were not predictive of clinical outcomes in multivariate models. Patient navigators were not frequently included in support networks, but provided distinctive types of support. If navigators can identify patients with poorly integrated (less dense) social networks, or who have unmet tangible support needs, the intensity of navigation services could be tailored. Services and systems that address gaps and variations in patient social networks should be explored for their potential to reduce cancer health disparities. This study used a new method to identify the breadth and strength of social support following a diagnosis of breast cancer, especially examining the role of patient navigators in providing support. While navigators were only included in one quarter of patient support networks, they did provide essential supports to some individuals. Health care providers and systems need to better understand the contributions of social supports both within and outside of health care to design and tailor interventions that seek to reduce health care disparities and improve cancer outcomes. © AlphaMed Press 2017.

An alternative approach to solar system exploration providing safety of human mission to Mars.

PubMed

Gitelson, J I; Bartsev, S I; Mezhevikin, V V; Okhonin, V A

2003-01-01

For systematic human Mars exploration, meeting crew safety requirements, it seems perspective to assemble into a spacecraft: an electrical rocket, a well-shielded long-term life support system, and a manipulator-robots operating in combined "presence effect" and "master-slave" mode. The electrical spacecraft would carry humans to the orbit of Mars, providing short distance (and low signal time delay) between operator and robot-manipulators, which are landed on the surface of the planet. Long-term hybrid biological and physical/chemical LSS could provide environment supporting human health and well being. Robot-manipulators operating in "presence effect" and "master-slave" mode exclude necessity of human landing on Martian surface decreasing the level of risk for crew. Since crewmen would not have direct contact with the Martian environment then the problem of mutual biological protection is essentially reduced. Lightweight robot-manipulators, without heavy life support systems and without the necessity of returning to the mother vessel, could be sent as scouts to different places on the planet surface, scanning the most interesting for exobiological research site. Some approximate estimations of electric spacecraft, long-term hybrid LSS, radiation protection and mission parameters are conducted and discussed. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

International Collaboration in Satellite Observations for Disaster Management

NASA Technical Reports Server (NTRS)

Duda, Kenneth A.; Abrams, Michael

2012-01-01

When lives are threatened or lost due to catastrophic disasters, and when massive financial impacts are experienced, international emergency response teams rapidly mobilize to provide urgently required support. Satellite observations of affected areas often provide essential insight into the magnitude and details of the impacts. The large cost and high complexity of developing and operating satellite flight and ground systems encourages international collaboration in acquiring imagery for such significant global events in order to speed delivery of critical information to help those affected, and optimize spectral, spatial, and temporal coverage of the areas of interest. The International Charter-Space and Major Disasters was established to enable such collaboration in sensor tasking during times of crisis and is often activated in response to calls for assistance from authorized users. Insight is provided from a U.S. perspective into sensor support for Charter activations and other disaster events through a description of the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), which has been used to support emergency situations for over a decade through its expedited tasking and near real-time data delivery capabilities. Examples of successes achieved and challenges encountered in international collaboration to develop related systems and fulfill tasking requests suggest operational considerations for new missions as well as areas for future enhancements.

ASTER satellite observations for international disaster management

USGS Publications Warehouse

Duda, K.A.; Abrams, M.

2012-01-01

When lives are threatened or lost due to catastrophic disasters, and when massive financial impacts are experienced, international emergency response teams rapidly mobilize to provide urgently required support. Satellite observations of affected areas often provide essential insight into the magnitude and details of the impacts. The large cost and high complexity of developing and operating satellite flight and ground systems encourages international collaboration in acquiring imagery for such significant global events in order to speed delivery of critical information to help those affected, and optimize spectral, spatial, and temporal coverage of the areas of interest. The International Charter-Space and Major Disasters was established to enable such collaboration in sensor tasking during times of crisis and is often activated in response to calls for assistance from authorized users. Insight is provided from a U.S. perspective into sensor support for Charter activations and other disaster events through a description of the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), which has been used to support emergency situations for over a decade through its expedited tasking and near real-time data delivery capabilities. Examples of successes achieved and challenges encountered in international collaboration to develop related systems and fulfill tasking requests suggest operational considerations for new missions as well as areas for future enhancements.

In vitro 3D corneal tissue model with epithelium, stroma, and innervation.

PubMed

Wang, Siran; Ghezzi, Chiara E; Gomes, Rachel; Pollard, Rachel E; Funderburgh, James L; Kaplan, David L

2017-01-01

The interactions between corneal nerve, epithelium, and stroma are essential for maintaining a healthy cornea. Thus, corneal tissue models that more fully mimic the anatomy, mechanical properties and cellular components of corneal tissue would provide useful systems to study cellular interactions, corneal diseases and provide options for improved drug screening. Here a corneal tissue model was constructed to include the stroma, epithelium, and innervation. Thin silk protein film stacks served as the scaffolding to support the corneal epithelial and stromal layers, while a surrounding silk porous sponge supported neuronal growth. The neurons innervated the stromal and epithelial layers and improved function and viability of the tissues. An air-liquid interface environment of the corneal tissue was also mimicked in vitro, resulting in a positive impact on epithelial maturity. The inclusion of three cell types in co-culture at an air-liquid interface provides an important advance for the field of in vitro corneal tissue engineering, to permit improvements in the study of innervation and corneal tissue development, corneal disease, and tissue responses to environmental factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

In Vitro Evaluation of Essential Oils Derived from Piper nigrum (Piperaceae) and Citrus limonum (Rutaceae) against the Tick Rhipicephalus (Boophilus) microplus (Acari: Ixodidae)

PubMed Central

Nogueira, Jeane; Rocha, Leandro; Castro, Helena C.

2017-01-01

The present research aimed to study the chemical composition and acaricidal activity of Citrus limonum and Piper nigrum essential oils against the cattle tick Rhipicephalus microplus. GC-MS analysis of C. limonum essential oil showed limonene (50.3%), β-pinene (14.4%), and γ-terpinene (11.7%) as the major components; P. nigrum oil was mainly composed of β-caryophyllene (26.2%), σ-ocymene (5.8%), and α-pinene (5.5%). Acaricide activity was evaluated at concentrations of 2.5, 5.0, and 10.0% (v/v) of each plant oil, as well as 1 : 1 combination of both oils (5% : 5%, 2.5% : 2.5%, and 1.25% : 1.25% each), by immersing engorged R. microplus females for one minute. The LC90 of oils from C. limonum, P. nigrum, and the combination were 4.9%, 14.8%, and 5.1%, respectively. C. limonum essential oil caused 100% mortality of engorged females at the highest concentration (10%). P. nigrum essential oil inhibited egg-laying by up to 96% in a concentration-dependent manner, suggesting it reduces tick fecundity. When combined, the oils presented toxicity as to C. limonum oil alone, but with stronger inhibition of oviposition (5% : 5%), indicating a possible additive effect against R. microplus. The present data provide support for further investigation of novel natural products to control bovine tick infestations. PMID:29123924

In Vitro Evaluation of Essential Oils Derived from Piper nigrum (Piperaceae) and Citrus limonum (Rutaceae) against the Tick Rhipicephalus (Boophilus) microplus (Acari: Ixodidae).

PubMed

Vinturelle, Rafaelle; Mattos, Camila; Meloni, Jéssica; Nogueira, Jeane; Nunes, Maria Júlia; Vaz, Itabajara S; Rocha, Leandro; Lione, Viviane; Castro, Helena C; Chagas, Evelize Folly das

2017-01-01

The present research aimed to study the chemical composition and acaricidal activity of Citrus limonum and Piper nigrum essential oils against the cattle tick Rhipicephalus microplus . GC-MS analysis of C. limonum essential oil showed limonene (50.3%), β -pinene (14.4%), and γ -terpinene (11.7%) as the major components; P. nigrum oil was mainly composed of β -caryophyllene (26.2%), σ -ocymene (5.8%), and α -pinene (5.5%). Acaricide activity was evaluated at concentrations of 2.5, 5.0, and 10.0% (v/v) of each plant oil, as well as 1 : 1 combination of both oils (5% : 5%, 2.5% : 2.5%, and 1.25% : 1.25% each), by immersing engorged R. microplus females for one minute. The LC90 of oils from C. limonum, P. nigrum, and the combination were 4.9%, 14.8%, and 5.1%, respectively. C. limonum essential oil caused 100% mortality of engorged females at the highest concentration (10%). P. nigrum essential oil inhibited egg-laying by up to 96% in a concentration-dependent manner, suggesting it reduces tick fecundity. When combined, the oils presented toxicity as to C. limonum oil alone, but with stronger inhibition of oviposition (5% : 5%), indicating a possible additive effect against R. microplus . The present data provide support for further investigation of novel natural products to control bovine tick infestations.

Women's experiences of social support during the first year following primary breast cancer surgery.

PubMed

Drageset, Sigrunn; Lindstrøm, Torill Christine; Giske, Tove; Underlid, Kjell

2016-06-01

The aim of this qualitative follow-up study was to describe women's individual experiences of social support during their first year after primary breast cancer surgery. Individual semi-structured interviews with 10 women 1 year after surgery analysed by Kvales' meaning condensation method. Sharing experiences, being understood as an individual, continuity, and information and explanations were themes identified. Sharing mutual experiences increased the women's knowledge regarding cancer, increased experience of support and minimised rumination. After 1 year, the women felt that the network around them had 'normalised' and was less supportive. Being seen as a person, not as 'a diagnosis being treated', and continuity of professional support were important, giving feelings of security and trust. The women felt uncertainty after loss of professional support post-treatment. Information and explanations regarding treatment and treatment-related problems were essential. Mutual sharing of experiences is an important part of social support. Continuity, availability, information and respect were essential aspects of experienced professional support. © 2015 Nordic College of Caring Science.

Operator Support System Design forthe Operation of RSG-GAS Research Reactor

NASA Astrophysics Data System (ADS)

Santoso, S.; Situmorang, J.; Bakhri, S.; Subekti, M.; Sunaryo, G. R.

2018-02-01

The components of RSG-GAS main control room are facing the problem of material ageing and technology obsolescence as well, and therefore the need for modernization and refurbishment are essential. The modernization in control room can be applied on the operator support system which bears the function in providing information for assisting the operator in conducting diagnosis and actions. The research purpose is to design an operator support system for RSG-GAS control room. The design was developed based on the operator requirement in conducting task operation scenarios and the reactor operation characteristics. These scenarios include power operation, low power operation and shutdown/scram reactor. The operator support system design is presented in a single computer display which contains structure and support system elements e.g. operation procedure, status of safety related components and operational requirements, operation limit condition of parameters, alarm information, and prognosis function. The prototype was developed using LabView software and consisted of components structure and features of the operator support system. Information of each component in the operator support system need to be completed before it can be applied and integrated in the RSG-GAS main control room.

High Altitude Platforms for Disaster Recovery: Capabilities, Strategies, and Techniques for Providing Emergency Telecommunications

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

Juan D. Deaton

2008-05-01

Natural disasters and terrorist acts have significant potential to disrupt emergency communication systems. These emergency communication networks include first-responder, cellular, landline, and emergency answering services such as 911, 112, or 999. Without these essential emergency communications capabilities, search, rescue, and recovery operations during a catastrophic event will be severely debilitated. High altitude platforms could be fitted with telecommunications equipment and used to support these critical communications missions once the catastrophic event occurs. With the ability to be continuously on station, HAPs provide excellent options for providing emergency coverage over high-risk areas before catastrophic incidents occur. HAPs could also provide enhancedmore » 911 capabilities using either GPS or reference stations. This paper proposes potential emergency communications architecture and presents a method for estimating emergency communications systems traffic patterns for a catastrophic event.« less

Hospital at night: an organizational design that provides safer care at night

PubMed Central

2014-01-01

The reduction in the working hours of doctors represents a challenge to the delivery of medical care to acutely sick patients 24 hours a day. Increasing the number of doctors to support multiple specialty rosters is not the solution for economic or organizational reasons. This paper outlines an alternative, economically viable multidisciplinary solution that has been shown to improve patient outcomes and provides organizational consistency. The change requires strong clinical leadership, with organizational commitment to both cultural and structural change. Careful attention to ensuring the teams possess the appropriate competencies, implementing a reliable process to identify the sickest patients and escalate their care, and structuring rotas efficiently are essential features of success. PMID:25561063

A commitment to high-value care education from the internal medicine community.

PubMed

Smith, Cynthia D; Levinson, Wendy S

2015-05-05

The Alliance for Academic Internal Medicine, American Board of Internal Medicine (ABIM), ABIM Foundation, and American College of Physicians are collaborating to enhance the education of physicians in high-value care (HVC) and make its practice an essential competency in undergraduate and postgraduate education by 2017. This article serves as the organizations' formal commitment to providing a foundation of HVC education on which others may build. The 5 key targets for HVC education are experiential learning and curriculum, environment and culture, clinical support, regulatory requirements, and sustainability. The goal is to train future health care professionals for whom HVC is part of normal practice, thus providing patients with improved clinical outcomes at a lower cost.

Plants Consumption and Liver Health

PubMed Central

He, Qing

2015-01-01

The liver is a very important organ with a lot of functions for the host to survive. Dietary components are essential for and can be beneficial or detrimental to the healthy or diseased liver. Plants food is an essential part of the human diet and comprises various compounds which are closely related to liver health. Selected food plants can provide nutritional and medicinal support for liver disease. At the present, the knowledge of the effects of plants on the liver is still incomplete. The most urgent task at the present time is to find the best dietary and medicinal plants for liver health in an endless list of candidates. This review article updates the knowledge about the effects of plants consumption on the health of the liver, putting particular emphasis on the potential beneficial and harmful impact of dietary and medicinal plants on liver function. PMID:26221179

Fish movement ecology in high gradient headwater streams: Its relevance to fish passage restoration through stream culvert barriers

USGS Publications Warehouse

Hoffman, Robert L.; Dunham, Jason B.

2007-01-01

Restoration of fish passage through culvert barriers has emerged as a major issue in the Pacific Northwest and nationwide, in part, because of their potential influence on fish movement. Movement is an essential mechanism by which mobile animals acquire the resources necessary for the successful completion of their life-cycles. In this report, we provide a brief review of some essential characteristics of animal movement and examples from a focal group of fishes in Washington State: salmon, trout, and char. We begin by outlining some basic characteristics of animal movement and then apply that foundation to the case of salmonid fishes. Next we consider the consequences of disrupting fish movement with human-constructed barriers, such as culverts. Finally, this body of evidence is summarized, and we propose a short list of what we view as high priority information needs to support more effective restoration of fish passage through culverts.

Sustained choroid plexus function in human elderly and Alzheimer's disease patients.

PubMed

Spector, Reynold; Johanson, Conrad E

2013-09-24

We and other investigators have postulated deterioration of essential choroid plexus (CP) functions in some elderly and especially Alzheimer's disease patients based on apparent anatomical, histological and pathological changes in CP. We have termed this putative phenomenon CP failure. By focusing on four essential energy-requiring CP functions, specifically ascorbic acid (AA) and folate transport from blood into CSF, transthyretin synthesis and secretion into CSF, and electrolyte/acid-base balance in CSF, we were able to evaluate the hypothesis of CP failure by reviewing definitive human data. In both healthy elderly and Alzheimer's disease patients, the CP functions normally to transport AA and folates actively from blood into CSF, synthesize and secrete transthyretin into CSF, and maintain CSF acid-base balance and ion concentrations. These human CSF compositional data provide no support for the notion of CP failure in elderly humans and Alzheimer's disease patients.

Eliciting probabilistic expectations: Collaborations between psychologists and economists

PubMed Central

Bruine de Bruin, Wändi

2017-01-01

We describe two collaborations in which psychologists and economists provided essential support on foundational projects in major research programs. One project involved eliciting adolescents’ expectations regarding significant future life events affecting their psychological and economic development. The second project involved eliciting consumers’ expectations regarding inflation, a potentially vital input to their investment, saving, and purchasing decisions. In each project, we sought questions with the precision needed for economic modeling and the simplicity needed for lay respondents. We identify four conditions that, we believe, promoted our ability to sustain these transdisciplinary collaborations and coproduce the research: (i) having a shared research goal, which neither discipline could achieve on its own; (ii) finding common ground in shared methodology, which met each discipline’s essential evidentiary conditions, but without insisting on its culturally acquired tastes; (iii) sharing the effort throughout, with common language and sense of ownership; and (iv) gaining mutual benefit from both the research process and its products. PMID:28270610

Eliciting probabilistic expectations: Collaborations between psychologists and economists.

PubMed

Bruine de Bruin, Wändi; Fischhoff, Baruch

2017-03-28

We describe two collaborations in which psychologists and economists provided essential support on foundational projects in major research programs. One project involved eliciting adolescents' expectations regarding significant future life events affecting their psychological and economic development. The second project involved eliciting consumers' expectations regarding inflation, a potentially vital input to their investment, saving, and purchasing decisions. In each project, we sought questions with the precision needed for economic modeling and the simplicity needed for lay respondents. We identify four conditions that, we believe, promoted our ability to sustain these transdisciplinary collaborations and coproduce the research: ( i ) having a shared research goal, which neither discipline could achieve on its own; ( ii ) finding common ground in shared methodology, which met each discipline's essential evidentiary conditions, but without insisting on its culturally acquired tastes; ( iii ) sharing the effort throughout, with common language and sense of ownership; and ( iv ) gaining mutual benefit from both the research process and its products.

The national mobile health worker project in England.

PubMed

Drayton, Kathryn; Robinson, Karen

2014-01-01

Community services provide essential care to many, often vulnerable, people, families and communities along the spectrum from health promotion to end of life care. The Mobile Health Worker Project is part of a larger project, the Transforming Community Services programme, which was established to support providers make changes to service provision that would provide better health outcomes, as well as increasing efficiency through the use of technology. This paper draws on the results of the two phase Mobile Health Worker project which involved 11 sites around England, the aim of which was to understand the requirements of mobile working. The results demonstrate that increased productivity and efficiency can be achieved by making changes to working processes. The project also provides guidance to increase the rate of mobile working adoption by providing a solid economic basis for investment in and deployment of mobile solutions to community organisations.

A Climate Information Platform for Copernicus (CLIPC): managing the data flood

NASA Astrophysics Data System (ADS)

Juckes, Martin; Swart, Rob; Bärring, Lars; Groot, Annemarie; Thysse, Peter; Som de Cerff, Wim; Costa, Luis; Lückenkötter, Johannes; Callaghan, Sarah; Bennett, Victoria

2016-04-01

The FP7 project "Climate Information Platform for Copernicus" (CLIPC) is developing a demonstration portal for the Copernicus Climate Change Service (C3S). The project confronts many problems associated with the huge diversity of underlying data, complex multi-layered uncertainties and extremely complex and evolving user requirements. The infrastructure is founded on a comprehensive approach to managing data and documentation, using global domain independent standards where possible. An extensive thesaurus of terms provides both a robust and flexible foundation for data discovery services and accessible definitions to support users. It is, of course, essential to provide information to users through an interface which reflects their expectations rather than the intricacies of abstract data models. CLIPC has reviewed user engagement activities from other collaborative European projects, conducted user polls, interviews and meetings and is now entering an evaluation phase in which users discuss new features and options in the portal design. The CLIPC portal will provide access to raw climate science data and climate impact indicators derived from that data. The portal needs the flexibility to support access to extremely large datasets as well as providing means to manipulate data and explore complex products interactively.

Cardio-Facio-Cutaneous Syndrome: Clinical Features, Diagnosis, and Management Guidelines

PubMed Central

Magoulas, Pilar L.; Adi, Saleh; Kavamura, Maria Ines; Neri, Giovanni; Noonan, Jacqueline; Pierpont, Elizabeth I.; Reinker, Kent; Roberts, Amy E.; Shankar, Suma; Sullivan, Joseph; Wolford, Melinda; Conger, Brenda; Santa Cruz, Molly; Rauen, Katherine A.

2014-01-01

Cardio-facio-cutaneous syndrome (CFC) is one of the RASopathies that bears many clinical features in common with the other syndromes in this group, most notably Noonan syndrome and Costello syndrome. CFC is genetically heterogeneous and caused by gene mutations in the Ras/mitogen-activated protein kinase pathway. The major features of CFC include characteristic craniofacial dysmorphology, congenital heart disease, dermatologic abnormalities, growth retardation, and intellectual disability. It is essential that this condition be differentiated from other RASopathies, as a correct diagnosis is important for appropriate medical management and determining recurrence risk. Children and adults with CFC require multidisciplinary care from specialists, and the need for comprehensive management has been apparent to families and health care professionals caring for affected individuals. To address this need, CFC International, a nonprofit family support organization that provides a forum for information, support, and facilitation of research in basic medical and social issues affecting individuals with CFC, organized a consensus conference. Experts in multiple medical specialties provided clinical management guidelines for pediatricians and other care providers. These guidelines will assist in an accurate diagnosis of individuals with CFC, provide best practice recommendations, and facilitate long-term medical care. PMID:25180280

[Communicating about breastfeeding in a child and family-centered care approach].

PubMed

Girard, L

2013-09-01

Breastfeeding is a public health issue: health expenditures related to not breastfeeding have been evaluated in the US and the UK, annually amounting to billions of dollars and tens of millions of pounds. Breastfeeding is also a family issue, and this intimate practice involves the presence of emotions and feelings going beyond rationality. Healthcare professionals are responsible for promoting health in the physical, mental, and social domains. Information and individualized support are essential to enable parents to make the best possible choice and play an active role in their own health and that of their child. There are communication and support tools to help build a trusting relationship between professionals and parents, to provide relevant information, and to assist parents in their reflection, while supporting them in their choices. In France, healthcare professionals have available a tool for intervention and education proposed by the French Institute for Health Promotion and Health Education (Institut national de prévention et d'éducation pour la santé, INPES) in the Pregnancy and Parenting section. It provides a high degree of homogeneity in the various healthcare professional's interventions occurring during pregnancy and thereafter. It aims to promote and strengthen parenting skills. Thus, support for breastfeeding is part of a dynamic process to support parenting, focused on people, not on the object, for both ethical and effectiveness reasons. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Online extremism and the communities that sustain it: Detecting the ISIS supporting community on Twitter.

PubMed

Benigni, Matthew C; Joseph, Kenneth; Carley, Kathleen M

2017-01-01

The Islamic State of Iraq and ash-Sham (ISIS) continues to use social media as an essential element of its campaign to motivate support. On Twitter, ISIS' unique ability to leverage unaffiliated sympathizers that simply retweet propaganda has been identified as a primary mechanism in their success in motivating both recruitment and "lone wolf" attacks. The present work explores a large community of Twitter users whose activity supports ISIS propaganda diffusion in varying degrees. Within this ISIS supporting community, we observe a diverse range of actor types, including fighters, propagandists, recruiters, religious scholars, and unaffiliated sympathizers. The interaction between these users offers unique insight into the people and narratives critical to ISIS' sustainment. In their entirety, we refer to this diverse set of users as an online extremist community or OEC. We present Iterative Vertex Clustering and Classification (IVCC), a scalable analytic approach for OEC detection in annotated heterogeneous networks, and provide an illustrative case study of an online community of over 22,000 Twitter users whose online behavior directly advocates support for ISIS or contibutes to the group's propaganda dissemination through retweets.

Diabetes is a community issue: the critical elements of a successful outreach and education model on the U.S.-Mexico border.

PubMed

Ingram, Maia; Gallegos, Gwen; Elenes, JoJean

2005-01-01

Diabetes is reaching epidemic proportions on the U.S.-Mexico Border, and culturally competent diabetes education is not available in many communities. People with diabetes often do not have access to regular medical care, cannot afford medication, and lack the community infrastructure that supports self-management practices. Self-management education and support have great potential to impact diabetes control in this environment. To address this need, partners of the Border Health Strategic Initiative (Border Health iSI!) collaboratively developed a culturally relevant diabetes outreach and education program. The model included a five-week series of free diabetes education classes that assisted participants in gaining the knowledge and skills necessary to be physically active, control diet, monitor blood sugar, take medications, and be aware of complications. Central to the model was the use of community health workers - or promotores de salud - to conduct outreach, participate in patient education, and provide individual support. Program participants achieved significant improvements in self-management behaviors and HbA1c, random blood glucose, and blood pressure levels. Quantitative and qualitative evaluation helped to identify the essential elements of a successful program, including partnership of providers, community diabetes classes, promotores outreach and support, linkage between diabetes education and clinical care, and program evaluation.

"Preventing the pain" when working with family and sexual violence in primary care.

PubMed

Coles, Jan; Dartnall, Elizabeth; Astbury, Jill

2013-01-01

Primary care professionals (PCPs) are increasingly being expected to identify and respond to family and sexual violence as the chronic nature and severity of the long-term health impacts are increasingly recognized. This discussion paper reports the authors' expert opinion from their experiences running international workshops to prevent trauma among those who work and research sexual violence. It describes the burnout and secondary traumatic stress literature which provides the evidence supporting their work. Implications for practicing basic training in response to trauma and ongoing education are a key area for responding to family violence and preventing professional stress. A professional culture that supports and values caring well for those who have experienced family violence as well as "caring for the carer" is needed. Working in teams and having more support systems in place are likely to protect PCPs from secondary traumatic stress and burnout. Undergraduate and postgraduate training of PCPs to develop trauma knowledge and the skills to ask about and respond to family violence safely are essential. In addition, the healthcare system, workplace, and the individual practitioner support structures need to be in place to enable PCPs to provide safe and effective long-term care and access to other appropriate services for those who have experienced family violence.

Where we are now and how we can improve: a qualitative study of practitioners' perspectives on providing ART adherence support in Romania.

PubMed

Dima, Alexandra Lelia; Linn, Annemiek J; Schweitzer, Ana-Maria

2016-01-01

Supporting medication adherence is a priority in HIV care worldwide as low adherence threatens the effectiveness of antiretroviral treatment (ART). While evidence on adherence causes and consequences has steadily accumulated, investigating current practice and relevant determinants of practitioners' behaviors has only recently been highlighted as essential for developing effective and sustainable interventions. In Romania, ART adherence is low despite universal access to HIV care, and improving support services is a priority. We report a qualitative exploration of practitioners' experiences and views on ART adherence support, guided by current behavioral theory. Semi-structured interviews were performed with 10 practitioners from six HIV centers, aiming for maximum variation sampling on professional experience, location, and organization type. Questions addressed practitioners' views and experiences on assessing patients' adherence behaviors and determinants, content and format of adherence support, and perceived influences on their capacity to deliver support. Verbatim transcripts were analyzed via template analysis. Results show that adherence support is provided in Romania by trained psychologists in multidisciplinary teams that operate flexibly and perform multiple HIV care activities. Assessment of adherence behaviors and determinants is primarily interview-based, and practitioners use mostly psychotherapeutic techniques and theories with a degree of intervention tailoring. Practitioners' descriptions covered a broad range of common determinants and behavior change techniques, but showed limited use of behavioral theory. Participants also described difficulties to cope with limited resources, and lack of support for managing practical and emotional challenges. Several opportunities for improvement were identified, such as standardizing patient profiling and intervention delivery, conceptualizing and recording active intervention content based on behavioral theory, and actively monitoring intervention effectiveness. This qualitative inquiry provided valuable information for improving adherence support in this clinical context. Understanding practitioners' perspectives based on behavioral theory-informed analyses can help intervention developers increase intervention fidelity by integrating current practice information in program design.

20 CFR 416.1220 - Property essential to self-support; general.

Code of Federal Regulations, 2011 CFR

2011-04-01

... and supplies, motor vehicles, and tools, etc.) used in a trade or business (as defined in § 404.1066... activities. Liquid resources other than those used as part of a trade or business are not property essential...

Critical incident stress management (CISM) in support of special agents and other first responders responding to the Fort Hood shooting: summary and recommendations.

PubMed

Strand, Russell; Felices, Karina; Williams, Kenneth

2010-01-01

On November 5, 2009, an individual entered the Fort Hood Soldier Readiness Processing (SRP) site and opened fire with a handgun. The result of the shooting was a total of 13 people killed and 31 wounded. A two-person critical incident peer support (CIPS) team from the United States Army Military Police School (USAMPS) provided critical incident stress management (CISM) in the forms of critical incident stress debriefings (CISD) and one-on-one crisis intervention for investigators and their spouses. This article provides a summary and discussion of the results of the interventions that were conducted. Key results for successful CISM were accessibility of CIPS team, the credibility of trained peers and the development of supportive relationships, the reduction of stigma by requiring attendance at interventions, and the commitment of the CIPS team to the principles of CISM (e.g., homogenous groups, utilizing a multicomponent approach, and facilitating the normalization of emotional reactions to the crisis). Recommendations include mandating critical incident peer support cells for Criminal Investigation Division (CID) units, Director of Emergency Services (DES) on military installations, and Military Police units; providing a pool of trained peers in the above-mentioned organizations; providing permanent funding for USAMPS' CIPS Course; and recognition of CIPS/CISMas an essential element of Comprehensive Soldier Fitness and Army Human Capital in promoting Soldier Family, and Civilian well-being and resiliency. This article would benefit leaders, chaplains, mental health professionals, and emergency services personnel in investigative, operational, and U.S. Army Garrison units.

The dimensions of responsiveness of a health system: a Taiwanese perspective.

PubMed

Hsu, Chih-Cheng; Chen, Likwang; Hu, Yu-Whuei; Yip, Winnie; Shu, Chen-Chun

2006-03-17

Responsiveness is an indicator used to measure how well a health system performs relative to non-health aspects. This study assessed whether seven dimensions proposed by the World Health Organization (WHO) to measure responsiveness (dignity, autonomy, confidentiality, prompt attention, social support, basic amenities, and choices of providers) are applicable in evaluating the health system of Taiwan. A key informant survey and focus group research were used in this study. The translated WHO proposed questionnaire was sent to 205 nominated key informants by mail, and 132 (64.4%) were returned. We used principal component analysis to extract factors. Linear regression analysis was used to assess the relationship between the total score and the extracted factors. A qualitative content analysis was also carried out in focus group research. Principal component analysis produced five factors (respect, access, confidentiality, basic amenities, and social support) that explained 63.5% of the total variances. These five factors demonstrated acceptable internal consistency and four of them (except social support) were significantly correlated with the total responsiveness score. The focus group interviews revealed health providers' communication ability and medical ethics were also highly appraised by Taiwanese. When the performance of a health system is to be evaluated, elements of responsiveness proposed by WHO may have to be tailored to fit different cultural backgrounds. Four key features illustrate the uniqueness of Taiwanese perspectives: the idea of autonomy may not be conceptualized, prompt attention and choice of providers are on the same track, social support during care is trivially correlated to the total responsiveness score, and accountability of health providers is deemed essential to a health system.

The facilitators and impediment factors of structural empowerment in pregnancy and delivery care: achievement of power

PubMed Central

Janighorban, M; Yousefi, H; Yamani, N

2015-01-01

Background: The organizations essentially affect empowerment of personnel through the preparation of the needed grounds for them. Also, the students may acquire the required potentials and capabilities in the educational organizations when the possibility is provided to them to access power and opportunity in educational environments. Objective: The present study aimed to explain the facilitators and impediment factors of structural empowerment in pregnancy and delivery care. Methods: According to Kanter’s theory, this qualitative study was conducted with the participation of 15 superior midwifery students, ten academic teachers of midwifery, and two midwives employed in the educational hospitals. Data were collected by semi-structured interviews individually and in the group and analyzed by using a directed content analysis method. Results: To explain the facilitators and impediment factors of empowerment in pregnancy and delivery care in the power structure, the access was provided to a support formed by three broad categories of support from the instructors, support from personnel, and support from a classmate. The access to resources was created with three broad categories of access to the appropriate clinical environment, to the laboratory of clinical skills and to information sources, and to information, forming with two broad categories of awareness of the educational objectives as well as legal and legitimate issues. Conclusion: One could prepare the ground for the midwifery students to access this empowerment in pregnancy and delivery cares more than ever by providing equipped clinical environments and the presence of all-inclusive supportive climate in such environments. Along with the efficient training of students in the laboratory PMID:28316710

The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature.

PubMed

Georgiou, Andrew; Prgomet, Mirela; Paoloni, Richard; Creswick, Nerida; Hordern, Antonia; Walter, Scott; Westbrook, Johanna

2013-06-01

We undertake a systematic review of the quantitative literature related to the effect of computerized provider order entry systems in the emergency department (ED). We searched MEDLINE, EMBASE, Inspec, CINAHL, and CPOE.org for English-language studies published between January 1990 and May 2011. We identified 1,063 articles, of which 22 met our inclusion criteria. Sixteen used a pre/post design; 2 were randomized controlled trials. Twelve studies reported outcomes related to patient flow/clinical work, 7 examined decision support systems, and 6 reported effects on patient safety. There were no studies that measured decision support systems and its effect on patient flow/clinical work. Computerized provider order entry was associated with an increase in time spent on computers (up to 16.2% for nurses and 11.3% for physicians), with no significant change in time spent on patient care. Computerized provider order entry with decision support systems was related to significant decreases in prescribing errors (ranging from 17 to 201 errors per 100 orders), potential adverse drug events (0.9 per 100 orders), and prescribing of excessive dosages (31% decrease for a targeted set of renal disease medications). There are tangible benefits associated with computerized provider order entry/decision support systems in the ED environment. Nevertheless, when considered as part of a framework of technical, clinical, and organizational components of the ED, the evidence base is neither consistent nor comprehensive. Multimethod research approaches (including qualitative research) can contribute to understanding of the multiple dimensions of ED care delivery, not as separate entities but as essential components of a highly integrated system of care. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Nation-wide primary healthcare research network: a privacy protection assessment.

PubMed

De Clercq, Etienne; Van Casteren, Viviane; Bossuyt, Nathalie; Moreels, Sarah; Goderis, Geert; Bartholomeeusen, Stefaan; Bonte, Pierre; Bangels, Marc

2012-01-01

Efficiency and privacy protection are essential when setting up nationwide research networks. This paper investigates the extent to which basic services developed to support the provision of care can be re-used, whilst preserving an acceptable privacy protection level, within a large Belgian primary care research network. The generic sustainable confidentiality management model used to assess the privacy protection level of the selected network architecture is described. A short analysis of the current architecture is provided. Our generic model could also be used in other countries.

Space Station Freedom CHeCS overview. [Crew Health Care System

NASA Technical Reports Server (NTRS)

Boyce, Joey B.

1990-01-01

The current status, progress, and future plans for development of the Crew Health Care System (CHeCS) for the International Space Station Freedom are presented. Essential operational biomedical support requirements for the astronauts, including medical care, environmental habitat monitoring, and countermeasures for the potentially maladaptive physiological effects of space flight will be provided by the CHeCS. Three integral parts will make up the system: a health maintenance facility, an environmental health system, and the exercise countermeasures facility. Details of each of the major systems and their subsystems are presented.

Food production & availability--essential prerequisites for sustainable food security.

PubMed

Swaminathan, M S; Bhavani, R V

2013-09-01

Food and nutrition security are intimately interconnected, since only a food based approach can help in overcoming malnutrition in an economically and socially sustainable manner. Food production provides the base for food security as it is a key determinant of food availability. This paper deals with different aspects of ensuring high productivity and production without associated ecological harm for ensuring adequate food availability. By mainstreaming ecological considerations in technology development and dissemination, we can enter an era of evergreen revolution and sustainable food and nutrition security. Public policy support is crucial for enabling this.

New technology of underground structures the framework of restrained urban conditions

NASA Astrophysics Data System (ADS)

Pleshko, Mikhail; Pankratenko, Alexander; Revyakin, Alexey; Shchekina, Ekaterina; Kholodova, Svetlana

2018-03-01

In the paper was indicated the essentiality of large-scale underground space development and high-rise construction of cities in Russia. The basic elements of transport facilities construction effective technology without traffic restriction are developed. Unlike the well-known solutions, it offers the inclusion of an advanced lining in the construction that strengthens the soil mass. The fundamental principles of methods for determining stress in advanced support and monitoring of underground construction, providing the application of pressure sensors, strain sensors and displacement sensors are considered.

35 Years of Innovation - Leading the Way to a Clean Energy Future (Brochure)

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

Not Available

The U.S. Department of Energy (DOE) National Wind Technology Center (NWTC) at the National Renewable Energy Laboratory (NREL) is at the forefront of energy innovation. For more than three decades, our researchers have built unparalleled expertise in renewable energy technologies while supporting the nation's vision that wind and water can provide clean, reliable, and cost-effective electricity. The NWTC strives to be an essential partner to companies, other DOE laboratories, government agencies, and universities around the world seeking to create a better, more sustainable future.

Just-in-time coding of the problem list in a clinical environment.

PubMed Central

Warren, J. J.; Collins, J.; Sorrentino, C.; Campbell, J. R.

1998-01-01

Clinically useful problem lists are essential to the CPR. Providing a terminology that is standardized and understood by all clinicians is a major challenge. UNMC has developed a lexicon to support their problem list. Using a just-in-time coding strategy, the lexicon is maintained and extended prospectively in a dynamic clinical environment. The terms in the lexicon are mapped to ICD-9-CM, NANDA, and SNOMED International classification schemes. Currently, the lexicon contains 12,000 terms. This process of development and maintenance of the lexicon is described. PMID:9929226

Direct ethanol solid oxide fuel cell operating in gradual internal reforming

NASA Astrophysics Data System (ADS)

Nobrega, S. D.; Galesco, M. V.; Girona, K.; de Florio, D. Z.; Steil, M. C.; Georges, S.; Fonseca, F. C.

2012-09-01

An electrolyte supported solid oxide fuel cell (SOFC) using standard electrodes, doped-lanthanum manganite cathode and Ni-cermet anode, was operated with direct (anhydrous) ethanol for more than 100 h, delivering essentially the same power output as running on hydrogen. A ceria-based layer provides the catalytic activity for the gradual internal reforming, which uses the steam formed by the electrochemical oxidation of hydrogen for the decomposition of ethanol. Such a concept opens up the way for multi-fuel SOFCs using standard components and a catalytic layer.

TOPICAL REVIEW: The stability for the Cauchy problem for elliptic equations

NASA Astrophysics Data System (ADS)

Alessandrini, Giovanni; Rondi, Luca; Rosset, Edi; Vessella, Sergio

2009-12-01

We discuss the ill-posed Cauchy problem for elliptic equations, which is pervasive in inverse boundary value problems modeled by elliptic equations. We provide essentially optimal stability results, in wide generality and under substantially minimal assumptions. As a general scheme in our arguments, we show that all such stability results can be derived by the use of a single building brick, the three-spheres inequality. Due to the current absence of research funding from the Italian Ministry of University and Research, this work has been completed without any financial support.

Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

USGS Publications Warehouse

Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

2016-01-01

Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

Strategically Positioned: Breastfeeding, Advocacy, and the Hands-On Nurse.

PubMed

Gathron, Erika L

2017-08-01

Breastfeeding, a health behavior that provides well-known benefits for mothers, infants, and children, is an essential strategy to improve public health. Breastfeeding can reduce the incidence of infant illness and death and provides both short- and longterm physiological benefits to mothers. National and international government agencies and grassroots organizations supporting breastfeeding include the World Health Organization, the United Nations International Children's Emergency Fund, the World Alliance for Breastfeeding Action, the Centers for Disease Control and Prevention, and the La Leche League. In the United States, breastfeeding of infants was the norm until the late 1890s when the Progressive Era's emphasis on science and modernity led to the transition of childbirth from residential in-home births to community-based hospital births and the aggressive rise of the baby formula industry. By 1966, only 18% of mothers were exclusively breastfeeding their infants at hospital discharge. This drastic decrease in breastfeeding reduced the percentage of mothers and grandmothers who could share their breastfeeding knowledge and experience. Nurses who provide care for women and infants are essential stakeholders in bridging the breastfeeding knowledge gap by offering education on the short- and long-term health benefits of breastfeeding to both mother and baby and timely encouragement to mothers during the most significant time for establishing lactation.

"You Get More Than You Give": Experiences of Community Partners in Facilitating Active Recreation with Individuals who have Complex Communication Needs.

PubMed

Hajjar, David J; McCarthy, John W; Benigno, Joann P; Chabot, Jennifer

2016-06-01

Recreation is an essential part of life that provides enriching experiences that may define one's life course similar to careers or other interests. An understanding of the role of volunteers in active community-based recreational programs can help to generate ways to enhance participation and contribute to additional communication opportunities with people who have complex communication needs. Nine volunteers from two adaptive ski programs and one therapeutic horseback-riding program in the Northeast region of the United States participated in semi-structured interviews. Audio-recordings were transcribed and analyzed and resulted in five thematic areas: (a) benefits, (b) why individuals volunteer, (c) barriers, (d) successful program supports, and (e) who are the riders and skiers using AAC. The findings provided insight to support the notion that active community-based recreational activities foster an environment for communication, meaningful engagement, and social relationships between volunteers and people with complex communication needs.

Upholding the human right of children in New Zealand experiencing communication difficulties to voice their needs and dreams.

PubMed

Doell, Elizabeth; Clendon, Sally

2018-02-01

New Zealand Ministry of Education's proposal for an updated service to support children experiencing communication difficulties provides an opportunity to consider the essential criteria required for children to express their opinion, information and ideas as outlined under Article 19 of the Universal Declaration of Human Rights. This commentary begins with a summary of key policies that provide strategic direction for enhancing children's rights to be actively involved in the development of services designed to support them and to communicate and participate in inclusive environments. The authors use a human rights lens to inform the development of speech-language pathology services that facilitate individuals' contribution and engagement and are responsive to their needs. A review of international literature describing the lived experience of children and young people identifies key factors related to accessible information, service coordination, holistic practice, and partnerships that facilitate co-constructed understanding and decision-making. The commentary concludes with suggested recommendations for structuring services, establishing partnership models, and capability building.

Virtual coach technology for supporting self-care.

PubMed

Ding, Dan; Liu, Hsin-Yi; Cooper, Rosemarie; Cooper, Rory A; Smailagic, Asim; Siewiorek, Dan

2010-02-01

"Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities.

Implementation Pearls from a New Guidebook on Improving Medication Use and Outcomes with Clinical Decision Support

PubMed Central

Sirajuddin, Anwar M; Osheroff, Jerome A.; Sittig, Dean F.; Chuo, John; Velasco, Ferdinand; Collins, David A.

2012-01-01

Effective clinical decision support (CDS) is essential for addressing healthcare performance improvement imperatives, but care delivery organizations (CDO) typically struggle with CDS deployment. Ensuring safe and effective medication delivery to patients is a central focus of CDO performance improvement efforts, and this article provides an overview of best-practice strategies for applying CDS to these goals. The strategies discussed are drawn from a new guidebook, co-published and co-sponsored by more than a dozen leading organizations. Developed by scores of CDS implementers and experts, the guidebook outlines key steps and success factors for applying CDS to medication management. A central thesis is that improving outcomes with CDS interventions requires that the CDS five rights be addressed successfully. That is, the interventions must deliver the right information, to the right person, in the right format, through the right channel, at the right point in workflow. This paper provides further details about these CDS five rights, and highlights other important strategies for successful CDS programs. PMID:19894486

Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

PubMed Central

Ostrow, Laysha; Hayes, Stephania L.

2015-01-01

Objective Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Methods Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N = 380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Results Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. Conclusions These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow. PMID:25639988

Institutional training programs for research personnel conducted by laboratory-animal veterinarians.

PubMed

Dyson, Melissa C; Rush, Howard G

2012-01-01

Research institutions are required by federal law and national standards to ensure that individuals involved in animal research are appropriately trained in techniques and procedures used on animals. Meeting these requirements necessitates the support of institutional authorities; policies for the documentation and enforcement of training; resources to support and provide training programs; and high-quality, effective educational material. Because of their expertise, laboratory-animal veterinarians play an essential role in the design, implementation, and provision of educational programs for faculty, staff, and students in biomedical research. At large research institutions, provision of a training program for animal care and use personnel can be challenging because of the animal-research enterprise's size and scope. At the University of Michigan (UM), approximately 3,500 individuals have direct contact with animals used in research. We describe a comprehensive educational program for animal care and use personnel designed and provided by laboratory-animal veterinarians at UM and discuss the challenges associated with its implementation.

Homophily of Vocabulary Usage: Beneficial Effects of Vocabulary Similarity on Online Health Communities Participation

PubMed Central

Park, Albert; Hartzler, Andrea L.; Huh, Jina; McDonald, David W.; Pratt, Wanda

2015-01-01

Online health communities provide popular platforms for individuals to exchange psychosocial support and form ties. Although regular active participation (i.e., posting to interact with other members) in online health communities can provide important benefits, sustained active participation remains challenging for these communities. Leveraging previous literature on homophily (i.e., “love of those who are like themselves”), we examined the relationship between vocabulary similarity (i.e., homophily of word usage) of thread posts and members’ future interaction in online health communities. We quantitatively measured vocabulary similarity by calculating, in a vector space model, cosine similarity between the original post and the first reply in 20,499 threads. Our findings across five online health communities suggest that vocabulary similarity is a significant predictor of members’ future interaction in online health communities. These findings carry practical implications for facilitating and sustaining online community participation through beneficial effects of homophily in the vocabulary of essential peer support. PMID:26958240

Internationalization of healthcare applications: a generic approach for PACS workstations.

PubMed

Hussein, R; Engelmann, U; Schroeter, A; Meinzer, H P

2004-01-01

Along with the revolution of information technology and the increasing use of computers world-wide, software providers recognize the emerging need for internationalized, or global, software applications. The importance of internationalization comes from its benefits such as addressing a broader audience, making the software applications more accessible, easier to use, more flexible to support and providing users with more consistent information. In addition, some governmental agencies, e.g., in Spain, accept only fully localized software. Although the healthcare communication standards, namely, Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) support wide areas of internationalization, most of the implementers are still protective about supporting the complex languages. This paper describes a generic internationalization approach for Picture Archiving and Communication System (PACS) workstations. The Unicode standard is used to internationalize the application user interface. An encoding converter was developed to encode and decode the data between the rendering module (in Unicode encoding) and the DICOM data (in ISO 8859 encoding). An integration gateway was required to integrate the internationalized PACS components with the different PACS installations. To introduce a pragmatic example, the described approach was applied to the CHILI PACS workstation. The approach has enabled the application to handle the different internationalization aspects transparently, such as supporting complex languages, switching between different languages at runtime, and supporting multilingual clinical reports. In the healthcare enterprises, internationalized applications play an essential role in supporting a seamless flow of information between the heterogeneous multivendor information systems.

Older family carers in rural areas: experiences from using caregiver support services based on Information and Communication Technology (ICT).

PubMed

Blusi, Madeleine; Asplund, Kenneth; Jong, Mats

2013-09-01

The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion . The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.

Oligodendrocyte Regeneration and CNS Remyelination Require TACE/ADAM17.

PubMed

Palazuelos, Javier; Klingener, Michael; Raines, Elaine W; Crawford, Howard C; Aguirre, Adan

2015-09-02

The identification of the molecular network that supports oligodendrocyte (OL) regeneration under demyelinating conditions has been a primary goal for regenerative medicine in demyelinating disorders. We recently described an essential function for TACE/ADAM17 in regulating oligodendrogenesis during postnatal myelination, but it is unknown whether this protein also plays a role in OL regeneration and remyelination under demyelinating conditions. By using genetic mouse models to achieve selective gain- or loss-of-function of TACE or EGFR in OL lineage cells in vivo, we found that TACE is critical for EGFR activation in OLs following demyelination, and therefore, for sustaining OL regeneration and CNS remyelination. TACE deficiency in oligodendrocyte progenitor cells following demyelination disturbs OL lineage cell expansion and survival, leading to a delay in the remyelination process. EGFR overexpression in TACE deficient OLs in vivo restores OL development and postnatal CNS myelination, but also OL regeneration and CNS remyelination following demyelination. Our study reveals an essential function of TACE in supporting OL regeneration and CNS remyelination that may contribute to the design of new strategies for therapeutic intervention in demyelinating disorders by promoting oligodendrocyte regeneration and myelin repair. Oligodendrocyte (OL) regeneration has emerged as a promising new approach for the treatment of demyelinating disorders. By using genetic mouse models to selectively delete TACE expression in oligodendrocyte progenitors cells (OPs), we found that TACE/ADAM17 is required for supporting OL regeneration following demyelination. TACE genetic depletion in OPs abrogates EGFR activation in OL lineage cells, and perturbs cell expansion and survival, blunting the process of CNS remyelination. Moreover, EGFR overexpression in TACE-deficient OPs in vivo overcomes the defects in OL development during postnatal development but also OL regeneration during CNS remyelination. Our study identifies TACE as an essential player in OL regeneration that may provide new insights in the development of new strategies for promoting myelin repair in demyelinating disorders. Copyright © 2015 the authors 0270-6474/15/3512241-07$15.00/0.

Is being a medical educator a lonely business? The essence of social support.

PubMed

van den Berg, Joost W; Verberg, Christel P M; Scherpbier, Albert J J A; Jaarsma, A Debbie C; Lombarts, Kiki M J M H

2017-03-01

Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study describes the essential elements of social support and their meaning for medical educators. We held interviews with medical educators purposefully sampled for diverse backgrounds and working circumstances and who spent a considerable amount of time on education. Both clinicians and basic scientists participated. The Pictor technique guided the interviews. Participants were invited to talk about the breadth of social support and elaborate on meaningful experiences. Template analysis was used for a descriptive phenomenological approach. Thirteen medical educators were interviewed. We identified four themes: (i) sources of support and their intent (e.g. a superior with the intent to stimulate personal growth); (ii) the materialisation of support (e.g. sought or offered); (iii) its manifestation (e.g. the act of providing protected time); and (iv) the overarching effect of social support, both in terms of practical effects and the meaning of support. We identified three sorts of meanings of social support for educators. Receiving support could lead to (i) feeling reassured and confident; (ii) feeling encouraged and determined and (iii) a sense of relatedness and acknowledgement of the educator role. Support for education comes from a wide range of sources because it is both sought and offered beyond the boundaries of the educational role. The resulting differences in support provided necessitate that educational leaders and policymakers consider the sources available to each educator, connecting educators where necessary. When facilitating or designing social support it is important that the need to feel reassured, encouraged or related is met. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Do informal caregivers for elderly in the community use support measures? A qualitative study in five European countries.

PubMed

Willemse, Evi; Anthierens, Sibyl; Farfan-Portet, Maria Isabel; Schmitz, Olivier; Macq, Jean; Bastiaens, Hilde; Dilles, Tinne; Remmen, Roy

2016-07-16

Informal caregivers are essential figures for maintaining frail elderly at home. Providing informal care can affect the informal caregivers' physical and psychological health and labour market participation capabilities. They need support to prevent caregiver burden. A variety of existing support measures can help the caregiver care for the elderly at home, but with some limitations. The objective of this review was to explore the experiences of informal caregivers caring for elderly in the community with the use of supportive policy measures in Belgium and compare these to the experiences in other European countries. An empirical qualitative case study research was conducted in five European countries (Belgium, The Netherlands, Luxembourg, France and Germany). Semi-structured interviews were conducted with informal caregivers and their dependent elderly. Interview data from the different cases were analysed. In particular data from Belgium was compared to data from the cases abroad. Formal services (e.g. home care) were reported to have the largest impact on allowing the caregiver to care for the dependent elderly at home. One of the key issues in Belgium is the lack of timely access to reliable information about formal and informal services in order to proactively support the informal caregiver. Compared to the other countries, informal caregivers in Belgium expressed more difficulties in accessing support measures and navigating through the health system. In the other countries information seemed to be given more timely when home care was provided via care packages. To support the informal caregiver, who is the key person to support the frail elderly, fragmentation of information regarding supportive policy measures is an important issue of concern.

Composite Materials for Thermal Energy Storage: Enhancing Performance through Microstructures

PubMed Central

Ge, Zhiwei; Ye, Feng; Ding, Yulong

2014-01-01

Chemical incompatibility and low thermal conductivity issues of molten-salt-based thermal energy storage materials can be addressed by using microstructured composites. Using a eutectic mixture of lithium and sodium carbonates as molten salt, magnesium oxide as supporting material, and graphite as thermal conductivity enhancer, the microstructural development, chemical compatibility, thermal stability, thermal conductivity, and thermal energy storage performance of composite materials are investigated. The ceramic supporting material is essential for preventing salt leakage and hence provides a solution to the chemical incompatibility issue. The use of graphite gives a significant enhancement on the thermal conductivity of the composite. Analyses suggest that the experimentally observed microstructural development of the composite is associated with the wettability of the salt on the ceramic substrate and that on the thermal conduction enhancer. PMID:24591286

Canto: an online tool for community literature curation.

PubMed

Rutherford, Kim M; Harris, Midori A; Lock, Antonia; Oliver, Stephen G; Wood, Valerie

2014-06-15

Detailed curation of published molecular data is essential for any model organism database. Community curation enables researchers to contribute data from their papers directly to databases, supplementing the activity of professional curators and improving coverage of a growing body of literature. We have developed Canto, a web-based tool that provides an intuitive curation interface for both curators and researchers, to support community curation in the fission yeast database, PomBase. Canto supports curation using OBO ontologies, and can be easily configured for use with any species. Canto code and documentation are available under an Open Source license from http://curation.pombase.org/. Canto is a component of the Generic Model Organism Database (GMOD) project (http://www.gmod.org/). © The Author 2014. Published by Oxford University Press.

Development of an information platform for new grid users in the biomedical field.

PubMed

Skrowny, Daniela; Dickmann, Frank; Löhnhardt, Benjamin; Knoch, Tobias A; Sax, Ulrich

2010-01-01

Bringing new users into grids is a top priority for all grid initiatives and one of the most challenging tasks. Especially in life sciences it is essential to have a certain amount of users to establish a critical mass for a sustainable grid and give feedback back to the technological middleware layer. Based on the presumable lack of grid IT knowledge it is notably more arduous to satisfy user demands although here the requirements are especially demanding. Therefore, the development of an information- and learning platform could support the efforts of grid experts to guide new users. By providing a platform about grid technology and their feasibilities for users of the community of biomedicine potential, users could be supported using the high potential of their discipline.

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.

Essentials of total quality management: a meta-analysis.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

The purpose of this paper is to identify critical successful factors for Total Quality Management (TQM) implementation. A literature review was conducted to explore the critical successful factors for TQM implementation between 1980 and 2010. A successful TQM implementation need sufficient education and training, supportive leadership, consistent support of top management, customer focus, employee involvement, process management and continuous improvement of processes. The review was limited to articles written in English language during the past 30 years. From a practical point of view, the findings of this paper provide managers with a practical understanding of the factors that are likely to facilitate TQM implementation in organisations. Understanding the factors that are likely to promote TQM implementation would enable managers to develop more effective strategies that will enhance the chances of achieving business excellence.

Language plus for international graduate students in nursing.

PubMed

Julian, M A; Keane, A; Davidson, K

1999-01-01

To provide information about an English-language support program that focuses on the needs of international graduate nursing students. The growing presence of these students coincides with the increasing numbers of universities committed to world health. Crucial social and language competence affect the success and progress of international students in graduate nursing programs. Reviewed literature was 1980 to 1998, in nursing and applied linguistic research including second-language acquisition, phonology, discourse analysis, and language pragmatics to identify social and language phenomena. Investigators suggest essential elements such as conventions of academic writing, reading comprehension, vocabulary, and pronunciation skills be included in the supportive Language Plus program. Ongoing development of the Language Plus program can promote collaboration between nurses and linguists and increase the success of international graduate nursing students.

An informatics research agenda to support precision medicine: seven key areas

PubMed Central

Avillach, Paul; Benham-Hutchins, Marge; Breitenstein, Matthew K; Crowgey, Erin L; Hoffman, Mark A; Jiang, Xia; Madhavan, Subha; Mattison, John E; Nagarajan, Radhakrishnan; Ray, Bisakha; Shin, Dmitriy; Visweswaran, Shyam; Zhao, Zhongming; Freimuth, Robert R

2016-01-01

The recent announcement of the Precision Medicine Initiative by President Obama has brought precision medicine (PM) to the forefront for healthcare providers, researchers, regulators, innovators, and funders alike. As technologies continue to evolve and datasets grow in magnitude, a strong computational infrastructure will be essential to realize PM’s vision of improved healthcare derived from personal data. In addition, informatics research and innovation affords a tremendous opportunity to drive the science underlying PM. The informatics community must lead the development of technologies and methodologies that will increase the discovery and application of biomedical knowledge through close collaboration between researchers, clinicians, and patients. This perspective highlights seven key areas that are in need of further informatics research and innovation to support the realization of PM. PMID:27107452

Mars Science Laboratory CHIMRA/IC/DRT Flight Software for Sample Acquisition and Processing

NASA Technical Reports Server (NTRS)

Kim, Won S.; Leger, Chris; Carsten, Joseph; Helmick, Daniel; Kuhn, Stephen; Redick, Richard; Trujillo, Diana

2013-01-01

The design methodologies of using sequence diagrams, multi-process functional flow diagrams, and hierarchical state machines were successfully applied in designing three MSL (Mars Science Laboratory) flight software modules responsible for handling actuator motions of the CHIMRA (Collection and Handling for In Situ Martian Rock Analysis), IC (Inlet Covers), and DRT (Dust Removal Tool) mechanisms. The methodologies were essential to specify complex interactions with other modules, support concurrent foreground and background motions, and handle various fault protections. Studying task scenarios with multi-process functional flow diagrams yielded great insight to overall design perspectives. Since the three modules require three different levels of background motion support, the methodologies presented in this paper provide an excellent comparison. All three modules are fully operational in flight.

Applying Service-Oriented Architecture on The Development of Groundwater Modeling Support System

NASA Astrophysics Data System (ADS)

Li, C. Y.; WANG, Y.; Chang, L. C.; Tsai, J. P.; Hsiao, C. T.

2016-12-01

Groundwater simulation has become an essential step on the groundwater resources management and assessment. There are many stand-alone pre- and post-processing software packages to alleviate the model simulation loading, but the stand-alone software do not consider centralized management of data and simulation results neither do they provide network sharing functions. Hence, it is difficult to share and reuse the data and knowledge (simulation cases) systematically within or across companies. Therefore, this study develops a centralized and network based groundwater modeling support system to assist model construction. The system is based on service-oriented architecture and allows remote user to develop their modeling cases on internet. The data and cases (knowledge) are thus easy to manage centralized. MODFLOW is the modeling engine of the system, which is the most popular groundwater model in the world. The system provides a data warehouse to restore groundwater observations, MODFLOW Support Service, MODFLOW Input File & Shapefile Convert Service, MODFLOW Service, and Expert System Service to assist researchers to build models. Since the system architecture is service-oriented, it is scalable and flexible. The system can be easily extended to include the scenarios analysis and knowledge management to facilitate the reuse of groundwater modeling knowledge.

Cell–scaffold interaction within engineered tissue

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

Chen, Haiping; Liu, Yuanyuan, E-mail: Yuanyuan_liu@shu.edu.cn; Jiang, Zhenglong

The structure of a tissue engineering scaffold plays an important role in modulating tissue growth. A novel gelatin–chitosan (Gel–Cs) scaffold with a unique structure produced by three-dimensional printing (3DP) technology combining with vacuum freeze-drying has been developed for tissue-engineering applications. The scaffold composed of overall construction, micro-pore, surface morphology, and effective mechanical property. Such a structure meets the essential design criteria of an ideal engineered scaffold. The favorable cell–matrix interaction supports the active biocompatibility of the structure. The structure is capable of supporting cell attachment and proliferation. Cells seeded into this structure tend to maintain phenotypic shape and secreted largemore » amounts of extracellular matrix (ECM) and the cell growth decreased the mechanical properties of scaffold. This novel biodegradable scaffold has potential applications for tissue engineering based upon its unique structure, which acts to support cell growth. - Highlights: • The scaffold is not only for providing a surface for cell residence but also for determining cell phenotype and retaining structural integrity. • The mechanical property of scaffold can be affected by activities of cell. • The scaffold provides a microenvironment for cell attachment, growth, and migration.« less

Health and social support services to HIV/AIDS infected individuals in Tanzania: employees and employers perceptions.

PubMed

Kassile, Telemu; Anicetus, Honest; Kukula, Raphael; Mmbando, Bruno P

2014-06-20

HIV is a major public health problem in the world, especially in sub-Saharan Africa. It often leads to loss of productive labour and disruption of existing social support system which results in deterioration of population health. This poses a great challenge to infected people in meeting their essential goods and services. This paper examines health and social support services provided by employers to HIV/AIDS infected employees in Tanzania. This was a cross-sectional study, which employed qualitative and quantitative methods in data collection and analysis. Structured questionnaires and in-depth interviews were used to assess the health and social support services provision at employers and employees perspectives. The study participants were employees and employers from public and private organizations. A total of 181 employees and 23 employers from 23 workplaces aged between 18-68 years were involved. The results show that 23.8% (i.e., 20.4% males and 27.3% females) of the employees had at least one member of the family or close relatives living with HIV at the time of the study. Fifty six percent of the infected employees reported to have been receiving health or social support from their employers. Employees' responses were consistent with those reported by their employers. A total of 12(52.2%) and 11(47.8%) employers reported to have been providing health and social supports respectively. Female employees (58.3%) from the private sector (60.0%) were more likely to receive supports than male employees (52.6%) and than those from the public sector (46.2%). The most common health and social support received by the employees were treatment, and nutritional support and reduction of workload, respectively. HIV/AIDS infected employees named treatment and nutritional support, and soft loans and reduced workload respectively, as the most important health and social supports they needed from their employers. This study provides baseline information for further studies on provision of health and social support services by employers to HIV/AIDS infected employees in the context of a developing economy like Tanzania.

Health and social support services to HIV/AIDS infected individuals in Tanzania: employees and employers perceptions

PubMed Central

2014-01-01

Background HIV is a major public health problem in the world, especially in sub-Saharan Africa. It often leads to loss of productive labour and disruption of existing social support system which results in deterioration of population health. This poses a great challenge to infected people in meeting their essential goods and services. This paper examines health and social support services provided by employers to HIV/AIDS infected employees in Tanzania. Methods This was a cross-sectional study, which employed qualitative and quantitative methods in data collection and analysis. Structured questionnaires and in-depth interviews were used to assess the health and social support services provision at employers and employees perspectives. The study participants were employees and employers from public and private organizations. Results A total of 181 employees and 23 employers from 23 workplaces aged between 18–68 years were involved. The results show that 23.8% (i.e., 20.4% males and 27.3% females) of the employees had at least one member of the family or close relatives living with HIV at the time of the study. Fifty six percent of the infected employees reported to have been receiving health or social support from their employers. Employees’ responses were consistent with those reported by their employers. A total of 12(52.2%) and 11(47.8%) employers reported to have been providing health and social supports respectively. Female employees (58.3%) from the private sector (60.0%) were more likely to receive supports than male employees (52.6%) and than those from the public sector (46.2%). The most common health and social support received by the employees were treatment, and nutritional support and reduction of workload, respectively. Conclusions HIV/AIDS infected employees named treatment and nutritional support, and soft loans and reduced workload respectively, as the most important health and social supports they needed from their employers. This study provides baseline information for further studies on provision of health and social support services by employers to HIV/AIDS infected employees in the context of a developing economy like Tanzania. PMID:24950701

[Improve the accessibility of essential drugs for the populations of one medical region in Burkina Faso].

PubMed

Ridde, Valéry; Nitièma, Abdoulaye P; Dadjoari, Moussa

2005-01-01

Despite the formulation of the Bamako initiative in 1992 in Burkina Faso, not until 2001 and the launching of a project by a nongovernmental organization was the policy really implemented in a region of the country. One of the goals of this policy is to improve access to health care by using generic essential drugs. The objective of this article is to summarize the results of the evaluation of the project's ability to improve the population's access to drugs. The project lasted three years (2001-2003) and the interventions took place in 41 basic health centres of three districts. According to WHO, improving access to drugs requires consideration of four essential factors: rational use, affordable prices, financial viability, and effectiveness of the distribution. The average number of drugs prescribed per prescription sheet (n = 1061) was 2.4; 93% of the drugs were prescribed by their generic name (international non-proprietary names); 44% of infant diarrheas were treated with oral rehydration salt. National drug prices were respected but not the directives aiming at exempting from payment or subsidizing certain population sub-groups (children, indigents). The average annual cash flow of the basic health centres was 1.2 million F CFA and it increased by 854% compared to the beginning of the project. The cost-recovery scheme for administrative expenses was 106%. The average annual availability of the 10 essential drugs was 89%. Utilization rates increased (0.13 in 1999 to 0.21 in 2003) but not significantly differently than in other basic health centres of the area not supported by the project (p = 0.084). The project succeeded in improving access to these drugs for the overall population but not for the worst-off. The drugs are now geographically available for all and financially accessible for those who can afford to pay. The intervention strategy supported the sustainability of the project's activities but much remains to be done to provide the poorest with access to drugs.

Digital atmospheres: affective practices of care in Elefriends.

PubMed

Tucker, Ian M; Goodings, Lewis

2017-05-01

This article develops the concept of digital atmosphere to analyse the affective power of social media to shape practices of care and support for people living with mental distress. Using contemporary accounts of affective atmospheres, the article focuses on feelings of distress, support and care that unfold through digital atmospheres. The power of social media intersects with people's support and care-seeking practices in multiple ways and not in a straightforward model of 'accessing or providing support'. Indeed, we find that the caring relations developed through social media often need to be cared for themselves. The article draws on online and interview data from a larger project investigating how practices of care and support are (re)configured in the mental health-related social media site Elefriends. Users have to negotiate the disruption of moving support online, as well as the possibility of becoming subject to a fragility in care, in which caring for oneself becomes bound up in the ambiguities of caring for others. We argue that understanding how experiences of distress are shaped by social media is essential for understanding the implications of the increased digitisation of mental healthcare. © 2017 Foundation for the Sociology of Health & Illness.

Exploration Life Support Technology Development for Lunar Missions

NASA Technical Reports Server (NTRS)

Ewert, Michael K.; Barta, Daniel J.; McQuillan, Jeffrey

2009-01-01

Exploration Life Support (ELS) is one of NASA's Exploration Technology Development Projects. ELS plans, coordinates and implements the development of new life support technologies for human exploration missions as outlined in NASA's Vision for Space Exploration. ELS technology development currently supports three major projects of the Constellation Program - the Orion Crew Exploration Vehicle (CEV), the Altair Lunar Lander and Lunar Surface Systems. ELS content includes Air Revitalization Systems (ARS), Water Recovery Systems (WRS), Waste Management Systems (WMS), Habitation Engineering, Systems Integration, Modeling and Analysis (SIMA), and Validation and Testing. The primary goal of the ELS project is to provide different technology options to Constellation which fill gaps or provide substantial improvements over the state-of-the-art in life support systems. Since the Constellation missions are so challenging, mass, power, and volume must be reduced from Space Shuttle and Space Station technologies. Systems engineering analysis also optimizes the overall architecture by considering all interfaces with the life support system and potential for reduction or reuse of resources. For long duration missions, technologies which aid in closure of air and water loops with increased reliability are essential as well as techniques to minimize or deal with waste. The ELS project utilizes in-house efforts at five NASA centers, aerospace industry contracts, Small Business Innovative Research contracts and other means to develop advanced life support technologies. Testing, analysis and reduced gravity flight experiments are also conducted at the NASA field centers. This paper gives a current status of technologies under development by ELS and relates them to the Constellation customers who will eventually use them.

Text-based Analytics for Biosurveillance

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

Charles, Lauren E.; Smith, William P.; Rounds, Jeremiah

The ability to prevent, mitigate, or control a biological threat depends on how quickly the threat is identified and characterized. Ensuring the timely delivery of data and analytics is an essential aspect of providing adequate situational awareness in the face of a disease outbreak. This chapter outlines an analytic pipeline for supporting an advanced early warning system that can integrate multiple data sources and provide situational awareness of potential and occurring disease situations. The pipeline, includes real-time automated data analysis founded on natural language processing (NLP), semantic concept matching, and machine learning techniques, to enrich content with metadata related tomore » biosurveillance. Online news articles are presented as an example use case for the pipeline, but the processes can be generalized to any textual data. In this chapter, the mechanics of a streaming pipeline are briefly discussed as well as the major steps required to provide targeted situational awareness. The text-based analytic pipeline includes various processing steps as well as identifying article relevance to biosurveillance (e.g., relevance algorithm) and article feature extraction (who, what, where, why, how, and when). The ability to prevent, mitigate, or control a biological threat depends on how quickly the threat is identified and characterized. Ensuring the timely delivery of data and analytics is an essential aspect of providing adequate situational awareness in the face of a disease outbreak. This chapter outlines an analytic pipeline for supporting an advanced early warning system that can integrate multiple data sources and provide situational awareness of potential and occurring disease situations. The pipeline, includes real-time automated data analysis founded on natural language processing (NLP), semantic concept matching, and machine learning techniques, to enrich content with metadata related to biosurveillance. Online news articles are presented as an example use case for the pipeline, but the processes can be generalized to any textual data. In this chapter, the mechanics of a streaming pipeline are briefly discussed as well as the major steps required to provide targeted situational awareness. The text-based analytic pipeline includes various processing steps as well as identifying article relevance to biosurveillance (e.g., relevance algorithm) and article feature extraction (who, what, where, why, how, and when).« less