Analytic innovations for air quality modeling

EPA Science Inventory

The presentation provides an overview of ongoing research activities at the U.S. EPA, focusing on improving long-term emission projections and the development of decision support systems for coordinated environmental, climate and energy planning.

A Design of Electronic Performance Support Systems.

ERIC Educational Resources Information Center

Sheu, Feng-Ru

The project described in this paper, representing the initial phases of a one-year on-going project, was organized to build a supportive environment for Instructional Systems Technology (IST) doctoral students at Indiana University-Bloomington to help them prepare for the Qualifying exams. An overview is provided of steps taken to create an…

A Sustainable Model for Training Teachers to Use Pivotal Response Training

ERIC Educational Resources Information Center

Suhrheinrich, Jessica

2015-01-01

The increase in the rate of autism diagnoses has created a growing demand for teachers who are trained to use effective interventions. The train-the-trainer model, which involves training supervisors to train others, may be ideal for providing cost-effective training and ongoing support to teachers. Although research supports interventions, such…

It Takes Research to Build a Community: Ongoing Challenges for Scholars in Digitally-Supported Communicative Language Teaching

ERIC Educational Resources Information Center

Dooly, Melinda

2015-01-01

This article provides an argument for closer multilateral alliances between the emergent and loosely-bound international community of educational researchers who are working in areas related to Digitally Supported Communicative Language Teaching and learning (herein DSCLT). By taking advantage of the communications revolution that is currently…

Teaching Haniyah

ERIC Educational Resources Information Center

Sokolower, Jody

2012-01-01

Having a parent or loved one caught up in the criminal justice system is an ongoing crisis that affects every aspect of family life. Teachers need to understand what is happening so they can provide support. One source of information is programs like Project WHAT! which provides leadership development and paid jobs to youth with incarcerated…

An Examination of Behavioral Rehearsal During Consultation as a Predictor of Training Outcomes

PubMed Central

Kendall, Philip C.; Ringle, Vanesa A.; Read, Kendra L.; Brodman, Douglas A.; Pimentel, Sandra S.; Beidas, Rinad S.

2013-01-01

The training literature suggests that ongoing support following initial therapist training enhances training outcomes, yet little is known about what occurs during ongoing support and what accounts for its effectiveness. The present study examined consultation sessions provided to 99 clinicians following training in cognitive-behavioral therapy for youth anxiety. The 104 recorded consultation sessions were coded for content and consultative methods. It was hypothesized that behavioral rehearsal (an active learning technique) would predict therapist adherence, skill, self-efficacy, and satisfaction at post-consultation. Regression analyses found no significant relation, however, clinician involvement during consultation sessions positively moderated the relationship between behavioral rehearsals and skill. Implications, limitations, and future directions are discussed. PMID:23616234

ASRS Reports on Wake Vortex Encounters

NASA Technical Reports Server (NTRS)

Connell, Linda J.; Taube, Elisa Ann; Drew, Charles Robert; Barclay, Tommy Earl

2010-01-01

ASRS is conducting a structured callback research project of wake vortex incidents reported to the ASRS at all US airports, as well as wake encounters in the enroute environment. This study has three objectives: (1) Utilize the established ASRS supplemental data collection methodology and provide ongoing analysis of wake vortex encounter reports; (2) Document event dynamics and contributing factors underlying wake vortex encounter events; and (3) Support ongoing FAA efforts to address pre-emptive wake vortex risk reduction by utilizing ASRS reporting contributions.

Alternative Fuel for Marine Application

DOT National Transportation Integrated Search

2012-02-29

The U.S. Maritime Administration (MARAD) is participating in the U.S. Navy's ongoing efforts to test alternative fuels for marine use by demonstrating their applicability on commercial vessels. In support of this effort, the Navy provided neat hydrot...

A web-portal for interactive data exploration, visualization, and hypothesis testing

PubMed Central

Bartsch, Hauke; Thompson, Wesley K.; Jernigan, Terry L.; Dale, Anders M.

2014-01-01

Clinical research studies generate data that need to be shared and statistically analyzed by their participating institutions. The distributed nature of research and the different domains involved present major challenges to data sharing, exploration, and visualization. The Data Portal infrastructure was developed to support ongoing research in the areas of neurocognition, imaging, and genetics. Researchers benefit from the integration of data sources across domains, the explicit representation of knowledge from domain experts, and user interfaces providing convenient access to project specific data resources and algorithms. The system provides an interactive approach to statistical analysis, data mining, and hypothesis testing over the lifetime of a study and fulfills a mandate of public sharing by integrating data sharing into a system built for active data exploration. The web-based platform removes barriers for research and supports the ongoing exploration of data. PMID:24723882

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.

Remote Operations and Ground Control Centers

NASA Technical Reports Server (NTRS)

Bryant, Barry S.; Lankford, Kimberly; Pitts, R. Lee

2004-01-01

The Payload Operations Integration Center (POIC) at the Marshall Space Flight Center supports the International Space Station (ISS) through remote interfaces around the world. The POIC was originally designed as a gateway to space for remote facilities; ranging from an individual user to a full-scale multiuser environment. This achievement was accomplished while meeting program requirements and accommodating the injection of modern technology on an ongoing basis to ensure cost effective operations. This paper will discuss the open POIC architecture developed to support similar and dissimilar remote operations centers. It will include technologies, protocols, and compromises which on a day to day basis support ongoing operations. Additional areas covered include centralized management of shared resources and methods utilized to provide highly available and restricted resources to remote users. Finally, the effort of coordinating the actions of participants will be discussed.

An Integrative Conceptual Framework for Assessing and Treating Suicidal Behavior in Adolescents.

ERIC Educational Resources Information Center

Rudd, M. David; Joiner, Thomas E., Jr.

1998-01-01

An integrative conceptual framework is provided for ongoing assessment and day-to-day treatment of suicidal adolescents. Goals are to provide a summary of therapeutic and assessment tasks consistent with existing standards of care and supported by empirical findings and to emphasize the roles, tasks, demands, and limitations of psychotherapy with…

Intraoperative Clinical Decision Support for Anesthesia: A Narrative Review of Available Systems.

PubMed

Nair, Bala G; Gabel, Eilon; Hofer, Ira; Schwid, Howard A; Cannesson, Maxime

2017-02-01

With increasing adoption of anesthesia information management systems (AIMS), there is growing interest in utilizing AIMS data for intraoperative clinical decision support (CDS). CDS for anesthesia has the potential for improving quality of care, patient safety, billing, and compliance. Intraoperative CDS can range from passive and post hoc systems to active real-time systems that can detect ongoing clinical issues and deviations from best practice care. Real-time CDS holds the most promise because real-time alerts and guidance can drive provider behavior toward evidence-based standardized care during the ongoing case. In this review, we describe the different types of intraoperative CDS systems with specific emphasis on real-time systems. The technical considerations in developing and implementing real-time CDS are systematically covered. This includes the functional modules of a CDS system, development and execution of decision rules, and modalities to alert anesthesia providers concerning clinical issues. We also describe the regulatory aspects that affect development, implementation, and use of intraoperative CDS. Methods and measures to assess the effectiveness of intraoperative CDS are discussed. Last, we outline areas of future development of intraoperative CDS, particularly the possibility of providing predictive and prescriptive decision support.

The Other Side of Caring: Adult Children with Mental Illness as Supports to Their Mothers in Later Life.

ERIC Educational Resources Information Center

Greenberg, Jan Steven

1995-01-01

Discusses the role of adult children with serious mental illness as a source of support to their aging parents. Most mothers reported that their mentally-ill children provided at least some ongoing help with daily living tasks. The adult child's assistance related significantly to lower levels of maternal subjective burden. (RJM)

Topic Areas to Consider when Planning Transition from High School to Postsecondary Education for Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Roberts, Kelly D.

2010-01-01

For many individuals with an autism spectrum disorder (ASD), attending and completing postsecondary education is a viable option. However, success in postsecondary education for these individuals may require more planning and ongoing support than students without an ASD. This article provides educators and transition support personnel with a range…

Evolving earth-based and in-situ satellite network architectures for Mars communications and navigation support

NASA Technical Reports Server (NTRS)

Hastrup, Rolf; Weinberg, Aaron; Mcomber, Robert

1991-01-01

Results of on-going studies to develop navigation/telecommunications network concepts to support future robotic and human missions to Mars are presented. The performance and connectivity improvements provided by the relay network will permit use of simpler, lower performance, and less costly telecom subsystems for the in-situ mission exploration elements. Orbiting relay satellites can serve as effective navigation aids by supporting earth-based tracking as well as providing Mars-centered radiometric data for mission elements approaching, in orbit, or on the surface of Mars. The relay satellite orbits may be selected to optimize navigation aid support and communication coverage for specific mission sets.

Evolving earth-based and in-situ satellite network architectures for Mars communications and navigation support

NASA Astrophysics Data System (ADS)

Hastrup, Rolf; Weinberg, Aaron; McOmber, Robert

1991-09-01

Results of on-going studies to develop navigation/telecommunications network concepts to support future robotic and human missions to Mars are presented. The performance and connectivity improvements provided by the relay network will permit use of simpler, lower performance, and less costly telecom subsystems for the in-situ mission exploration elements. Orbiting relay satellites can serve as effective navigation aids by supporting earth-based tracking as well as providing Mars-centered radiometric data for mission elements approaching, in orbit, or on the surface of Mars. The relay satellite orbits may be selected to optimize navigation aid support and communication coverage for specific mission sets.

ERTS-1 DCS technical support provided by Wallops Station. [ground truth stations and DCP repair depot

NASA Technical Reports Server (NTRS)

Smith, R.

1975-01-01

Wallops Station accepted the tasks of providing ground truth to several ERTS investigators, operating a DCP repair depot, designing and building an airborne DCP Data Acquisition System, and providing aircraft underflight support for several other investigators. Additionally, the data bank is generally available for use by ERTS and other investigators that have a scientific interest in data pertaining to the Chesapeake Bay area. Working with DCS has provided a means of evaluating the system as a data collection device possibly applicable to ongoing Earth Resources Program activities in the Chesapeake Bay area as well as providing useful data and services to other ERTS investigators. The two areas of technical support provided by Wallops, ground truth stations and repair for DCPs, are briefly discussed.

Exploring which patients without return of spontaneous circulation following ventricular fibrillation out-of-hospital cardiac arrest should be transported to hospital?

PubMed

Stub, Dion; Nehme, Ziad; Bernard, Stephen; Lijovic, Marijana; Kaye, David M; Smith, Karen

2014-03-01

Currently many emergency medical services (EMS) that provide advanced cardiac life support (ACLS) at scene do not routinely transport out-of-hospital cardiac arrest (OHCA) patients without sustained return of spontaneous circulation (ROSC). This is due to logistical difficulties and historical poor outcomes. However, new technology for mechanical chest compression has made transport to hospital safer and extracorporeal membrane oxygenation during cardiopulmonary resuscitation (ECPR) enabling further intervention, may result in ROSC. We aimed to explore the characteristics and outcomes of patients with OHCA who were transported to hospital with ongoing CPR in the absence of ROSC, who might benefit from this new technology. The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for adult OHCA with an initial shockable rhythm between 2003 and 2012. There were 5593 OHCA meeting inclusion criteria. Analysis was performed on 3095 (55%) of patients who did not achieve sustained ROSC in the field. Of these only 589 (20%) had ongoing CPR to hospital. There was a significant decline in rates of transport over the study period. Predictors of transport with ongoing CPR included younger patients, decreased time to first shock and intermittent ROSC prior to transport. Survival to hospital discharge occurred in 52 (9%) of patients who had ongoing CPR to hospital. In an EMS that provides ACLS at scene, patients without ROSC in the field who receive CPR to hospital have poor outcomes. Developing a system which provides safe transport with ongoing CPR to a hospital that provides ECPR, should be considered. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Relationship between cancer-related traumatic stress and family milestone achievement in adolescent and young adult survivors of childhood cancer.

PubMed

Tillery, Rachel; Beal, Sarah J; Thompson, Aimee N; Pai, Ahna L H

2018-06-01

Late physical and emotional effects of cancer treatment pose a burden for adolescent and young adult survivors of childhood cancer, including family milestone achievement. This brief report examined links between ongoing cancer-related post-traumatic stress symptoms (CR-PTSS) and family milestone achievement. Survivors (n = 51; M age  = 24.73, SD = 8.20) completed CR-PTSS and family formation questionnaires. Descriptive statistics, univariate parameter-constraints, and correlation analyses examined relations among study variables. Ongoing intrusive thoughts and hyperarousal were negatively linked to family identity development and family achievement. Findings from the present study provide support that ongoing CR-PTSS may be a barrier to family formation. © 2018 Wiley Periodicals, Inc.

Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder.

PubMed

Rice, Simon M; Simmons, Magenta B; Bailey, Alan P; Parker, Alexandra G; Hetrick, Sarah E; Davey, Christopher G; Phelan, Mark; Blaikie, Simon; Edwards, Jane

2014-01-01

There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation. In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15-25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data. The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision. The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.

Acquisition of Cleanroom Research Equipment to Support Ongoing DoD Programs at ASU

DTIC Science & Technology

2017-12-12

Report: Acquisition of cleanroom research equipment to support ongoing DoD programs at ASU The views, opinions and/or findings contained in this report...documentation. 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709...Agreement Number: W911NF-16-1-0354 Organization: Arizona State University Title: Acquisition of cleanroom research equipment to support ongoing DoD

New EVSE Analytical Tools/Models: Electric Vehicle Infrastructure Projection Tool (EVI-Pro)

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

Wood, Eric W; Rames, Clement L; Muratori, Matteo

This presentation addresses the fundamental question of how much charging infrastructure is needed in the United States to support PEVs. It complements ongoing EVSE initiatives by providing a comprehensive analysis of national PEV charging infrastructure requirements. The result is a quantitative estimate for a U.S. network of non-residential (public and workplace) EVSE that would be needed to support broader PEV adoption. The analysis provides guidance to public and private stakeholders who are seeking to provide nationwide charging coverage, improve the EVSE business case by maximizing station utilization, and promote effective use of private/public infrastructure investments.

Ongoing data reduction, theoretical studies, and supporting research in magnetospheric physics

NASA Technical Reports Server (NTRS)

Scarf, F. L.; Greenstadt, E. W.

1982-01-01

The investigators published a very large number of space science research papers, and in almost all cases these papers involved correlative multi-spacecraft studies. A tabulation of these research papers is provided. Quarterly progress reports for the second contractual period are included.

40 CFR 51.361 - Motorist compliance enforcement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... database, generate computerized notices, and provide regular backup to said system while maintaining auxiliary storage devices to insure ongoing operation of the system and prevent data losses; (vi) Track each... mechanism shall be supported with detailed analyses. (3) The SIP shall include the legal authority to...

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

PubMed

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

2010-01-01

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

Children’s Hospice

DTIC Science & Technology

2006-01-01

referral supports. Mr. Lafferty is a licensed social worker with certification as an Employee Assistance Professional with military experience in the ...families and providers • Assist the family to become more effective advocates for their child’s needs Work is still ongoing to determine which model of... assistance . This database provides information related to relationship issues, domestic violence, suicide, mental health concerns, substance abuse , grief

GI-POP: a combinational annotation and genomic island prediction pipeline for ongoing microbial genome projects.

PubMed

Lee, Chi-Ching; Chen, Yi-Ping Phoebe; Yao, Tzu-Jung; Ma, Cheng-Yu; Lo, Wei-Cheng; Lyu, Ping-Chiang; Tang, Chuan Yi

2013-04-10

Sequencing of microbial genomes is important because of microbial-carrying antibiotic and pathogenetic activities. However, even with the help of new assembling software, finishing a whole genome is a time-consuming task. In most bacteria, pathogenetic or antibiotic genes are carried in genomic islands. Therefore, a quick genomic island (GI) prediction method is useful for ongoing sequencing genomes. In this work, we built a Web server called GI-POP (http://gipop.life.nthu.edu.tw) which integrates a sequence assembling tool, a functional annotation pipeline, and a high-performance GI predicting module, in a support vector machine (SVM)-based method called genomic island genomic profile scanning (GI-GPS). The draft genomes of the ongoing genome projects in contigs or scaffolds can be submitted to our Web server, and it provides the functional annotation and highly probable GI-predicting results. GI-POP is a comprehensive annotation Web server designed for ongoing genome project analysis. Researchers can perform annotation and obtain pre-analytic information include possible GIs, coding/non-coding sequences and functional analysis from their draft genomes. This pre-analytic system can provide useful information for finishing a genome sequencing project. Copyright © 2012 Elsevier B.V. All rights reserved.

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.

Diabetes Education and Support: A Must for Students With Diabetes.

PubMed

Siminerio, Linda M

2015-11-01

Ongoing diabetes self-management education and support is critical to helping youth with diabetes and their families learn about the disease, make and sustain behavioral changes, and cope with the reality of a chronic illness. Diabetes self-management education and support is best provided by a multidisciplinary team. School nurses are an important part of the student's diabetes health care team. This article highlights information and resources that school nurses can use to help support students with diabetes, their families, and other school personnel. © 2015 The Author(s).

Monitoring Coastal Marshes for Persistent Saltwater Intrusion

NASA Technical Reports Server (NTRS)

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

2009-01-01

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

ACOT Classroom Networks: Today and Tomorrow. ACOT Report #5.

ERIC Educational Resources Information Center

Knapp, Linda

The Apple Classrooms of Tomorrow (ACOT) research project provides classroom sites with equipment, ongoing support, and training, enabling educators to discover the potential of networked learning environments. ACOT networks link together technology from Apple IIe computers and Image Writer printers, to Macintosh II systems, synthesizers, laserdisc…

Counseling the Young Adult Lesbian.

ERIC Educational Resources Information Center

Miller, Rhoda

1980-01-01

Focuses on problems faced by young adult lesbians. Suggests counselors should: (1) encourage the counselee to "dump"; (2) guide her in a decision on coming out; (3) explain the legal rights and restrictions; (4) provide ongoing support for those who socialize openly; and (5) publicly promote gay rights. (Author)

Professional Development Design: Embedding Educational Reform in New Zealand

ERIC Educational Resources Information Center

Starkey, Louise; Yates, Anne; Meyer, Luanna H.; Hall, Cedric; Taylor, Mike; Stevens, Susan; Toia, Rawiri

2009-01-01

Teacher professional development variously supports ongoing skill development, new knowledge, and systems change. In New Zealand, the implementation of major assessment reforms in senior secondary schools provided opportunity to investigate teacher professional development as a function of the particular stage of an educational reform.…

Final Report - BRER Core Support

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

Evan B. Douple

2007-01-09

This contract provided core support for activities of the advisory committee of experts comprising the Board on Radiation Effects Research (BRER), in The National Academies' Division on Earth and Life Studies. That committee met two times during the funding period. The committee members provided oversight and advice regarding ongoing BRER projects and also assisted in the identification of potential committee members for new studies and the development of proposals for projects in the radiation sciences worthy for future study. In addition, funding provided support for the planning, advertisement, and invited speakers' travel-expense reimbursement for the Third and Fourth Gilbert W.more » Beebe Symposia held at The National Academies on December 1, 2004 and on November 30, 2005, respectively.« less

An Application of Double-Loop Learning to Community College Remedial Education: A New Model of Integrated Supports for Ongoing Student Success

ERIC Educational Resources Information Center

Doren, Andrew T.

2013-01-01

Community colleges have multiple missions and one of them is to provide open access services to those seeking to further their education. Community colleges provide remedial courses in math, reading, and writing because many of their students do not meet entrance requirements in these core subjects. However, the usual developmental education track…

Professional Development in the United States: Trends and Challenges. Phase II of a Three-Phase Study. Executive Summary

ERIC Educational Resources Information Center

Wei, Ruth Chung; Darling-Hammond, Linda; Adamson, Frank

2010-01-01

A new study that analyzes the status of professional learning in the United States reveals that the nation is making some progress in providing increased support and mentoring for new teachers. But the study also reveals that the United States has moved backward in providing the vast majority of teachers with the kind of ongoing, intensive…

AADE position statement: education for continuous subcutaneous insulin infusion pump users. American Association of Diabetes Educators.

PubMed

1997-01-01

Successful implementation of CSII requires a motivated patient with a range of technical skills and self-management capabilities. Patients develop this expertise through an ongoing program of education and the support that a healthcare team knowledgeable in insulin pump therapy can provide.

A Strong Start for Families: Voluntary Home Visiting in California

ERIC Educational Resources Information Center

Children Now, 2016

2016-01-01

Home visiting programs are voluntary, family-centered programs that match new and expectant parents with trained professionals who provide ongoing, individualized support during critical points throughout pregnancy and a child's first year(s) of life. By reaching families early in their transition into parenthood, and linking them with needed…

Exploring Blended Learning for Science Teacher Professional Development in an African Context

ERIC Educational Resources Information Center

Boitshwarelo, Bopelo

2009-01-01

This paper explores a case of teacher professional development in Botswana where a blended learning solution was attempted. The analysis of the implementation environment reveals deficiencies in policy, schools (workplaces), and training providers. The paper concludes with three recommendations: 1) Schools should support ongoing teacher learning…

PRECISION OF ATMOSPHERIC DRY DEPOSITION DATA FROM THE CLEAN AIR STATUS AND TRENDS NETWORK (CASTNET)

EPA Science Inventory

A collocated, dry deposition sampling program was begun in January 1987 by the US Environmental Protection Agency to provide ongoing estimates of the overall precision of dry deposition and supporting data entering the Clean Air Status and Trends Network (CASTNet) archives Duplic...

Developing Principal Instructional Leadership through Collaborative Networking

ERIC Educational Resources Information Center

Cone, Mariah Bahar

2010-01-01

This study examines what occurs when principals of urban schools meet together to learn and improve their instructional leadership in collaborative principal networks designed to support, sustain, and provide ongoing principal capacity building. Principal leadership is considered second only to teaching in its ability to improve schools, yet few…

Arts in the Curriculum.

ERIC Educational Resources Information Center

Weinstock, Ruth

This monograph, part of an ongoing series, discusses the need for school arts programs and provides some examples of how the arts can be infused into the regular curriculum at the elementary level. Support systems for such programs are also discussed. Properly conceived, the arts constitute a great integrating force in the curriculum. To achieve…

Development of a cell-based treatment for long-term neurotrophin expression and spiral ganglion neuron survival.

PubMed

Zanin, M P; Hellström, M; Shepherd, R K; Harvey, A R; Gillespie, L N

2014-09-26

Spiral ganglion neurons (SGNs), the target cells of the cochlear implant, undergo gradual degeneration following loss of the sensory epithelium in deafness. The preservation of a viable population of SGNs in deafness can be achieved in animal models with exogenous application of neurotrophins such as brain-derived neurotrophic factor (BDNF) and neurotrophin-3. For translation into clinical application, a suitable delivery strategy that provides ongoing neurotrophic support and promotes long-term SGN survival is required. Cell-based neurotrophin treatment has the potential to meet the specific requirements for clinical application, and we have previously reported that Schwann cells genetically modified to express BDNF can support SGN survival in deafness for 4 weeks. This study aimed to investigate various parameters important for the development of a long-term cell-based neurotrophin treatment to support SGN survival. Specifically, we investigated different (i) cell types, (ii) gene transfer methods and (iii) neurotrophins, in order to determine which variables may provide long-term neurotrophin expression and which, therefore, may be the most effective for supporting long-term SGN survival in vivo. We found that fibroblasts that were nucleofected to express BDNF provided the most sustained neurotrophin expression, with ongoing BDNF expression for at least 30 weeks. In addition, the secreted neurotrophin was biologically active and elicited survival effects on SGNs in vitro. Nucleofected fibroblasts may therefore represent a method for safe, long-term delivery of neurotrophins to the deafened cochlea to support SGN survival in deafness. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2018-01-01

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

Work environment stressors, social support, anxiety, and depression among secondary school teachers.

PubMed

Mahan, Pamela L; Mahan, Michael P; Park, Na-Jin; Shelton, Christie; Brown, Kathleen C; Weaver, Michael T

2010-05-01

Work environment stress, a salient health and safety issue for secondary school teachers, school administrators, parents, and students, was examined in 168 teachers from two urban and five suburban high schools. The purpose of this study was to examine relationships between ongoing and episodic stressors and anxiety and depression, as well as the extent to which anxiety and depression may be predicted by stressors and coworker and supervisor support. The Ongoing Stressor Scale (OSS) and the Episodic Stressor Scale (ESS), the Coworker and Supervisor Contents of Communication Scales (COCS), the State Anxiety inventory (S-Anxiety), and the Center for Epidemiological Studies Depression Scale (CES-D) were used to measure the variables. Ongoing and episodic stressors were significantly and positively associated with anxiety and depression. Ongoing stressors and coworker support were significant in explaining anxiety and depression among secondary school teachers. Coworker support had an inverse relationship to anxiety and depression.

75 FR 9493 - Commission Statement in Support of Convergence and Global Accounting Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

...The Securities and Exchange Commission (the ``Commission'') is publishing this statement to provide an update regarding its consideration of global accounting standards, including its continued support for the convergence of U.S. Generally Accepted Accounting Principles (``U.S. GAAP'') and International Financial Reporting Standards (``IFRS'') and the implications of convergence with respect to the Commission's ongoing consideration of incorporating IFRS into the financial reporting system for U.S. issuers.

Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative.

PubMed

Stolee, Paul; McAiney, Carrie A; Hillier, Loretta M; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J Kenneth

2009-01-01

This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management support, particularly designation of time for PRP activities, development of PRP teams, and supportive learning strategies were significant factors affecting sustained knowledge transfer. Continuing education that is provided and evaluated on an ongoing basis, secures management commitment, is integrated within a broader system strategy, and provides on-the-job support has the greatest potential to affect care.

Supporting the Thesis Writing Process of International Research Students through an Ongoing Writing Group

ERIC Educational Resources Information Center

Li, Linda Y.; Vandermensbrugghe, Joelle

2011-01-01

Evidence from research suggests writing support is particularly needed for international research students who have to tackle the challenges of thesis writing in English as their second language in Western academic settings. This article reports the development of an ongoing writing group to support the thesis writing process of international…

Presentation to Office of Surface Mines about use of LEAF in evaluating use of CCRs in mine reclamation

EPA Science Inventory

Providing information on new EPA methods that predict environmental release based on changing environmental conditions. The purpose is to determine if OSM needs support on their ongoing rulemaking. According to OSWER, there is a need and OSM is anxious to meet with us particula...

Assessment of a Multinational Online Faculty Development Program on Online Teaching: Reflections of Candidate E-Tutors

ERIC Educational Resources Information Center

Adnan, Muge; Kalelioglu, Filiz; Gulbahar, Yasemin

2017-01-01

Teaching online requires different skills, roles and competencies for online instructors compared to teaching in traditional learning environments. Universities should offer ongoing support in various forms to help academic staff through their online journey. This paper provides insights into a multinational faculty development program for…

High School Students' Experiences of Bullying and Victimization and the Association with School Health Center Use

ERIC Educational Resources Information Center

Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D.

2015-01-01

Background: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of…

Creating a Sustainable and Supportive Teaching Practicum in Rural and Regional Locations

ERIC Educational Resources Information Center

Ryan, Josephine; Jones, Melitta; Walta, Caroline

2012-01-01

The study described in this paper Creating an effective practicum model for rural and regional preservice teachers is designed to address the ongoing difficulties experienced by schools and universities as they seek to provide high quality preservice teacher education for individuals in rural areas. Lecturers from the regional campuses of two…

REL Pacific Program Guide: Working Together to Answer Education Questions That Matter

ERIC Educational Resources Information Center

Regional Educational Laboratory Pacific, 2014

2014-01-01

The Regional Educational Laboratory of the Pacific (REL Pacific) program at McREL International partners with schools, state departments of education, and other education stakeholders to use data and research to drive data-informed decisions. Dedicated, experienced staff work closely with local experts, who provide support for ongoing regional…

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…

Educator Effectiveness in Colorado: The Connection between Evaluation and Professional Learning

ERIC Educational Resources Information Center

O'Brien, Colleen

2014-01-01

Purpose: The purpose of this study was to understand how schools and districts plan professional learning that provides the ongoing feedback and support needed to improve teacher performance under the new Colorado Educator Effectiveness Law. The study focused on the professional learning that follows a teacher's rating on the new educator…

Prenatal Support To Educate and Counsel Pregnant Mothers with Children in a Preschool Program.

ERIC Educational Resources Information Center

Mack, Sarah L.

A health specialist working in a program providing health, social, and educational services to low-income children and families implemented and evaluated a practicum intervention designed to increase inner-city mothers' knowledge of the importance of ongoing prenatal care throughout pregnancy and to improve the mothers' health. A prenatal…

A Mixed-Methods Study Examining the Role of the Instructional Coach within a Professional Learning Community

ERIC Educational Resources Information Center

Jorgensen, Christie L.

2016-01-01

Although instructional coaching and professional learning communities provide ongoing, job-embedded support and professional learning, little is known about what role the instructional coach serves within the setting of the professional learning community or what coaching skills teachers find most helpful within this setting. Research examining…

Mitigating Errors of Representation: A Practical Case Study of the University Experience Survey

ERIC Educational Resources Information Center

Whiteley, Sonia

2014-01-01

The Total Survey Error (TSE) paradigm provides a framework that supports the effective planning of research, guides decision making about data collection and contextualises the interpretation and dissemination of findings. TSE also allows researchers to systematically evaluate and improve the design and execution of ongoing survey programs and…

Building Geographic Information System Capacity in Local Health Departments: Lessons From a North Carolina Project

PubMed Central

Miranda, Marie Lynn; Silva, Jennifer M.; Overstreet Galeano, M. Alicia; Brown, Jeffrey P.; Campbell, Douglas S.; Coley, Evelyn; Cowan, Christopher S.; Harvell, Dianne; Lassiter, Jenny; Parks, Jerry L.; Sandelé, Wanda

2005-01-01

State government, university, and local health department (LHD) partners collaborated to build the geographic information system (GIS) capacity of 5 LHDs in North Carolina. Project elements included procuring hardware and software, conducting individualized and group training, developing data layers, guiding the project development process, coordinating participation in technical conferences, providing ongoing project consultation, and evaluating project milestones. The project provided health department personnel with the skills and resources required to use sophisticated information management systems, particularly those that address spatial dimensions of public health practice. This capacity-building project helped LHDs incorporate GIS technology into daily operations, resulting in improved time and cost efficiency. Keys to success included (1) methods training rooted in problems specific to the LHD, (2) required project identification by LHD staff with associated timelines for development, (3) ongoing technical support as staff returned to home offices after training, (4) subgrants to LHDs to ease hardware and software resource constraints, (5) networks of relationships among LHDs and other professional GIS users, and (6) senior LHD leadership who supported the professional development activities being undertaken by staff. PMID:16257950

The PLAID graphics analysis impact on the space program

NASA Technical Reports Server (NTRS)

Nguyen, Jennifer P.; Wheaton, Aneice L.; Maida, James C.

1994-01-01

An ongoing project design often requires visual verification at various stages. These requirements are critically important because the subsequent phases of that project might depend on the complete verification of a particular stage. Currently, there are several software packages at JSC that provide such simulation capabilities. We present the simulation capabilities of the PLAID modeling system used in the Flight Crew Support Division for human factors analyses. We summarize some ongoing studies in kinematics, lighting, EVA activities, and discuss various applications in the mission planning of the current Space Shuttle flights and the assembly sequence of the Space Station Freedom with emphasis on the redesign effort.

Preparing childhood cancer survivors for transition to adult care: The young adult perspective.

PubMed

Frederick, Natasha N; Bober, Sharon L; Berwick, Lexie; Tower, Mary; Kenney, Lisa B

2017-10-01

Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care. Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach. Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system. Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making. © 2017 Wiley Periodicals, Inc.

Determinants of Children's Mental Health in War-Torn Settings: Translating Research Into Action.

PubMed

Miller, Kenneth E; Jordans, Mark J D

2016-06-01

Research on the mental health and psychosocial wellbeing of children in conflict-affected settings has undergone a significant paradigm shift in recent years. Earlier studies based on a war exposure model primarily emphasized the effects of direct exposure to armed conflict; this has gradually given way to a broader understanding of the diverse pathways by which organized violence affects children. A robustly supported comprehensive model includes risk factors at multiple points in time (prior war exposure, ongoing daily stressors) and at all levels of the social ecology. In particular, findings suggest that material deprivation and a set of family variables, including harsh parenting, parental distress, and witnessing intimate partner violence, are important mediators of the relationship between armed conflict and children's wellbeing. To date, however, interventions aimed at supporting war-affected children's wellbeing, both preventive and treatment-focused, have focused primarily on direct work with children, while paying only modest attention to ongoing risk factors in their families and broader environments. Possible reasons for the ongoing prioritization of child-focused interventions are considered, and examples are provided of recent evidence-based interventions that have reduced toxic stressors (harsh parenting and the use of violent discipline by teachers) in conflict-affected communities.

Pulsed Out of Awareness: EEG Alpha Oscillations Represent a Pulsed-Inhibition of Ongoing Cortical Processing

PubMed Central

Mathewson, Kyle E.; Lleras, Alejandro; Beck, Diane M.; Fabiani, Monica; Ro, Tony; Gratton, Gabriele

2011-01-01

Alpha oscillations are ubiquitous in the brain, but their role in cortical processing remains a matter of debate. Recently, evidence has begun to accumulate in support of a role for alpha oscillations in attention selection and control. Here we first review evidence that 8–12 Hz oscillations in the brain have a general inhibitory role in cognitive processing, with an emphasis on their role in visual processing. Then, we summarize the evidence in support of our recent proposal that alpha represents a pulsed-inhibition of ongoing neural activity. The phase of the ongoing electroencephalography can influence evoked activity and subsequent processing, and we propose that alpha exerts its inhibitory role through alternating microstates of inhibition and excitation. Finally, we discuss evidence that this pulsed-inhibition can be entrained to rhythmic stimuli in the environment, such that preferential processing occurs for stimuli at predictable moments. The entrainment of preferential phase may provide a mechanism for temporal attention in the brain. This pulsed inhibitory account of alpha has important implications for many common cognitive phenomena, such as the attentional blink, and seems to indicate that our visual experience may at least some times be coming through in waves. PMID:21779257

Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme

PubMed Central

Stein, J; Lewin, S; Fairall, L; Mayers, P; English, R; Bheekie, A; Bateman, E; Zwarenstein, M

2008-01-01

Background South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). Methods Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. Results Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context. Conclusion PALSA PLUS training successfully engaged all PHC nurses in a comprehensive approach to a range of illnesses affecting both HIV positive and negative patients. PHC nurse-training for integrated systems-based interventions should be prioritized on the ART funding agenda. Training for individual provider behaviour change is nonetheless only one aspect of the ongoing system-wide interventions required to effect lasting improvements in patient care in the context of an over-burdened and under-resourced PHC system. PMID:19017394

Use of a Relational Database to Support Clinical Research: Application in a Diabetes Program

PubMed Central

Lomatch, Diane; Truax, Terry; Savage, Peter

1981-01-01

A database has been established to support conduct of clinical research and monitor delivery of medical care for 1200 diabetic patients as part of the Michigan Diabetes Research and Training Center (MDRTC). Use of an intelligent microcomputer to enter and retrieve the data and use of a relational database management system (DBMS) to store and manage data have provided a flexible, efficient method of achieving both support of small projects and monitoring overall activity of the Diabetes Center Unit (DCU). Simplicity of access to data, efficiency in providing data for unanticipated requests, ease of manipulations of relations, security and “logical data independence” were important factors in choosing a relational DBMS. The ability to interface with an interactive statistical program and a graphics program is a major advantage of this system. Out database currently provides support for the operation and analysis of several ongoing research projects.

The role of technical assistance in the replication of effective HIV interventions.

PubMed

O'Donnell, L; Scattergood, P; Adler, M; Doval, A S; Barker, M; Kelly, J A; Kegeles, S M; Rebchook, G M; Adams, J; Terry, M A; Neumann, M S

2000-01-01

This article examines the role of technical assistance (TA) in supporting the replication of proven HIV interventions. A case study of the replication of the VOICES/VOCES intervention elucidates the level and types of TA provided to support new users through the adoption process. TA included help in garnering administrative support, identifying target audiences, recruiting groups for sessions, maintaining fidelity to the intervention's core elements, tailoring the intervention to meet clients' needs, strengthening staff members' facilitation skills, troubleshooting challenges, and devising strategies to sustain the intervention. Two to four hours per month of TA were provided to each agency adopting the intervention, at an estimated monthly cost of $206 to $412. Findings illustrate how TA supports replication by establishing a conversation between the researcher TA providers experienced with the intervention and new users. This communication helps preserve key program elements and contributes to ongoing refinement of the intervention.

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

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

NASA Technical Reports Server (NTRS)

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

2014-01-01

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

Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

PubMed

Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

2015-08-01

Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ongoing child welfare services: Understanding the relationship of worker and organizational characteristics to service provision.

PubMed

Lwin, Kristen; Fluke, John; Trocmé, Nico; Fallon, Barbara; Mishna, Faye

2018-06-01

Ongoing child welfare services are put in place after completion of the initial maltreatment investigation when there is a perceived need to mitigate the risk of future harm. The knowledge of how clinical, worker, and organizational characteristics interact with this decision to provide ongoing child welfare services is not well integrated in the research literature. Using secondary data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008, this study's primary objective is to understand the relationship of clinical, worker, and organizational characteristics to the decision to transfer a case to ongoing child welfare services and their relative contribution to the transfer decision in Canada. Findings indicate that several clinical level variables are associated with families receiving ongoing services. Additionally, organizational factors, such as type of services offered by the organization and the number of employee support programs available to workers, significantly predicted the decision to transfer a case to ongoing services. While no worker factors, such as education, amount of training, experience, or caseload, were associated with ongoing service receipt, the intraclass correlation coefficient of the final three-level parsimonious model indicated substantial clustering at the worker level. Results indicate that Canadian child welfare workers make decisions differently based on factors not available in the current study and that what would be deemed as important worker characteristics do not necessarily predict this outcome. Findings and implications for future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

STS-107 Crew Surgeon

NASA Technical Reports Server (NTRS)

Johnston, Smith

2005-01-01

NASA Crew Surgeons (CS) provides medical support to crewmembers assigned to a space flight. Upon this mission assignment, CS s develop close working and personal relationships with crewmembers, their families and close friends. This discussion covers the role of the NASA CS from start of a mission assignment through its completion. Specific emphasis is placed on events associated with the Columbia accident to include; premission planning, initial family medical support, interface with the astronaut Casualty Assistance Control Officers (CACOs), AFIP relationship and on-going care for the families.

Evidence for parallel activation of the pre-supplementary motor area and inferior frontal cortex during response inhibition: a combined MEG and TMS study

PubMed Central

Singh, Krish D.; Verbruggen, Frederick

2018-01-01

This pre-registered experiment sought to uncover the temporal relationship between the inferior frontal cortex (IFC) and the pre-supplementary motor area (pre-SMA) during stopping of an ongoing action. Both regions have previously been highlighted as being central to cognitive control of actions, particularly response inhibition. Here we tested which area is activated first during the stopping process using magnetoencephalography, before assessing the relative chronometry of each region using functionally localized transcranial magnetic stimulation. Both lines of evidence pointed towards simultaneous activity across both regions, suggesting that parallel, mutually interdependent processing may form the cortical basis of stopping. Additional exploratory analysis, however, provided weak evidence in support of previous suggestions that the pre-SMA may provide an ongoing drive of activity to the IFC. PMID:29515852

Diabetes self-management among Arab Americans: patient and provider perspectives.

PubMed

Fritz, Heather; DiZazzo-Miller, Rosanne; Bertran, Elizabeth A; Pociask, Fredrick D; Tarakji, Sandra; Arnetz, Judith; Lysack, Catherine L; Jaber, Linda A

2016-08-31

Arab Americans have a high burden of diabetes and poor outcomes compared to the general U.S. Diabetes self-management (DSM) requires a partnership between patients and providers that fosters mutual understanding and shared decision-making. Cultural factors influence this process; however, little is known regarding the cultural impact on DSM or if perceptions differ between patients and providers. Qualitative content analysis was used to analyze five focus groups-two groups with Arab American providers (n = 8) and three groups with adult Arab Americans with diabetes (n = 23). Focus groups examined patient and provider perspectives on the meaning of DSM and cultural barriers and facilitators among Arab American patients. Four distinct themes included limited resources for DSM education and support, stigma as a barrier to ongoing support, family support as an opportunity and challenge, and Arab American patient-provider relationships. Findings indicate several domains should be considered for clinical practice including a need to develop linguistically and culturally reliant educational materials and relevant supports for use in the Arab American population. Findings highlight differing views among providers and patients on the familial role in supporting DSM efforts and why some patients feel dissatisfied with clinical encounters.

Developing and Sustaining an Educative Mentoring Model of STEM Teacher Professional Development through Collaborative Partnership

ERIC Educational Resources Information Center

Richmond, Gail; Dershimer, R. Charles; Ferreira, Maria; Maylone, Nelson; Kubitskey, Beth; Meriweather, Alycia

2017-01-01

In this paper, we present details of a partnership undertaken by four universities with field-based, alternative STEM teacher preparation programs and a large urban school district to provide ongoing professional support for teachers serving as mentors for individuals preparing for careers in high-poverty schools. We also present key findings…

Early College High School Initiative. Evaluation Year End Report: 2003?2004

ERIC Educational Resources Information Center

Berger, Andrea R.; Cole, Susan; Melton, Janet; Safran, Stephanie; Vogel, Tyler; Walton, Laura; Adelman, Nancy; Hall, Catherine; Keating, Kaelie Knowles; Murray, Samantha; Nielsen, Natalie; Schaffner, Monika

2005-01-01

This is the first year-end report produced as part of the on-going evaluation of the Bill & Melinda Gates Foundation's Early College High School Initiative. The program provides funding and support for the establishment of Early College High Schools, which are organized to allow all enrolled students the opportunity to earn a high school diploma…

Reading Is a BLAST! Inside an Innovative Literacy Collaboration between Public Schools and the Public Library

ERIC Educational Resources Information Center

Genest, Maria T.

2014-01-01

Public libraries have long supported the literacy goals of public schools in their communities by providing access to printed and electronic resources that enhance learning and teaching. This article describes an ongoing collaboration between the Carnegie Library of Pittsburgh's BLAST outreach program and the Pittsburgh Public Schools that has…

Presenters in Focus: School-Based Social-Emotional and Behavior Screening--Using Data to Guide Interventions

ERIC Educational Resources Information Center

Eklund, Katie; Kilgus, Stephen

2017-01-01

Systematic screening for behavioral and social-emotional concerns at school is one way to ensure that at-risk children are identified and provided services. School psychologists play a critical role in creating multitiered systems of support that consider universal screening, early intervention, and ongoing progress monitoring to help support…

Does a School Social Worker's Gender Matter? The Experience of Pregnant and Parenting Teens

ERIC Educational Resources Information Center

Lucio, Robert; Dixon, Donald M.

2008-01-01

Nearly one million adolescent girls in the United States become pregnant annually, which has significant negative social and economic consequences. The number of teen pregnancies totals 50,000 in Florida, where state statutes require that these adolescents be provided with ongoing education and other support services in schools. While school…

Enhancing Primary Science Teaching: Interconnections of Content, Policy and Practice in a New Zealand Professional Learning and Development Programme

ERIC Educational Resources Information Center

Sexton, Steven S.

2018-01-01

This paper reports on an ongoing professional learning and development (PLD) initiative in New Zealand. The Academy is designed to provide primary and intermediate classroom teachers with the knowledge, materials and support needed for effective delivery of "The New Zealand Curriculum's" science subject area. Specifically, this paper…

Achieving Inclusion? Effective Resourcing of Students with Special Educational Needs

ERIC Educational Resources Information Center

Banks, Joanne; Frawley, Denise; McCoy, Selina

2015-01-01

In line with the increasing policy emphasis on inclusive education, there is now a greater focus on how best to provide for students special educational needs (SEN) in mainstream schools. However, there is little consensus internationally as to the most equitable way in which to support these students. Despite ongoing evaluations of the existing…

Early Communication Strategies: Using Video Analysis to Support Teachers Working with Preverbal Pupils

ERIC Educational Resources Information Center

Anderson, Carolyn

2006-01-01

Carolyn Anderson is a speech and language therapist who is currently working as a senior lecturer at the University of Strathclyde. In this article she provides an early account of her ongoing research into communication between teachers and pupils with severe and complex learning disabilities. Video recordings were made of teacher-pupil…

Report: Third Regional Seminar, Southeastern Region Adult Basic Education Staff Development Project (New Orleans, May 5-10, 1970).

ERIC Educational Resources Information Center

Southern Regional Education Board, Atlanta, GA.

The regional seminars of the Southern Regional Education Board (SREB) are designed to provide inservice training and planning experiences to foster the professional growth of state department of education, university, and local AE/ABE staff members. The third regional seminar was aimed at developing ongoing, self-supporting training programs…

Space Station Freedom operations planning

NASA Technical Reports Server (NTRS)

Smith, Kevin J.

1988-01-01

This paper addresses the development of new planning methodologies which will evolve to serve the Space Station Freedom program; these planning processes will focus on the complex task of effectively managing the resources provided by the Space Station Freedom and will be made available to the diverse international community of space station users in support of their ongoing investigative activities.

WHY MUSEUMS MATTER: A TALE OF PINWORMS (OXYUROIDEA: HETEROXYNEMATIDAE) AMONG PIKAS (OCHOTONA PRINCEPS AND O. COLLARIS) IN THE AMERICAN WEST.

USDA-ARS?s Scientific Manuscript database

Permanent and well supported museum collections provide a solid foundation for the process of systematics research through creation of an empirical record which validates our understanding of the biosphere. We explore the role of museums in ongoing studies of the complex helminth fauna characterist...

Improving Preschoolers' Language and Literacy Skills through Web-Mediated Professional Development

ERIC Educational Resources Information Center

Cabell, Sonia Q.; Downer, Jason T.

2011-01-01

MyTeachingPartner (MTP) is a Web-mediated approach that provides ongoing support for teachers to improve the quality of their interactions with children. This study examined the effects of MTP on the preschool language and literacy development of children who are at risk for later academic difficulties. Results of this randomized controlled trial…

Supporting mentors working with students with intellectual disabilities in higher education.

PubMed

Giust, Amanda M; Valle-Riestra, Diana M

2017-06-01

Project Panther LIFE is an inclusive postsecondary transition program for students with intellectual disabilities providing university access and participation with the primary goal of employment at program completion. Students in the program receive support from their academic mentors and peer coaches during the academic year. This study examines the skills and activities mentors use during their weekly sessions with students with intellectual disabilities and identifies areas in which mentors may require further support or training. Data analysis revealed major themes related to inclusion, self-determination, and adaptive behavior skills. Upon review of the data, we suggest that mentors need ongoing support from transition programs especially in areas related to encouraging self-advocacy and supporting time management.

The changing role of the medical technologist from technologist to information specialist.

PubMed

Miller, W G

2000-01-01

Pathology laboratory services are dependent on the laboratory information system (LIS) to organize the work, manage the operation, and communicate the results for effective laboratory medicine. For maximum efficiency, staffing for the LIS should be an integral component of laboratory operations and is facilitated by a two-tier structure. A core LIS staff provides system support and continuous services. A group of bench medical technologists have multitasking responsibilities, including LIS support for a specific laboratory work area. The two components form a team that uses staff efficiently to provide ongoing operational services and flexibility for problem solving and new functionality implementation.

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

PubMed

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

2018-04-28

Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Systematic scoping review. MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The road to pharmacist prescribing in Alberta Health Services.

PubMed

Gray, Margaret; Mysak, Tania

2016-09-15

The implementation of policy within a health organization to support a new legislative and regulatory framework of pharmacist prescribing in the Canadian province of Alberta is described. The evolution of pharmacists' practice activities to encompass medication management through independent prescribing authority has occurred in many jurisdictions around the world. In 2007, Alberta pharmacists were granted the most progressive scope of practice in all of North America. Pursuant to a series of legislative and regulatory initiatives enacted since 2000, the provincial health authority, Alberta Health Services (AHS), has worked to (1) establish a policy framework that supports pharmacist prescribing, (2) provide opportunities for pharmacist prescribing in both inpatient and ambulatory care practice environments, and (3) provide motivation and resources for AHS pharmacists to acquire "additional prescribing authorization" (APA) that enables them to independently prescribe and manage patients' ongoing drug therapy. Pharmacists with APA currently are permitted to prescribe all medications requiring a prescription, with the exception of opiates and other controlled substances; efforts to expand pharmacist prescribing to include those medications are ongoing. Currently, nearly half of all AHS pharmacists have APA. The health authority plans to make APA a standard expectation for all clinical pharmacists working in collaborative practice settings. Opportunities provided to Alberta pharmacists by legislation have been embraced by the provincial health authority. The AHS leadership remains committed to ensuring that its pharmacists practice to the full extent of their scope of practice and actively encourages and supports them in their efforts to provide optimal patient care. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Peer support for people with chronic conditions in rural areas: a scoping review.

PubMed

Lauckner, Heidi M; Hutchinson, Susan L

2016-01-01

Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselves and maintain their health from people also living with chronic conditions, is one approach gaining recognition. What remains unknown are the unique challenges and strategies associated with peer support for chronic condition self-management in rural contexts. In order to inform the development of peer supports in the authors' local context in rural eastern Canada, a scoping review was undertaken to discover community-based peer support initiatives for adults in rural settings living with chronic conditions. The authors followed established scoping review methods to answer the research question What is known from the existing literature about the key features and potential formats of community-based peer support initiatives for adults living with chronic conditions in rural settings? Six databases (CINAHL, PubMed, Sociological Abstracts, Embase, Cochrane Libraries and PsycInfo) were searched using the following concepts: chronic conditions, peer support, community-based and rural context. Two researchers reviewed the titles and/or abstracts of the 1978 articles retrieved from the initial search to include articles that were in English, published in 2000 to 2014, and that explicitly discussed rural programs/interventions with peers that were community-based. The initial screen excluded 1907 articles, leaving 71 articles, which were read by two research members in light of the inclusion/exclusion criteria. Thirteen articles representing 10 separate programs were included and analyzed using qualitative content analysis. Included programs were from the USA, Australia and Canada. A range of formats (telecommunications only, in-person meetings only, or a combination of both) were used. Peer leaders had varied experiences with chronic conditions and received training in content and facilitation skills. Peer leaders were provided with ongoing support. Program participants received training on chronic conditions, and programs provided opportunities for social support and the development of new skills. Programs focused on creating social connections, reducing stigma, ensuring relevance and promoting empowerment. Of the nine programs that reported outcomes, eight reported positive outcomes and one reported mixed results. Consistent with the extant literature, the programs identified unique issues faced by people with chronic conditions in rural areas that these programs addressed. The key findings of this scoping review are as follows: 1. A combination of telecommunications with some face-to-face meetings can support the accessibility of peer support programs in rural areas. 2. Core elements of these programs are the provision of social support and skill development. 3. Peer leaders benefit from skills training and ongoing support. 4. Sustainability of such programs is complex and requires multiple strategies. Cultural relevance, ongoing support and the use of telecommunications were key features of rural peer support programs. Guiding questions to facilitate a community consultation around these findings are provided. Peer support chronic condition self-management programs require further research.

JPL Mission Bibliometrics

NASA Technical Reports Server (NTRS)

Coppin, Ann

2013-01-01

For a number of years ongoing bibliographies of various JPL missions (AIRS, ASTER, Cassini, GRACE, Earth Science, Mars Exploration Rovers (Spirit & Opportunity)) have been compiled by the JPL Library. Mission specific bibliographies are compiled by the Library and sent to mission scientists and managers in the form of regular (usually quarterly) updates. Charts showing publications by years are periodically provided to the ASTER, Cassini, and GRACE missions for supporting Senior Review/ongoing funding requests, and upon other occasions as a measure of the impact of the missions. Basically the Web of Science, Compendex, sometimes Inspec, GeoRef and Aerospace databases are searched for the mission name in the title, abstract, and assigned keywords. All get coded for journal publications that are refereed publications.

Supporting Primary Care Practices in Building Capacity to Use Health Information Data

PubMed Central

Fernald, Douglas; Wearner, Robyn; Dickinson, W. Perry

2014-01-01

Introduction: Our objective was to describe essential support resources and strategies in order to advance the pace and scope of the use of health information technology (HIT) data. Background and Context: Primary data were collected between January 2011 and October 2012. The primary study population comprised 51 primary care practices enrolled in the Colorado Beacon Consortium in western Colorado. Methods: We used qualitative methods embedded in a mixed-method evaluation: monthly narrative reports from practices; interviews with providers and staff; and focused, group discussions with quality improvement (QI) advisors and staff from the Health Information Technology Regional Extension Center. Findings: Practices valued effective support strategies to assist with using HIT, including the following: translating rules and regulations into individual practice settings; facilitating peer-to-peer connections; providing processes and tools for practice improvement; maintaining accountability and momentum; and providing local electronic health record (EHR) technical expertise. Benefits of support included improved quality measures, operational improvements, increased provider and staff engagement, and deeper understanding of EHR data. Discussion: The findings affirm the utility of practice facilitation for HIT-focused aims with personalized attention and cross-fertilization among practices for improvements. Facilitation to sustain ongoing improvements and prepare for future HIT-intensive improvement activities was highly valued. In addition to the general practice facilitator, an EHR technical expert was critical to improving practice capacity to use electronic clinical data. Collaborative learning expands the pool of mentors and teachers, who can further translate their own lessons into practical advice for their peers, yielding the emergence of a stronger sense of community among the practices. Conclusions: Using HIT more effectively in primary care will require sustained, focused efforts by practices as regulations, incentives and HIT evolve. Ongoing support for community-based practice facilitators; collaborative learning; and local, personalized EHR advisors will help practices care for patients while more effectively deploying HIT to improve care. PMID:25848621

77 FR 73586 - Further Inquiry Into Issues Related to Mobility Fund Phase II

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... certain issues relating to the award of ongoing support for advanced mobile services. DATES: Comments are... availability of mobile broadband and high quality voice services in certain areas. Building on the comments... comprehensive record on certain issues related to the award of ongoing support for advanced mobile services. In...

Initial and Ongoing Teacher Preparation and Support: Current Problems and Possible Solutions

ERIC Educational Resources Information Center

Johnson, Harold A.

2013-01-01

The effective initial preparation and ongoing support of teachers of students who are deaf and hard of hearing has always been a difficult and controversial task. Changes in student demographic characteristics and educational settings, combined with the rapidly diminishing number and diversity of deaf education teacher preparation (DETP) programs,…

A patient centered care plan in the EHR: improving collaboration and engagement.

PubMed

Chunchu, Kavitha; Mauksch, Larry; Charles, Carol; Ross, Valerie; Pauwels, Judith

2012-09-01

Patients attempting to manage their chronic conditions require ongoing support in changing and adopting self-management behaviors. However, patient values, health goals, and action plans are not well represented in the electronic health record (EHR) impeding the ability of the team (MA and providers) to provide respectful, ongoing self-management support. We evaluated whether a team approach to using an EHR based patient centered care plan (PCCP) improved collaborative self-management planning. An experimental, prospective cohort study was conducted in a family medicine residency clinic. The experimental group included 7 physicians and a medical assistant who received 2 hr of PCCP training. The control group consisted of 7 physicians and a medical assistant. EHR charts were analyzed for evidence of 8 behavior change elements. Follow-up interviews with experimental group patients and physicians and the medical assistant assessed their experiences. We found that PCCP charts had more documented behavior change elements than control charts in all 8 domains (p < .001). Experimental group physicians valued the PCCP model and suggested ways to improve its use. Patient feedback demonstrated support for the model. A PCCP can help team members to engage patients with chronic illnesses in goal setting and action planning to support self-management. An EHR design that stores patient values, health goals, and action plans may strengthen continuity and quality of care between patients and primary care team members. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Evaluation of an ongoing psychoeducational inflammatory bowel disease support group in an adult outpatient setting.

PubMed

McMaster, Kristin; Aguinaldo, Laika; Parekh, Nimisha K

2012-01-01

Previous studies assessing efficacy of support groups for patients with inflammatory bowel disease showed mixed results in terms of attendance and overall effectiveness. In this study, researchers evaluated the use of an ongoing open psychoeducational support group for adult patients with inflammatory bowel disease in an outpatient tertiary setting. The sample consisted of 18 adults who have attended more than 2 meetings of the support group. Topics addressed in the support group include complementary medicine, diet and nutrition, the psychological impact of inflammatory bowel disease, medication and side effects, and insurance/disability. Participants were asked to complete the Client Satisfaction Questionnaire, Multidimensional Support Scale, 11 general demographic questions, and a brief open-ended qualitative questionnaire developed by the researchers. Results demonstrated that participants reported very high satisfaction with the support group and rated the adequacy of peer support from others with inflammatory bowel disease higher than support from family/friends and professionals. A majority of group members reported joining the group for mutual support and education; this expectation was met through the psychoeducational structure of the group. This study demonstrates the potential for success of an ongoing psychoeducational inflammatory bowel disease support group for adult patients and their caregivers.

Sustaining “Meaningful Use” of Health Information Technology in Low-Resource Practices

PubMed Central

Green, Lee A.; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

2015-01-01

PURPOSE The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices—those with limited financial, technical, and organizational resources—but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. METHODS We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. RESULTS Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. CONCLUSIONS Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a “digital divide” as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. PMID:25583887

Sustaining "meaningful use" of health information technology in low-resource practices.

PubMed

Green, Lee A; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

2015-01-01

The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices-those with limited financial, technical, and organizational resources-but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a "digital divide" as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. © 2015 Annals of Family Medicine, Inc.

Mechanisms and Effects of Transcranial Direct Current Stimulation

PubMed Central

Giordano, James; Bikson, Marom; Kappenman, Emily S.; Clark, Vincent P.; Coslett, H. Branch; Hamblin, Michael R.; Hamilton, Roy; Jankord, Ryan; Kozumbo, Walter J.; McKinley, R. Andrew; Nitsche, Michael A.; Reilly, J. Patrick; Richardson, Jessica; Wurzman, Rachel

2017-01-01

The US Air Force Office of Scientific Research convened a meeting of researchers in the fields of neuroscience, psychology, engineering, and medicine to discuss most pressing issues facing ongoing research in the field of transcranial direct current stimulation (tDCS) and related techniques. In this study, we present opinions prepared by participants of the meeting, focusing on the most promising areas of research, immediate and future goals for the field, and the potential for hormesis theory to inform tDCS research. Scientific, medical, and ethical considerations support the ongoing testing of tDCS in healthy and clinical populations, provided best protocols are used to maximize safety. Notwithstanding the need for ongoing research, promising applications include enhancing vigilance/attention in healthy volunteers, which can accelerate training and support learning. Commonly, tDCS is used as an adjunct to training/rehabilitation tasks with the goal of leftward shift in the learning/treatment effect curves. Although trials are encouraging, elucidating the basic mechanisms of tDCS will accelerate validation and adoption. To this end, biomarkers (eg, clinical neuroimaging and findings from animal models) can support hypotheses linking neurobiological mechanisms and behavioral effects. Dosage can be optimized using computational models of current flow and understanding dose–response. Both biomarkers and dosimetry should guide individualized interventions with the goal of reducing variability. Insights from other applied energy domains, including ionizing radiation, transcranial magnetic stimulation, and low-level laser (light) therapy, can be prudently leveraged. PMID:28210202

"I've got somebody there, someone cares": what support is most valued following a stroke?

PubMed

Northcott, Sarah; Hilari, Katerina

2017-06-19

There is often a need for increased support following a stroke. This study explored what types of support are provided by different network members and what support functions are most valued. Adults with first stroke were recruited from a stroke unit and participated in in-depth interviews 8-15 months poststroke. Framework Analysis was used to build thematic and explanatory accounts of the data. Twenty-nine participants took part. Main themes to emerge were as follows: the spouse was the most important provider of support; children were a relatively stable source of support, although many participants expressed reservations about worrying a child; relatives and friends typically provided social companionship and emotional support rather than on-going practical support. The only universally valued support function was the sense that someone was concerned and cared. Other valued functions were as follows: social companionship including everyday social "chit chat"; practical support provided sensitively; and, for many, sharing worries and sensitive encouragement. The manner and context in which support was provided was important: support was easiest to receive when it communicated concern, and was part of a reciprocal, caring relationship. As well as measuring supportive acts, researchers and clinicians should consider the manner and context of support. Implications for rehabilitation The manner in which support was provided mattered: support was easier to receive when it communicated concern. The spouse was the most important source of all support functions; children, relatives and friends were important providers of emotional and social companionship support. Researchers and clinicians should not only focus on what support is received, but also the context (e.g., contribution, reciprocity, quality of relationship) and manner (e.g., responsiveness, sensitivity) of the support.

Skills, systems and supports: An Aboriginal Community Controlled Health Service (Apunipima) approach to building health promotion evaluation capacity of staff.

PubMed

Nichols, Nina; McFarlane, Kathryn; Gibson, Priscilla; Millard, Fiona; Packer, Andrew; McDonald, Malcolm

2018-04-01

Building the health promotion evaluation capacity of a workforce requires more than a focus on individual skills and confidence. We must also consider the organisational systems and supports that enable staff to embed learnings into practice. This paper describes the processes used to build health promotion evaluation capacity of staff in an Aboriginal Community Controlled Health Service (ACCHS). To build health promotion evaluation capacity three approaches were used: (i) workshops and mentoring; (ii) strengthening systems to support program reporting; and (iii) recruitment of staff with skills and experience. Pre- and post-questionnaires determined levels of individual skills and confidence, updated systems were assessed for adequacy to support new health promotion practices and surveys captured the usefulness of workshops and mentoring. There was increased participant skills and confidence. Participants completed program impact evaluation reports and results were successfully presented at national conferences. The health promotion team was then able to update in-house systems to support new health promotion practices. Ongoing collaboration with experienced in-house researchers provided basic research training and professional mentoring. Building health promotion evaluation capacity of staff in an ACCHS can be achieved by providing individual skill development, strengthening organisational systems and utilising professional support. SO WHAT?: Health promotion practitioners have an ongoing professional obligation to improve the quality of routine practice and embrace new initiatives. This report outlines a process of building evaluation capacity that promotes quality reporting of program impacts and outcomes, reflects on ways to enhance program strengths, and communicates these findings internally and to outside professional bodies. This is particularly significant for ACCHSs responsible for addressing the high burden of preventable disease in Aboriginal and Torres Strait Islander populations. © 2017 Australian Health Promotion Association.

NASA Johnson Space Center Usability Testing and Analysis Facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, M.

2004-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility provides support to the Office of Biological and Physical Research, the Space Shuttle Program, the International Space Station Program, and other NASA organizations. In addition, there are ongoing collaborative research efforts with external businesses and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes. This presentation will provide an overview of ongoing activities, and will address how the projects will evolve to meet new space initiatives.

NASA Johnson Space Center Usability Testing and Analysis Facility (WAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, M.

2004-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility provides support to the Office of Biological and Physical Research, the Space Shuttle Program, the International Space Station Program, and other NASA organizations. In addition, there are ongoing collaborative research efforts with external businesses and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes. This presentation will provide an overview of ongoing activities, and will address how the projects will evolve to meet new space initiatives.

Detrended Fluctuation Analysis: A Scale-Free View on Neuronal Oscillations

PubMed Central

Hardstone, Richard; Poil, Simon-Shlomo; Schiavone, Giuseppina; Jansen, Rick; Nikulin, Vadim V.; Mansvelder, Huibert D.; Linkenkaer-Hansen, Klaus

2012-01-01

Recent years of research have shown that the complex temporal structure of ongoing oscillations is scale-free and characterized by long-range temporal correlations. Detrended fluctuation analysis (DFA) has proven particularly useful, revealing that genetic variation, normal development, or disease can lead to differences in the scale-free amplitude modulation of oscillations. Furthermore, amplitude dynamics is remarkably independent of the time-averaged oscillation power, indicating that the DFA provides unique insights into the functional organization of neuronal systems. To facilitate understanding and encourage wider use of scaling analysis of neuronal oscillations, we provide a pedagogical explanation of the DFA algorithm and its underlying theory. Practical advice on applying DFA to oscillations is supported by MATLAB scripts from the Neurophysiological Biomarker Toolbox (NBT) and links to the NBT tutorial website http://www.nbtwiki.net/. Finally, we provide a brief overview of insights derived from the application of DFA to ongoing oscillations in health and disease, and discuss the putative relevance of criticality for understanding the mechanism underlying scale-free modulation of oscillations. PMID:23226132

Effectiveness of the Civil Aviation Security Program.

DTIC Science & Technology

1979-12-05

The airline and airport security measures currently in effect continue to provide increased safety for airline passengers and crews as well as...107 governing airport security . other ongoing programs which contributed significantly to airport security included the training of law enforce- ment...officers supporting airport security programs and the explosives detection K(9 team program. Highlights of these actions and programs are summarized

Insights on Inspirational Education for "High-Risk" Youth Informed by Participatory Action Research (PAR) on Youth Engagement: Short Communication

ERIC Educational Resources Information Center

Iwasaki, Yoshitaka; Hopper, Tristan; Whelan, Patricia

2017-01-01

This short communication provides our insights into how or in what ways educators can more effectively support aspiration of at-risk/high-risk youth toward meaningful education. These are informed by the key learnings from our ongoing youth engagement research. Those insights emphasize the importance of "meaningful engagement of youth"…

Group Work at University: Significance of Personal Goals in the Regulation Strategies of Students with Positive and Negative Appraisals

ERIC Educational Resources Information Center

Volet, Simone; Mansfield, Caroline

2006-01-01

This paper examines the mediating role of students' goals in group work at university. Research on cooperative and collaborative learning has provided empirical support for the cognitive, motivational and social benefits of group work but the antecedents of motivation and ongoing management of emerging motivational and socio-emotional issues have…

Landowner and visitor response to forest landscape restoration: the Chequamegon-Nicolet National Forest Northeast Sands Project

Treesearch

Kristin Floress; Anna Haines; Emily Usher; Paul Gobster; Mike Dockry

2018-01-01

This report is intended to support the ongoing pine barrens restoration on work in the Lakewood-Laona Ranger District on the Chequamegon-Nicolet National Forest (CNNF). The report provides the results from 2016 surveys and focus groups examining landowner and visitor attitudes toward forest management treatments, communication, and restoration project outcomes; their...

Electronic portfolios in nursing education: a review of the literature.

PubMed

Green, Janet; Wyllie, Aileen; Jackson, Debra

2014-01-01

As health professionals, nurses are responsible for staying abreast of current professional knowledge and managing their own career, professional growth and development, and ideally, practices to support these activities should start during their student years. Interest in electronic or eportfolios is gathering momentum as educationalists explore their potential as a strategy for fostering lifelong learning and enhancing on-going personal and professional development. In this paper, we present an overview of e-portfolios and their application to nurse education, highlighting potential benefits and considerations of useage. We argue that the e-portfolio can represent an authentic means of assessing cognitive, reflective and affective skills. Furthermore, the e-portfolio provides a means through which nurses can record and provide evidence of skills, achievements, experience, professional development and on-going learning, not only for themselves, but for the information and scrutiny of registration boards, employers, managers and peers. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

New Direction of NASA Exploration Life Support

NASA Technical Reports Server (NTRS)

Chambliss, Joe; Lawson, B. Michael; Barta, Daniel J.

2006-01-01

NASA's activities in life support Research and Technology Development (R&TD) have changed in both focus and scope following implementation of recommendations from the Exploration System Architecture Study (ESAS). The limited resources available and the compressed schedule to conduct life support R&TD have required that future efforts address the needs of the Crew Exploration Vehicle (CEV), the Lunar Surface Access Module (LSAM) and Lunar Outpost (LO). Advanced Life Support (ALS) efforts related to long duration planetary bases have been deferred or canceled. This paper describes the scope of the new Exploration Life Support (ELS) project; how it differs from ALS, and how it supports critical needs for the CEV, LSAM and LO. In addition, this paper provides rationale for changes in the scope and focus of technical content within ongoing life support R&TD activities.

Consumers as mental health providers: first-person accounts of benefits and limitations.

PubMed

Mowbray, C T; Moxley, D P; Collins, M E

1998-11-01

Community support programs are increasingly establishing paid service positions designated exclusively for consumers. Project WINS (Work Incentives and Needs Study), a hybrid case management-vocational program for individuals with severe mental illness, used consumers as peer support specialists (PSSs) to supplement professional roles. Semistructured interviews were conducted with PSSs about 12 months after their employment ended. They identified substantial personal benefits specific to consumer-designated roles (e.g., a "safe" employment setting with accommodations) and general benefits from employment. Problems described were just as numerous, encompassing attitudes toward assigned peers and costs to their own well-being. Critical commentary addressed program operations (structure, supervision, and training needs) and problems in the mental health system. The authors discuss the changed sense of self that service provider roles can create for consumers and suggest that mental health administrators provide anticipatory socialization for this service innovation throughout their agencies and ongoing supports for consumers in their new roles.

Weighing the Anti-Ischemic Benefits and Bleeding Risks from Aspirin Therapy: a Rational Approach.

PubMed

Dugani, Sagar; Ames, Jeffrey M; Manson, JoAnn E; Mora, Samia

2018-02-21

The role of aspirin in secondary cardiovascular prevention is well understood; however, the role in primary prevention is less clear, and requires careful balancing of potential benefits with risks. Here, we summarize the evidence base on the benefits and risks of aspirin therapy, discuss clinical practice guidelines and decision support tools to assist in initiating aspirin therapy, and highlight ongoing trials that may clarify the role of aspirin in cardiovascular disease prevention. In 2016, the USPSTF released guidelines on the use of aspirin for primary prevention. Based on 11 trials (n = 118,445), aspirin significantly reduced all-cause mortality and nonfatal myocardial infarction, and in 7 trials that evaluated aspirin ≤ 100 mg/day, there was significant reduction in nonfatal stroke. The USPSTF recommends individualized use of aspirin based on factors including age, 10-year atherosclerotic cardiovascular disease risk score, and bleeding risk. Several ongoing trials are evaluating the role of aspirin in primary prevention, secondary prevention, and in combination therapy for atrial fibrillation. Evidence-based approaches to aspirin use should consider the anti-ischemic benefits and bleeding risks from aspirin. In this era of precision medicine, tools that provide the personalized benefit to risk assessment, such as the freely available clinical decision support tool (Aspirin-Guide), can be easily incorporated into the electronic health record and facilitate more informed decisions about initiating aspirin therapy for primary prevention. Aspirin has a complex matrix of benefits and risks, and its use in primary prevention requires individualized decision-making. Results from ongoing trials may guide healthcare providers in identifying appropriate candidates for aspirin therapy.

Pregnancy and Parenting Support for Incarcerated Women: Lessons Learned

PubMed Central

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

2017-01-01

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

Strengthening Māori participation in the New Zealand health and disability workforce.

PubMed

Ratima, Mihi M; Brown, Rachel M; Garrett, Nick K G; Wikaire, Erena I; Ngawati, Renei M; Aspin, Clive S; Potaka, Utiku K

2007-05-21

Substantial progress has been made in Māori health and disability workforce development in the past 15 years. Key factors in successful programs to increase Māori health workforce recruitment and retention include Māori leadership, mentorship and peer support; and comprehensive support within study programs and in the transitions between school, university and work. The interventions to date provide a strong basis for ongoing action to address inequities in Māori health workforce participation, and are likely to be relevant to health workforce development approaches for other indigenous peoples.

Nurse Leadership and Informatics Competencies: Shaping Transformation of Professional Practice.

PubMed

Kennedy, Margaret Ann; Moen, Anne

2017-01-01

Nurse leaders must demonstrate capacities and develop specific informatics competencies in order to provide meaningful leadership and support ongoing transformation of the healthcare system. Concurrently, staff informatics competencies must be planned and fostered to support critical principles of transformation and patient safety in practice, advance evidence-informed practice, and enable nursing to flourish in complex digital environments across the healthcare continuum. In addition to nurse leader competencies, two key aspects of leadership and informatics competencies will be addressed in this chapter - namely, the transformation of health care and preparation of the nursing workforce.

Allied health careers special resources and services program: increasing the probabilities of success for 'high risk' students in allied health career programs.

PubMed

Murtha, J P; Grimm, F M

1979-11-01

This article describes a successful developmental program specifically designed for academically "high risk" students entering a two-year community college career program in allied health. The program consisted of providing an intensive three-week instructional program to students before they entered the allied health career program, and subsequently providing an ongoing support system of tutoring, counseling and career development activities. Participants attained higher levels of academic performance and retention than nonparticipants.

Avionics Architectures for Exploration: Wireless Technologies and Human Spaceflight

NASA Technical Reports Server (NTRS)

Goforth, Montgomery B.; Ratliff, James E.; Barton, Richard J.; Wagner, Raymond S.; Lansdowne, Chatwin

2014-01-01

The authors describe ongoing efforts by the Avionics Architectures for Exploration (AAE) project chartered by NASA's Advanced Exploration Systems (AES) Program to evaluate new avionics architectures and technologies, provide objective comparisons of them, and mature selected technologies for flight and for use by other AES projects. The AAE project team includes members from most NASA centers and from industry. This paper provides an overview of recent AAE efforts, with particular emphasis on the wireless technologies being evaluated under AES to support human spaceflight.

The gains and pains of being a cancer support group leader: a qualitative survey of rewards and challenges.

PubMed

Butow, Phyllis; Beeney, Linda; Juraskova, Ilona; Ussher, Jane; Zordan, Rachel

2009-01-01

Rewards derived from leading a cancer support group are poorly understood yet may be crucial to offset the challenges and difficulties of this role. This study sought to obtain the views of a representative sample of Australian cancer support group leaders (CSGLs) concerning the perceived rewards and challenges of their role. All CSGLs identified by the state-based Cancer Councils were invited to participate by postal questionnaire. Qualitative methods were used to analyze responses to open-ended questions concerning rewards and challenges. A total of 300 CSGLs returned the questionnaire (response rate = 66%) with 272 providing qualitative comments. Four parallel themes emerged from the qualitative analysis: (i) Personal, (ii) Relationship, (iii) Group, and (iv) Community rewards and challenges. These were integrated into a model depicting key positive and negative aspects of the CSGL's role, to provide direction for future training and ongoing support of CSGLs.

ORAC: a modern observing system for UKIRT

NASA Astrophysics Data System (ADS)

Bridger, Alan; Wright, Gillian S.; Economou, Frossie; Tan, Min; Currie, Malcolm J.; Pickup, David A.; Adamson, Andrew J.; Rees, Nicholas P.; Purves, Maren; Kackley, Russell

2000-06-01

The steady improvement in telescope performance at UKIRT and the increase in data acquisition rates led to a strong desired for an integrated observing framework that would meet the needs of future instrumentation, as well as providing some support for existing instrumentation. Thus the Observatory Reduction and Acquisition Control (ORAC) project was created in 1997 with the goals of improving the scientific productivity in the telescope, reducing the overall ongoing support requirements, and eventually supporting the use of more flexibly scheduled observing. The project was also expected to achieve this within a tight resource allocation. In October 1999 the ORAC system was commissioned at the United Kingdom Infrared Telescope.

Developing User-Driven Climate Information Services to Build Resilience Amongst Groups at Risk of Drought and Flood in Arid and Semi-Arid Land Counties in Kenya

NASA Astrophysics Data System (ADS)

Githungo, W. N.; Shaka, A.; Kniveton, D.; Muithya, L.; Powell, R.; Visman, E. L.

2014-12-01

The Arid and Semi-Arid Land (ASAL) counties of Kitui and Makueni in Kenya are experiencing increasing climate variability in seasonal rainfall, including changes in the onset, cessation and distribution of the two principal rains upon which the majority of the population's small-holder farmers and livestock keepers depend. Food insecurity is prevalent with significant numbers also affected by flooding during periods of intense rainfall. As part of a multi-partner Adaptation Consortium, Kenya Meteorological Services (KMS) are developing Climate Information Services (CIS) which can better support decision making amongst the counties' principal livelihoods groups and across County Government ministries. Building on earlier pilots and stakeholder discussion, the system combines the production of climate information tailored for transmission via regional and local radio stations with the establishment of a new SMS service. SMS are provided through a network of CIS intermediaries drawn from across key government ministries, religious networks, non-governmental and community groups, aiming to achieve one SMS recipient per 3-500 people. It also introduces a demand-led, premium-rate SMS weather information service which is designed to be self-financing in the long term. Supporting the ongoing process of devolution, KMS is downscaling national forecasts for each county, and providing seasonal, monthly, weekly and daily forecasts, as well as warnings of weather-related hazards. Through collaboration with relevant ministries, government bodies and research institutions, including livestock, agriculture, drought management and health, technical advisories are developed to provide guidance on application of the climate information. The system seeks to provide timely, relevant information which can enable people to use weather and climate information to support decisions which protect life and property and build resilience to ongoing climate variability and future change.

A qualitative study exploring the value of a catheter passport.

PubMed

Jaeger, Melanie De; Fox, Fiona; Cooney, Geraldine; Robinson, Jacqueline

2017-08-10

Many patients leaving hospital with a catheter do not have sufficient information to self-care and can experience physical and psychological difficulties. This study aimed to explore how a patient-held catheter passport affects the experiences of patients leaving hospital with a urethral catheter, the hospital nurses who discharge them and the community nurses who provide ongoing care for them. Qualitative methods used included interviews, focus groups and questionnaires, and thematic analysis. Three major themes were reported-informing patients, informing nurses; improving catheter care, promoting self-management; and supporting transition. The catheter passport can bridge the existing information gap, improve care, promote self-care and help patients adjust to their catheter, especially if complemented by ongoing input from a nurse or other health professional.

InTASC Model Core Teaching Standards and Learning Progressions for Teachers 1.0: A Resource for Ongoing Teacher Development

ERIC Educational Resources Information Center

Council of Chief State School Officers, 2013

2013-01-01

The Council of Chief State School Officers (CCSSO), through its Interstate Teacher Assessment and Support Consortium (InTASC), offers this set of combined resources that define and support ongoing teacher effectiveness to ensure students reach college and career ready standards. This document includes the "InTASC Model Core Teaching…

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

PubMed

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

2011-04-01

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

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.

VA Health Care: Actions Needed to Improve Newly Enrolled Veterans Access to Primary Care

DTIC Science & Technology

2015-03-01

that arise prior to making contact with veterans. Further, ongoing scheduling errors, such as incorrectly revising preferred dates when rescheduling ...primary care provider and support staff—a nurse care manager, clinical associate, and administrative clerk. Letter Page 2 GAO-16-328...appointments were canceled, and if so, whether and when they were rescheduled . We also obtained information on the dates

Database of Renewable Energy and Energy Efficiency Incentives and Policies Final Technical Report

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

Lips, Brian

The Database of State Incentives for Renewables and Efficiency (DSIRE) is an online resource that provides summaries of all financial incentives and regulatory policies that support the use of renewable energy and energy efficiency across all 50 states. This project involved making enhancements to the database and website, and the ongoing research and maintenance of the policy and incentive summaries.

Social Network Data Validity: The Example of the Social Network of Caregivers of Older Persons with Alzheimer-Type Dementia

ERIC Educational Resources Information Center

Carpentier, Normand

2007-01-01

This article offers reflection on the validity of relational data such as used in social network analysis. Ongoing research on the transformation of the support network of caregivers of persons with an Alzheimer-type disease provides the data to fuel the debate on the validity of participant report. More specifically, we sought to understand the…

Analytic innovations for air quality modeling | Science ...

EPA Pesticide Factsheets

The presentation provides an overview of ongoing research activities at the U.S. EPA, focusing on improving long-term emission projections and the development of decision support systems for coordinated environmental, climate and energy planning. This presentation will be given on October 10th, 2016, at the Johns Hopkins Dept. of Environmental Health and Engineering as part of the Environmental Science and Management Seminar Series.

Biologist postdoctoral fellow | Center for Cancer Research

Cancer.gov

A fully funded postdoctoral position is available at the National Cancer Institute on the NIH main campus in Bethesda, MD.  Specifically, this opening is for an ongoing project examining the role of tissue architecture and mechanotransduction in the establishment of metastatic lesions, using zebrafish as a model system.  The NIH will provide funding and benefits, though extramural fellowship applications will be strongly encouraged and supported.

Alternative Assessments in Practice Data Base. Project 1.2: Technical Assistance on Assessment Issues. Annual Report of Communication, Training and Dissemination Activities.

ERIC Educational Resources Information Center

Center for Research on Evaluation, Standards, and Student Testing, Los Angeles, CA.

The Center for Research on Evaluation, Standards, and Student Testing (CRESST) has developed an Alternative Assessments in Practice Data Base to support technical assistance needs and to promote the exchange of new assessment ideas. The database is designed to provide easy access and retrieval of information about ongoing and newly developed…

Registered nurse and health care chaplains experiences of providing the family support person role during family witnessed resuscitation.

PubMed

James, Jayne; Cottle, Elita; Hodge, Reverend Debbie

2011-02-01

To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

Optimizing identification and management of COPD patients – reviewing the role of the community pharmacist

PubMed Central

van Boven, Job F. M.; Maguire, Terence; Goyal, Pankaj; Altman, Pablo

2016-01-01

The aim of this paper was to propose key steps for community pharmacist integration into a patient care pathway for chronic obstructive pulmonary disease (COPD) management. A literature search was conducted to identify publications focusing on the role of the community pharmacist in identification and management of COPD. The literature search highlighted evidence supporting an important role for pharmacists at each of the four key steps in the patient care pathway for COPD management. Step 1 (primary prevention): pharmacists are ideally placed to provide information on disease awareness and risk prevention campaigns, and to encourage lifestyle interventions, including smoking cessation. Step 2 (early detection/case finding): pharmacists are often the first point of contact between the patient and the healthcare system and can therefore play an important role in the early identification of patients with COPD. Step 3 (management and ongoing support): pharmacists can assist patients by providing advice and education on dosage, inhaler technique, treatment expectations and the importance of adherence, and by supporting self‐management, including recognition and treatment of COPD exacerbations. Step 4 (review and follow‐up): pharmacists can play an important role in monitoring adherence and ongoing inhaler technique in patients with COPD. In summary, pharmacists are ideally positioned to play a vital role in all key stages of an integrated COPD patient care pathway from early disease detection to the support of management plans, including advice and counselling regarding medications, inhaler technique and treatment adherence. Areas requiring additional consideration include pharmacist training, increasing awareness of the pharmacist role, administration and reimbursement, and increasing physician–pharmacist collaboration. PMID:27510273

The Use of the Data-to-Action Framework in the Evaluation of CDC's DELTA FOCUS Program.

PubMed

Armstead, Theresa L; Kearns, Megan; Rambo, Kirsten; Estefan, Lianne Fuino; Dills, Jenny; Rivera, Moira S; El-Beshti, Rasha

The Centers for Disease Control and Prevention's (CDC's) Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States (DELTA FOCUS) program is a 5-year cooperative agreement (2013-2018) funding 10 state domestic violence coalitions and local coordinated community response teams to engage in primary prevention of intimate partner violence. Grantees' prevention strategies were often developmental and emergent; therefore, CDC's approach to program oversight, administration, and support to grantees required a flexible approach. CDC staff adopted a Data-to-Action Framework for the DELTA FOCUS program evaluation that supported a culture of learning to meet dynamic and unexpected information needs. Briefly, a Data-to-Action Framework involves the collection and use of information in real time for program improvement. Utilizing this framework, the DELTA FOCUS data-to-action process yielded important insights into CDC's ongoing technical assistance, improved program accountability by providing useful materials, and information for internal agency leadership, and helped build a learning community among grantees. CDC and other funders, as decision makers, can promote program improvements that are data-informed by incorporating internal processes supportive of ongoing data collection and review.

Behavioral Health and Performance at NASA JSC: Recent Successes and Future Plan for BHP Research and Operations

NASA Technical Reports Server (NTRS)

Leveton, L. B.; VanderArk, S. T.

2014-01-01

The Behavioral Health and Performance discipline at NASA Johnson Space Center is organized into two distinct Divisions (Biomedical Research and Environmental Science Division and Space and Clinical Operations Division) but is integrated and interrelated in its day-to-day work. Ongoing operations supporting NASA's spaceflight goals benefit from the research portfolios that address risks to mission success. Similarly, these research portfolios are informed by operations to ensure investigations stay relevant given the dynamic environment of spaceflight. There are many success stories that can be presented where initial work begun as a BHP Research project, and funded through the Human Research Program, was fully implemented in operations or addressed an operational need. Examples include improving effectiveness of the debriefings used within Mission Control by the Mission Operations Directorate and countermeasures for fatigue management. There is also ongoing collaboration with research and operations for developing selection methods for future generation astronauts, and to enhance and inform the current family support function. The objective of this panel is to provide examples of recent success stories, describe areas where close collaboration is benefitting ongoing research and operations, and summarize how this will come together as NASA plans for the one year ISS mission - a unique opportunity for both BHP operations and research to learn more about preparing and supporting crewmembers for extended missions in space. The proposed panel will be comprised of six presentations, each describing a unique aspect of research or operations and the benefits to current and future spaceflight.

"It Takes a Network": Building National Capacity for Climate Change Interpretation

NASA Astrophysics Data System (ADS)

Spitzer, W.

2014-12-01

Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. More than 1,500 informal science venues (science centers, museums, aquariums, zoos, nature centers, national parks) are visited annually by 61% of the U.S. population. These visitors expect reliable information about environmental issues and solutions. NNOCCI enables teams of informal science interpreters across the country to serve as "communication strategists" - beyond merely conveying information they can influence public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. Beyond providing in-depth training, we have found that our "alumni network" is assuming an increasingly important role in achieving our goals: 1. Ongoing learning - Training must be ongoing given continuous advances in climate and social science research. 2. Implementation support - Social support is critical as interpreters move from learning to practice, given complex and potentially contentious subject matter. 3. Leadership development - We rely on a national cadre of interpretive leaders to conduct workshops, facilitate study circle trainings, and support alumni. 4. Coalition building - A peer network helps to build and maintain connections with colleagues, and supports further dissemination through the informal science community. We are experimenting with a variety of online and face to face strategies to support the growing alumni network. Our goals are to achieve a systemic national impact, embed our work within multiple ongoing regional and national climate change education networks, and leave an enduring legacy.

Helping parents live with the hole in their heart: The role of health care providers and institutions in the bereaved parents' grief journeys.

PubMed

Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah V; Baker, Justin N

2016-09-01

Bereaved parents experience significant psychosocial and health sequelae, suggesting that this population may benefit from the ongoing extension of support and resources throughout the grief journey. The interaction of hospital staff with patients and families at the end of a child's life and after death profoundly affects parental grief, offering a unique opportunity for the medical community to positively impact the bereavement experience. The current study was conducted to explore the role of the health care team and medical institutions in the grief journeys of parents whose child died a cancer-related death. Eleven bereaved parents participated in 2 focus groups. Responses to each of the 3 main prompts were coded and analyzed independently using semantic content analysis techniques. Four main concepts were identified within the parental narratives, including the importance of strong and ongoing relationships between providers and bereaved families, the importance of high-quality communication, the effect of negative experiences between providers and families on parental grief, and the importance of the institution's role in the grief journeys of bereaved parents. Bereaved parents consistently identified the critical role played by medical staff and medical institutions throughout the grief journey. Key components of bereavement support identified by parents should serve to guide the actions of providers as well as provide a template for the development of a comprehensive bereavement program within an institution. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2757-2765. © 2016 American Cancer Society. © 2016 American Cancer Society.

Evolving career choice narratives of new graduate nurses.

PubMed

Price, Sheri L; McGillis Hall, Linda; Murphy, Gail Tomblin; Pierce, Bridget

2018-01-01

This article describes findings from one stage of a longitudinal study of the professional socialization experiences of Millennial nurses as they prepared for graduation and transition to practice. This study employed an interpretive narrative methodology guided by Polkinghorne's theory of narrative identity. Analysis of face-to-face interviews and journal entries by Millennial nursing students uncovered the formal professional socialization experiences over four years of nursing education. Participants include six Millennial nursing student participants (born after 1980) interviewed approximately one-month aftergraduation. These six participants are a voluntary subset of twelve who were interviewed prior to beginning their nursing studies, the analysis of which is captured in Price et al. (2013a) and Price et al. (2013b). Narrative analysis of the post-graduation interviews resulted in three main themes: 'Real Nursing: Making a Difference', 'The Good Nurse: Defined by Practice' and 'Creating Career Life Balance'. Graduate nurses strive to provide excellent nursing care as they transition into the workforce and identify a need for ongoing peer and professional supports to assist their ongoing professional socialization. Ongoing formal socialization and professional development is required to support the transition and retention of new nurse graduates in the workplace and the profession. Millenial generation nurses seek opportunities for career mapping, goal setting and formal mentorship by role models and peers to actualize their professional aspirations. Copyright © 2017. Published by Elsevier Ltd.

Building National Capacity for Climate Change Interpretation: The Role of Leaders, Partnerships, and Networks

NASA Astrophysics Data System (ADS)

Spitzer, W.

2015-12-01

Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. NNOCCI enables teams of informal science interpreters across the country to serve as "communication strategists" - beyond merely conveying information they can influence public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. We provide in-depth training as well as an alumni network for ongoing learning, implementation support, leadership development, and coalition building. Our goals are to achieve a systemic national impact, embed our work within multiple ongoing regional and national climate change education networks, and leave an enduring legacy. Our project represents a cross-disciplinary partnership among climate scientists, social and cognitive scientists, and informal education practitioners. We have built a growing national network of more than 250 alumni, including approximately 15-20 peer leaders who co-lead both in-depth training programs and introductory workshops. We have found that this alumni network has been assuming increasing importance in providing for ongoing learning, support for implementation, leadership development, and coalition building. As we look toward the future, we are exploring potential partnerships with other existing networks, both to sustain our impact and to expand our reach. This presentation will address what we have learned in terms of network impacts, best practices, factors for success, and future directions.

Center of Excellence in Aerospace Manufacturing Automation

DTIC Science & Technology

1983-11-01

affiliated industrial companies, who will pi,)vide financial support and ongoing guidance to the Institute. SIMA will encompass the design and management ...tactile sensing, intelligent systems for robot task management , and computer vision for robot management . We are addressing the question of how to provide...than anything today’s control systems could stably manage . To do this we have begun to develop a sequen- tial family of new manipulators that are

Protecting United States Interests in Antarctica

DTIC Science & Technology

1988-04-01

highest continental eievation(7). Because its average annual (water equivalent) precinitation amounts to only a few: inches(B). Antartic a is, irr &c’lc...Antarctic environment and ec. s ys tem( 89D These recomraendaticns are the only formal policymaking mechan1sm of the Antartic Tren.- reime. The...Ocean and Saudi Arabia provides financial support for ongoing, iceberg towing studies. NATIONAL SCIENCE FOUNDATION, UN’ITED STATES ANTARCTIC RESEARCH

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

NASA Technical Reports Server (NTRS)

Fern, Lisa; Rorie, Conrad; Shively, Jay

2015-01-01

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

Caring for caregivers of high-needs children.

PubMed

Peckham, Allie; Spalding, Karen; Watkins, Jillian; Bruce-Barrett, Cindy; Grasic, Marta; Williams, A Paul

2014-01-01

The Caregiver Framework for Children with Medical Complexity, led by the Hospital for Sick Children, is a ground-breaking initiative that validates and supports the vital role of unpaid, family caregivers. The project uses a supported self-management model that includes a modest amount of funding to address pressing needs, and relies on Key Workers who provide ongoing education, counselling and care management to assist caregivers in planning over the longer-term. This paper describes the findings from a multi-stage, mixed-methods evaluation to examine the design and outcomes of the Caregiver Framework. Copyright © 2014 Longwoods Publishing.

Developing a smartphone app to support the nursing community.

PubMed

Colton, Scott; Hunt, Louise

2016-02-01

Healthcare professionals are turning increasingly to the digital sector to access information they need for their work. Mobile technology, such as smartphones and tablets, provides a unique opportunity to place high-quality information directly into users' hands. This article describes the ongoing development of a smartphone app, Preparing for Caring, designed to prepare the future workforce by enabling mentors and nursing students to access supportive material during practice-based learning episodes. The article explores the rationale for designing the app and discusses the challenges and benefits of developing this resource from the perspectives of student, mentor and healthcare manager.

Innovation networks for improving access and quality across the healthcare ecosystem.

PubMed

Carroll, Mark; James, Judith A; Lardiere, Michael R; Proser, Michelle; Rhee, Kyu; Sayre, Michael H; Shore, Jay H; Ternullo, Joseph

2010-01-01

Partnerships between patient communities, healthcare providers, and academic researchers are key to stepping up the pace and public health impact of clinical and translational research supported by the National Institutes of Health. With emphasis shifting toward community engagement and faster translation of research advances into clinical practice, academic researchers have a vital stake in widening the use of health information technology systems and telehealth networks to support collaboration and innovation. However, limited interaction between academic institutions and healthcare providers hinders the ability to form and sustain the integrated networks that are needed to conduct meaningful community-engaged research that improves public health outcomes. Healthcare providers, especially those affiliated with smaller practices, will need sustainable infrastructure and real incentives to utilize such networks, as well as training and additional resources for ongoing technical assistance.

Inter-Annual and Shorter-Term Variability in Physical and Biological Characteristics Across Barrow Canyon in August - September 2005-2014

NASA Astrophysics Data System (ADS)

Ashjian, C. J.; Okkonen, S. R.; Campbell, R. G.; Alatalo, P.

2014-12-01

Late summer physical and biological conditions along a 37-km transect crossing Barrow Canyon have been described for the past ten years as part of an ongoing program, supported by multiple funding sources including the NSF AON, focusing on inter-annual variability and the formation of a bowhead whale feeding hotspot near Barrow. These repeated transects (at least two per year, separated in time by days-weeks) provide an opportunity to assess the inter-annual and shorter term (days-weeks) changes in hydrographic structure, ocean temperature, current velocity and transport, chlorophyll fluorescence, nutrients, and micro- and mesozooplankton community composition and abundance. Inter-annual variability in all properties was high and was associated with larger scale, meteorological forcing. Shorter-term variability could also be high but was strongly influenced by changes in local wind forcing. The sustained sampling at this location provided critical measures of inter-annual variability that should permit detection of longer-term trends that are associated with ongoing climate change.

Integration of National Laboratory and Low-Activity Waste Pre-Treatment System Technology Service Providers - 16435

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

Subramanian, Karthik H.; Thien, Michael G.; Wellman, Dawn M.

The National Laboratories are a critical partner and provide expertise in numerous aspects of the successful execution of the Direct-Feed Low Activity Waste Program. The National Laboratories are maturing the technologies of the Low-Activity Waste Pre-Treatment System (LAWPS) consistent with DOE Order 413.3B “Program and Project Management for the Acquisition of Capital Assets” expectations. The National Laboratories continue to mature waste forms, i.e. glass and secondary waste grout, for formulations and predictions of long-term performance as inputs to performance assessments. The working processes with the National Laboratories have been developed in procurements, communications, and reporting to support the necessary delivery-basedmore » technology support. The relationship continues to evolve from planning and technology development to support of ongoing operations and integration of multiple highly coordinated facilities.« less

An intergenerational reminiscence programme for older adults with early dementia and youth volunteers: values and challenges.

PubMed

Chung, Jenny C C

2009-06-01

To examine the values of a reminiscence programme, adopting an intergenerational approach, on older persons with early dementia and youth volunteers. A pre- and post- one group design was adopted. Forty-nine elderly participants with early dementia and 117 youth volunteers participated in the study. Each elderly participant was assigned to two youth participants. This dyad group participated in a 12-session reminiscence programme. The youth participants acted as facilitators to prompt the elderly participants to share and discuss past events and experiences, and to support them to fabricate a personalized life-story book. An occupational therapist provided ongoing support and monitoring. The elderly participants were evaluated by the Chinese version of Mini-mental State Examination, Quality of Life-Alzheimer's Disease (QoL-AD), and Chinese version of Geriatric Depression Scale (CGDS) before and after the programme. Dementia Quiz (DQ), Rosenberg Self-Esteem Scale and a 20-item feedback questionnaire on the programme were used to evaluate the youth participants. Significant pre- and postprogramme differences were found for QoL-AD (mean change = -1.91; 95% CI = -3.18, -0.64) and CGDS (mean change = 1.86; 95% CI = 0.92, 2.80) among the elderly participants, and for DQ (mean change = -1.14; 95% CI = -2.11, -0.17) among the youth participants. Volunteers also showed positive appreciation of older persons and opined that this community service provided them an opportunity to reflect on their relationship with elderly relatives. Some volunteers, however, commented the heavy workload of the reminiscence programme. The intergenerational reminiscence programme suggests mutually beneficial values for both groups of participants. Whilst it is feasible to involve trained volunteers in the implementation of dementia-related programmes, it is essential that they are adequately trained and that ongoing support and monitoring are provided.

Enabling Research Tools for Sustained Climate Assessment

NASA Technical Reports Server (NTRS)

Leidner, Allison K.; Bosilovich, Michael G.; Jasinski, Michael F.; Nemani, Ramakrishna R.; Waliser, Duane Edward; Lee, Tsengdar J.

2016-01-01

The U.S. Global Change Research Program Sustained Assessment process benefits from long-term investments in Earth science research that enable the scientific community to conduct assessment-relevant science. To this end, NASA initiated several research programs over the past five years to support the Earth observation community in developing indicators, datasets, research products, and tools to support ongoing and future National Climate Assessments. These activities complement NASA's ongoing Earth science research programs. One aspect of the assessment portfolio funds four "enabling tools" projects at NASA research centers. Each tool leverages existing capacity within the center, but has developed tailored applications and products for National Climate Assessments. The four projects build on the capabilities of a global atmospheric reanalysis (MERRA-2), a continental U.S. land surface reanalysis (NCA-LDAS), the NASA Earth Exchange (NEX), and a Regional Climate Model Evaluation System (RCMES). Here, we provide a brief overview of each enabling tool, highlighting the ways in which it has advanced assessment science to date. We also discuss how the assessment community can access and utilize these tools for National Climate Assessments and other sustained assessment activities.

Marital Conflict and Support Seeking by Parents in Adolescence: Empirical Support for the Parentification Construct

PubMed Central

Peris, Tara S.; Goeke-Morey, Marcie C.; Cummings, E. Mark; Emery, Robert E.

2010-01-01

Parentification, a parent–child dynamic wherein children come to provide ongoing emotional support for their parents, has been documented extensively in the clinical literature; however, it rarely has been studied systematically. Using a community sample of 83 couples and their adolescent children (mean age = 15.26 years; 52% male, 48% female), the authors linked adolescent self-report of parentification to specific youth and adult behaviors using multiple methods and examined its associations with youth adjustment problems. The parentification measure demonstrated strong internal consistency and 1-year stability. Parentification was associated with marital conflict, youth perceptions of threat, low warmth in the parent–child relationship, and the tendency for youths to intervene in marital conflict. Links were also found with youth reports of internalizing and externalizing behavior and poorer competency in close friendships. These findings thus support the parentification construct and provide evidence that parentification may contribute to poor youth outcomes by burdening children with developmentally inappropriate responsibilities. PMID:18729677

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

Organization and Management of the International Space Station (ISS) Multilateral Medical Operations

NASA Technical Reports Server (NTRS)

Duncan, J. M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

2007-01-01

The goal of this work is to review the principles, design, and function of the ISS multilateral medical authority and the medical support system of the ISS Program. Multilateral boards and panels provide operational framework, direct, and supervise the ISS joint medical operational activities. The Integrated Medical Group (IMG) provides front-line medical support of the crews. Results of ongoing activities are reviewed weekly by physician managers. A broader status review is conducted monthly to project the state of crew health and medical support for the following month. All boards, panels, and groups function effectively and without interruptions. Consensus prevails as the primary nature of decisions made by all ISS medical groups, including the ISS medical certification board. The sustained efforts of all partners have resulted in favorable medical outcomes of the initial fourteen long-duration expeditions. The medical support system appears to be mature and ready for further expansion of the roles of all Partners, and for the anticipated increase in the size of ISS crews.

Optimizing identification and management of COPD patients - reviewing the role of the community pharmacist.

PubMed

van der Molen, Thys; van Boven, Job F M; Maguire, Terence; Goyal, Pankaj; Altman, Pablo

2017-01-01

The aim of this paper was to propose key steps for community pharmacist integration into a patient care pathway for chronic obstructive pulmonary disease (COPD) management. A literature search was conducted to identify publications focusing on the role of the community pharmacist in identification and management of COPD. The literature search highlighted evidence supporting an important role for pharmacists at each of the four key steps in the patient care pathway for COPD management. Step 1 (primary prevention): pharmacists are ideally placed to provide information on disease awareness and risk prevention campaigns, and to encourage lifestyle interventions, including smoking cessation. Step 2 (early detection/case finding): pharmacists are often the first point of contact between the patient and the healthcare system and can therefore play an important role in the early identification of patients with COPD. Step 3 (management and ongoing support): pharmacists can assist patients by providing advice and education on dosage, inhaler technique, treatment expectations and the importance of adherence, and by supporting self-management, including recognition and treatment of COPD exacerbations. Step 4 (review and follow-up): pharmacists can play an important role in monitoring adherence and ongoing inhaler technique in patients with COPD. In summary, pharmacists are ideally positioned to play a vital role in all key stages of an integrated COPD patient care pathway from early disease detection to the support of management plans, including advice and counselling regarding medications, inhaler technique and treatment adherence. Areas requiring additional consideration include pharmacist training, increasing awareness of the pharmacist role, administration and reimbursement, and increasing physician-pharmacist collaboration. © 2016 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

The Joint Chiefs of Staff and National Policy, 1977-1980

DTIC Science & Technology

2015-01-01

advice on program, budget, and force structure issues, allowing him augmented staff support in the studies, analysis, and gaming area, as appropriate... Gaming Agency (SAGA) to provide an assessment of US capabilities to meet contingencies in the Middle East- Persian Gulf. As this study was being...ongoing analysis by the JCS Studies, Analysis, and Gaming Agency (SAGA), a Soviet advance southward toward Tehran in the wake of simultaneous air and

Pacific Pediatric Advanced Care Initiative

DTIC Science & Technology

2011-01-01

original Training Manual developed in 2007 . Hardcopy and electronic versions are available. • ECMO Training Course–the course is ongoing to provide...www.elso.med.umich.edu/Registry.htm, accessed December 19, 2005. Laerdal. SimBaby. http://www.laerdal.com/simbaby/ . Last Accessed October 19, 2007 . Martin GS...Develop simulation training for ECMO curriculum 14 Hero 15 16 17 18 As of July 1, 2007 • Establish ECMO center to support Department of Defense (DOD

Report on Partial Findings of an Ongoing Research: Social Networking Sites (SNS) as a Platform to Support Teaching and Learning in Secondary Schools

ERIC Educational Resources Information Center

Bt. Ubaidullah, Nor Hasbiah; Samsuddin, Khairulanuar; Bt. Fabil, Norsikin; Bt. Mahadi, Norhayati

2011-01-01

This paper reports the partial findings of a survey that was carried out in the analysis phase of an ongoing research for the development of a prototype of a Social Networking Site (SNS) to support teaching and learning in secondary schools. For the initial phase of the study, a quantitative research method was used based on a survey involving 383…

Inhibition of caspases prevents ototoxic and ongoing hair cell death

NASA Technical Reports Server (NTRS)

Matsui, Jonathan I.; Ogilvie, Judith M.; Warchol, Mark E.

2002-01-01

Sensory hair cells die after acoustic trauma or ototoxic insults, but the signal transduction pathways that mediate hair cell death are not known. Here we identify several important signaling events that regulate the death of vestibular hair cells. Chick utricles were cultured in media supplemented with the ototoxic antibiotic neomycin and selected pharmacological agents that influence signaling molecules in cell death pathways. Hair cells that were treated with neomycin exhibited classically defined apoptotic morphologies such as condensed nuclei and fragmented DNA. Inhibition of protein synthesis (via treatment with cycloheximide) increased hair cell survival after treatment with neomycin, suggesting that hair cell death requires de novo protein synthesis. Finally, the inhibition of caspases promoted hair cell survival after neomycin treatment. Sensory hair cells in avian vestibular organs also undergo continual cell death and replacement throughout mature life. It is unclear whether the loss of hair cells stimulates the proliferation of supporting cells or whether the production of new cells triggers the death of hair cells. We examined the effects of caspase inhibition on spontaneous hair cell death in the chick utricle. Caspase inhibitors reduced the amount of ongoing hair cell death and ongoing supporting cell proliferation in a dose-dependent manner. In isolated sensory epithelia, however, caspase inhibitors did not affect supporting cell proliferation directly. Our data indicate that ongoing hair cell death stimulates supporting cell proliferation in the mature utricle.

Development of a hospital reiki training program: training volunteers to provide reiki to patients, families, and staff in the acute care setting.

PubMed

Hahn, Julie; Reilly, Patricia M; Buchanan, Teresa M

2014-01-01

Creating a healing and healthy environment for patients, families, and staff is an ongoing challenge. As part of our hospital's Integrative Care Program, a Reiki Volunteer Program has helped to foster a caring and healing environment, providing a means for patients, family, and staff to reduce pain and anxiety and improve their ability to relax and be present. Because direct care providers manage multiple and competing needs at any given time, they may not be available to provide Reiki when it is needed. This program demonstrates that a volunteer-based program can successfully support nurses in meeting patient, family, and staff demand for Reiki services.

The Need for Vendor Source Code at NAS. Revised

NASA Technical Reports Server (NTRS)

Carter, Russell; Acheson, Steve; Blaylock, Bruce; Brock, David; Cardo, Nick; Ciotti, Bob; Poston, Alan; Wong, Parkson; Chancellor, Marisa K. (Technical Monitor)

1997-01-01

The Numerical Aerodynamic Simulation (NAS) Facility has a long standing practice of maintaining buildable source code for installed hardware. There are two reasons for this: NAS's designated pathfinding role, and the need to maintain a smoothly running operational capacity given the widely diversified nature of the vendor installations. NAS has a need to maintain support capabilities when vendors are not able; diagnose and remedy hardware or software problems where applicable; and to support ongoing system software development activities whether or not the relevant vendors feel support is justified. This note provides an informal history of these activities at NAS, and brings together the general principles that drive the requirement that systems integrated into the NAS environment run binaries built from source code, onsite.

The MMPI-2 in sexual harassment and discrimination litigants.

PubMed

Long, Barbara; Rouse, Steven V; Nelsen, R Owen; Butcher, James N

2004-06-01

In order to understand patterns of respondents on validity and clinical scales, this study analyzed archival Minnesota Multiphasic Personality Inventory 2s (MMPI-2s) produced by 192 women and 14 men who initiated legal claims of ongoing emotional harm related to workplace sexual harassment and discrimination. The MMPI-2s were administered as a part of a comprehensive psychiatric forensic evaluation of the claimants' current psychological condition. All validity and clinical scale scores were manually entered into the computer, and codetype and cluster analyses were obtained. Among the women, 28% produced a "normal limits" profile, providing no MMPI-2 support for their claims of ongoing emotional distress. Cluster analysis of the validity scales of the remaining profiles produced four distinctive clusters of profiles representing different approaches to the test items. Copyright 2004 Wiley Periodicals, Inc.

Social and Emotional Learning and the Work of Itinerant Teachers of the Deaf and Hard of Hearing.

PubMed

Norman, Nancy; Jamieson, Janet R

2015-01-01

The study investigated how social and emotional learning (SEL) is reflected in the attitudes, beliefs, and practices of itinerant teachers of the deaf and hard of hearing (ITDHHs). A mixed-methods approach was taken to survey 53 ITDHHs about their comfort with teaching SEL, commitment to ongoing professional development in SEL skills, and perceptions of SEL in school cultures. Follow-up interviews with 11 ITDHHs provided a deeper perspective on how these teachers prioritize and teach SEL skills within their unique teaching role. Overall, the findings revealed that ITDHHs overwhelmingly recognized the need to provide SEL support to their students, and very often provided direct teaching of SEL skills. However, they did not necessarily feel adequately prepared, nor supported by their schools, in terms of teaching SEL. Implications of the findings for professional preparation and practice are discussed.

Moving diabetes management from clinic to community: development of a prototype based on automated voice messaging.

PubMed

Piette, J D

1997-01-01

The purpose of this study is twofold. First, it provides a review of the literature supporting the development of a new service to help patients with diabetes and their providers manage their care. This service, automated voice messaging (AVM) with nurse follow-up, allows for systematic and intensive patient monitoring and diabetes education as well as a means of focusing clinical resources where they are most needed. Second, it provides a description of a prototype AVM-based diabetes management service that has been developed as part of two ongoing, randomized, controlled trials to test the efficacy of AVM care for patients with Type 2 diabetes. Preliminary findings from implementing this service in two large public healthcare systems suggest that AVM-supported care is feasible, desirable by clinicians and patients with diabetes, and may identify serious health problems that otherwise would go unnoted through standard means of clinic-based patient care.

Peer Coaching Interventions for Parents of Children with Type 1 Diabetes.

PubMed

Tully, Carrie; Shneider, Caitlin; Monaghan, Maureen; Hilliard, Marisa E; Streisand, Randi

2017-06-01

Peer support is a promising model of providing psychosocial support to parents of children with type 1 diabetes. This review seeks to discuss the findings of the existing literature in peer coaching as it relates to parents and diabetes as well as to identify gaps in knowledge for future intervention development and implementation. Peer support programs vary widely with regard to recruitment, training, and delivery protocols. Across most programs, ongoing support and supervision are provided to peer coaches. Despite inconsistent effects on psychosocial and child health outcomes, parent coaching is consistently a highly acceptable and feasible intervention with parents of children with T1D. Current evidence supports use of parent coaching as part of a multicomponent intervention or program to increase patient satisfaction, but more research is needed to determine if it can stand alone as an active mechanism for behavior change. The use of peer coach interventions for parents of young children with diabetes is feasible to implement and highly acceptable. However, more research is needed to understand the enduring impact for target parents and peer coaches alike, as well as impact on child outcomes.

Defining the challenges of the Modern Analytical Laboratory (CPSA USA 2014): the risks and reality of personalized healthcare.

PubMed

Weng, Naidong; Needham, Shane; Lee, Mike

2015-01-01

The 17th Annual Symposium on Clinical and Pharmaceutical Solutions through Analysis (CPSA) 29 September-2 October 2014, was held at the Sheraton Bucks County Hotel, Langhorne, PA, USA. The CPSA USA 2014 brought the various analytical fields defining the challenges of the modern analytical laboratory. Ongoing discussions focused on the future application of bioanalysis and other disciplines to support investigational new drugs (INDs) and new drug application (NDA) submissions, clinical diagnostics and pathology laboratory personnel that support patient sample analysis, and the clinical researchers that provide insights into new biomarkers within the context of the modern laboratory and personalized medicine.

The Microwave Temperature Profiler (PERF)

NASA Technical Reports Server (NTRS)

Lim, Boon; Mahoney, Michael; Haggerty, Julie; Denning, Richard

2013-01-01

The JPL developed Microwave Temperature Profiler (MTP) has recently participated in GloPac, HIPPO (I to V) and TORERO, and the ongoing ATTREX campaigns. The MTP is now capable of supporting the NASA Global Hawk and a new canister version supports the NCAR G-V. The primary product from the MTP is remote measurements of the atmospheric temperature at, above and below the flight path, providing for the vertical state of the atmosphere. The NCAR-MTP has demonstrated unprecedented instrument performance and calibration with plus or minus 0.2 degrees Kelvin flight level temperature error. Derived products include curtain plots, isentropes, lapse rate, cold point height and tropopause height.

Experimental and Analytical Studies for a Computational Materials Program

NASA Technical Reports Server (NTRS)

Knauss, W. G.

1999-01-01

The studies supported by Grant NAG1-1780 were directed at providing physical data on polymer behavior that would form the basis for computationally modeling these types of materials. Because of ongoing work in polymer characterization this grant supported part of a larger picture in this regard. Efforts went into two combined areas of their time dependent mechanical response characteristics: Creep properties on the one hand, subject to different volumetric changes (nonlinearly viscoelastic behavior) and time or frequency dependence of dilatational material behavior. The details of these endeavors are outlined sufficiently in the two appended publications, so that no further description of the effort is necessary.

Prevention of atherosclerosis with dietary antioxidants: fact or fiction?

PubMed

Duell, P B

1996-04-01

The notion that oxidation of lipids and lipoproteins may contribute to the pathogenesis of atherosclerosis is supported by a large body of evidence. It is hypothesized that dietary antioxidants may help prevent development and progression of atherosclerosis. The available evidence helps substantiate this hypothesis but is not yet conclusive. The results of several ongoing large randomized intervention trials will provide valuable information about the efficacy and safety of supplemental dietary antioxidants in prevention of atherosclerosis.

Coverage Metrics for Model Checking

NASA Technical Reports Server (NTRS)

Penix, John; Visser, Willem; Norvig, Peter (Technical Monitor)

2001-01-01

When using model checking to verify programs in practice, it is not usually possible to achieve complete coverage of the system. In this position paper we describe ongoing research within the Automated Software Engineering group at NASA Ames on the use of test coverage metrics to measure partial coverage and provide heuristic guidance for program model checking. We are specifically interested in applying and developing coverage metrics for concurrent programs that might be used to support certification of next generation avionics software.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

The development of supported employment services for people with mental illness: local experience in Hong Kong.

PubMed

Chiu, Frank P.F.

2000-01-01

Before the 1960s in Hong Kong, specialized vocational services for people with mental illness were very limited, and sheltered workshop seemed to be the only option for their future vocational placement at that time. As discussed in the literature, there are still many shortcomings of the sheltered workshop model, that brings us to the emergence of another community-based vocational service: Supported Employment. Unlike traditional vocational services, the concept of supported employment emphasizes the placing of the clients into integrated work environments and then providing on-going support and work-related skills training in the job post. Though supported employment services help many clients to sustain a job in the competitive market, many service barriers and problems still remain unsolved. These service barriers and problems will be discussed in this article, and suggestions will be made.

Working at the frontline in cases of elder abuse: 'it keeps me awake at night'.

PubMed

Cairns, Jane; Vreugdenhil, Anthea

2014-03-01

To explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse. In-depth interviews with 16 Tasmanian community-based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis. All participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse. Frontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age-inclusive family violence support services. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Nursing implications of personalized and precision medicine.

PubMed

Vorderstrasse, Allison A; Hammer, Marilyn J; Dungan, Jennifer R

2014-05-01

Identify and discuss the nursing implications of personalized and precision oncology care. PubMed, CINAHL. The implications in personalized and precision cancer nursing care include interpretation and clinical use of novel and personalized information including genetic testing; patient advocacy and support throughout testing, anticipation of results and treatment; ongoing chronic monitoring; and support for patient decision-making. Attention must also be given to the family and ethical implications of a personalized approach to care. Nurses face increasing challenges and opportunities in communication, support, and advocacy for patients given the availability of advanced testing, care and treatment in personalized and precision medicine. Nursing education and continuing education, clinical decision support, and health systems changes will be necessary to provide personalized multidisciplinary care to patients, in which nurses play a key role. Copyright © 2014 Elsevier Inc. All rights reserved.

20171015 - Generating Exposure-Relevant Measurement Data for Potential Use in Support of TSCA Requirements (ISES)

EPA Science Inventory

The EPA Office of Research and Development (ORD) has a number of ongoing projects which generate exposure measurements. These data may inform ongoing implementation of the amended Toxic Substances Control Act (TSCA). Exposure measurements include physical-chemical property inform...

The Columbus logistics support at the APMC: Requirements and implementation aspects

NASA Technical Reports Server (NTRS)

Canu, C.; Battocchio, L.; Masullo, S.

1993-01-01

This paper focuses on the logistics support to be provided by the APM Center (APMC). Among the Columbus ground infrastructures, this center is tasked to provide logistics, sustaining engineering and P/L integration support to the ongoing missions of the APM, i.e. the Columbus Laboratory attached to the Freedom Space Station. The following is illustrated: an analysis of the requirements that are levied on the logistics support of the APM; how such requirements are reflected in the corresponding support to be available on-ground and at APMC; the functional components of the APMC logistics support and how such components interact each other; how the logistics support function interfaces with the other functions of the ground support; and how the logistics support is being designed in terms of resources (such as hardware, data bases, etc.). Emphasis is given to the data handling aspects and to the related data bases that will constitute for the logistics activities the fundamental source of information during the APM planned lifetime. Functional and physical architectures, together with trades for possible implementation, are addressed. Commonalities with other centers are taken into account and recommendations are made for possible reuse of tools already developed in the C/D phase. Finally, programmatic considerations are discussed for the actual implementation of the center.

NASA Johnson Space Center Usability Testing and Analysis facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina L.

2005-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility performs research for NASA's HumanSystems Integration Program, under the HumanSystems Research and Technology Division. Specifically, the UTAF provides human factors support for space vehicles, including the International Space Station, the Space Shuttle, and the forthcoming Crew Exploration Vehicle. In addition, there are ongoing collaborative research efforts with external corporations and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes and requirements. This presentation will provide an overview of ongoing activities, and will address how the UTAF projects will evolve to meet new space initiatives.

Start-Up and Ongoing Practice Expenses of Behavioral Health and Primary Care Integration Interventions in the Advancing Care Together (ACT) Program.

PubMed

Wallace, Neal T; Cohen, Deborah J; Gunn, Rose; Beck, Arne; Melek, Steve; Bechtold, Donald; Green, Larry A

2015-01-01

Provide credible estimates of the start-up and ongoing effort and incremental practice expenses for the Advancing Care Together (ACT) behavioral health and primary care integration interventions. Expenditure data were collected from 10 practice intervention sites using an instrument with a standardized general format that could accommodate the unique elements of each intervention. Average start-up effort expenses were $44,076 and monthly ongoing effort expenses per patient were $40.39. Incremental expenses averaged $20,788 for start-up and $4.58 per patient for monthly ongoing activities. Variations in expenditures across practices reflect the differences in intervention specifics and organizational settings. Differences in effort to incremental expenditures reflect the extensive use of existing resources in implementing the interventions. ACT program incremental expenses suggest that widespread adoption would likely have a relatively modest effect on overall health systems expenditures. Practice effort expenses are not trivial and may pose barriers to adoption. Payers and purchasers interested in attaining widespread adoption of integrated care must consider external support to practices that accounts for both incremental and effort expense levels. Existing knowledge transfer mechanisms should be employed to minimize developmental start-up expenses and payment reform focused toward value-based, Triple Aim-oriented reimbursement and purchasing mechanisms are likely needed. © Copyright 2015 by the American Board of Family Medicine.

Self-management support for insulin therapy in type 2 diabetes.

PubMed

Funnell, Martha M; Kruger, Davida F; Spencer, Mary

2004-01-01

The purpose of this article is to describe the self-management support that can be provided by diabetes educators for type 2 diabetes patients who are transitioning from therapy with oral hypoglycemic agents to insulin. The role of the diabetes educator in patient education and self-management support during all aspects of insulin therapy is discussed. Phases during which support may be especially important include the decision-making process, initiation, and maintenance. Although some patients make the decision fairly easily, the introduction of insulin therapy is likely to raise many issues and questions for many type 2 diabetes patients. The more reluctant patients may experience psychological insulin resistance, a syndrome where insulin therapy is viewed as a threat or failure, which can affect health professionals as well. The diabetes educator can provide support and approaches to help diminish this resistance and make the transition to insulin therapy easier and more effective for patients with type 2 diabetes. Education and ongoing self-management support are needed for informed decision making and the initiation and maintenance of insulin therapy. Therefore, diabetes educators have a critical role to play during both the decision-making process and the safe transition to insulin therapy.

Stormtime Magnetosphere-Ionosphere-Thermosphere Interactions and Dynamics

DTIC Science & Technology

2013-03-13

1 2. BACKGROUND ... BACKGROUND The studies described in this report were performed in support of ongoing and planned space weather programs in the areas of Space Situational...Ionosphere The purpose of this effort was to initiate on-going analysis of COSMIC -GPS measurements of total electron content (TEC) in the dayside

Exposure Modeling Tools and Databases for Consideration for Relevance to the Amended TSCA (ISES)

EPA Science Inventory

The Agency’s Office of Research and Development (ORD) has a number of ongoing exposure modeling tools and databases. These efforts are anticipated to be useful in supporting ongoing implementation of the amended Toxic Substances Control Act (TSCA). Under ORD’s Chemic...

Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

PubMed

Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

2018-04-01

Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

Knowledge management: Role of the the Radiation Safety Information Computational Center (RSICC)

NASA Astrophysics Data System (ADS)

Valentine, Timothy

2017-09-01

The Radiation Safety Information Computational Center (RSICC) at Oak Ridge National Laboratory (ORNL) is an information analysis center that collects, archives, evaluates, synthesizes and distributes information, data and codes that are used in various nuclear technology applications. RSICC retains more than 2,000 software packages that have been provided by code developers from various federal and international agencies. RSICC's customers (scientists, engineers, and students from around the world) obtain access to such computing codes (source and/or executable versions) and processed nuclear data files to promote on-going research, to ensure nuclear and radiological safety, and to advance nuclear technology. The role of such information analysis centers is critical for supporting and sustaining nuclear education and training programs both domestically and internationally, as the majority of RSICC's customers are students attending U.S. universities. Additionally, RSICC operates a secure CLOUD computing system to provide access to sensitive export-controlled modeling and simulation (M&S) tools that support both domestic and international activities. This presentation will provide a general review of RSICC's activities, services, and systems that support knowledge management and education and training in the nuclear field.

A Data-Driven Framework for Incorporating New Tools for ...

EPA Pesticide Factsheets

This talk was given during the “Exposure-Based Toxicity Testing” session at the annual meeting of the International Society for Exposure Science. It provided an update on the state of the science and tools that may be employed in risk-based prioritization efforts. It outlined knowledge gained from the data provided using these high-throughput tools to assess chemical bioactivity and to predict chemical exposures and also identified future needs. It provided an opportunity to showcase ongoing research efforts within the National Exposure Research Laboratory and the National Center for Computational Toxicology within the Office of Research and Development to an international audience. The National Exposure Research Laboratory (NERL) Computational Exposure Division (CED) develops and evaluates data, decision-support tools, and models to be applied to media-specific or receptor-specific problem areas. CED uses modeling-based approaches to characterize exposures, evaluate fate and transport, and support environmental diagnostics/forensics with input from multiple data sources. It also develops media- and receptor-specific models, process models, and decision support tools for use both within and outside of EPA.

NHDPlusHR: A national geospatial framework for surface-water information

USGS Publications Warehouse

Viger, Roland; Rea, Alan H.; Simley, Jeffrey D.; Hanson, Karen M.

2016-01-01

The U.S. Geological Survey is developing a new geospatial hydrographic framework for the United States, called the National Hydrography Dataset Plus High Resolution (NHDPlusHR), that integrates a diversity of the best-available information, robustly supports ongoing dataset improvements, enables hydrographic generalization to derive alternate representations of the network while maintaining feature identity, and supports modern scientific computing and Internet accessibility needs. This framework is based on the High Resolution National Hydrography Dataset, the Watershed Boundaries Dataset, and elevation from the 3-D Elevation Program, and will provide an authoritative, high precision, and attribute-rich geospatial framework for surface-water information for the United States. Using this common geospatial framework will provide a consistent basis for indexing water information in the United States, eliminate redundancy, and harmonize access to, and exchange of water information.

Providing the Larger Climate Context During Extreme Weather - Lessons from Local Television News

NASA Astrophysics Data System (ADS)

Woods, M.; Cullen, H. M.

2015-12-01

Local television weathercasters, in their role as Station Scientists, are often called upon to educate viewers about the science and impacts of climate change. Climate Central supports these efforts through its Climate Matters program. Launched in 2010 with support from the National Science Foundation, the program has grown into a network that includes more than 245 weathercasters from across the country and provides localized information on climate and ready-to-use, broadcast quality graphics and analyses in both English and Spanish. This presentation will focus on discussing best practices for integrating climate science into the local weather forecast as well as advances in the science of extreme event attribution. The Chief Meteorologist at News10 (Sacramento, CA) will discuss local news coverage of the ongoing California drought, extreme weather and climate literacy.

Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

PubMed

Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

2014-01-01

Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

The digital revolution in phenotyping

PubMed Central

Oellrich, Anika; Collier, Nigel; Groza, Tudor; Rebholz-Schuhmann, Dietrich; Shah, Nigam; Bodenreider, Olivier; Boland, Mary Regina; Georgiev, Ivo; Liu, Hongfang; Livingston, Kevin; Luna, Augustin; Mallon, Ann-Marie; Manda, Prashanti; Robinson, Peter N.; Rustici, Gabriella; Simon, Michelle; Wang, Liqin; Winnenburg, Rainer; Dumontier, Michel

2016-01-01

Phenotypes have gained increased notoriety in the clinical and biological domain owing to their application in numerous areas such as the discovery of disease genes and drug targets, phylogenetics and pharmacogenomics. Phenotypes, defined as observable characteristics of organisms, can be seen as one of the bridges that lead to a translation of experimental findings into clinical applications and thereby support ‘bench to bedside’ efforts. However, to build this translational bridge, a common and universal understanding of phenotypes is required that goes beyond domain-specific definitions. To achieve this ambitious goal, a digital revolution is ongoing that enables the encoding of data in computer-readable formats and the data storage in specialized repositories, ready for integration, enabling translational research. While phenome research is an ongoing endeavor, the true potential hidden in the currently available data still needs to be unlocked, offering exciting opportunities for the forthcoming years. Here, we provide insights into the state-of-the-art in digital phenotyping, by means of representing, acquiring and analyzing phenotype data. In addition, we provide visions of this field for future research work that could enable better applications of phenotype data. PMID:26420780

An energy/emissions/economic analysis resource for north Moravia, upper Silesia, and Kisuca

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

Walder, V.

1995-12-31

The United States Agency for International Development (USAID) is sponsoring the Technology Transfer Network (TTN) which is centered in Ostrava, Czech Republic. The primary objective of the TTN is to provide a resource for municipalities, industries, and companies interested in reducing air pollution, improving energy efficiency, and implementing projects in North Moravia, Upper Silesia, and Kisuca. The TTN is providing a communications network (newsletters, mailings, and other media), seminars, workshops, software, access to past and ongoing studies, and a database of U.S. vendors supporting the region. Seminars and major communication material of the TTN will be provided in Czech/Slovak, Polish,more » and English as appropriate.« less

Development and pilot testing of an intervention to promote care engagement and adherence among HIV-positive Kenyan MSM.

PubMed

Graham, Susan M; Micheni, Murugi; Kombo, Bernadette; Van Der Elst, Elisabeth M; Mugo, Peter M; Kivaya, Esther; Aunon, Frances; Kutner, Bryan; Sanders, Eduard J; Simoni, Jane M

2015-12-01

In many African settings, MSM are a stigmatized group whose access to and engagement in HIV care may be challenging. Our aim was to design a targeted, culturally appropriate intervention to promote care engagement and antiretroviral therapy (ART) adherence for MSM in coastal Kenya, and describe intervention safety, feasibility, and acceptability based upon a small pilot study. Based on qualitative work including in-depth interviews with HIV-positive MSM and focus groups with providers, we developed a tailored intervention and conducted a pilot test to refine intervention materials and procedures. The Shikamana intervention combines modified Next-Step Counseling by trained providers, support from a trained peer navigator, and tailored use of SMS messaging, phone calls, and discrete pill carriers. Providers, including counselors and clinicians, work together with peer navigators as a case management team. Forty HIV-positive MSM aged 19-51 participated in intervention development and testing. Six counselors, three clinical officers, and four MSM peers were trained in intervention procedures. Of 10 ART-naïve participants who enrolled in the pilot, eight completed follow-up with no adverse events reported. One participant was lost to follow-up after 2 months and another failed to initiate ART despite ongoing counseling. No adverse events were reported. Staff feedback and exit interviews rated the intervention as feasible and acceptable. This adherence support intervention tailored for Kenyan MSM was well tolerated, feasible, and acceptable in the pilot phase. A randomized controlled trial of a scaled-up programme to estimate intervention efficacy is ongoing.

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

Brunett, A. J.; Fanning, T. H.

The United States has extensive experience with the design, construction, and operation of sodium cooled fast reactors (SFRs) over the last six decades. Despite the closure of various facilities, the U.S. continues to dedicate research and development (R&D) efforts to the design of innovative experimental, prototype, and commercial facilities. Accordingly, in support of the rich operating history and ongoing design efforts, the U.S. has been developing and maintaining a series of tools with capabilities that envelope all facets of SFR design and safety analyses. This paper provides an overview of the current U.S. SFR analysis toolset, including codes such asmore » SAS4A/SASSYS-1, MC2-3, SE2-ANL, PERSENT, NUBOW-3D, and LIFE-METAL, as well as the higher-fidelity tools (e.g. PROTEUS) being integrated into the toolset. Current capabilities of the codes are described and key ongoing development efforts are highlighted for some codes.« less

Surveying Supported Employment in Finland: A Follow-up

ERIC Educational Resources Information Center

Saloviita, Timo; Pirttimaa, Raija

2007-01-01

The longitudinal status of supported employment in Finland was examined via a 2003 nationwide survey sent to job coaches involved in supporting workers with intellectual and other disabilities. Sustained supported employment, defined as "paid work in integrated settings with ongoing supports that contained at least two on-site visits per…

eHealth in Switzerland - building consensus, awareness and architecture.

PubMed

Lovis, Christian; Looser, Hansjorg; Schmid, Adrian; Wagner, Judith; Wyss, Stefan

2011-01-01

This paper reports on the process of the Swiss national strategy to define and implement eHealth. Switzerland is a federal political organization with 26 cantons that are autonomous for the health legal framework. Switzerland must also provide support for four national languages. Thus, this experience addresses many challenges that are experienced at the European level in a much larger scale. Also, Switzerland benefits from the major projects ongoing in Europe, such as epSOS, to define its own strategy.

A case study from a nursing and occupational therapy perspective - Providing care for a patient with a traumatic brachial plexus injury.

PubMed

Wellington, Beverley; McGeehan, Claire

2015-02-01

This paper presents a case study that demonstrates how collaborative working between professionals enhanced the holistic care for a patient following a traumatic brachial plexus injury. The paper will describe the patient's journey of care from initial presentation, diagnosis and assessment, acute care provision, discharge & rehabilitation to ongoing supportive counselling. The care encompasses input from both a nursing and occupational therapy perspective. Copyright © 2014 Elsevier Ltd. All rights reserved.

Plans for the development of cryogenic engines for space exploration

NASA Technical Reports Server (NTRS)

Stone, James R.; Shaw, Loretta M.; Aukerman, Carl A.

1991-01-01

The NASA Lewis Research Center (LeRC) is conducting a broad range of basic research and focused technology development activities in both aeronautical and space propulsion. By virtue of the successful conduct of these programs, LeRC is strongly qualified to lead Advanced Development and subsequent development programs on cryogenic space propulsion systems on support of the Space Exploration Initiative. A review is provided of technology status, including recent progress in the ongoing activities, and a top level description of the proposed program.

Chemical composition analysis and product consistency tests supporting refinement of the Nepheline model for the high aluminum Hanford Glass composition region

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

Fox, K. M.; Edwards, T. B.; Mcclane, D. L.

2016-02-17

In this report, SRNL provides chemical analyses and Product Consistency Test (PCT) results for a series of simulated HLW glasses fabricated by Pacific Northwest National Laboratory (PNNL) as part of an ongoing nepheline crystallization study. The results of these analyses will be used to improve the ability to predict crystallization of nepheline as a function of composition and heat treatment for glasses formulated at high alumina concentrations.

Chemical composition analysis and product consistency tests supporting refinement of the Nepheline Model for the high aluminum Hanford glass composition region

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

Fox, K. M.; Edwards, T. B.; Mcclane, D. L.

2016-03-01

In this report, Savannah River National Laboratory provides chemical analyses and Product Consistency Test (PCT) results for a series of simulated high level waste (HLW) glasses fabricated by Pacific Northwest National Laboratory (PNNL) as part of an ongoing nepheline crystallization study. The results of these analyses will be used to improve the ability to predict crystallization of nepheline as a function of composition and heat treatment for glasses formulated at high alumina concentrations.

The Role of Oscillatory Phase in Determining the Temporal Organization of Perception: Evidence from Sensory Entrainment.

PubMed

Ronconi, Luca; Melcher, David

2017-11-01

Recent behavioral, neuroimaging, and neurophysiological studies have renewed the idea that the information processing within different temporal windows is linked to the phase and/or frequency of the ongoing oscillations, predominantly in the theta/alpha band (∼4-7 and 8-12 Hz, respectively). However, being correlational in nature, this evidence might reflect a nonfunctional byproduct rather than having a causal role. A more direct link can be shown with methods that manipulate oscillatory activity. Here, we used audiovisual entrainment at different frequencies in the prestimulus period of a temporal integration/segregation task. We hypothesized that entrainment would align ongoing oscillations and drive them toward the stimulation frequency. To reveal behavioral oscillations in temporal perception after the entrainment, we sampled the segregation/integration performance densely in time. In Experiment 1, two groups of human participants (both males and females) received stimulation either at the lower or the upper boundary of the alpha band (∼8.5 vs 11.5 Hz). For both entrainment frequencies, we found a phase alignment of the perceptual oscillation across subjects, but with two different power spectra that peaked near the entrainment frequency. These results were confirmed when perceptual oscillations were characterized in the time domain with sinusoidal fittings. In Experiment 2, we replicated the findings in a within-subject design, extending the results for frequencies in the theta (∼6.5 Hz), but not in the beta (∼15 Hz), range. Overall, these findings show that temporal segregation can be modified by sensory entrainment, providing evidence for a critical role of ongoing oscillations in the temporal organization of perception. SIGNIFICANCE STATEMENT The continuous flow of sensory input is not processed in an analog fashion, but rather is grouped by the perceptual system over time. Recent studies pinpointed the phase and/or frequency of the neural oscillations in the theta/alpha band (∼4-12 Hz) as possible mechanisms underlying temporal windows in perception. Here, we combined two innovative methodologies to provide more direct support for this evidence. We used sensory entrainment to align neural oscillations to different frequencies and then characterized the resultant perceptual oscillation with a temporal dense sampling of the integration/segregation performance. Our results provide the first evidence that the frequency of temporal segregation can be modified by sensory entrainment, supporting a critical role of ongoing oscillations in the integration/segregation of information over time. Copyright © 2017 Ronconi and Melcher.

People with COPD perceive ongoing, structured and socially supportive exercise opportunities to be important for maintaining an active lifestyle following pulmonary rehabilitation: a qualitative study.

PubMed

Hogg, Lauren; Grant, Amy; Garrod, Rachel; Fiddler, Helen

2012-01-01

What are the views and perceptions of people with chronic obstructive pulmonary disease (COPD) regarding maintaining an active lifestyle following a course of pulmonary rehabilitation? Qualitative study of two focus groups using a grounded theory approach. Sixteen people with COPD who had completed a course of pulmonary rehabilitation. Data from focus groups concurred and five main themes emerged: value of pulmonary rehabilitation, ongoing exercise, professional support, peer social support, and health status. Pulmonary rehabilitation was seen as facilitating greater participation in everyday activity by improving physical ability and confidence to manage breathlessness, and reducing fear about exertional activity. An exercise routine following rehabilitation was perceived as essential for maintaining activity, with participants voicing a need for ongoing, structured and supervised sessions to maintain new found abilities. The exercise facility presented a possible barrier to attendance due to its potential to provoke feelings of embarrassment or intimidation. Professional and peer support were identified as key elements; participants expressed a desire to exercise within a peer group combined with an opportunity for social interaction. Health status relating to COPD symptoms was also identified as negatively impacting on physical activity participation. Confidence or self-efficacy for physical activity emerged as a prominent factor within main themes. The opportunity for structured, ongoing exercise with peer and professional support, in a suitable venue, is perceived as important to people with COPD in facilitating a physically active lifestyle following pulmonary rehabilitation. This desire for such opportunities may be related to individuals' self-efficacy towards physical activity. Copyright © 2012 Australian Physiotherapy Association. Published by .. All rights reserved.

Patients' needs following colorectal cancer diagnosis: where does primary care fit in?

PubMed

Browne, Susan; Dowie, Al; Mitchell, Elizabeth; Mitchell, Liz; Wyke, Sally; Ziebland, Sue; Campbell, Neil; Macleod, Una

2011-11-01

Colorectal cancer is the third most common cancer in the UK. Patients with colorectal cancer spend most of their time in the community, but the role of primary care in their management and follow-up is unclear. To explore colorectal cancer patients' experiences of psychosocial problems and their management in primary and specialist care. Longitudinal qualitative study of participants recruited from three hospitals in the west of Scotland and interviewed in their own homes. In-depth interviews with 24 participants with a new diagnosis of colorectal cancer, and then follow-up interviews 12 months later. Participants' needs following a diagnosis for colorectal cancer included physical, psychological, and social issues. GPs played a key role in diagnosis, after which they were less involved. Participants valued GPs making unsolicited contact and offering support. Participants described being well supported by clinical nurse specialists who are expert in the illness, and who provide continuity of care and psychological support. A year after diagnosis, when there was less contact with GPs and clinical nurse specialists, participants still faced challenges associated with the ongoing impact of colorectal cancer. While some patients enjoyed straightforward recoveries from surgery, others experienced longer-term implications from their disease and treatment, particularly bowel-function issues, fatigue, anxiety, and sexual problems. The potential for primary care to contribute more to the ongoing care of colorectal cancer patients was identified.

Social-support needs among adolescents living with HIV in transition from pediatric to adult care in Cambodia: findings from a cross-sectional study.

PubMed

Toth, Graham; Mburu, Gitau; Tuot, Sovannary; Khol, Vohith; Ngin, Chanrith; Chhoun, Pheak; Yi, Siyan

2018-03-28

Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia. A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country. Descriptive analyses were conducted to summarize their characteristics, access to social support and ongoing support needs among male and female adolescents. Mean age of the study participants was 15.8 (SD = 0.8) years. Just over half (55.2%) were male. Most had at least one deceased parent (mother 50.9%; father 60.5%), and majority were living with biological parents (40.8%) or relatives (49.3%). A third came from families with an ID poor card, and 21.0% were working for pay. Almost half (46.6%) reported that their family had received social support for their health care, including food support (76.5%), school allowance (62.1%), transport allowance to ART clinics (53.6%), psychosocial counseling (35.3%), vocational training (22.9%) or home visits (11.1%). Several ongoing social support needs were identified, including ongoing inability to cover health expenses unless they are supported by health insurance or health equity fund (55.0%). In addition, adolescents reported having been asked to come back earlier than their scheduled appointment (13.7%), having had to purchase their own drugs (2.7%), experiencing HIV stigma (32.0%), having been denied housing or food due to HIV (8.2%) or failing to attend school within the past month partly because of HIV (16.8%). Two-thirds did not have access to peer support groups. Social protection mechanisms are reaching some adolescents in need, while other remain without social support due to discontinuities in health and social care. Multi-sectoral interventions, supporting school attendance, adolescent-friendly clinic scheduling, reductions in child employment, mitigation of HIV-related stigma and strengthening of peer-to-peer support are required to improve coverage of social protection interventions for adolescents in transition.

The Sao Paulo Lightning Mapping Array (SPLMA): Prospects to GOES-R GLM and CHUVA

NASA Technical Reports Server (NTRS)

Albrecht, Rachel I.; Carrey, Larry; Blakeslee, Richard J.; Bailey, Jeffrey C.; Goodman, Steven J.; Bruning, Eric C.; Koshak, William; Morales, Carlos A.; Machado, Luiz A. T.; Angelis, Carlos F.;

Prehospital Care of Canine Gastric Dilatation and Volvulus.

PubMed

Palmer, Lee E

The intent of the Operational K9 (OpK9) ongoing series is to provide the Special Operations Medical Association community with clinical concepts and scientific information on preventive and prehospital emergency care relevant to the OpK9. Often the only medical support immediately available for an injured or ill OpK9 in the field is their handler or the human Special Operations Combat Medic or civilian tactical medic attached to the team (e.g., Pararescueman, 18D, SWAT medic). The information is applicable to personnel operating within the US Special Operations Command as well as civilian Tactical Emergency Medical Services communities that may have the responsibility of supporting an OpK9. 2018.

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

Nalu is a Sierra ToolKit (STK) based application module, and it has provided a set of "lessons learned" for the STK transition effort through its early adoption of STK. It makes use of the open-sourced Trilinos/ Tpetra library. Through the investment of LORD and ASCR projects, the Nalu code module has been extended beyond prototype status. Physics capability includes low Mach, variable density turbulent flow. The ongoing objective for Nalu is to facilitate partnerships with external organizations in order to extend code capability and knowledge; however, it is not intended to support routine CFD analysis. The targeted usage of thismore » module is for non-NW applications that support work-for-others in the multiphysics energy sector.« less

Handheld computers in nursing education: PDA pilot project.

PubMed

Koeniger-Donohue, Rebecca

2008-02-01

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

A Planetary Defense Gateway for Smart Discovery of relevant Information for Decision Support

NASA Technical Reports Server (NTRS)

Bambacus, Myra; Yang, Chaowei Phil; Leung, Ronald Y.; Barbee, Brent; Nuth, Joseph A.; Seery, Bernard; Jiang, Yongyao; Qin, Han; Li, Yun; Yu, Manzhu;

What makes a house a home? An evaluation of a supported housing project for individuals with long-term psychiatric backgrounds.

PubMed

Boydell, K M; Everett, B

1992-01-01

Supported housing (as distinct from supportive housing) emphasizes the values of consumer choice; independence; participation; permanence; normalcy; and flexible, ongoing supports. As a model, it has only recently become popular in the literature and therefore little is known of its effectiveness in serving people with long-term psychiatric backgrounds. In 1989, Homeward Projects, a community mental health agency located in Metropolitan Toronto, established a supported housing project. Homeward included an evaluative component in its program from the outset. In order to give equal weight to the tenants' opinions, both quantitative and qualitative methodologies were employed. In the quantitative component, residential milieu, social support, and service delivery were examined. The qualitative component involved an ethnographic study which allowed the tenants to voice their experiences of living in such a setting. Results provided a rich understanding of the model. Overall, the tenants eventually came to describe their house as a home.

FCS Technology Investigation Overview

NASA Technical Reports Server (NTRS)

Budinger, James; Gilbert, Tricia

2007-01-01

This working paper provides an overview of the Future Communication Study (FCS) technology investigation progress. It includes a description of the methodology applied to technology evaluation; evaluation criteria; and technology screening (down select) results. A comparison of screening results with other similar technology screening activities is provided. Additional information included in this working paper is a description of in-depth studies (including characterization of the L-band aeronautical channel; L-band deployment cost assessment; and performance assessments of candidate technologies in the applicable aeronautical channel) that have been conducted to support technology evaluations. The paper concludes with a description on-going activities leading to conclusion of the technology investigation and the development of technology recommendations.

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

NASA Astrophysics Data System (ADS)

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

2004-12-01

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

76 FR 63509 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services... Standards: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business...) Sector 56, Administrative and Support, Waste Management and Remediation Services. As part of its ongoing...

22q11 deletion syndrome: Parents' and children's experiences of educational and healthcare provision in the United Kingdom.

PubMed

Cohen, Wendy; McCartney, Elspeth; Crampin, Lisa

2017-06-01

22q11 deletion syndrome (22q11DS) is a genetic syndrome, prevalence around 1:4000-1:6000 live births, with a complex array of associated features, impacting on healthcare and educational support. This study reports the perceptions of families and individuals with 22q11DS in relation to these needs. Individuals and families of those with 22q11DS were approached though two national charities - the Max Appeal and 22Crew. An initial observational survey design was used to gather views via questions probing access to healthcare and educational experiences. Thirty-four responses were received and the data subjected to descriptive analysis. Over half of the respondents were diagnosed before the age of 1. Ninety-one percent reported ongoing difficulties with learning at school, compounded by school attendance being compromised as a result of medical interventions. Individuals reported engaging heavily with educational support and a high number of health professions (mean 9.5; mode 10). Age of diagnosis of 22q11DS ranged from birth to nine years. Families had ongoing concerns about aspects of education and healthcare services, and lack of knowledge and awareness of the difficulties faced by individuals with 22q11DS was raised. Healthcare and education providers should be aware of the range of services individuals required on a regular basis so as to provide a more holistic approach to care.

A pan-Canadian web-based education program to support screening for distress: evaluation of outcomes.

PubMed

McLeod, Deborah L; Morck, Angela C; Curran, Janet A

2014-02-01

Cancer-related distress has been endorsed as the sixth vital sign by many international cancer organizations, and some countries such as Canada have implemented national screening for distress programs. The completion of a screening tool is an important first step in improving responsiveness to cancer-related distress, but screening must be followed with skilled supportive care to make a difference in patient-reported outcomes. Our objective was to create a web-based education program to support nurses and other frontline staff in providing an initial response to screening results. To address screening and supportive care learning needs, the Canadian Association of Psychosocial Oncology (CAPO), with support from the Canadian Partnership Against Cancer, created a web-based education program as one component of the national screening for distress agenda. The program provides clinically grounded and interactive learning through the use of PowerPoint presentations, video clips of clinical interactions with patients and family members, and test questions. Presentation topics include, for example, strategies for dealing with screening results, managing referrals, and supportive counseling. We employed a matched pairs, pre-post survey design to assess the effect of the education program on confidence in screening and in providing initial supportive care. Our analysis of the first 147 matched pairs to complete the course suggests that satisfaction with the course was high. Statistically significant increases in confidence in relation to screening for distress and assessing distress, and in providing initial supportive care, were evident. Our ongoing experience with CAPO's Interprofessional Psychosocial Oncology Distance Education (IPODE) project (www.ipode.ca) project suggests that healthcare professionals value web-based learning for its accessibility and convenience. Such programs appear to offer excellent opportunities for cost-effective education that supports practice change.

Towards a virtual health record for mobile home care of elderly citizens.

PubMed

Koch, Sabine; Hägglund, Maria; Scandurra, Isabella; Moström, Dennis

2004-01-01

Mobile work situations within home care of the elderly require immediate and ubiquitous access to patient-oriented data. The ongoing Swedish research project "Technical support for Mobile CloseCare" focuses on the development and evaluation of work-scenario oriented ICT support for enhanced home care of elderly citizens. The aim of the project is to provide a seamless and consistent information flow between different health care providers and to give intuitive access to information services for the elderly and their relatives. For that purpose, different independent software components are connected through a mobile communication platform. Flexible access to prioritized information for different users in different work situations will be given through a virtual health record. In order to obtain both usable and clinically relevant results, a user centered system development approach is followed. Evaluation of the project results will be based on usability tests and quasi-experimental studies on how system implementation influences quality of care and job- and life satisfaction for care providers, patients and relatives.

Multisite Investigation of Strategies for the Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy.

PubMed

Empey, Philip E; Stevenson, James M; Tuteja, Sony; Weitzel, Kristin W; Angiolillo, Dominick J; Beitelshees, Amber L; Coons, James C; Duarte, Julio D; Franchi, Francesco; Jeng, Linda J B; Johnson, Julie A; Kreutz, Rolf P; Limdi, Nita A; Maloney, Kristin A; Owusu Obeng, Aniwaa; Peterson, Josh F; Petry, Natasha; Pratt, Victoria M; Rollini, Fabiana; Scott, Stuart A; Skaar, Todd C; Vesely, Mark R; Stouffer, George A; Wilke, Russell A; Cavallari, Larisa H; Lee, Craig R

2017-12-26

CYP2C19 genotype-guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building clinical decision support processes, providing patient and provider education, and integrating methods to support the translation of emerging evidence to clinical practice are barriers to broad adoption. In this report, we compare and contrast implementation strategies of 12 early adopters, describing solutions to common problems and initial performance metrics for each program. Key differences between programs included the test result turnaround time and timing of therapy changes, which are both related to the CYP2C19 testing model and platform used. Sites reported the need for new informatics infrastructure, expert clinicians such as pharmacists to interpret results, physician champions, and ongoing education. Consensus lessons learned are presented to provide a path forward for those seeking to implement similar clinical pharmacogenomics programs within their institutions. © 2018, The American Society for Clinical Pharmacology and Therapeutics.

Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia

PubMed Central

Mayston, Rosie; Alem, Atalay; Habtamu, Alehegn; Shibre, Teshome; Fekadu, Abebaw; Hanlon, Charlotte

2016-01-01

Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from community consultation meetings (n = 4), focus group discussions (n = 7) and in-depth interviews (n = 11) with key stakeholders (healthcare administrators and providers, caregivers, service-users and community leaders) which were carried out over a 2-year period in the context of ongoing dialogue with the community. The principle of local delivery of mental health services was agreed upon by all stakeholder groups. Key reasons for supporting local delivery were increased access for the majority due to proximity, reduced cost and reduced stress related to transportation. However, acceptance of the new service was qualified by concerns about the competence of staff to deliver a comprehensive and dependable service of equal quality to that currently provided at the hospital. Adequate training and support, as well as ensuring consistency of medication supply were identified as key components to ensure success. Encouragingly, our results suggest that there is significant support for the service change and an interest for the mobilization of community resources to support this. One of the study strengths was that we were able to present the different perspectives of multiple stakeholder groups. By nesting the study in an ongoing community-based cohort of people with SMD we were able to interview a more representative and empowered group of caregivers and service users than is often available in LMICs. Despite this, the extent to which service-users are able to express their opinions is likely limited by their marginalized role in rural Ethiopian society. PMID:26282860

Feedback about Teaching in Higher Ed: Neglected Opportunities to Promote Change

PubMed Central

Evans, Mara; Brickman, Peggy

2014-01-01

Despite ongoing dissemination of evidence-based teaching strategies, science teaching at the university level is less than reformed. Most college biology instructors could benefit from more sustained support in implementing these strategies. One-time workshops raise awareness of evidence-based practices, but faculty members are more likely to make significant changes in their teaching practices when supported by coaching and feedback. Currently, most instructional feedback occurs via student evaluations, which typically lack specific feedback for improvement and focus on teacher-centered practices, or via drop-in classroom observations and peer evaluation by other instructors, which raise issues for promotion, tenure, and evaluation. The goals of this essay are to summarize the best practices for providing instructional feedback, recommend specific strategies for providing feedback, and suggest areas for further research. Missed opportunities for feedback in teaching are highlighted, and the sharing of instructional expertise is encouraged. PMID:26086652

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

PubMed

Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

2015-09-28

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

The development of a multi-target compiler-writing system for flight software development

NASA Technical Reports Server (NTRS)

Feyock, S.; Donegan, M. K.

1977-01-01

A wide variety of systems designed to assist the user in the task of writing compilers has been developed. A survey of these systems reveals that none is entirely appropriate to the purposes of the MUST project, which involves the compilation of one or at most a small set of higher-order languages to a wide variety of target machines offering little or no software support. This requirement dictates that any compiler writing system employed must provide maximal support in the areas of semantics specification and code generation, the areas in which existing compiler writing systems as well as theoretical underpinnings are weakest. This paper describes an ongoing research and development effort to create a compiler writing system which will overcome these difficulties, thus providing a software system which makes possible the fast, trouble-free creation of reliable compilers for a wide variety of target computers.

International Space Station Aeromedical Support in Star City, Russia

NASA Technical Reports Server (NTRS)

Cole, Richard; Chamberlin, Blake; Dowell, Gene; Castleberry, Tarah; Savage, Scott

2010-01-01

The Space Medicine Division at Johnson Space Center works with the International Space Station s international partners (IP) to accomplish assigned health care tasks. Each IP may assign a flight surgeon to support their assigned crewmembers during all phases of training, in-flight operations, and postflight activities. Because of the extensive amount of astronaut training conducted in Star City; NASA, in collaboration with its IPs, has elected to keep a flight surgeon assigned to NASA s Star City office to provide support to the U.S., Canadian, Japanese, and European astronauts during hazardous training activities and provide support for any contingency landings of Soyuz spacecraft in Kazakhstan. The physician also provides support as necessary to the Mission Control Center in Moscow for non-Russian crew-related activities. In addition, the physician in Star City provides ambulatory medical care to the non-Russian-assigned personnel in Star City and visiting dependents. Additional work involves all medical supplies, administration, and inventory. The Star City physician assists in medical evacuation and/or in obtaining support from western clinics in Moscow when required care exceeds local resources. Overall, the Russians are responsible for operations and the medical care of the entire crew when training in Star City and during launch/landing operations. However, they allow international partner flight surgeons to care for their crewmembers as agreed to in the ISS Medical Operations Requirements Document. Medical support focuses on pressurized, monitored, and other hazardous training activities. One of the most important jobs is to act as a medical advocate for the astronauts and to reduce the threat that these hazardous activities pose. Although the Russians have a robust medical system, evacuation may be needed to facilitate ongoing medical care. There are several international medical evacuation companies that provide this care.

Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda.

PubMed

Igras, Susan; Sinai, Irit; Mukabatsinda, Marie; Ngabo, Fidele; Jennings, Victoria; Lundgren, Rebecka

2014-05-01

There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the Standard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda. Much of the success of the scale-up effort was due to systematic use of monitoring and evaluation (M&E) data from several sources to make midcourse corrections. Four lessons learned illustrate this crucially important approach. First, ongoing M&E data showed that provider training protocols and client materials that worked in the pilot phase did not work at scale; therefore, we simplified these materials to support integration into the national program. Second, triangulation of ongoing monitoring data with national health facility and population-based surveys revealed serious problems in supply chain mechanisms that affected SDM (and the accompanying CycleBeads client tool) availability and use; new procedures for ordering supplies and monitoring stockouts were instituted at the facility level. Third, supervision reports and special studies revealed that providers were imposing unnecessary medical barriers to SDM use; refresher training and revised supervision protocols improved provider practices. Finally, informal environmental scans, stakeholder interviews, and key events timelines identified shifting political and health policy environments that influenced scale-up outcomes; ongoing advocacy efforts are addressing these issues. The SDM scale-up experience in Rwanda confirms the importance of monitoring and evaluating programmatic efforts continuously, using a variety of data sources, to improve program outcomes.

Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda

PubMed Central

Igras, Susan; Sinai, Irit; Mukabatsinda, Marie; Ngabo, Fidele; Jennings, Victoria; Lundgren, Rebecka

2014-01-01

There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the Standard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda. Much of the success of the scale-up effort was due to systematic use of monitoring and evaluation (M&E) data from several sources to make midcourse corrections. Four lessons learned illustrate this crucially important approach. First, ongoing M&E data showed that provider training protocols and client materials that worked in the pilot phase did not work at scale; therefore, we simplified these materials to support integration into the national program. Second, triangulation of ongoing monitoring data with national health facility and population-based surveys revealed serious problems in supply chain mechanisms that affected SDM (and the accompanying CycleBeads client tool) availability and use; new procedures for ordering supplies and monitoring stockouts were instituted at the facility level. Third, supervision reports and special studies revealed that providers were imposing unnecessary medical barriers to SDM use; refresher training and revised supervision protocols improved provider practices. Finally, informal environmental scans, stakeholder interviews, and key events timelines identified shifting political and health policy environments that influenced scale-up outcomes; ongoing advocacy efforts are addressing these issues. The SDM scale-up experience in Rwanda confirms the importance of monitoring and evaluating programmatic efforts continuously, using a variety of data sources, to improve program outcomes. PMID:25276581

State Systems Change Spotlight: Nevada. Transforming State Systems to Improve Outcomes for Children with Disabilities

ERIC Educational Resources Information Center

Ruedel, Kristin; Nelson, Gena; Bailey, Tessie; Pierce, Jennifer

2018-01-01

Data show that effective and ongoing communication and evaluation can have a positive impact on local and statewide systems change. Local and statewide systems change requires ongoing communication and evaluation. The Nevada Department of Education (NDE) used a communication protocol to support implementation of the Assess-Plan-Teach (APT) model.…

NASA Automated Fiber Placement Capabilities: Similar Systems, Complementary Purposes

NASA Technical Reports Server (NTRS)

Wu, K. Chauncey; Jackson, Justin R.; Pelham, Larry I.; Stewart, Brian K.

2015-01-01

New automated fiber placement systems at the NASA Langley Research Center and NASA Marshall Space Flight Center provide state-of-art composites capabilities to these organizations. These systems support basic and applied research at Langley, complementing large-scale manufacturing and technology development at Marshall. These systems each consist of a multi-degree of freedom mobility platform including a commercial robot, a commercial tool changer mechanism, a bespoke automated fiber placement end effector, a linear track, and a rotational tool support structure. In addition, new end effectors with advanced capabilities may be either bought or developed with partners in industry and academia to extend the functionality of these systems. These systems will be used to build large and small composite parts in support of the ongoing NASA Composites for Exploration Upper Stage Project later this year.

Imprisoned Husbands: Palestinian Wives and Experiences of Difficulties.

PubMed

Shehadeh, Amer; Dawani, Sama; Saed, Mohammed; Derluyn, Ilse; Loots, Gerrit

2016-01-01

This study aimed to investigate difficulties experienced by the wives of Palestinian men arrested and held in Israeli prisons. 16 captives' wives were interviewed using a semi-structured interview to provide them with a greater opportunity to speak about their experiences. Three main research questions were discussed; community difficulties, social support, and coping strategies. A thematic analysis was used throughout the interviews. We concluded that in addition to the stress of being separated from their husbands, the frustrating visitation process to prison and the ongoing political conflict, the wives expressed a frustrating social network characterized by constant interferences in their personal lives and the choices they make. Most women expressed a lack in psychosocial support given through governmental and non-governmental organizations; in addition they expressed a need for that kind of support. Coping strategies ranged from religious, acceptance, distraction, to planning strategies.

Two decades of nation-wide community-based stroke support - The Singapore National Stroke Association.

PubMed

Venketasubramanian, Narayanaswamy; Yin, Ann; Lee, Lay B; De Silva, Deidre A

2017-04-01

The Singapore National Stroke Association, registered in 1996, offers support and information to stroke survivors and caregivers, and aims to raise public stroke awareness. In the last 20 years, we have developed programs to equip stroke survivors and caregivers with knowledge, life skills, comfort, and opportunities for socialization and reintegration. We have on-going public education and advocacy initiatives. Obtaining funding, member recruitment, volunteer retention, and leadership renewal are on-going challenges. Singapore National Stroke Association will continue to strive for the betterment of stroke survivors, their caregivers, and the public.

Interventions to improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation of ART in low- and middle-income settings – a systematic review

PubMed Central

Govindasamy, Darshini; Meghij, Jamilah; Negussi, Eyerusalem Kebede; Baggaley, Rachel Clare; Ford, Nathan; Kranzer, Katharina

2014-01-01

Introduction Several approaches have been taken to reduce pre-antiretroviral therapy (ART) losses between HIV testing and ART initiation in low- and middle-income countries, but a systematic assessment of the evidence has not yet been undertaken. The aim of this systematic review is to assess the potential for interventions to improve or facilitate linkage to or retention in pre-ART care and initiation of ART in low- and middle-income settings. Methods An electronic search was conducted on Medline, Embase, Global Health, Web of Science and conference databases to identify studies describing interventions aimed at improving linkage to or retention in pre-ART care or initiation of ART. Additional searches were conducted to identify on-going trials on this topic, and experts in the field were contacted. An assessment of the risk of bias was conducted. Interventions were categorized according to key domains in the existing literature. Results A total of 11,129 potentially relevant citations were identified, of which 24 were eligible for inclusion, with the majority (n=21) from sub-Saharan Africa. In addition, 15 on-going trials were identified. The most common interventions described under key domains included: health system interventions (i.e. integration in the setting of antenatal care); patient convenience and accessibility (i.e. point-of-care CD4 count (POC) testing with immediate results, home-based ART initiation); behaviour interventions and peer support (i.e. improved communication, patient referral and education) and incentives (i.e. food support). Several interventions showed favourable outcomes: integration of care and peer supporters increased enrolment into HIV care, medical incentives increased pre-ART retention, POC CD4 testing and food incentives increased completion of ART eligibility screening and ART initiation. Most studies focused on the general adult patient population or pregnant women. The majority of published studies were observational cohort studies, subject to an unclear risk of bias. Conclusions Findings suggest that streamlining services to minimize patient visits, providing adequate medical and peer support, and providing incentives may decrease attrition, but the quality of the current evidence base is low. Few studies have investigated combined interventions, or assessed the impact of interventions across the HIV cascade. Results from on-going trials investigating POC CD4 count testing, patient navigation, rapid ART initiation and mobile phone technology may fill the quality of evidence gap. Further high-quality studies on key population groups are required, with interventions informed by previously reported barriers to care. PMID:25095831

Trialling an electronic decision aid for policy developers to support ageing well.

PubMed

Cummings, Elizabeth; Ellis, Leonie; Tin, Eh Eh; Boyer, Kim; Orpin, Peter

2015-01-01

The complex process of developing policies and planning services requires the compilation and collation of evidence from multiple sources. With the increasing numbers of people living longer there will be a high demand for a wide range of aged care services to support people in ageing well. The premise of ageing well is based on providing an ageing population with quality care and resources that support their ongoing needs. These include affordable healthcare, end of life care improvement, mental health services improvement, care and support improvement for people with dementia, and support for healthy ageing. The National Health and Medical Research Council funded a research project to develop a policy tool to provide a framework to assist policy makers and service planners in the area of ageing well in rural and regional Australia. It was identified that development of an electronic version of the policy tool could be useful resulting in a small pilot development being undertaken and tested with policy makers and service planners. This paper describes the development and trialling of a tablet based application used to assess the acceptability of computerised forms for participants actively involved in policy development. It reports on the policy developer's experience of the electronic tool to support ageing well policy making based on evidence.

Interactive effects in transfer-appropriate processing for event-based prospective memory: the roles of effort, ongoing task, and PM cue properties.

PubMed

Abney, Drew H; McBride, Dawn M; Petrella, Samantha N

2013-10-01

Past studies (e.g., Marsh, Hicks, & Cook Journal of Experimental Psychology: Learning, Memory, and Cognition 31:68-75, 2005; Meiser & Schult European Journal of Cognitive Psychology 20:290-311, 2008) have shown that transfer-appropriate processing (TAP) effects in event-based prospective memory (PM) depend on the effort directed toward the ongoing task. In the present study, we addressed mixed findings from these studies and examined monitoring in TAP and transfer-inappropriate processing (TIP) conditions. In two experiments, a semantic or orthographic ongoing task was paired with a PM cue that either was matched in processing (TAP) or did not match in processing (TIP). Within each condition, effort was varied across trials. The results indicated that PM accuracy was higher in TAP than in TIP conditions, regardless of effort condition, supporting the findings reported by Meiser and Schult. Ex-Gaussian functions were fit to the mean reaction times (cf. Brewer Journal of Psychology 219:117-124, 2011) in order to examine monitoring across conditions. The analysis of distributional skew (τ parameter) showed sensitivity to ongoing task instructions and properties of the PM cues. These results support Meiser and Schult's suggestion that TIP conditions require more attentional processing, and they also afford novel discussion on the interactive effects of ongoing task condition, PM cue properties, and manipulations of effort.

An Action Research Approach to Supporting Elite Student-Athletes in Higher Education

ERIC Educational Resources Information Center

McKenna, Jim; Dunstan-Lewis, Nicky

2004-01-01

Support for elite student-athletes was explored within a single English university using Stringer's (1996) Look, Think, Act model of action research. Entry to the ongoing support programme is competitive and participation is voluntary, with sessions delivered every second week after lectures. Based on supporting documentation, interviews, focus…

Schizophrenia—Time to Commit to Policy Change

PubMed Central

Fleischhacker, W. Wolfgang

2014-01-01

Care and outcomes for people with schizophrenia have improved in recent years, but further progress is needed to help more individuals achieve an independent and fulfilled life. This report sets out the current need, informs policy makers and all relevant stakeholders who influence care quality, and supports their commitment to creating a better future. The authors recommend the following policy actions, based on research evidence, stakeholder consultation, and examples of best practice worldwide. (1) Provide an evidence-based, integrated care package for people with schizophrenia that addresses their mental and physical health needs. (2) Provide support for people with schizophrenia to enter and to remain in their community, and develop mechanisms to help guide them through the complex benefit and employment systems. (3) Provide concrete support, information, and educational programs to families and carers on how to enhance care for an individual living with schizophrenia in a manner that entails minimal disruption to their lives. (4) All stakeholders, including organizations that support people living with schizophrenia, should be consulted to regularly revise, update, and improve policy on the management of schizophrenia. (5) Provide support, which is proportionate to the impact of the disease, for research and development of new treatments. (6) Establish adequately funded, ongoing, and regular awareness-raising campaigns that form an integral part of routine plans of action. Implementation of the above recommendations will require engagement by every stakeholder, but with commitment from all, change can be achieved. PMID:24778411

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study

PubMed Central

Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-01-01

Background Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. Objective The aim was to illustrate uses and experiences with the secure e-recovery portal “ReConnect” as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. Methods ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Results Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users’ control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Conclusions Regardless of providers’ portal use, service users’ control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users’ autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). PMID:28465277

AztecOO user guide.

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

Heroux, Michael Allen

2004-07-01

The Trilinos{trademark} Project is an effort to facilitate the design, development, integration and ongoing support of mathematical software libraries. AztecOO{trademark} is a package within Trilinos that enables the use of the Aztec solver library [19] with Epetra{trademark} [13] objects. AztecOO provides access to Aztec preconditioners and solvers by implementing the Aztec 'matrix-free' interface using Epetra. While Aztec is written in C and procedure-oriented, AztecOO is written in C++ and is object-oriented. In addition to providing access to Aztec capabilities, AztecOO also provides some signficant new functionality. In particular it provides an extensible status testing capability that allows expression of sophisticatedmore » stopping criteria as is needed in production use of iterative solvers. AztecOO also provides mechanisms for using Ifpack [2], ML [20] and AztecOO itself as preconditioners.« less

Reciprocity of agonistic support in ravens.

PubMed

Fraser, Orlaith N; Bugnyar, Thomas

2012-01-01

Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim's likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals.

Key Features Of Peer Support In Chronic Disease Prevention And Management.

PubMed

Fisher, Edwin B; Ballesteros, Juana; Bhushan, Nivedita; Coufal, Muchieh M; Kowitt, Sarah D; McDonough, A Manuela; Parada, Humberto; Robinette, Jennifer B; Sokol, Rebeccah L; Tang, Patrick Y; Urlaub, Diana

2015-09-01

Peer support from community health workers, promotores de salud, and others through community and health care organizations can provide social support and other assistance that enhances health. There is substantial evidence for both the effectiveness and the cost-effectiveness of peer support, as well as for its feasibility, reach, and sustainability. We discuss findings from Peers for Progress, a program of the American Academy of Family Physicians Foundation, to examine when peer support does not work, guide dissemination of peer support programs, and help integrate approaches such as e-health into peer support. Success factors for peer support programs include proactive implementation, attention to participants' emotions, and ongoing supervision. Reaching those whom conventional clinical and preventive services too often fail to reach; reaching whole populations, such as people with diabetes, rather than selected samples; and addressing behavioral health are strengths of peer support that can help achieve health care that is efficient and of high quality. Challenges for policy makers going forward include encouraging workforce development, balancing quality control with maintaining key features of peer support, and ensuring that underresourced organizations can develop and manage peer support programs. Project HOPE—The People-to-People Health Foundation, Inc.

The neonatal nurses' view of their role in emotional support of parents and its complexities.

PubMed

Turner, Melanie; Chur-Hansen, Anna; Winefield, Helen

2014-11-01

To explore the nurses' views of their role both in the neonatal intensive care unit and in the provision of interacting with, and emotionally supporting, families. The neonatal intensive care nurse has a large and complex clinical role and also a role of emotional supporter for parents in the neonatal intensive care unit. Identifying components of their role and recognising the elements within the nursery that obstruct or encourage this role can allow for modification of nurse education and peer support. Qualitative study based on semistructured interviews. Nine neonatal nurses from a single neonatal intensive care unit were interviewed and the data analysed thematically using NVIVO version 10. Participants viewed their role as an enjoyable yet difficult one, requiring seniority, training and experience. They provided support to parents by communicating, listening, providing individualised support and by encouraging parental involvement with their baby. Constructive elements that contributed to the provision of support included a positive neonatal intensive care unit environment and providing a parent support group. More obstructive elements were a lack of physical neonatal intensive care unit space, little time available for nurse-to-parent conversation and language and cultural barriers between nurses and parents. The role of the neonatal nurse in providing emotional support is complex and requires a high level of ongoing support and education for staff, and minimisation of physical and staff-related obstructions. The modern neonatal intensive care unit offers complex medical and nursing services and with this care comes higher needs from both babies and their parents. Neonatal intensive care unit nurses should be supported in their roles by having peer support available in the neonatal intensive care unit and education and training in emotional support and counselling skills. The nursing staff also require a comfortable and practical physical working space in which to assist parents to be with their baby. © 2014 John Wiley & Sons Ltd.

Patient Recruitment 2.0: Become a Partner in the Patient Journey Using Digital Media

PubMed Central

Lindemann, Michael; Freeman, Tobe; Kilchenmann, Timothy; Harrison, Shuree; Chan, Margaret; Wygonik, Mark; Haines, Lea

2016-01-01

We describe a digital platform, Pioneering Healthcare, designed to inform and empower people who are impacted by lung cancer. The platform enables Roche to support an online conversation with patients and caregivers about lung cancer, and about the role of lung cancer clinical studies in the development of future treatment options. This conversation is live and ongoing on the platform. It provides insights about the views and motivations of patients, and about how to better support patients pursuing treatment for life-threatening illness. We discuss the strategies used to deploy Pioneering Healthcare, and the advantages of using digital platforms for raising disease awareness, increasing patient engagement and, ultimately, for boosting patient enrollment into clinical trials. PMID:26818938

NASA's Hall Thruster Program 2002

NASA Technical Reports Server (NTRS)

Jankovsky, Robert S.; Jacobson, David T.; Pinero, Luis R.; Manzella, David H.; Hofer, Richard R.; Peterson, Peter Y.

2002-01-01

The NASA Hall thruster program currently supports a number of tasks related to high power thruster development for a number of customers including the Energetics Program (formerly called the Space-based Program), the Space Solar Power Program, and the In-space Propulsion Program. In program year 2002, two tasks were central to the NASA Hall thruster program: 1) the development of a laboratory Hall thruster capable of providing high thrust at high power-, and 2) investigations into operation of Hall thrusters at high specific impulse. In addition to these two primary thruster development activities, there are a number of other on-going activities supported by the NASA Hall thruster program. These additional activities are related to issues such as high-power power processor architecture, thruster lifetime, and spacecraft integration.

Mentoring--a staff retention tool.

PubMed

Kanaskie, Mary Louise

2006-01-01

Staff retention presents a common challenge for hospitals nationwide. Mentorship programs have been explored as one method of creating environments that promote staff retention. Successful achievement of nurse competencies identified in the Synergy Model for Patient Care can best be achieved in an environment that encourages and facilitates mentoring. Mentoring relationships in critical care provide the ongoing interactions, coaching, teaching, and role modeling to facilitate nurses' progression along this continuum. Mentoring relationships offer support and professional development for nurses at all levels within an organization as well as an optimistic outlook for the nursing profession.

Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

PubMed

Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

2016-01-01

Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Traffic Flow Management and Optimization

NASA Technical Reports Server (NTRS)

Rios, Joseph Lucio

2014-01-01

This talk will present an overview of Traffic Flow Management (TFM) research at NASA Ames Research Center. Dr. Rios will focus on his work developing a large-scale, parallel approach to solving traffic flow management problems in the national airspace. In support of this talk, Dr. Rios will provide some background on operational aspects of TFM as well a discussion of some of the tools needed to perform such work including a high-fidelity airspace simulator. Current, on-going research related to TFM data services in the national airspace system and general aviation will also be presented.

Implementation of an EPN-TAP Service to Improve Accessibility to the Planetary Science Archive

NASA Astrophysics Data System (ADS)

Macfarlane, A.; Barabarisi, I.; Docasal, R.; Rios, C.; Saiz, J.; Vallejo, F.; Martinez, S.; Arviset, C.; Besse, S.; Vallat, C.

2017-09-01

The re-engineered PSA has a focus on improved access and search-ability to ESA's planetary science data. In addition to the new web interface released in January 2017, the new PSA supports several common planetary protocols in order to increase the visibility and ways in which the data may be queried and retrieved. Work is on-going to provide an EPN-TAP service covering as wide a range of parameters as possible to facilitate the discovery of scientific data and interoperability of the archive.

An overview of key technology thrusts at Bell Helicopter Textron

NASA Technical Reports Server (NTRS)

Harse, James H.; Yen, Jing G.; Taylor, Rodney S.

1988-01-01

Insight is provided into several key technologies at Bell. Specific topics include the results of ongoing research and development in advanced rotors, methodology development, and new configurations. The discussion on advanced rotors highlight developments on the composite, bearingless rotor, including the development and testing of full scale flight hardware as well as some of the design support analyses and verification testing. The discussion on methodology development concentrates on analytical development in aeromechanics, including correlation studies and design application. New configurations, presents the results of some advanced configuration studies including hardware development.

Working with families of children with special needs: the parent adviser scheme.

PubMed

Buchan, L; Clemerson, J; Davis, H

1988-01-01

This paper describes a project in which an attempt is made to provide regular, ongoing support and counselling for families of children with severe developmental delays and intellectual or physical impairments. This service is available to both English speaking and Bangladeshi families, and is concerned with the needs of the whole family, not just the child. Professionals already working in this field are trained in counselling skills and then work in partnership with the families, attempting to develop a respectful, open relationship based upon active listening.

Preparing Teachers of Young Children: The Current State of Knowledge, and a Blueprint for the Future. Part 1: Teacher Preparation and Professional Development in Grades K-12 and in Early Care and Education: Differences and Similarities, and Implications for Research. Policy Report

ERIC Educational Resources Information Center

Whitebook, Marcy; Gomby, Deanna; Bellm, Dan; Sakai, Laura; Kipnis, Fran

2009-01-01

When it comes to teacher preparation, the support provided to new teachers, and ongoing professional development for working teachers, Grades K-12 and the field of early care and education (ECE) are two very different worlds. While both worlds assume that teachers' classroom skills and behavior can be influenced at multiple points in time (through…

Trauma healing in refugee camps in Guinea: a psychosocial program for Liberian and Sierra Leonean survivors of torture and war.

PubMed

Stepakoff, Shanee; Hubbard, Jon; Katoh, Maki; Falk, Erika; Mikulu, Jean-Baptiste; Nkhoma, Potiphar; Omagwa, Yuvenalis

2006-11-01

From 1999 to 2005, the Minneapolis-based Center for Victims of Torture (CVT) served Liberian and Sierra Leonean survivors of torture and war living in the refugee camps of Guinea. A psychosocial program was developed with 3 main goals: (a) to provide mental health care, (b) to train local refugee counselors, and (c) to raise community awareness about war trauma and mental health. Utilizing paraprofessional counselors under the close, on-site supervision of expatriate clinicians, the treatment model blended elements of Western and indigenous healing. The core component consisted of relationship-based supportive group counseling. Clinical interventions were guided by a 3-stage model of trauma recovery (safety, mourning, reconnection), which was adapted to the realities of the refugee camp setting. Over 4,000 clients were provided with counseling, and an additional 15,000 were provided with other supportive services. Results from follow-up assessments indicated significant reductions in trauma symptoms and increases in measures of daily functioning and social support during and after participation in groups. The treatment model developed in Guinea served as the basis for CVT's ongoing work with survivors in Sierra Leone and Liberia. ((c) 2006 APA, all rights reserved).

77 FR 72691 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

...: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business Administration..., Administrative and Support, Waste Management and Remediation Services. As part of its ongoing comprehensive... size standard for Environmental Remediation Services, an ``exception'' under NAICS 562910, Remediation...

A strategic vision for telemedicine and medical informatics in space flight

NASA Technical Reports Server (NTRS)

Williams, D. R.; Bashshur, R. L.; Pool, S. L.; Doarn, C. R.; Merrell, R. C.; Logan, J. S.

2000-01-01

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

Ebola Virus Training: A Needs Assessment and Gap Analysis.

PubMed

Yeskey, Kevin; Hughes, Joseph; Galluzzo, Betsy; Jaitly, Nina; Remington, James; Weinstock, Deborah; Lee Pearson, Joy; Rosen, Jonathan D

In response to the 2014 Ebola virus disease outbreak, the Worker Training Program embarked on an assessment of existing training for those at risk for exposure to the virus. Searches of the recent peer-reviewed literature were conducted for descriptions of relevant training. Federal guidance issued during 2015 was also reviewed. Four stakeholder meetings were conducted with representatives from health care, academia, private industry, and public health to discuss issues associated with ongoing training. Our results revealed few articles about training that provided sufficient detail to serve as models. Training programs struggled to adjust to frequently updated federal guidance. Stakeholders commented that most healthcare training focused solely on infection control, and there was an absence of employee health-related training for non-healthcare providers. Challenges to ongoing training included funding and organizational complacency. Best practices were noted where management and employees planned training cooperatively and where infection control, employee health, and hospital emergency managers worked together on the development of protective guidance. We conclude that sustainable training for infectious disease outbreaks requires annual funding, full support from organizational management, input from all stakeholders, and integration of infection control, emergency management, and employee health when implementing guidance and training.

Improved Aerodynamic Analysis for Hybrid Wing Body Conceptual Design Optimization

NASA Technical Reports Server (NTRS)

Gern, Frank H.

2012-01-01

This paper provides an overview of ongoing efforts to develop, evaluate, and validate different tools for improved aerodynamic modeling and systems analysis of Hybrid Wing Body (HWB) aircraft configurations. Results are being presented for the evaluation of different aerodynamic tools including panel methods, enhanced panel methods with viscous drag prediction, and computational fluid dynamics. Emphasis is placed on proper prediction of aerodynamic loads for structural sizing as well as viscous drag prediction to develop drag polars for HWB conceptual design optimization. Data from transonic wind tunnel tests at the Arnold Engineering Development Center s 16-Foot Transonic Tunnel was used as a reference data set in order to evaluate the accuracy of the aerodynamic tools. Triangularized surface data and Vehicle Sketch Pad (VSP) models of an X-48B 2% scale wind tunnel model were used to generate input and model files for the different analysis tools. In support of ongoing HWB scaling studies within the NASA Environmentally Responsible Aviation (ERA) program, an improved finite element based structural analysis and weight estimation tool for HWB center bodies is currently under development. Aerodynamic results from these analyses are used to provide additional aerodynamic validation data.

A strategic vision for telemedicine and medical informatics in space flight.

PubMed

Williams, D R; Bashshur, R L; Pool, S L; Doarn, C R; Merrell, R C; Logan, J S

2000-01-01

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

The "Big C"-stigma, cancer, and workplace discrimination.

PubMed

Stergiou-Kita, Mary; Pritlove, Cheryl; Kirsh, Bonnie

2016-12-01

Stigma and workplace discrimination have been identified as prominent challenges to employment following cancer. However, there has been limited examination of how stigma develops in work contexts and how it influences cancer survivors' return to work process and their disclosure decisions. In the broader study from which this paper emerges, we used an exploratory qualitative design to examine the return to work process (including workplace supports and accommodations) of cancer survivors. We conducted 40 semi-structured interviews with (i) cancer survivors (n = 16), (ii) health care/vocational service providers (n = 16), and (iii) employer representatives (n = 8). We used thematic analysis methods to analyze the data. In this paper, we present data related specifically to workplace stigma, discrimination, and disclosure. Contrasting perspectives were identified among our stakeholder groups regarding the existence and impact of stigma in the workplace. While most provider and employer representatives believed survivors were not likely to be stigmatized, cancer survivors themselves perceived cancer as a highly stigmatized illness in the workplace. Two inter-related elements were implicated in the development of workplace stigma following cancer: (1) ongoing misconceptions and fears associating cancer with death and (2) misperceptions regarding impacts on the workplace, including survivors' work abilities, productivity, reliability, the costs associated with their continued employment (e.g., workplace accommodations), and future impacts on the workplace related to cancer re-occurrence. Discriminatory behaviors, such as hiring discrimination, bullying, harassment, refusal of workplace accommodations, and limited career advancement opportunities, were also discussed. A supportive workplace, a desire to be open with co-workers, and a need to request supports and manage expectations were reasons provided for disclosure. Conversely, an unsupportive workplace, fear of discrimination, and a minimal need for assistance were reasons provided for not disclosing their cancer. Stigma and workplace discrimination are significant concerns for cancer survivors. Anti-stigma programs should target ongoing myths regarding cancer and survivors' right to work, work abilities and productivity, and incorporate survivors' voices to enhance understanding. Survivors, health care providers, vocational service providers, and employers should become familiar with anti-discrimination legislation and recognize stigma and discriminatory behaviors when they occur. Survivors require guidance to decide whether (or not) to disclose their cancer, how to respond to discriminatory behaviors, and how to best state their needs for workplace accommodations.

Subcortical processing of speech regularities underlies reading and music aptitude in children.

PubMed

Strait, Dana L; Hornickel, Jane; Kraus, Nina

2011-10-17

Neural sensitivity to acoustic regularities supports fundamental human behaviors such as hearing in noise and reading. Although the failure to encode acoustic regularities in ongoing speech has been associated with language and literacy deficits, how auditory expertise, such as the expertise that is associated with musical skill, relates to the brainstem processing of speech regularities is unknown. An association between musical skill and neural sensitivity to acoustic regularities would not be surprising given the importance of repetition and regularity in music. Here, we aimed to define relationships between the subcortical processing of speech regularities, music aptitude, and reading abilities in children with and without reading impairment. We hypothesized that, in combination with auditory cognitive abilities, neural sensitivity to regularities in ongoing speech provides a common biological mechanism underlying the development of music and reading abilities. We assessed auditory working memory and attention, music aptitude, reading ability, and neural sensitivity to acoustic regularities in 42 school-aged children with a wide range of reading ability. Neural sensitivity to acoustic regularities was assessed by recording brainstem responses to the same speech sound presented in predictable and variable speech streams. Through correlation analyses and structural equation modeling, we reveal that music aptitude and literacy both relate to the extent of subcortical adaptation to regularities in ongoing speech as well as with auditory working memory and attention. Relationships between music and speech processing are specifically driven by performance on a musical rhythm task, underscoring the importance of rhythmic regularity for both language and music. These data indicate common brain mechanisms underlying reading and music abilities that relate to how the nervous system responds to regularities in auditory input. Definition of common biological underpinnings for music and reading supports the usefulness of music for promoting child literacy, with the potential to improve reading remediation.

Tying eHealth Tools to Patient Needs: Exploring the Use of eHealth for Community-Dwelling Patients With Complex Chronic Disease and Disability

PubMed Central

Miller, Daniel; Kuluski, Kerry; Cott, Cheryl

2014-01-01

Background Health policy makers have recently shifted attention towards examining high users of health care, in particular patients with complex chronic disease and disability (CCDD) characterized as having multimorbidities and care needs that require ongoing use of services. The adoption of eHealth technologies may be a key strategy in supporting and providing care for these patients; however, these technologies need to address the specific needs of patients with CCDD. This paper describes the first phase of a multiphased patient-centered research project aimed at developing eHealth technology for patients with CCDD. Objective As part of the development of new eHealth technologies to support patients with CCDD in primary care settings, we sought to determine the perceived needs of these patients with respect to (1) the kinds of health and health service issues that are important to them, (2) the information that should be collected and how it could be collected in order to help meet their needs, and (3) their views on the challenges/barriers to using eHealth mobile apps to collect the information. Methods Focus groups were conducted with community-dwelling patients with CCDD and caregivers. An interpretive description research design was used to identify the perceived needs of participants and the information sharing and eHealth technologies that could support those needs. Analysis was conducted concurrently with data collection. Coding of transcripts from four focus groups was conducted by 3 authors. QSR NVivo 10 software was used to manage coding. Results There were 14 total participants in the focus groups. The average age of participants was 64.4 years; 9 participants were female, and 11 were born in Canada. Participants identified a need for open two-way communication and dialogue between themselves and their providers, and better information sharing between providers in order to support continuity and coordination of care. Access issues were mainly around wait times for appointments, challenges with transportation, and costs. A visual depiction of these perceived needs and their relation to each other is included as part of the discussion, which will be used to guide development of our eHealth technologies. Participants recognized the potential for eHealth technologies to support and improve their care but also expressed common concerns regarding their adoption. Specifically, they mentioned privacy and data security, accessibility, the loss of necessary visits, increased social isolation, provider burden, downloading responsibility onto patients for care management, entry errors, training requirements, and potentially confusing interfaces. Conclusions From the perspective of our participants, there is a significant potential for eHealth tools to support patients with CCDD in community and primary care settings, but we need to be wary of the potential downfalls of adopting eHealth technologies and pay special attention to patient-identified needs and concerns. eHealth tools that support ongoing patient-provider interaction, patient self-management (such as telemonitoring), and provider-provider interactions (through electronic health record integration) could be of most benefit to patients similar to those in our study. PMID:25428028

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

PubMed

Palmer, Rebecca; Enderby, Pam

2016-10-01

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

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

Rutqvist, Jonny; Blanco Martin, Laura; Mukhopadhyay, Sumit

The modeling efforts in support of the field test planning conducted at LBNL leverage on recent developments of tools for modeling coupled thermal-hydrological-mechanical-chemical (THMC) processes in salt and their effect on brine migration at high temperatures. This work includes development related to, and implementation of, essential capabilities, as well as testing the model against relevant information and published experimental data related to the fate and transport of water. These are modeling capabilities that will be suitable for assisting in the design of field experiment, especially related to multiphase flow processes coupled with mechanical deformations, at high temperature. In this report,more » we first examine previous generic repository modeling results, focusing on the first 20 years to investigate the expected evolution of the different processes that could be monitored in a full-scale heater experiment, and then present new results from ongoing modeling of the Thermal Simulation for Drift Emplacement (TSDE) experiment, a heater experiment on the in-drift emplacement concept at the Asse Mine, Germany, and provide an update on the ongoing model developments for modeling brine migration. LBNL also supported field test planning activities via contributions to and technical review of framework documents and test plans, as well as participation in workshops associated with field test planning.« less

The experiences of frequent users of crisis helplines: A qualitative interview study.

PubMed

Middleton, Aves; Gunn, Jane; Bassilios, Bridget; Pirkis, Jane

2016-11-01

To understand why some users call crisis helplines frequently. Nineteen semi-structured telephone interviews were conducted with callers to Lifeline Australia who reported calling 20 times or more in the past month and provided informed consent. Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was used to generate common themes. Approval was granted by The University of Melbourne Human Research Ethics Committee. Three overarching themes emerged from the data and included reasons for calling, service response and calling behaviours. Respondents called seeking someone to talk to, help with their mental health issues and assistance with negative life events. When they called, they found short-term benefits in the unrestricted support offered by the helpline. Over time they called about similar issues and described reactive, support-seeking and dependent calling behaviours. Frequent users of crisis helplines call about ongoing issues. They have developed distinctive calling behaviours which appear to occur through an interaction between their reasons for calling and the response they receive from the helpline. The ongoing nature of the issues prompting frequent users to call suggests that a service model that includes a continuity of care component may be more efficient in meeting their needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparisons of Prevention Programs for Homeless Youth

PubMed Central

Rotheram-Borus, Mary Jane

2014-01-01

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths’ families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate. PMID:19067164

Comparisons of prevention programs for homeless youth.

PubMed

Arnold, Elizabeth Mayfield; Rotheram-Borus, Mary Jane

2009-03-01

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths' families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate.

Partnering to run a community-based program for deaf-blind young adults.

PubMed

Riester, A E

1992-12-01

Community-based programs that assist deaf-blind young adults with living skills can be a cost effective alternative to institutional care. Their unique medical, psychosocial training, and daily living needs require services and support from a variety of agencies and providers. The elements and concepts necessary to conduct a program 24 hours a day for young adults who are deaf and blind includes sound management, realistic staff expectations for clients, developmentally appropriate activities, family participation in planning accessible medical and psychological services, and close collaboration with universities and community organizations. Management must also be sensitive to the emotional concerns of the staff and provide ongoing opportunities for supervision and training.

Revitalizing academic-service partnerships to resolve nursing faculty shortages.

PubMed

Connolly, Maria A; Wilson, Carol Jo

2008-01-01

Vacancy rates of nursing faculty are on the increase as fewer educators are being prepared and nurses at the bedside are in short supply. Advanced practice nurses--uniquely suited to provide clinical education for undergraduate and graduate students--are underutilized. However, without release time, preparation as educators, ongoing support from education and administration, and remuneration for providing both evidence-based education and evidence-based patient care, they can hardly be expected to assume additional responsibilities. This article reviews academic-service partnerships, noting a general lack of published efficacy and cost-effectiveness data, and highlights 21st-century innovations for academia and service to share resources for the benefit of all stakeholders--especially patients and students.

The 1981 current research on aviation weather (bibliography)

NASA Technical Reports Server (NTRS)

Daniel, J.; Frost, W.

1982-01-01

Current and ongoing research programs related to various areas of aviation meteorology are presented. Literature searches of major abstract publications, were conducted. Research project managers of various government agencies involved in aviation meteorology research provided a list of current research project titles and managers, supporting organizations, performing organizations, the principal investigators, and the objectives. These are tabulated under the headings of advanced meteorological instruments, forecasting, icing, lightning and atmospheric electricity; fog, visibility, and ceilings; low level wind shear, storm hazards/severe storms, turbulence, winds, and ozone and other meteorological parameters. This information was reviewed and assembled into a bibliography providing a current readily useable source of information in the area of aviation meteorology.

Alaska and Yukon magnetic compilation, residual total magnetic field

USGS Publications Warehouse

Miles, W.; Saltus, Richard W.; Hayward, N.; Oneschuk, D.

2017-01-01

This map is a compilation of aeromagnetic surveys over Yukon and eastern Alaska. Aeromagnetic surveys measure the total intensity of the earth's magnetic field. The field was measured by a magnetometer aboard an aircraft flown in parallel lines spaced at 200 m to 10000 m across the map area. The magnetic field reflects magnetic properties of bedrock and provides qualitative and quantitative information used in geological mapping. Understanding the geology will help geologists map the area, assist mineral/hydrocarbon exploration activities, and provide useful information necessary for communities, aboriginal associations, and government to make land use decisions. This survey was flown to improve our knowledge of the area. It will support ongoing geological mapping and resource assessment.

The development of an acute care case manager orientation.

PubMed

Strzelecki, S; Brobst, R

1997-01-01

The authors describe the development of an inpatient acute care case manager orientation in a community hospital. Benner's application of the Dreyfus model of skill acquisition provides the basis for the orientation program. The candidates for the case manager position were expert clinicians. Because of the role change it was projected that they would function as advanced beginners. It was also predicted that, as the case managers progressed within the role, the educational process would need to be adapted to facilitate progression of skills to the proficient level. Feedback from participants reinforced that the model supported the case manager in the role transition. In addition, the model provided a predictive framework for ongoing educational activities.

Factors associated with the effectiveness of continuing education in long-term care.

PubMed

Stolee, Paul; Esbaugh, Jacquelin; Aylward, Sandra; Cathers, Tamzin; Harvey, David P; Hillier, Loretta M; Keat, Nancy; Feightner, John W

2005-06-01

This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education. In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the workplace factors that affect transfer of learning into practice. Thirty-five people were interviewed across six focus groups. In Study 2, a Delphi technique was used to refine our list of factors. Consensus was achieved in two survey rounds involving 30 and 27 participants, respectively. Management support was identified as the most important factor impacting the effectiveness of continuing education. Other factors included resources (staff, funding, space) and the need for ongoing expert support. Organizational support is necessary for continuing education programs to be effective and ongoing expert support is needed to enable and reinforce learning.

Supporting family caregivers to identify their own needs in end-of-life care: Qualitative findings from a stepped wedge cluster trial.

PubMed

Aoun, Samar; Deas, Kathleen; Toye, Chris; Ewing, Gail; Grande, Gunn; Stajduhar, Kelli

2015-06-01

The Carer Support Needs Assessment Tool encompasses the physical, psychological, social, practical, financial, and spiritual support needs that government policies in many countries emphasize should be assessed and addressed for family caregivers during end-of-life care. To describe the experience of family caregivers of terminally ill people of the Carer Support Needs Assessment Tool intervention in home-based palliative care. This study was conducted during 2012-2014 in Silver Chain Hospice Care Service in Western Australia. This article reports on one part of a three-part evaluation of a stepped wedge cluster trial. All 233 family caregivers receiving the Carer Support Needs Assessment Tool intervention provided feedback on their experiences via brief end-of-trial semi-structured telephone interviews. Data were subjected to a thematic analysis. The overwhelming majority reported finding the Carer Support Needs Assessment Tool assessment process straightforward and easy. Four key themes were identified: (1) the practicality and usefulness of the systematic assessment; (2) emotional responses to caregiver reflection; (3) validation, reassurance, and empowerment; and (4) accessing support and how this was experienced. Family caregivers appreciated the value of the Carer Support Needs Assessment Tool intervention in engaging them in conversations about their needs, priorities, and solutions. The Carer Support Needs Assessment Tool presented a simple, yet potentially effective intervention to help palliative care providers systematically assess and address family caregivers' needs. The Carer Support Needs Assessment Tool provided a formal structure to facilitate discussions with family caregivers to enable needs to be addressed. Such discussions can also inform an evidence base for the ongoing development of services for family caregivers, ensuring that new or improved services are designed to meet the explicit needs of family caregivers. © The Author(s) 2015.

Tea, talk and technology: patient and public involvement to improve connected health 'wearables' research in dementia.

PubMed

Hassan, Lamiece; Swarbrick, Caroline; Sanders, Caroline; Parker, Angela; Machin, Matt; Tully, Mary P; Ainsworth, John

2017-01-01

There are a growing number of mobile phones, watches and electronic devices which can be worn on the body to track aspects of health and well-being, such as daily steps, sleep and exercise. Dementia researchers think that these devices could potentially be used as part of future research projects, for example to help spot changes in daily activity that may signal the early symptoms of dementia. We asked a range of older people, including people living with dementia and their carers, to participate in interactive discussions about how future participants might find using these devices as part of research projects. We also invited volunteers to borrow a range of devices to test at home, giving them further insights. Discussions revealed that people were generally supportive of this type of research, provided they gave informed consent and that devices were discreet, comfortable and easy to use. They also valued technical support and regular feedback on study progress to encourage ongoing participation. These findings were used to develop a pool of devices for researchers, with computer software and written guidance to help plan, design and support studies. Our work shows that when given the right opportunities, people who are affected by dementia can provide valuable insights that can enhance the design, delivery and quality of future research. Background Increasingly, researchers are recognising the potential for connected health devices, including smartphones and smartwatches, to generate high resolution data about patterns of daily activity and health outcomes. One aim of the Dementias Platform UK (DPUK) project is to provide researchers with a secure means to collect, collate and link data generated by such devices, thereby accelerating this type of research in the field of dementia. We aimed to involve members of the public in discussions about the acceptability and feasibility of different devices and research designs to inform the development of a device pool, software platform and written guidance to support future studies. Methods Over 30 people attended a series of interactive workshops, drop-in sessions and meetings in Greater Manchester. This included people living with dementia and cognitive impairments, carers and people without memory problems. Discussions were tailored to suit different audiences and focused on the feasibility and acceptability of a range of different wearable devices and research designs. We also invited volunteers to borrow a device to test at home, enabling further insights from hands-on interactions with devices. Results Discussions revealed that people were supportive of connected health dementia research in principle, provided they gave informed consent and that devices were discreet, comfortable and easy to use. Moreover, they recommended technical support and regular feedback on study progress to encourage ongoing participation. Conclusion By using a range of discussion-based and practical activities, we found it was feasible to involve people affected by dementia and use their insights to shape the development of a software platform and device pool to support future connected health dementia research. We recommend that researchers planning such studies in future pay adequate attention to designing suitable participant information, technical support and mechanisms of providing study progress updates to support sustained engagement from participants.

An ongoing process: a qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence.

PubMed

Yeh, Mei-Yu; Che, Hui-Lian; Wu, Shu-Mei

2009-11-24

Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services.

An ongoing process: A qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence

PubMed Central

2009-01-01

Background Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Methods Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. Results We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. Conclusion This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services. PMID:19930698

Development of a Primary Care-Based Clinic to Support Adults With a History of Childhood Cancer: The Tactic Clinic.

PubMed

Overholser, Linda S; Moss, Kerry M; Kilbourn, Kristin; Risendal, Betsy; Jones, Alison F; Greffe, Brian S; Garrington, Timothy; Leonardi-Warren, Kristin; Yamashita, Traci E; Kutner, Jean S

2015-01-01

Describe the development and evolution of a primary-care-based, multidisciplinary clinic to support the ongoing care of adult survivors of childhood cancer. A consultative clinic for adult survivors of childhood cancer has been developed that is located in an adult, academic internal medicine setting and is based on a long-term follow-up clinic model available at Children's Hospital Colorado. The clinic opened in July 2008. One hundred thirty-five patients have been seen as of April 2014. Referrals and clinic capacity have gradually increased over time, and a template has been developed in the electronic medical record to help facilitate completion of individualized care plan letters. A primary care-based, multidisciplinary consultative clinic for adults with a history of childhood cancer survivor is feasible and actively engages adult primary care resources to provide risk-based care for long-term pediatric cancer survivors. This model of care planning can help support adult survivors of pediatric cancer and their primary care providers in non-academic, community settings as well. Copyright © 2015 Elsevier Inc. All rights reserved.

Update on the Ares V to Support Heavy Lift for U.S. Space Exploration Policy

NASA Technical Reports Server (NTRS)

Sumrall, John P.; Creech, Steve

2008-01-01

When NASA's Ares V cargo launch vehicle begins flying late next decade, its capabilities will significantly exceed the 1960s-era Saturn V. It will send more crew and cargo to more places on the lunar surface than Apollo and provide ongoing support to a permanent lunar outpost that will open the Moon to greater exploration, science and adventure than ever before. Moreover, it will restore the United States heavy-lift capability, which can support human and robotic exploration for decades to come. Ares V remains in a pre-design analysis cycle stage pending a planned Authority to Proceed (ATP) in late 2010. Ares V benefits from the decision to draw from heritage hardware and its commonality with the Ares I crew launch vehicle, which completed its preliminary design review (PDR) in September 2008. Most of the work on Ares V to date has been focused on refining the vehicle design through a variety of internal studies. This paper will provide background information on the Ares V evolution, emphasizing the vehicle configuration as it exists today.

IDAHO NATIONAL LABORATORY TRANSPORTATION TASK REPORT ON ACHIEVING MODERATOR EXCLUSION AND SUPPORTING STANDARDIZED TRANSPORTATION

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

D.K. Morton

2011-09-01

Following the defunding of the Yucca Mountain Project, it is reasonable to assume that commercial used fuel will remain in storage for the foreseeable future. This report proposes supplementing the ongoing research and development work related to potential degradation of used fuel, baskets, poisons, and storage canisters during an extended period of storage with a parallel path. This parallel path can assure criticality safety during transportation by implementing a concept that achieves moderator exclusion (no in-leakage of moderator into the used fuel cavity). Using updated risk assessment insights for additional technical justification and relying upon a component inside of themore » transportation cask that provides a watertight function, a strong argument can be made that moderator intrusion is not credible and should not be a required assumption for criticality evaluations during normal conditions of transportation. A demonstrating testing program supporting a detailed analytical effort as well as updated risk assessment insights can provide the basis for moderator exclusion during hypothetical accident conditions. This report also discusses how this engineered concept can support the goal of standardized transportation.« less

Distributed collaborative environments for predictive battlespace awareness

NASA Astrophysics Data System (ADS)

McQuay, William K.

2003-09-01

The past decade has produced significant changes in the conduct of military operations: asymmetric warfare, the reliance on dynamic coalitions, stringent rules of engagement, increased concern about collateral damage, and the need for sustained air operations. Mission commanders need to assimilate a tremendous amount of information, make quick-response decisions, and quantify the effects of those decisions in the face of uncertainty. Situational assessment is crucial in understanding the battlespace. Decision support tools in a distributed collaborative environment offer the capability of decomposing complex multitask processes and distributing them over a dynamic set of execution assets that include modeling, simulations, and analysis tools. Decision support technologies can semi-automate activities, such as analysis and planning, that have a reasonably well-defined process and provide machine-level interfaces to refine the myriad of information that the commander must fused. Collaborative environments provide the framework and integrate models, simulations, and domain specific decision support tools for the sharing and exchanging of data, information, knowledge, and actions. This paper describes ongoing AFRL research efforts in applying distributed collaborative environments to predictive battlespace awareness.

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.

Ongoing Recovery Basic Information Tool (ORBIT)

NASA Technical Reports Server (NTRS)

Oberg, Donald

1993-01-01

The Federal Drug Free Work Place Program (DFWP) has now matured to the point of being able to return employees to sensitive testing designated positions (TDP) after completion of treatment of their addiction. The known tendency of addicted individuals to suffer multiple relapses prior to their final recovery has resulted in several positive urine tests (relapses) occurring among those Federal employees who have already completed treatment and who have been returned to TDP's. The very real potential for further relapses occurring after additional employees return to TDP's will be a critical factor in the ultimate success of the DFWP and in the public's impression of the program's effectiveness. In response to this concern, NASA has begun development of its Ongoing Recovery Basic Information Tool (ORBIT) instrument. The aim of the NASA ORBIT is to provide Employee Assistance Program (EAP) professionals with an advanced clinical tool which will be helpful in supporting recovery from substance abuse and which will allow more accurate determinations of when clients may be successfully returned to sensitive positions.

Digital technologies in support of flood resilience: A case study from Nepal

NASA Astrophysics Data System (ADS)

Liu, Wei; McCallum, Ian; See, Linda; Dugar, Sumit; Laso-Bayas, Juan-Carlos

2016-04-01

This paper presents ongoing efforts to support flood resilience in the Karnali basin in Nepal through the provision of different forms of digital technology. Flood Risk Geo-Wiki is an online visualization and crowdsourcing tool, which has been adapted to display flood risk maps at the global scale as well as information of relevance to planners and the community at the local level. Community-based flood risk maps, which have traditionally been drawn on paper, are being digitized and integrated with OpenStreetMap to provide better access to this collective knowledge base. Mobile phones, using the GeoODK (Geographical Open Data Kit) questionnaire builder, are being deployed to collect georeferenced information on flood risks and vulnerability, which can be used to validate flood models and design action plans and strategies for coping with future flood events. These types of digital technologies are simple to implement yet together can help support flood prone communities.

The other side of caring: adult children with mental illness as supports to their mothers in later life.

PubMed

Greenberg, J S

1995-05-01

This article discusses the role of adult children with serious mental illness as a source of support to their aging parents. The data come from a cross-sectional study of 105 mothers age 55 and older who were living with and caring for an adult child with a serious mental illness. The mothers participated in in-depth face-to-face interviews conducted in their homes and also completed a set of self-administered questionnaires. The majority of mothers in this study reported that their children provided at least some ongoing help with a range of daily living tasks. As hypothesized, the adult child's assistance and support were related significantly to lower levels of maternal subjective burden. By beginning to acknowledge the contributions that people with mental illness make to their families, social workers can help clients maintain and sustain self-esteem and improve the quality of their lives.

Integrated Cancer Research in Five Thematic Areas in Interest

DTIC Science & Technology

2005-07-01

Professor of Urology (on-going RSU), Howard Crawford, PhD, Assistant Professor of Pharmacological Sciences (on-going RSU), Marjana Maletic- Savatic ...young scientists. Drs. Adler, Crawford, Maletic- Savatic received base support from this mechanism as they further develop their research programs...Mirjana Maletic- Savatic , MD-PhD, Assistant Professor Neurology: Human Neural Stem Cells - In Vivo Models for Cerebral Carcinoma The study of human

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

Indoor Athletic Facilities.

ERIC Educational Resources Information Center

Fleming, E. Scott

2000-01-01

Examines the concept of shared-use facilities to help financially support and meet the demand for athletic facilities. Shared-use considerations are explored including cost sharing of ongoing operations, aesthetics, locker rooms, support facilities, parking and site access, and building access and security. (GR)

Exploiting Social Media for Army Operations: Syrian Civil War Use Case

DTIC Science & Technology

2014-07-01

language translation and intercultural communication . Local expertise goes beyond language and cultural gaps though, in that it provides a naturalistic way...security and counter-terrorism. The information exchanged in SM sites and the networks of people who interact with these online communities can provide...the networks of people who interact with these online communities can provide insights into ongoing events. For example, SM could provide ongoing

Building a virtual network in a community health research training program.

PubMed

Lau, F; Hayward, R

2000-01-01

To describe the experiences, lessons, and implications of building a virtual network as part of a two-year community health research training program in a Canadian province. An action research field study in which 25 health professionals from 17 health regions participated in a seven-week training course on health policy, management, economics, research methods, data analysis, and computer technology. The participants then returned to their regions to apply the knowledge in different community health research projects. Ongoing faculty consultations and support were provided as needed. Each participant was given a notebook computer with the necessary software, Internet access, and technical support for two years, to access information resources, engage in group problem solving, share ideas and knowledge, and collaborate on projects. Data collected over two years consisted of program documents, records of interviews with participants and staff, meeting notes, computer usage statistics, automated online surveys, computer conference postings, program Web site, and course feedback. The analysis consisted of detailed review and comparison of the data from different sources. NUD*IST was then used to validate earlier study findings. The ten key lessons are that role clarity, technology vision, implementation staging, protected time, just-in-time training, ongoing facilitation, work integration, participatory design, relationship building, and the demonstration of results are essential ingredients for building a successful network. This study provides a descriptive model of the processes involved in developing, in the community health setting, virtual networks that can be used as the basis for future research and as a practical guide for managers.

A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners.

PubMed

Boyle, Eileen; Saunders, Rosemary; Drury, Vicki

2016-07-01

To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. Qualitative interpretive. Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses. © 2016 John Wiley & Sons Ltd.

Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia.

PubMed

Khan, Farrah; Krishnan, Archana; Ghani, Mansur A; Wickersham, Jeffrey A; Fu, Jeannia J; Lim, Sin How; Dhaliwal, Sangeeth Kaur; Kamarulzaman, Adeeba; Altice, Frederick L

2018-01-28

As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services.   We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia's second C&C Center located in Kota Bharu, Kelantan. In June-July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance: Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia's ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely.

Callers’ attitudes and experiences of UK breastfeeding helpline support

PubMed Central

2013-01-01

Background Breastfeeding peer support, is considered to be a key intervention for increasing breastfeeding duration rates. Whilst a number of national organisations provide telephone based breastfeeding peer support, to date there have been no published evaluations into callers’ experiences and attitudes of this support. In this study we report on the descriptive and qualitative insights provided by 908 callers as part of an evaluation of UK-based breastfeeding helpline(s). Methods A structured telephone interview, incorporating Likert scale responses and open-ended questions was undertaken with 908 callers over May to August, 2011 to explore callers’ experiences of the help and support received via the breastfeeding helpline(s). Results Overall satisfaction with the helpline was high, with the vast majority of callers’ recalling positive experiences of the help and support received. Thematic analysis was undertaken on all qualitative and descriptive data recorded during the evaluation, contextualised within the main areas addressed within the interview schedule in terms of ‘contact with the helplines’; ‘experiences of the helpline service’, ‘perceived effectiveness of support provision’ and ‘impact on caller wellbeing’. Conclusion Callers valued the opportunity for accessible, targeted, non-judgmental and convenient support. Whilst the telephone support did not necessarily influence women’s breastfeeding decisions, the support they received left them feeling reassured, confident and more determined to continue breastfeeding. We recommend extending the helpline service to ensure support can be accessed when needed, and ongoing training and support for volunteers. Further advertising and promotion of the service within wider demographic groups is warranted. PMID:23628104

Willingness to complete advance directives among low-income older adults living in the USA.

PubMed

Ko, Eunjeong; Lee, Jaehoon; Hong, Youngjoon

2016-11-01

This study explored low-income older adults' willingness to (i) complete advance directives, legal documents, whereby an individual designates decision-makers in the event that they cannot make their own decisions about end-of-life treatment preferences, and (ii) the role of social support and other predictors that impact their willingness. This study was conducted as part of a larger study exploring behaviours of advance care planning among low-income older adults. Out of a total of 255 participants from the original study, this study included 204 participants who did not complete an advance directive for data analysis. A cross-sectional study using probability random sampling stratified by ethnicity was used. Older adults residing in two supportive housing facilities or who were members of a senior centre in San Diego, California, USA, were interviewed in person between December 2010 and April 2011. Hierarchical logistic regression analysis revealed that the majority of participants (72.1%) were willing to complete advance directives and the factors significantly predicting willingness to complete included self-rated health, attitudes towards advance decision-making and social support. Participants with a poorer health status (OR = 1.43, 95% CI = 1.07-1.90) were more willing to complete advance directives. Conversely, participants with higher positive attitudes (OR = 1.18, 95% CI = 1.00-1.39) and greater social support (OR = 1.07, 95% CI = 1.00-1.15) were also more willing to complete advance directives. The findings suggest the importance of ongoing support from healthcare professionals in end-of-life care planning. Healthcare professionals can be a source of support assisting older adults in planning end-of-life care. Initiating ongoing communication regarding personal value and preference for end-of-life care, providing relevant information and evaluating willingness to complete as well as assisting in the actual completion of advance directives will be necessary. © 2015 John Wiley & Sons Ltd.

The Dynamic Multiprocess Framework: Evidence from Prospective Memory with Contextual Variability

PubMed Central

Scullin, Michael K.; McDaniel, Mark A.; Shelton, Jill Talley

2013-01-01

The ability to remember to execute delayed intentions is referred to as prospective memory. Previous theoretical and empirical work has focused on isolating whether a particular prospective memory task is supported either by effortful monitoring processes or by cue-driven spontaneous processes. In the present work, we advance the Dynamic Multiprocess Framework, which contends that both monitoring and spontaneous retrieval may be utilized dynamically to support prospective remembering. To capture the dynamic interplay between monitoring and spontaneous retrieval we had participants perform many ongoing tasks and told them that their prospective memory cue may occur in any context. Following either a 20-min or a 12-hr retention interval, the prospective memory cues were presented infrequently across three separate ongoing tasks. The monitoring patterns (measured as ongoing task cost relative to a between-subjects control condition) were consistent and robust across the three contexts. There was no evidence for monitoring prior to the initial prospective memory cue; however, individuals who successfully spontaneously retrieved the prospective memory intention, thereby realizing that prospective memory cues could be expected within that context, subsequently monitored. These data support the Dynamic Multiprocess Framework, which contends that individuals will engage monitoring when prospective memory cues are expected, disengage monitoring when cues are not expected, and that when monitoring is disengaged, a probabilistic spontaneous retrieval mechanism can support prospective remembering. PMID:23916951

Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system.

PubMed

Vivanti, Angela; O'Sullivan, Therese A; Porter, Jane; Hogg, Marion

2017-09-01

Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved (P < 0.001). Perceptions of NCPT's importance (P < 0.020) and benefits of incorporating NCPT into practice (P = 0.029) increased. Time to complete NCPT documentation (P < 0.013) and access to mentors decreased (P < 0.001). Other areas including enhanced attitudes, familiarity, confidence, views, knowledge and incorporation into practice were sustained (P > 0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. © 2017 State of Queensland. Nutrition and Dietetics © 2017 Dietitians Association of Australia.

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.

Principal Support Is Imperative to the Retention of Teachers in Hard-to-Staff Schools

ERIC Educational Resources Information Center

Hughes, Amy L; Matt, John J.; O'Reilly, Frances L.

2015-01-01

Teacher retention is an ongoing problem in hard-to-staff schools. This research examined the relationship between principal support and retention of teachers in hard-to-staff schools. The purpose of this study was to, (a) to determine the relationship between teacher retention and principal support, (b) to examine the perception of support between…

Birthing Support and the Community-Based Doula

ERIC Educational Resources Information Center

Abramson, Rachel; Breedlove, Ginger K.; Isaacs, Beth

2007-01-01

This article is excerpted from the authors' "The Community-Based Doula: Supporting Families Before, During, and After Childbirth", published in 2006 by "ZERO TO THREE." In the U.S., many new parents are socially isolated and lack access to ongoing caring and support because of poverty, immigration, language barriers, or the growing mobility and…

The potential of technology for enhancing individual placement and support supported employment.

PubMed

Lord, Sarah E; McGurk, Susan R; Nicholson, Joanne; Carpenter-Song, Elizabeth A; Tauscher, Justin S; Becker, Deborah R; Swanson, Sarah J; Drake, Robert E; Bond, Gary R

2014-06-01

The potential of technology to enhance delivery and outcomes of Individual Placement and Support (IPS) supported employment. IPS supported employment has demonstrated robust success for improving rates of competitive employment among individuals with psychiatric disabilities. Still, a majority of those with serious mental illnesses are not employed (Bond, Drake, & Becker, 2012). The need to promote awareness of IPS and expand services is urgent. In this study, we describe ways that technologies may enhance delivery of IPS supported employment across the care continuum and stakeholder groups. Directions for research are highlighted. published literature, clinical observations, IPS learning collaborative. Technology has the potential to enhance direct service as well as workflow in the IPS supported employment process, which may lead to improved fidelity and client outcomes. Mobile and cloud technologies open opportunities for collaboration, self-directed care, and ongoing support to help clients obtain and maintain meaningful employment. Research is needed to evaluate efficacy of technology-based approaches for promoting client employment outcomes, to identify provider and organization barriers to using technology for IPS delivery, and to determine effective strategies for implementing technology with IPS in different settings and with diverse client audiences.

The Potential of Technology for Enhancing Individual Placement and Support Supported Employment

PubMed Central

Lord, Sarah E.; McGurk, Susan R.; Nicholson, Joanne; Carpenter-Song, Elizabeth A.; Tauscher, Justin S.; Becker, Deborah R.; Swanson, Sarah J.; Drake, Robert E.; Bond, Gary R.

2015-01-01

Topic The potential of technology to enhance delivery and outcomes of Individual Placement and Support (IPS) supported employment. Purpose IPS supported employment has demonstrated robust success for improving rates of competitive employment among individuals with psychiatric disabilities. Still, a majority of those with serious mental illnesses are not employed (Bond, Drake, & Becker, 2012). The need to promote awareness of IPS and expand services is urgent. In this study, we describe ways that technologies may enhance delivery of IPS supported employment across the care continuum and stakeholder groups. Directions for research are highlighted. Sources Used published literature, clinical observations, IPS learning collaborative. Conclusions and Implications for Practice Technology has the potential to enhance direct service as well as workflow in the IPS supported employment process, which may lead to improved fidelity and client outcomes. Mobile and cloud technologies open opportunities for collaboration, self-directed care, and ongoing support to help clients obtain and maintain meaningful employment. Research is needed to evaluate efficacy of technology-based approaches for promoting client employment outcomes, to identify provider and organization barriers to using technology for IPS delivery, and to determine effective strategies for implementing technology with IPS in different settings and with diverse client audiences. PMID:24912058

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study.

PubMed

Gammon, Deede; Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-05-02

Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. The aim was to illustrate uses and experiences with the secure e-recovery portal "ReConnect" as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users' control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Regardless of providers' portal use, service users' control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users' autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). ©Deede Gammon, Monica Strand, Lillian Sofie Eng, Elin Børøsund, Cecilie Varsi, Cornelia Ruland. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.05.2017.

Ectopic lymphoid structures support ongoing production of class-switched autoantibodies in rheumatoid synovium.

PubMed

Humby, Frances; Bombardieri, Michele; Manzo, Antonio; Kelly, Stephen; Blades, Mark C; Kirkham, Bruce; Spencer, Jo; Pitzalis, Costantino

2009-01-13

Follicular structures resembling germinal centres (GCs) that are characterized by follicular dendritic cell (FDC) networks have long been recognized in chronically inflamed tissues in autoimmune diseases, including the synovium of rheumatoid arthritis (RA). However, it is debated whether these ectopic structures promote autoimmunity and chronic inflammation driving the production of pathogenic autoantibodies. Anti-citrullinated protein/peptide antibodies (ACPA) are highly specific markers of RA, predict a poor prognosis, and have been suggested to be pathogenic. Therefore, the main study objectives were to determine whether ectopic lymphoid structures in RA synovium: (i) express activation-induced cytidine deaminase (AID), the enzyme required for somatic hypermutation and class-switch recombination (CSR) of Ig genes; (ii) support ongoing CSR and ACPA production; and (iii) remain functional in a RA/severe combined immunodeficiency (SCID) chimera model devoid of new immune cell influx into the synovium. Using immunohistochemistry (IHC) and quantitative Taqman real-time PCR (QT-PCR) in synovial tissue from 55 patients with RA, we demonstrated that FDC+ structures invariably expressed AID with a distribution resembling secondary lymphoid organs. Further, AID+/CD21+ follicular structures were surrounded by ACPA+/CD138+ plasma cells, as demonstrated by immune reactivity to citrullinated fibrinogen. Moreover, we identified a novel subset of synovial AID+/CD20+ B cells outside GCs resembling interfollicular large B cells. In order to gain direct functional evidence that AID+ structures support CSR and in situ manufacturing of class-switched ACPA, 34 SCID mice were transplanted with RA synovium and humanely killed at 4 wk for harvesting of transplants and sera. Persistent expression of AID and Igamma-Cmu circular transcripts (identifying ongoing IgM-IgG class-switching) was observed in synovial grafts expressing FDCs/CD21L. Furthermore, synovial mRNA levels of AID were closely associated with circulating human IgG ACPA in mouse sera. Finally, the survival and proliferation of functional B cell niches was associated with persistent overexpression of genes regulating ectopic lymphoneogenesis. Our demonstration that FDC+ follicular units invariably express AID and are surrounded by ACPA-producing plasma cells provides strong evidence that ectopic lymphoid structures in the RA synovium are functional and support autoantibody production. This concept is further confirmed by evidence of sustained AID expression, B cell proliferation, ongoing CSR, and production of human IgG ACPA from GC+ synovial tissue transplanted into SCID mice, independently of new B cell influx from the systemic circulation. These data identify AID as a potential therapeutic target in RA and suggest that survival of functional synovial B cell niches may profoundly influence chronic inflammation, autoimmunity, and response to B cell-depleting therapies.

Returning home: resettlement of formerly abducted children in Northern Uganda.

PubMed

Corbin, Joanne N

2008-06-01

This exploratory qualitative study considers the subjective resettlement experiences of children forced into armed conflict in Northern Uganda from the perspectives of 11 former child combatants and 11 adult community members. A thematic analysis was performed on the narrative data. The bioecological model was used to provide a conceptual framework for key themes. Major findings included the overarching impact of ongoing armed conflict on returnees' lives, the important role of the family in supporting children's resettlement, the harassment of former child soldiers by community members, and the community's inability to support systematically the returning children in tangible ways. This study recommends that humanitarian services at all levels strengthen the capacity of families to care for the material and psychoemotional needs of former child soldiers within their communities.

Integration of cloud-based storage in BES III computing environment

NASA Astrophysics Data System (ADS)

Wang, L.; Hernandez, F.; Deng, Z.

2014-06-01

We present an on-going work that aims to evaluate the suitability of cloud-based storage as a supplement to the Lustre file system for storing experimental data for the BES III physics experiment and as a backend for storing files belonging to individual members of the collaboration. In particular, we discuss our findings regarding the support of cloud-based storage in the software stack of the experiment. We report on our development work that improves the support of CERN' s ROOT data analysis framework and allows efficient remote access to data through several cloud storage protocols. We also present our efforts providing the experiment with efficient command line tools for navigating and interacting with cloud storage-based data repositories both from interactive sessions and grid jobs.

Benefits and challenges of health information systems for operations research: an illustrative example to improve surgical scheduling.

PubMed

Chow, Vincent S; Huang, Wenhai; Puterman, Martin L

2009-01-01

Operations research (OR) is playing an increasing role in the support of many health care initiatives. However one of the main challenges facing OR practitioners is the availability and the integrity of operations data. Hospital information systems (HIS) are often designed with a clinical or accounting focus and may lack the data necessary for operational studies. In this paper, we illustrate the data processing methods and data challenges faced by our team during a study of surgical scheduling practices at the Vancouver Island Health Authority. We also provide some general recommendations to improve HIS from an operations perspective. In general, more integration between operations researchers and HIS specialists are required to support ongoing operational improvements in the health care sector.

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.

Observing control and data reduction at the UKIRT

NASA Astrophysics Data System (ADS)

Bridger, Alan; Economou, Frossie; Wright, Gillian S.; Currie, Malcolm J.

1998-07-01

For the past seven years observing with the major instruments at the United Kingdom IR Telescope (UKIRT) has been semi-automated, using ASCII files top configure the instruments and then sequence a series of exposures and telescope movements to acquire the data. For one instrument automatic data reduction completes the cycle. The emergence of recent software technologies has suggested an evolution of this successful system to provide a friendlier and more powerful interface to observing at UKIRT. The Observatory Reduction and Acquisition Control (ORAC) project is now underway to construct this system. A key aim of ORAC is to allow a more complete description of the observing program, including the target sources and the recipe that will be used to provide on-line data reduction. Remote observation preparation and submission will also be supported. In parallel the observatory control system will be upgraded to use these descriptions for more automatic observing, while retaining the 'classical' interactive observing mode. The final component of the project is an improved automatic data reduction system, allowing on-line reduction of data at the telescope while retaining the flexibility to cope with changing observing techniques and instruments. The user will also automatically be provided with the scripts used for the real-time reduction to help provide post-observing data reduction support. The overall project goal is to improve the scientific productivity of the telescope, but it should also reduce the overall ongoing support requirements, and has the eventual goal of supporting the use of queue- scheduled observing.

NASA Glenn Research Center Support of the ASRG Project

NASA Technical Reports Server (NTRS)

Wilson, Scott D.; Wong, Wayne A.

2014-01-01

A high efficiency radioisotope power system is being developed for long-duration NASA space science missions. The U.S. Department of Energy (DOE) managed a flight contract with Lockheed Martin Space Systems Company (LMSSC) to build Advanced Stirling Radioisotope Generators (ASRGs), with support from NASA Glenn Research Center (GRC). Sunpower Inc. held two parallel contracts to produce Advanced Stirling Convertors (ASCs), one with DOELockheed Martin to produce ASC-F flight units, and one with GRC for the production of ASC-E3 engineering unit pathfinders that are built to the flight design. In support of those contracts, GRC provided testing, materials expertise, government furnished equipment, inspections, and related data products to DOELockheed Martin and Sunpower. The technical support includes material evaluations, component tests, convertor characterization, and technology transfer. Material evaluations and component tests have been performed on various ASC components in order to assess potential life-limiting mechanisms and provide data for reliability models. Convertor level tests have been used to characterize performance under operating conditions that are representative of various mission conditions. Technology transfers enhanced contractor capabilities for specialized production processes and tests. Despite termination of flight ASRG contract, NASA continues to develop the high efficiency ASC conversion technology under the ASC-E3 contract. This paper describes key government furnished services performed for ASRG and future tests used to provide data for ongoing reliability assessments.

The effectiveness of Teratology Information Services (TIS).

PubMed

Hancock, Rebecca L; Koren, Gideon; Einarson, Adrienne; Ungar, Wendy J

2007-02-01

Women and their health care providers have few reliable sources of information regarding the safety of exposures in pregnancy and lactation. Evidence-based information on these topics is provided by Teratology Information Services (TIS). Access to TIS, however, is limited in many regions, and many services have difficulty maintaining ongoing funding. The objective of this review is to highlight published reports of the effectiveness of TIS in improving maternal and neonatal health. A search of the Pub Med and Econ Lit databases was performed with no date restriction, using the search terms teratology, information, counseling, pregnancy, effectiveness, birth defects. Information disseminated from TIS has been shown to prevent congenital malformations, unnecessary pregnancy terminations, and occupational risks. TIS support optimal nutritional supplementation in pregnancy and optimal drug therapy in pregnancy and breast-feeding. In addition, they correct misperceptions of risk and facilitate knowledge transfer and translation. TIS have the potential to provide health care cost savings. TIS are vital services in supporting optimal maternal and neonatal health. A formal economic evaluation of TIS is required in order to inform resource allocation decision-making and continued funding of these services.

NASA Glenn Research Center Support of the Advanced Stirling Radioisotope Generator Project

NASA Technical Reports Server (NTRS)

Wilson, Scott D.; Wong, Wayne A.

2015-01-01

A high-efficiency radioisotope power system was being developed for long-duration NASA space science missions. The U.S. Department of Energy (DOE) managed a flight contract with Lockheed Martin Space Systems Company to build Advanced Stirling Radioisotope Generators (ASRGs), with support from NASA Glenn Research Center. DOE initiated termination of that contract in late 2013, primarily due to budget constraints. Sunpower, Inc., held two parallel contracts to produce Advanced Stirling Convertors (ASCs), one with Lockheed Martin to produce ASC-F flight units, and one with Glenn for the production of ASC-E3 engineering unit "pathfinders" that are built to the flight design. In support of those contracts, Glenn provided testing, materials expertise, Government-furnished equipment, inspection capabilities, and related data products to Lockheed Martin and Sunpower. The technical support included material evaluations, component tests, convertor characterization, and technology transfer. Material evaluations and component tests were performed on various ASC components in order to assess potential life-limiting mechanisms and provide data for reliability models. Convertor level tests were conducted to characterize performance under operating conditions that are representative of various mission conditions. Despite termination of the ASRG flight development contract, NASA continues to recognize the importance of high-efficiency ASC power conversion for Radioisotope Power Systems (RPS) and continues investment in the technology, including the continuation of the ASC-E3 contract. This paper describes key Government support for the ASRG project and future tests to be used to provide data for ongoing reliability assessments.

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

PubMed

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

2016-08-15

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

Post‐war development of emergency medicine in Kosovo

PubMed Central

O'Hanlon, K P

2007-01-01

Objectives To (1) investigate emergency medical care priorities in Kosovo, (2) assess Kosovo's post‐war development of emergency medical services and (3) identify expectations. Methods An instrument with seven open‐ended questions, approved by the institutional review board, was designed for in‐person interviews (preferred) or written survey. The survey was administered in October 2003 at the Kosovo University Clinical Center, Pristina, Kosovo, and one regional hospital. Targeted participants were emergency care providers, clinical consultants and health policy consultants. Surveys were conducted by interview with simultaneous interpretation by a native Albanian speaker, an orthopaedic surgeon or in written Albanian form. The responses were evaluated quantitatively and qualitatively. Results 13 respondents participated in the study: 10 gave interviews and 3 provided written response; 7 were emergency care providers, 4 were emergency care consultants and 2 were health policy consultants. Emergency care priorities were defined as trauma, cardiac disease and suicide. Most respondents believed that emergency medicine as a specialised field was a post‐war development. The international community was credited with the provision of infrastructure, supplies and training. Most respondents denied any harm from international assistance. However, some respondents described instances of inappropriate international investment. Ongoing needs are training of providers and equipping of facilities and vehicles. Improved hospital management, political administration and international involvement are thought to be necessary for continued development. Conclusions Survey respondents agreed on priorities in emergency care, credited the international community with development to date, and identified administrative structures and international training support as the keys to ongoing development. PMID:17183036

Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey.

PubMed

Schmied, Virginia; Fowler, Cathrine; Rossiter, Chris; Homer, Caroline; Kruske, Sue

2014-05-01

Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia. A national survey of CFH nurses was conducted. In all, 1098 CFH nurses responded to the survey. Over 60% were engaged in delivering primary prevention services from a universal platform. Overall, 82.8% reported that their service made first contact with families within 2 weeks of birth, usually in the home (80.7%). The proportion of respondents providing regular support to families decreased as the child aged. Services were primarily health centre based, although 25% reported providing services in other locations (parks, preschools).The timing and location of first contact, the frequency of ongoing services and the composition of families seen by nurses varied across Australian jurisdictions. Nurses identified time constraints as the key barrier to the delivery of comprehensive services. CFH nurses play an important role in supporting families across Australia. The impact of differences in the CFH nursing provision across Australia requires further investigation. What is known about the topic? Countries that offer universal well child health services demonstrate better child health and developmental outcomes than countries that do not. Australian jurisdictions offer free, universal child and family health (CFH) nursing services from birth to school entry. What does this paper add? This paper provides nation-wide data on the nature of work undertaken by CFH nurses offering universal care. Across Australia, there are differences in the timing and location of first contact, the frequency of ongoing services and the range of families seen by nurses. What are the implications for practitioners? The impact for families of the variation in CFH nursing services offered across Australia is not known. Further research is required to investigate the outcomes of the service provision variations identified in the present study.

Reciprocity of agonistic support in ravens

PubMed Central

Fraser, Orlaith N.; Bugnyar, Thomas

2012-01-01

Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim’s likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals. PMID:22298910

Reflective Supervision: A Clinical Supervision Model for Fostering Professional Growth

ERIC Educational Resources Information Center

Costello, Lisa H.; Belcaid, Erin; Arthur-Stanley, Amanda

2018-01-01

School psychologists experience a broad range of stressors in their role as school support professionals including feelings of isolation, insufficient resources, administrative pressures, and excessive caseloads (Boccio, Wiesz, & Lefkowitz, 2016). Ongoing support is necessary to help school psychologists successfully navigate these…

Implementing an ally development model to promote safer schools for LGB youth: a trans-disciplinary approach.

PubMed

Zammitt, Kimberly A; Pepperell, Jennifer; Coe, Megan

2015-01-01

Lesbian, gay, and bisexual (LGB) students experience ongoing bullying, harassment, and lack of safety in school. Specialized instructional support personnel (SISPs), such as school counselors, school social workers, and school psychologists, are in a unique position to advocate for LGB students and to implement an ally development model. The purpose of this article is to describe the current climate for LGB students, to discuss the current barriers facing SISPs in advocating for change, and to provide a model of ally development for use at each level of the K-12 system.

Being single in old age.

PubMed

Gubrium, J F

1975-01-01

The routine, everyday life of single elders differs from that of other old people. On the basis of interview date both about themselves and some aspects of the quality of their everyday lives, it is proposed that single elders constitute a distinct type of social personality in old age. Interviews provide subjective and methodological evidence to support this. The "normal", taken-for-granted social world of single elders is: relatively isolated; but not perceived in terms of loneliness, at present or anticipated; and considered an ordinary extension of their past. Death is conceived as "just another" event of their ongoing experiences.

'Strategic approach' can reveal benefits.

PubMed

Baillie, Jonathan

2011-01-01

Speaking at last October's Healthcare Estates 2010 conference in Manchester, Peter Haggarty, assistant director, Health Facilities Scotland, outlined some of the key steps and priorities for large healthcare providers seeking to establish and implement an effective asset management strategy, focusing particularly on work ongoing in this area in the Scottish public health service. While any radical change to a large healthcare organisation's existing asset management practices could be "challenging", both for the organisation itself, and for its staff, with "sufficient planning, persistence, and support", such changes could, he told delegates, often result in "unanticipated benefits". HEJ editor Jonathan Baillie reports.

Common Faults and Their Prioritization in Small Commercial Buildings: February 2017 - December 2017

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

Frank, Stephen M; Kim, Janghyun; Cai, Jie

To support an ongoing project at NREL titled 'An Open, Cloud-Based Platform for Whole-Building Fault Detection and Diagnostics' (work breakdown structure number 3.2.6.18 funded by the Department of Energy Building Technologies Office), this report documents faults that are commonly found in small commercial buildings (with a floor area of 10,000 ft2 or less) based on a literature review and discussions with building commissioning experts. It also provides a list of prioritized faults based on an estimation of the prevalence, energy impact, and financial impact of each fault.

Real-time operating system for selected Intel processors

NASA Technical Reports Server (NTRS)

Pool, W. R.

1980-01-01

The rationale for system development is given along with reasons for not using vendor supplied operating systems. Although many system design and performance goals were dictated by problems with vendor supplied systems, other goals surfaced as a result of a design for a custom system able to span multiple projects. System development and management problems and areas that required redesign or major code changes for system implementation are examined as well as the relative successes of the initial projects. A generic description of the actual project is provided and the ongoing support requirements and future plans are discussed.

Towards Legitimate Nursing Work? Historical Discursive Constructions of Abortion in The Canadian Nurse, 1950-1965.

PubMed

Haney, Catherine

2014-01-01

To the detriment of women's health, the abortion work of nurses in Canada has gone largely unexamined and is not well understood. This historical discourse analysis examines discursive constructions of nurses' abortion work and ongoing renegotiations of professional identity in The Canadian Nurse from 1950 to 1965. By investigating what has shaped and continues to inform nurses' understandings and enactment of abortion work over time, I hope to contribute to a foundation from which to evaluate contemporary abortion services and to foster conditions that support nurses in providing safe abortion care.

Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling.

PubMed

Gouse, H; Robbins, R N; Mellins, C A; Kingon, A; Rowe, J; Henry, M; Remien, R H; Pearson, A; Victor, F; Joska, J A

2018-05-19

Lay-counsellors in resource-limited settings convey critical HIV- and ART-information, and face challenges including limited training and variable application of counselling. This study explored lay-counsellors and Department of Health (DoH) perspectives on the utility of a multimedia adherence counselling program. Masivukeni, an mHealth application that provides scaffolding for delivering standardized ART counselling was used in a 3-year randomized control trail at two primary health care clinics in Cape Town, South Africa. In this programmatic and descriptive narrative report, we describe the application; lay-counsellors' response to open-ended questions regarding their experience with using Masivukeni; and perspectives of the City of Cape Town and Western Cape Government DoH, obtained through ongoing engagements and feedback sessions. Counsellors reported Masivukeni empowered them to provide high quality counselling. DoH indicated strong support for a future implementation study assessing feasibility for larger scale roll-out. Masivukeni has potential as a counselling tool in resource-limited settings.

A cognitive mobile BTS solution with software-defined radioelectric sensing.

PubMed

Muñoz, Jorge; Alonso, Javier Vales; García, Francisco Quiñoy; Costas, Sergio; Pillado, Marcos; Castaño, Francisco Javier González; Sánchez, Manuel García; Valcarce, Roberto López; Bravo, Cristina López

2013-02-05

Private communications inside large vehicles such as ships may be effectively provided using standard cellular systems. In this paper we propose a new solution based on software-defined radio with electromagnetic sensing support. Software-defined radio allows low-cost developments and, potentially, added-value services not available in commercial cellular networks. The platform of reference, OpenBTS, only supports single-channel cells. Our proposal, however, has the ability of changing BTS channel frequency without disrupting ongoing communications. This ability should be mandatory in vehicular environments, where neighbouring cell configurations may change rapidly, so a moving cell must be reconfigured in real-time to avoid interferences. Full details about frequency occupancy sensing and the channel reselection procedure are provided in this paper. Moreover, a procedure for fast terminal detection is proposed. This may be decisive in emergency situations, e.g., if someone falls overboard. Different tests confirm the feasibility of our proposal and its compatibility with commercial GSM terminals.

A Cognitive Mobile BTS Solution with Software-Defined Radioelectric Sensing

PubMed Central

Muñoz, Jorge; Alonso, Javier Vales; García, Francisco Quiñoy; Costas, Secundino; Pillado, Marcos; Castaño, Francisco Javier González; Sánchez, Manuel Garćia; Valcarce, Roberto López; Bravo, Cristina López

2013-01-01

Private communications inside large vehicles such as ships may be effectively provided using standard cellular systems. In this paper we propose a new solution based on software-defined radio with electromagnetic sensing support. Software-defined radio allows low-cost developments and, potentially, added-value services not available in commercial cellular networks. The platform of reference, OpenBTS, only supports single-channel cells. Our proposal, however, has the ability of changing BTS channel frequency without disrupting ongoing communications. This ability should be mandatory in vehicular environments, where neighbouring cell configurations may change rapidly, so a moving cell must be reconfigured in real-time to avoid interferences. Full details about frequency occupancy sensing and the channel reselection procedure are provided in this paper. Moreover, a procedure for fast terminal detection is proposed. This may be decisive in emergency situations, e.g., if someone falls overboard. Different tests confirm the feasibility of our proposal and its compatibility with commercial GSM terminals. PMID:23385417

Underground Test Area Activity Preemptive Review Guidance Nevada National Security Site, Nevada, Revision 0

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

Farnham, Irene; Rehfeldt, Kenneth

Preemptive reviews (PERs) of Underground Test Area (UGTA) Activity corrective action unit (CAU) studies are an important and long-maintained quality improvement process. The CAU-specific PER committees provide internal technical review of ongoing work throughout the CAU lifecycle. The reviews, identified in the UGTA Quality Assurance Plan (QAP) (Sections 1.3.5.1 and 3.2), assure work is comprehensive, accurate, in keeping with the state of the art, and consistent with CAU goals. PER committees review various products, including data, documents, software/codes, analyses, and models. PER committees may also review technical briefings including Federal Facility Agreement and Consent Order (FFACO)-required presentations to the Nevadamore » Division of Environmental Protection (NDEP) and presentations supporting key technical decisions (e.g., investigation plans and approaches). PER committees provide technical recommendations to support regulatory decisions that are the responsibility of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) and NDEP.« less

Child, Caregiver, and Health Care Provider Perspectives and Experiences Regarding Disclosure of HIV Status to Perinatally Infected Children in Lima, Peru.

PubMed

Baker, Amira Noori; Bayer, Angela Marie; Kolevic, Lenka; Najarro, Lizzete; Viani, Rolando Mario; Deville, Jaime Gerardo

2018-01-01

Despite recommendations for disclosure of HIV status to children living with HIV (CLHIV), fewer than half of CLHIV at the Instituto Nacional de Salud del Niño (INSN) in Lima, Peru, have had disclosure. How and when the disclosure process for CLHIV should take place in Peru has not been studied. We conducted a qualitative study at INSN to explore perceptions and experiences of 6 health care providers (HCPs), 14 disclosed and nondisclosed CLHIV (8-17 years), and their 14 caregivers regarding knowledge of illness, disclosure of HIV status, and appropriate disclosure approaches. Disclosed children wanted to be told their diagnosis earlier. Nondisclosed children expressed frustration taking medications. Caregivers and HCPs discussed motivations to disclose, including educating, honesty, improving medication adherence, and preventing secondary transmission. Culturally appropriate guidelines and training for HCPs and caregivers are needed to support disclosure of children's HIV status and ongoing support for CLHIV.

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

Looney, B; Dawn S. Kaback, D; Eugene L. LeBoeuf, E

Beginning in 2006, the US Department of Energy (DOE) supported nine applied research projects to improve the protection of the Columbia River and mitigate the impacts of Hanford Site groundwater. These projects were funded through a supplemental Congressional budget allocation, and are now in various stages of completion in accordance with the research plans. The DOE Office of Environmental Management Groundwater and Soil Cleanup Technologies (EM-22) sponsored a technical peer review meeting for these projects in Richland WA, July 28-31, 2008. The overall objective of the peer review is to provide information to support DOE decisions about the status andmore » potential future application of the various technologies. The charge for the peer review panel was to develop recommendations for each of the nine 'technologies'. Team members for the July 2008 review were Brian Looney, Gene LeBoeuf, Dawn Kaback, Karen Skubal, Joe Rossabi, Paul Deutsch, and David Cocke. Previous project reviews were held in May 2007 and March-May of 2006. The team used the following four rating categories for projects: (a) Incorporate the technology/strategy in ongoing and future EM activities; (b) Finish existing scope of applied research and determine potential for EM activities when research program is finished; (c) Discontinue current development activities and do not incorporate technology/strategy into ongoing and future EM activities unless a significant and compelling change in potential viability is documented; and (d) Supplement original funded work to obtain the data needed to support a DOE decision to incorporate the technology into ongoing and future EM activities. The supplemental funding portfolio included two projects that addressed strontium, five projects that addressed chromium, one project that addressed uranium and one project that addressed carbon tetrachloride. The projects ranged from in situ treatment methods for immobilizing contaminants using chemical-based methods such as phosphate addition, to innovative surface treatment technologies such as electrocoagulation. Total funding for the nine projects was $9,900,000 in fiscal year (FY) 2006 and $2,000,000 in FY 2007. At the Richland meeting, the peer reviewers provided a generally neutral assessment of the projects and overall progress, and a generally positive assessment with regard to the principal investigators meeting their stated research objectives and performing the planned laboratory research and limited field work. Only one project, the Electrocoagulation Treatability Test, received a rating of 'discontinue' from the team because the project goals had not been met. Because this particular project has already ended, no action with respect to funding withdrawal is necessary. All other projects were recommended to be finished and/or incorporated into field efforts at Hanford. Specific technical comments and recommendations were provided by the team for each project.« less

Building capacity in social service agencies to employ peer providers.

PubMed

Gates, Lauren B; Mandiberg, James M; Akabas, Sheila H

2010-01-01

While there is evidence that peer providers are valuable to service delivery teams, the agencies where they work face difficulties in fulfilling the potential of including peers on staff effectively. The purpose of this article is to report findings of a pilot test of a workplace strategy that promoted inclusion of peer providers at social service agencies by building organizational capacity to support people with mental health conditions in peer provider roles. The strategy included training, goal setting and ongoing consultation. Seventy-one peer, non-peer and supervisory staff participated from 6 agencies over a one year period. Goal attainment scaling and data from in-depth interviews about perceptions of differences in the ways in which staff are supported, administered prior to and after the consultation period, were used to assess strategy impact. Most frequently staff set goals to respond to role conflict or a lack of support. Staff that met or exceeded their goals utilized the formal structure of consultation to improve communication among themselves, had leadership that sanctioned changes and felt that their participation was of value to the organization and contributed to their individual development. Strategy participation promoted inclusion by initiating changes to policies and practices that devalued the peer provider role, increased skill sets, and formalized lines of communication for sharing information and understanding related to peer providers. Findings demonstrate that a strategy of training, goal setting and consultation can positively affect perceptions of inclusion, and promote implementation of practices associated with inclusive workplaces.

How do parents experience support after the death of their child?

PubMed

Gijzen, Sandra; L'Hoir, Monique P; Boere-Boonekamp, Magda M; Need, Ariana

2016-12-07

A child's death is an enormous tragedy for both the parents and other family members. Support for the parents can be important in helping them to cope with the loss of their child. In the Netherlands little is known about parents' experiences of the support they receive after the death of their child. The purpose of this study is to determine what support parents in the Netherlands receive after the death of their child and whether the type of care they receive meets their needs. Parents who lost a child during pregnancy, labour or after birth (up to the age of two) were eligible for participation. They were recruited from three parents' associations. Sixty-four parents participated in four online focus group discussions. Data on background characteristics were gathered through an online questionnaire. SPSS was used to analyse the questionnaires and Atlas ti. was used for the focus group discussions. Of the 64 participating parents, 97% mentioned the emotional support they received after the death of their child. This kind of support was generally provided by family, primary care professionals and their social network. Instrumental and informational support, which respectively 80% and 61% of the parents reported receiving, was mainly provided by secondary care professionals. Fifty-two per cent of the parents in this study reported having received insufficient emotional support. Shortcomings in instrumental and informational support were experienced by 25% and 19% of the parents respectively. Parental recommendations were directed at ongoing support and the provision of more information. To optimise the way Dutch professionals respond to a child's death, support initiated by the professional should be provided repeatedly after the death of a child. Parents appreciated follow-up contacts with professionals at key moments in which they were asked whether they needed support and what kind of support they would like to receive.

Organizational support and volunteering benefits for older adults.

PubMed

Tang, Fengyan; Choi, Eunhee; Morrow-Howell, Nancy

2010-10-01

This study tested a theoretical model of volunteering benefits and examined the mechanism through which volunteering benefits older adults. This is a 2-wave study of 253 older adult volunteers serving in 10 volunteer programs. Older volunteers completed the mailed surveys in 2005 and 2006. Structural equation modeling was used to define the latent variables and to test direct and indirect relationships among organizational support, socioemotional benefits, and self-reported health. Organizational support (measured by choice of volunteer activity, training, and ongoing support) had significant direct associations with 2 latent factors of socioemotional benefits, that is, perceived contribution and personal benefits. Perceived contribution was significantly related to mental health. Additionally, older volunteers with lower socioeconomic status (SES) committed more hours and perceived more personal benefits than higher SES peers. These findings suggest that volunteer programs can provide various organizational supports to older volunteers, especially to low-SES volunteers, in order to promote the socioemotional and health benefits of volunteering to older adults. Psychological well-being of older adults can be improved through engagement in meaningful volunteer activities and contribution to others.

Implementing a Primary Healthcare Framework: The Importance of Nursing Leadership in Developing and Maintaining a Brain Tumor Support Group.

PubMed

Nichols, Linda J; Wright, Kylie M

2015-08-01

Although brain tumor support groups have been available internationally for many years, Liverpool Hospital in Australia has not traditionally provided this service. As a leadership initiative, the development of a brain tumor support group that incorporates a primary healthcare framework is a sustainable approach that showcases the role of nursing leaders in changing attitudes and improving outcomes. The purpose of this review of the literature and reflection of clinical experience is to explore nursing leadership within brain tumor-specific support groups. This article will showcase a nurse-led group that incorporated a coordinated approach to delivering patient-centered care. The initiation of activities and interventions that reflected the five tenets of primary health care resulted in improved outcomes for individuals and their family caregivers throughout the trajectory of their illness. Vital to the success of this project was moving from a standalone leader to building collective and collaborative leadership more conducive to facilitating change. The support group successfully demonstrated that individuals and family caregivers may see ongoing and long-term improvements during and following treatment.

EXPANDING CAPD IN LOW-RESOURCE SETTINGS: A DISTANCE LEARNING APPROACH.

PubMed

Rope, Robert; Nanayakkara, Nishantha; Wazil, Abdul; Dickowita, Sewmini; Abeyeskera, Rajitha; Gunerathne, Lishanthe; Adoosoriya, Dinuka; Karunasena, Nishamani; Ratnayake, Charaka; Anand, Shuchi; Saxena, Anjali

2018-05-23

Despite growing need, treatment for end-stage renal disease is limited in low- and middle-income countries due to resource restraints. We describe the development of an educational curriculum and quality improvement program to support continuous ambulatory peritoneal dialysis (CAPD) performed primarily by non-nephrology providers in Sri Lanka. We developed a program of education, outcome tracking, and expert consultation to support providers in Kandy, Sri Lanka. Education included videos and in-person didactics covering core topics in CAPD. Event-tracking sheets recorded root causes and management of infections and hospitalizations. Conferences reviewed clinical cases and overall clinic management. We evaluated the patient census, peritonitis rates, and root causes and management of infections over 1 year. The curriculum was published through the International Society of Nephrology online academy. High provider turnover limited curriculum assessments. The CAPD patient census rose from 63 to 116 during the year. The peritonitis rate declined significantly, from 0.8 episodes per patient-year in the first 6 months to 0.4 in the latter 6 months, though the most common root causes of peritonitis, related to contamination events and hygiene, persisted. The appropriate ascertainment of culture data and prescription of antibiotics also increased. Our project supported the expansion of a CAPD program in a resource-limited setting, while also improving peritonitis outcomes. Ongoing challenges include ensuring a durable educational system for rotating providers, tracking outcomes beyond peritonitis, and formalizing management protocols. Our program can serve as an example of how established dialysis programs can support the burgeoning work of providers in resource-limited setting.

Implementation of standardized nomenclature in the electronic medical record.

PubMed

Klehr, Joan; Hafner, Jennifer; Spelz, Leah Mylrea; Steen, Sara; Weaver, Kathy

2009-01-01

To describe a customized electronic medical record documentation system which provides an electronic health record, Epic, which was implemented in December 2006 using standardized taxonomies for nursing documentation. Descriptive data is provided regarding the development, implementation, and evaluation processes for the electronic medical record system. Nurses used standardized nursing nomenclature including NANDA-I diagnoses, Nursing Interventions Classification, and Nursing Outcomes Classification in a measurable and user-friendly format using the care plan activity. Key factors in the success of the project included close collaboration among staff nurses and information technology staff, ongoing support and encouragement from the vice president/chief nursing officer, the ready availability of expert resources, and nursing ownership of the project. Use of this evidence-based documentation enhanced institutional leadership in clinical documentation.

Supporting refugee Somali Bantu mothers with children with disabilities.

PubMed

Beatson, Jean E

2013-01-01

This study sought to understand how local Somali Bantu refugee mothers perceive education or health needs of their children with disabilities. Using a grounded theory qualitative design, the investigator interviewed five Somali Bantu mothers and one father in their homes. Four predominant categories emerged from the data: Native Healing, Unmet Needs, Ongoing Challenges, and Helpful Helping. Study findings demonstrate the need for nurses and other health care providers to understand the refugee experience in raising children with special needs in Vermont. Better communication between providers and families on critical topics, such as etiology and treatment of disabilities, negotiating systems of care, and managing health and safety issues at home, is needed. The small number of participants with limited interaction is the greatest limitation of this study.

Working Memory and Consciousness: The Current State of Play

PubMed Central

Persuh, Marjan; LaRock, Eric; Berger, Jacob

2018-01-01

Working memory (WM), an important posit in cognitive science, allows one to temporarily store and manipulate information in the service of ongoing tasks. WM has been traditionally classified as an explicit memory system—that is, as operating on and maintaining only consciously perceived information. Recently, however, several studies have questioned this assumption, purporting to provide evidence for unconscious WM. In this article, we focus on visual working memory (VWM) and critically examine these studies as well as studies of unconscious perception that seem to provide indirect evidence for unconscious WM. Our analysis indicates that current evidence does not support an unconscious WM store, though we offer independent reasons to think that WM may operate on unconsciously perceived information. PMID:29551967

Concept of Operations for RCO SPO

NASA Technical Reports Server (NTRS)

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

2017-01-01

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

The dynamics of socio-connective trust within support networks accessed by informal caregivers.

PubMed

Ray, Robin A; Street, Annette F

2011-03-01

This article introduces the concept of socio-connective trust, the synapse between the social structures and processes that underpin relationships in supportive care networks. Data from an ethnographic case study of 18 informal caregivers providing in-home care for people with life-limiting illness were analysed drawing on theoretical concepts from the work of Giddens and writings on social capital, as well as the construction of trust in the caregiving literature. While conceptions of trust were found to contribute to understanding supportive care relationships, they did not account for the dynamic nature of the availability and use of support networks. Instead, informal caregivers undertook ongoing reflexive negotiation of relationship boundaries in response to their own conception of the current situation and their perception of trust in their relationships with the various members of the support network. The concept of socio-connective trust describes the movement and flow of the flexible bonds that influence relationships among care networks and determine the type and range of support accessed by informal caregivers. Understanding the complexities of socio-connective trust in caregiving relationships will assist health and social care workers to mobilize relevant resources to support informal caregivers.

District nurses' knowledge development in wound management: ongoing learning without organizational support.

PubMed

Friman, Anne; Wahlberg, Anna Carin; Mattiasson, Anne-Cathrine; Ebbeskog, Britt

2014-10-01

The aim of this study was to describe district nurses' (DNs') experiences of their knowledge development in wound management when treating patients with different types of wounds at healthcare centers. In primary healthcare, DNs are mainly responsible for wound management. Previous research has focused on DNs' level of expertise regarding wound management, mostly based on quantitative studies. An unanswered question concerns DNs' knowledge development in wound management. The present study therefore intends to broaden understanding and to provide deeper knowledge in regard to the DNs' experiences of their knowledge development when treating patients with wounds. A qualitative descriptive design was used. Subjects were a purposeful sample of 16 DNs from eight healthcare centers in a metropolitan area in Stockholm, Sweden. The study was conducted with qualitative interviews and qualitative content analysis was used to analyze the data. The content analysis resulted in three categories and 11 sub-categories. The first category, 'ongoing learning by experience,' was based on experiences of learning alongside clinical practice. The second category 'searching for information,' consisted of various channels for obtaining information. The third category, 'lacking organizational support,' consisted of experiences related to the DNs' work organization, which hindered their development in wound care knowledge. The DNs experienced that they were in a constant state of learning and obtained their wound care knowledge to a great extent through practical work, from their colleagues as well as from various companies. A lack of organizational structures and support from staff management made it difficult for DNs to develop their knowledge and skills in wound management, which can lead to inadequate wound management.

Early life factors initiate a 'vicious circle' of affective and gastrointestinal symptoms: A longitudinal study.

PubMed

Jones, Michael P; Oudenhove, Lukas Van; Koloski, Natasha; Tack, Jan; Talley, Nicholas J

2013-10-01

Functional gastrointestinal disorders (FGID) have been shown to be associated with both comorbid mood disorders and traumatic events such as abuse earlier in life. In a longitudinal study, we tested a model that hypothesized: (i) childhood abuse was associated with subsequent mood disorder and pain or interference in life by bowel symptoms both directly and indirectly via neurotic personality; and (ii) an ongoing cycle of mood disorder impacts on bowel symptoms. Subjects from the general population classified as irritable bowel syndrome and/or functional dyspepsia (IBS/FD, n = 207) or free of FGID (n = 100) were prospectively studied every 6 months over 18 months. In addition to bowel symptom interference and abdominal pain, measures of personality (neuroticism), childhood abuse history, depression, and anxiety were obtained. The hypothesized model was tested via Path Modelling. Childhood abuse was found to be directly associated with neuroticism but only indirectly associated with baseline interference and mood disorders (via neuroticism). The data further supported an ongoing cycle of elevations in mood disorders and pain/interference by bowel symptoms. The data supported direct effects of interference at one time point on interference at the subsequent time point in addition to indirect effects of prior anxiety and depression. Repeating the model with pain frequency as the outcome yielded almost identical findings which suggests the findings are generalized across domains of symptoms and quality-of-life. Our data provide support for a model characterized by a 'vicious circle' between mood disorders and FGID symptoms in adulthood, with initial input from early life factors.

Practice-centred evaluation and the privileging of care in health information technology evaluation.

PubMed

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

2014-06-05

Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of 'when' and 'under what conditions' technology-enabled service improvements are realised, and crucially, how such innovation improves care. Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes.

Rural youth violence: it is a public health concern!

PubMed

Kulig, Judith C; Nahachewsky, Deana; Hall, Barry L; Kalischuk, Ruth Grant

2005-01-01

Youth violence is a significant issue for public health because of the potential for long-term impacts on individuals, families and communities. Limited exposure to violence is seen as a component of healthy living. However, there is limited understanding of violence from a public health perspective within rural communities. Rural refers to those communities with a population less than 10,000 outside the main commuting zone of a large urban area. Population health approaches, including the social determinants of health, are well supported by public health officials. Generating information about rural youth violence from a Canadian perspective would add to our understanding of these social determinants while providing guidance for policy and program development. Current understandings of youth violence are limited to an urban, and oftentimes, American perspective. An ongoing two-phase Canadian study on rural youth violence included qualitative interviews with 52 youth and the completion of a questionnaire that had been developed from the qualitative responses. The questionnaire has been completed by a larger sample of rural youth. The findings generated from this ongoing study will be useful in linking violence with social factors that impact health and thereby guide population health programs and policies. In this way, the role of public health to develop policies and implement programs will be directly influenced by evidence while addressing an ongoing public health concern.

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2014 CFR

2014-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2011 CFR

2011-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

Long-Term Impacts Faced by Patients and Families After Harmful Healthcare Events.

PubMed

Ottosen, Madelene J; Sedlock, Emily W; Aigbe, Aitebureme O; Bell, Sigall K; Gallagher, Thomas H; Thomas, Eric J

2018-01-17

Patients and families report experiencing a multitude of harms from medical errors resulting in physical, emotional, and financial hardships. Little is known about the duration and nature of these harms and the type of support needed to promote patient and family healing after such events. We sought to describe the long-term impacts (LTIs) reported by patients and family members who experienced harmful medical events 5 or more years ago. We performed a content analysis on 32 interviews originally conducted with 72 patients or family members about their views of the factors contributing to their self-reported harmful event. Interviews selected occurred 5 or more years after the harmful event and were grouped by time since event, 5 to 9 years (22 interviews) or 10 or more years (10 interviews) for analysis. We analyzed these interviews targeting spontaneous references of ongoing impacts experienced by the participants. Participants collectively described the following four LTIs: psychological, social/behavioral, physical, and financial. Most cited psychological impacts with half-reporting ongoing anger and vivid memories. More than half reported ongoing physical impacts and one-third experienced ongoing financial impacts. Long-term social and behavioral impacts such as alterations in lifestyle, self-identity, and healthcare seeking behaviors were the most highly reported. These patients and families experienced many profound LTIs after their harmful medical event. For some, these impacts evolved into secondary harms ongoing 10 years and more after the event. Our results draw attention to the persistent impacts patients and families may experience long after harmful events and the need for future research to understand and support affected patients and families.

Social participation of children age 8-12 with SLI.

PubMed

Sylvestre, Audette; Brisson, Jacinthe; Lepage, Céline; Nadeau, Line; Deaudelin, Isabelle

2016-01-01

Two objectives are being pursued: (1) to describe the level of social participation of children aged 8-12 presenting a specific language impairment (SLI) and (2) to identify personal and family factors associated with their level of social participation. This cross-sectional study was conducted among 29 children with SLI and one of their parents. Parental stress and family adversity were measured as risk factors. The measure of life habits (LIFE-H) adapted to children aged 5-3 was used to measure social participation. The assumption that social participation of these children is impaired in relation to the communication dimension was generally confirmed. The statements referring to the "communication in the community" and "written communication" are those for which the results are weaker. "Communication at home" is made easier albeit with some difficulties, while "telecommunication" is totally preserved. A high level of parental stress is also confirmed, affecting the willingness of parents to support their child's autonomy. The achievement of a normal lifestyle of children with SLI is upset in many spheres of life. Methods of intervention must better reflect the needs and realities experienced by these children in their various living environments, in order to optimize social participation, and consequently, to improve their well-being and that of their families. The need to develop strategies to develop children's independence and to reduce parental stress must be recognized and all stakeholders need to be engaged in the resolution of this challenge. The realization of life habits of SLI children is compromised at various levels, especially in the domain related to "communication in the community" and "written communication". Speech-language pathologists must consider providing ongoing support throughout the primary years of these children and during adolescence, to promote and facilitate the continued realization of life habits of SLI persons. Providing ongoing support throughout the primary years and thereafter is needed to facilitate the continuing realization of life habits of SLI persons. Parents of children with SLI experience considerable stress in relation to the exercise of their parental roles. It is important to intervene and to support parents to promote autonomy for their SLI children.

Nine-Year Core Study Data for Sientra's FDA-Approved Round and Shaped Implants with High-Strength Cohesive Silicone Gel.

PubMed

Stevens, W Grant; Calobrace, M Bradley; Harrington, Jennifer; Alizadeh, Kaveh; Zeidler, Kamakshi R; d'Incelli, Rosalyn C

2016-04-01

Since approval in March 2012, data on Sientra's (Santa Barbara, CA) silicone gel implants have been updated and published regularly to provide immediate visibility to the continued safety and performance of these devices. The 9 year follow-up data support the previously published data confirming the ongoing safety and efficacy of Sientra silicone gel breast implants. The authors provide updated 9 year study data for Sientra's round and shaped silicone gel breast implants. The Core Study is an ongoing 10 year study that enrolled 1788 patients with 3506 Sientra implants across four indications (primary augmentation, revision-augmentation, primary reconstruction, and revision-reconstruction). For the safety analysis, Kaplan-Meier risk rates were calculated to evaluate postoperative complications, including all breast implant-related adverse effects. For the effectiveness analyses, results were presented through 8 years as patient satisfaction scores were assessed at even years. Through 9 years, the overall risk of capsular contracture was 12.6%. Smooth devices (16.6%, 95% CI, 14.2%, 19.5%) had a statistically significantly higher rate of capsular contracture compared to textured devices (8.0%, 95% CI, 6.2%, 10.4%). Out of the 610 reoperations in 477 patients, over half of all reoperations were due to cosmetic reasons (n = 315; 51.6%). Patient satisfaction remains high through 8 years, with 90% of primary augmentation patients indicating their breast implants look natural and feel soft. The 9-year follow-up data from the ongoing Core Study of the Sientra portfolio of HSC and HSC+ silicone gel breast implants reaffirm the very strong safety profile as well as continued patient satisfaction. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Factors promoting and inhibiting sustained impact of a mental health task-shifting program for HIV providers in Ethiopia.

PubMed

Jerene, D; Biru, M; Teklu, A; Rehman, T; Ruff, A; Wissow, L

2017-01-01

Task-shifting mental health into general medical care requires more than brief provider training. Generalists need long-term support to master new skills and changes to work context are required to sustain change in the face of competing priorities. We examined program and context factors promoting sustainability of a mental health task-shifting training for hospital-based HIV providers in Ethiopia. Convergent mixed-methods quasi-experimental study. Sustained impact was measured by trained/not-trained provider differences in case detection and management 16 months following the end of formal support. Factors related to sustainability were examined through interviews with trained providers. Extent of sustained impact: Trained providers demonstrated modest but better agreement with standardized screeners (greater sensitivity with similar specificity). They were more likely to request that patients with mental health problems return to see them v. making a referral. Factors promoting sustainability (reported in semi-structured interviews): provider belief that the treatments they had learned were effective. New interactions with on-site mental health staff were a source of ongoing learning and encouragement. Factors diminishing sustainability: providers feelings of isolation when mental health partners left for work elsewhere, failure to incorporate mental health indicators into administrative data, to re-stock staff education materials, and to build formal mechanisms for generalist-mental health staff interaction. An intervention seen as feasible and effective, and promotion of relationships across professional lines, helped generalists sustain new skills. Failure to address key system context issues made use of the skills unsustainable as external supports ended.

Aura Science and Validation

NASA Technical Reports Server (NTRS)

Hilsenrath, E.; Schoeberl, M.; Douglass, A.; Anderson, J.; Bhartia, P. K. (Technical Monitor)

2002-01-01

The EOS-Aura Mission is designed to answer three basic questions concerning the Earth's atmosphere: 1) Is ozone recovering as predicted, 2) is air quality getting worse, and 3) how is climate changing? Aura's four instruments work synergistically and are dedicated to answering these questions. These questions relate to NASA Earth Science Enterprise's overall strategic questions, which seek to understand the consequences of climate change for human civilization and determine if these changes can be predicted. NASA supports an ongoing research and analysis program, which is conducted independently and in support of satellite missions. The research program conducts several on-going field campaigns employing aircraft, balloons, and ground based systems. These campaigns have focused on exploring processes in the tropics, high latitudes, and continental outflow to explain the chemistry and transport in the troposphere and stratosphere and how these regions interact. NASA is now studying how the Aura mission and requirements of the research and analysis program might be merged to achieve its strategic goals related to global atmospheric chemistry changes. In addition, NASA field campaign resources will be folded into Aura's validation requirements. Aura validation requires correlative measurements throughout the troposphere and stratosphere under a range of observing and geophysical conditions. Because of the recent launches of Envisat and other smaller international chemistry satellites, the NASA program plans to collaborate with European space agencies in developing a series of campaigns that will provide continuity between those satellites missions and Aura.

It Is Time to Rethink Central Auditory Processing Disorder Protocols for School-Aged Children.

PubMed

DeBonis, David A

2015-06-01

The purpose of this article is to review the literature that pertains to ongoing concerns regarding the central auditory processing construct among school-aged children and to assess whether the degree of uncertainty surrounding central auditory processing disorder (CAPD) warrants a change in current protocols. Methodology on this topic included a review of relevant and recent literature through electronic search tools (e.g., ComDisDome, PsycINFO, Medline, and Cochrane databases); published texts; as well as published articles from the Journal of the American Academy of Audiology; the American Journal of Audiology; the Journal of Speech, Language, and Hearing Research; and Language, Speech, and Hearing Services in Schools. This review revealed strong support for the following: (a) Current testing of CAPD is highly influenced by nonauditory factors, including memory, attention, language, and executive function; (b) the lack of agreement regarding the performance criteria for diagnosis is concerning; (c) the contribution of auditory processing abilities to language, reading, and academic and listening abilities, as assessed by current measures, is not significant; and (d) the effectiveness of auditory interventions for improving communication abilities has not been established. Routine use of CAPD test protocols cannot be supported, and strong consideration should be given to redirecting focus on assessing overall listening abilities. Also, intervention needs to be contextualized and functional. A suggested protocol is provided for consideration. All of these issues warrant ongoing research.

DEFLECTION OF A HETEROGENEOUS WIDE-BEAM UNDER UNIFORM PRESSURE LOAD

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

T. V. Holschuh; T. K. Howard; W. R. Marcum

2014-07-01

Oregon State University (OSU) and the Idaho National Laboratory (INL) are currently collaborating on a test program which entails hydro-mechanical testing of a generic plate type fuel element, or generic test plate assembly (GTPA), for the purpose of qualitatively demonstrating mechanical integrity of uranium-molybdenum monolithic plates as compared to that of uranium aluminum dispersion, and aluminum fuel plates onset by hydraulic forces. This test program supports ongoing work conducted for/by the Global Threat Reduction Initiative (GTRI) Fuels Development Program. This study’s focus supports the ongoing collaborative effort by detailing the derivation of an analytic solution for deflection of a heterogeneousmore » plate under a uniform, distributed load in order to predict the deflection of test plates in the GTPA. The resulting analytical solutions for three specific boundary condition sets are then presented against several test cases of a homogeneous plate. In all test cases considered, the results for both homogeneous and heterogeneous plates are numerically identical to one another, demonstrating correct derivation of the heterogeneous solution. Two additional problems are presents herein that provide a representative deflection profile for the plates under consideration within the GTPA. Furthermore, qualitative observations are made about the influence of a more-rigid internal fuel-meat region and its influence on the overall deflection profile of a plate. Present work is being directed to experimentally confirm the analytical solution’s results using select materials.« less

Crew interface analysis: Selected articles on space human factors research, 1987 - 1991

NASA Technical Reports Server (NTRS)

Bagian, Tandi (Compiler)

1993-01-01

As part of the Flight Crew Support Division at NASA, the Crew Interface Analysis Section is dedicated to the study of human factors in the manned space program. It assumes a specialized role that focuses on answering operational questions pertaining to NASA's Space Shuttle and Space Station Freedom Programs. One of the section's key contributions is to provide knowledge and information about human capabilities and limitations that promote optimal spacecraft and habitat design and use to enhance crew safety and productivity. The section provides human factors engineering for the ongoing missions as well as proposed missions that aim to put human settlements on the Moon and Mars. Research providing solutions to operational issues is the primary objective of the Crew Interface Analysis Section. The studies represent such subdisciplines as ergonomics, space habitability, man-computer interaction, and remote operator interaction.

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

PubMed

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

2015-07-01

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

Service-based health human resources planning for older adults.

PubMed

Tomblin Murphy, Gail; MacKenzie, Adrian; Rigby, Janet; Rockwood, Kenneth; Gough, Amy; Greeley, Gogi; Montpetit, Frederick; Dill, Donna; Alder, Robert; Lackie, Kelly

2013-08-01

To test a service-based health human resources (HHR) planning approach for older adults in the context of home and long term care (LTC); to create a practical template/tools for use in various jurisdictions and/or health care settings. The most serious health needs of seniors in 2 Canadian jurisdictions were identified and linked to the specific services and associated competencies required of health care providers (HCPs) to address those needs. The amounts of each service required were quantified and compared against the capacity of HCPs to perform the services, measured using a self-assessment survey, by using a previously developed analytical framework. Home and LTC sectors in Nova Scotia and Nunavut, Canada. Regulated and nonregulated HCPs were invited to complete either an online or paper-based competency self-assessment survey. Survey response rates in Nova Scotia and Nunavut were 11% (160 responses) and 20% (22 responses), respectively. Comparisons of the estimated number of seniors likely to need each service with the number who can be served by the workforces in each jurisdiction indicated that the workforces in both jurisdictions are sufficiently numerous, active, productive, and competent to provide most of the services likely to be required. However, significant gaps were identified in pharmacy services, ongoing client assessment, client/family education and involvement, and client/family functional and social supports. Service-based HHR planning is feasible for identifying gaps in services required by older adults, and can guide policy makers in planning hiring/recruitment, professional development, and provider education curricula. Implementation will require commitment of policy makers and other stakeholders, as well as ongoing evaluation of its effectiveness. More broadly, the ongoing effectiveness of the approach will depend on workforce planning being conducted in an iterative way, driven by regular reevaluation of population health needs and HHR effectiveness. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2013-01-01

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

"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.

Distributed collaborative decision support environments for predictive awareness

NASA Astrophysics Data System (ADS)

McQuay, William K.; Stilman, Boris; Yakhnis, Vlad

2005-05-01

The past decade has produced significant changes in the conduct of military operations: asymmetric warfare, the reliance on dynamic coalitions, stringent rules of engagement, increased concern about collateral damage, and the need for sustained air operations. Mission commanders need to assimilate a tremendous amount of information, rapidly assess the enemy"s course of action (eCOA) or possible actions and promulgate their own course of action (COA) - a need for predictive awareness. Decision support tools in a distributed collaborative environment offer the capability of decomposing complex multitask processes and distributing them over a dynamic set of execution assets that include modeling, simulations, and analysis tools. Revolutionary new approaches to strategy generation and assessment such as Linguistic Geometry (LG) permit the rapid development of COA vs. enemy COA (eCOA). LG tools automatically generate and permit the operators to take advantage of winning strategies and tactics for mission planning and execution in near real-time. LG is predictive and employs deep "look-ahead" from the current state and provides a realistic, reactive model of adversary reasoning and behavior. Collaborative environments provide the framework and integrate models, simulations, and domain specific decision support tools for the sharing and exchanging of data, information, knowledge, and actions. This paper describes ongoing research efforts in applying distributed collaborative environments to decision support for predictive mission awareness.

Developing cessation interventions for the social and community service setting: a qualitative study of barriers to quitting among disadvantaged Australian smokers.

PubMed

Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy

2011-06-24

Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting. Semi-structured focus groups were conducted with clients attending five community welfare organisations located in New South Wales, Australia. Thirty-two clients participated in six focus groups. A discussion guide was used to explore the barriers and facilitators to smoking and smoking cessation including: current smoking behaviour, motivation to quit, past quit attempts, barriers to quitting and preferences for cessation support. Focus groups were audio-taped, transcribed and analysed using thematic analysis techniques. Participants were current smokers and most expressed a desire to quit. Factors predisposing continued smoking included perceived benefits of smoking for stress relief, doubting of ability to quit, fear of gaining weight, and poor knowledge and scepticism about available quit support. The high cost of nicotine replacement therapy was a barrier to its use. Continual exposure to smoking in personal relationships and in the community reinforced smoking. Participants expressed a strong preference for personalised quit support. Disadvantaged smokers in Australia express a desire to quit smoking, but find quitting difficult for a number of reasons. SCSOs may have a role in providing information about the availability of quit support, engaging disadvantaged smokers with available quit support, and providing personalised, ongoing support.

Supporting international medical graduates' transition to their host-country: realist synthesis.

PubMed

Kehoe, Amelia; McLachlan, John; Metcalf, Jane; Forrest, Simon; Carter, Madeline; Illing, Jan

2016-10-01

Many health services and systems rely on the contribution of international medical graduates (IMGs) to the workforce. However, concern has grown around their regulation and professional practice. There is a need, in the absence of strong evidence and a robust theoretical base, for a deeper understanding of the efficacy of interventions used to support IMGs' transition to their host countries. This study seeks to explore and synthesise evidence relating to interventions developed for IMGs. It aims to provide educators and policy makers with an understanding of how interventions should be developed to support IMGs in their transition to the workplace, particularly looking to identify how and why they are effective. The realist synthesis involved an initial systematic search of the literature for the period January 1990 to April 2015. Secondary searches were conducted throughout the review in order to inform and test the developing programme theory. The context, mechanism and outcome data were extracted from all sources meeting the inclusion criteria. Fourteen case studies were included to further aid theory refinement. Sixty-two articles were identified, describing diverse interventions of varying intensity. A further 26 articles were identified through a secondary search. The findings illustrate that, alongside a developed programme, ongoing support and cultural awareness at organisational and training levels are crucial. Individual differences must also be taken into consideration. This will ensure that IMGs engage in transformative learning, increase their levels of self-efficacy and cultural health capital, and reduce feelings of stress and anxiety. These factors will have an impact on work, interactions and cultural adjustment. Organisational, training and individual contexts all play a role in IMGs' adjustment during the transition process. Establishing ongoing support is critical. A list of recommendations for implementation is given. © 2016 The Authors. Medical Education Published by John Wiley & Sons Ltd and The Association for the Study of Medical Education.

How Can Innovative Learning Environments Promote the Diffusion of Innovation?

ERIC Educational Resources Information Center

Osborne, Mark

2016-01-01

Schools implementing innovative learning environments (ILEs) face many challenges, including the need to discard previously cherished practices and behaviours, adjust mindsets, and invent successful new ways of operating. Leaders can support these processes by implementing structures that: i) support ongoing, distributed, participatory innovation;…

DEVELOPMENT OF A DECISION SUPPORT FRAMEWORK FOR PLACEMENT OF BMPS IN URBAN-WATERSHEDS

EPA Science Inventory

This paper will present an on-going development of an integrated decision support framework (IDSF) for cost-effective placement of best management practices (BMPs) for managing wet weather flows (WWF) in urban watersheds. This decision tool will facilitate the selection and plac...

AN INTEGRATED DECISION SUPPORT FRAMEWORK FOR PLACEMENT OF BMPS IN URBAN-WATERSHEDS

EPA Science Inventory

This paper will present an on-going development of an integrated decision support framework (IDSF) for cost-effective placement of best management practices (BMPs) for managing wet weather flows (WWF) in urban watersheds. This decision tool will facilitate the selection and plac...

The US Support Program to IAEA Safeguards Priority of Training and Human Resources

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

Queirolo,A.

2008-06-13

The U.S. Support Program to IAEA Safeguards (USSP) priority of training and human resources is aimed at providing the Department of Safeguards with an appropriate mixture of regular staff and extrabudgetary experts who are qualified to meet the IAEA's technical needs and to provide personnel with appropriate instruction to improve the technical basis and specific skills needed to perform their job functions. The equipment and methods used in inspection activities are unique, complex, and evolving. New and experienced safeguards inspectors need timely and effective training to perform required tasks and to learn new skills prescribed by new safeguards policies ormore » agreements. The role of the inspector has changed from that of strictly an accountant to include that of a detective. New safeguards procedures are being instituted, and therefore, experienced inspectors must be educated on these new procedures. The USSP also recognizes the need for training safeguards support staff, particularly those who maintain and service safeguards equipment (SGTS), and those who perform information collection and analysis (SGIM). The USSP is committed to supporting the IAEA with training to ensure the effectiveness of all staff members and will continue to offer its assistance in the development and delivery of basic, refresher, and advanced training courses. This paper will discuss the USSP ongoing support in the area of training and IAEA staffing.« less

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study.

PubMed

Aarons, Gregory A; Green, Amy E; Trott, Elise; Willging, Cathleen E; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C

2016-11-01

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project's mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment.

Psychosocial issues in post-treatment cancer survivors: Desire for support and challenges in identifying individuals in need.

PubMed

Philip, Errol J; Merluzzi, Thomas V

2016-01-01

The ongoing and late effects of cancer treatment can interfere with quality of life and adoption of healthy behaviors, thus potentially impairing recovery and survival. Developing effective methods to identify individuals in need of support is crucial in providing comprehensive, ongoing care and ensuring optimal use of limited resources. The current study provides an examination of long-term survivors' reports of psychosocial issues, their desire for follow-up, and the role of widely used distress-screening measures for identifying survivors who desire help. 317 cancer survivors (M age = 62.98 years, female = 70%, Md years since treatment = 7.5 years, mixed diagnoses) completed measures of psychosocial adjustment and quality of life as well as a checklist of psychosocial issues on which they indicated whether they would like to speak with a health professional regarding each issue. Participants reported an average of 1.7 psychosocial issues. Only a minority desired to speak to a health professional; however, those desiring follow-up reported significant impairments in adjustment and quality of life. Though far from adequate as a stand-alone measure, area under the curve and regression analysis suggested a combination of the distress thermometer and number of psychosocial issues may be the best assessment of those desiring follow-up assistance. These results indicate that there is a need for a more sophisticated system of assisting survivors that takes into account issues, symptoms, and motivation for help. The present study is important in guiding the development of effective survivorship care and contributing to the growing literature describing the adjustment and care needs of survivors.

Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia

PubMed Central

Khan, Farrah; Krishnan, Archana; Ghani, Mansur A.; Wickersham, Jeffrey A.; Fu, Jeannia J.; Lim, Sin How; Dhaliwal, Sangeeth Kaur; Kamarulzaman, Adeeba; Altice, Frederick L.

2017-01-01

Background As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services. Objectives We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia’s second C&C Center located in Kota Bharu, Kelantan. Methods In June–July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Results Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia’s ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely. PMID:28635521

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study

PubMed Central

Aarons, Gregory A.; Green, Amy E.; Trott, Elise; Willging, Cathleen E.; Torres, Elisa M.; Ehrhart, Mark G.; Roesch, Scott C.

2017-01-01

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project’s mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment. PMID:27439504

Allogeneic mesenchymal precursor cells (MPCs): an innovative approach to treating advanced heart failure.

PubMed

Westerdahl, Daniel E; Chang, David H; Hamilton, Michele A; Nakamura, Mamoo; Henry, Timothy D

2016-09-01

Over 37 million people worldwide are living with Heart Failure (HF). Advancements in medical therapy have improved mortality primarily by slowing the progression of left ventricular dysfunction and debilitating symptoms. Ultimately, heart transplantation, durable mechanical circulatory support (MCS), or palliative care are the only options for patients with end-stage HF. Regenerative therapies offer an innovative approach, focused on reversing myocardial dysfunction and restoring healthy myocardial tissue. Initial clinical trials using autologous (self-donated) bone marrow mononuclear cells (BMMCs) demonstrated excellent safety, but only modest efficacy. Challenges with autologous stem cells include reduced quality and efficacy with increased patient age. The use of allogeneic mesenchymal precursor cells (MPCs) offers an "off the shelf" therapy, with consistent potency and less variability than autologous cells. Preclinical and initial clinical trials with allogeneic MPCs have been encouraging, providing the support for a large ongoing Phase III trial-DREAM-HF. We provide a comprehensive review of preclinical and clinical data supporting MPCs as a therapeutic option for HF patients. The current data suggest allogeneic MPCs are a promising therapy for HF patients. The results of DREAM-HF will determine whether allogeneic MPCs can decrease major adverse clinical events (MACE) in advanced HF patients.

Making a measurable difference in advanced Huntington disease care.

PubMed

Moskowitz, Carol Brown; Rao, Ashwini K

2017-01-01

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

Scientific Teaching: Defining a Taxonomy of Observable Practices

PubMed Central

Couch, Brian A.; Brown, Tanya L.; Schelpat, Tyler J.; Graham, Mark J.; Knight, Jennifer K.

2015-01-01

Over the past several decades, numerous reports have been published advocating for changes to undergraduate science education. These national calls inspired the formation of the National Academies Summer Institutes on Undergraduate Education in Biology (SI), a group of regional workshops to help faculty members learn and implement interactive teaching methods. The SI curriculum promotes a pedagogical framework called Scientific Teaching (ST), which aims to bring the vitality of modern research into the classroom by engaging students in the scientific discovery process and using student data to inform the ongoing development of teaching methods. With the spread of ST, the need emerges to systematically define its components in order to establish a common description for education researchers and practitioners. We describe the development of a taxonomy detailing ST’s core elements and provide data from classroom observations and faculty surveys in support of its applicability within undergraduate science courses. The final taxonomy consists of 15 pedagogical goals and 37 supporting practices, specifying observable behaviors, artifacts, and features associated with ST. This taxonomy will support future educational efforts by providing a framework for researchers studying the processes and outcomes of ST-based course transformations as well as a concise guide for faculty members developing classes. PMID:25713097

Aircraft interrogation and display system: A ground support equipment for digital flight systems

NASA Technical Reports Server (NTRS)

Glover, R. D.

1982-01-01

A microprocessor-based general purpose ground support equipment for electronic systems was developed. The hardware and software are designed to permit diverse applications in support of aircraft flight systems and simulation facilities. The implementation of the hardware, the structure of the software, describes the application of the system to an ongoing research aircraft project are described.

Promoting the Development of a Supportive Learning Environment through Action Research from the "Middle Out"

ERIC Educational Resources Information Center

Hodgson, David; May, Steve; Marks-Maran, Diane

2008-01-01

This paper reports on a case study of a supportive learning environment initiative (SLEI) for students on health and social care undergraduate programmes in one English university. It involved the development of small scale support projects that are firmly grounded in the outcomes of prior research as well as the ongoing experience of students and…

Telehealth--an effective delivery method for diabetes self-management education?

PubMed

Fitzner, Karen; Moss, Gail

2013-06-01

Diabetes is a chronic disease that is often comorbid with cardiovascular disease, hypertension, kidney disease, and neuropathy. Its management is complex, requiring ongoing clinical management, lifestyle changes, and self-care. This article examines recent literature on telehealth and emerging technological tools for supporting self-management of diabetes and identifies best practices. The authors conducted a PubMed search (January 2008-2012) that was supplemented by review of meeting materials and a scan of the Internet to identify emerging technologies. Fifty-eight papers were reviewed; 12 were selected for greater analysis. This review supports earlier findings that the delivery of diabetes self-management and training (DSME/T) via telehealth is useful, appropriate, and acceptable to patients and providers. Best practices are emerging; not all technology is appropriate for all populations--interactive technology needs to be appropriate to the patient's age, abilities, and sensitivities. Telehealth is scalable and sustainable provided that it adds value, does not add to the provider's workload, and is fairly reimbursed. However, there are multiple barriers (patient, provider, health system) to remotely provided DSME/T. DSME/T delivered via telehealth offers effective, efficient, and affordable ways to reach and support underserved minorities and other people with diabetes and related comorbidities. The new generation of smartphones, apps, and other technologies increase access, and the newest interventions are designed to meet patient needs, do not increase workloads, are highly appropriate, enhance self-management, and are desired by patients.

The German Long-Term Care Insurance Program: Evolution and Recent Developments.

PubMed

Nadash, Pamela; Doty, Pamela; von Schwanenflügel, Matthias

2018-05-08

Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing sustainability. The study reviews legislative and programmatic changes, using program data, as well as legislative documents and program reports. The program is widely accepted among citizens and has achieved many of its original goals: ensuring access to LTSS and reducing reliance on the locally-funded safety-net social assistance program, which can be used to cover nursing home costs. It also strengthened the LTSS provider infrastructure and expanded access to home care. Recent reforms have addressed some of the program's key issues: the benefit's decreasing value, the eligibility and benefit structure that largely excluded cognitive impairment, and the program's longer-term financial sustainability-particularly its ability to sustain newly expanded benefits, which provide stronger protections to caregivers, index-link benefits, and more systematically incorporate cognitive impairment via a new assessment system. It has addressed financing issues by increasing premiums, introducing subsidies for the purchase of private insurance, and creating a "demographic reserve fund." The reforms constitute a significant strengthening of the program, remarkable in an era of retrenchment. Overall, the program provides evidence for the financial viability of a social insurance model, although longer-term challenges may yet arise.

The effect of perceived person-job fit on employee attitudes toward change in trauma centers.

PubMed

Zatzick, Christopher D; Zatzick, Douglas F

2013-01-01

Employee attitudes toward change are critical for health care organizations implementing new procedures and practices. When employees are more positive about the change, they are likely to behave in ways that support the change, whereas when employees are negative about the change, they will resist the changes. This study examined how perceived person-job (demands-abilities) fit influences attitudes toward change after an externally mandated change. Specifically, we propose that perceived person-job fit moderates the negative relationship between individual job impact and attitudes toward change. We examined this issue in a sample of Level 1 trauma centers facing a regulatory mandate to develop an alcohol screening and brief intervention program. A survey of 200 providers within 20 trauma centers assessed perceived person-job fit, individual job impact, and attitudes toward change approximately 1 year after the mandate was enacted. Providers who perceived a better fit between their abilities and the new job demands were more positive about the change. Further, the impact of the alcohol screening and brief intervention program on attitudes toward change was mitigated by perceived fit, where the relationship between job impact and change attitudes was more negative for providers who perceived a worse fit as compared with those who perceived a better fit. Successful implementation of changes to work processes and procedures requires provider support of the change. Management can enhance this support by improving perceived person-job fit through ongoing training sessions that enhance providers' abilities to implement the new procedures.

Formerly Homeless People Had Lower Overall Health Care Expenditures After Moving Into Supportive Housing.

PubMed

Wright, Bill J; Vartanian, Keri B; Li, Hsin-Fang; Royal, Natalie; Matson, Jennifer K

2016-01-01

The provision of supportive housing is often recognized as important public policy, but it also plays a role in health care reform. Health care costs for the homeless reflect both their medical complexity and psychosocial risk factors. Supportive housing attempts to moderate both by providing stable places to live along with on-site integrated health services. In this pilot study we used a mixture of survey and administrative claims data to evaluate outcomes for formerly homeless people who were living in a supportive housing facility in Oregon between 2010 and 2014. Results from the claims analysis showed significantly lower overall health care expenditures for the people after they moved into supportive housing. Expenditure changes were driven primarily by reductions in emergency and inpatient care. Survey data suggest that the savings were not at the expense of quality: Respondents reported improved access to care, stronger primary care connections, and better subjective health outcomes. Together, these results indicate a potential association between supportive housing and reduced health care costs that warrants deeper consideration as part of ongoing health care reforms. Project HOPE—The People-to-People Health Foundation, Inc.

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.

Personalized use of ICT--from telemonitoring to ambient assisted living.

PubMed

Norgall, Thomas; Wichert, Reiner

2013-01-01

Individual availability of information and communications technology (ICT) has enabled "Personal Health" applications like the continuous ubiquitous telemonitoring of vital signs. The concept of Ambient Assisted Living (AAL) goes beyond health and care applications utilizing home automation technology for supporting individuals with specific needs, particularly enabling elderly to live in their accustomed home as long as possible. These users usually suffer from more than one disease and need compensation of several impairments. Most current AAL projects and products however provide insulated solutions addressing only a small selection of these user needs. For comprehensive dynamic system adaptation to changing user needs an open platform supporting interoperable components is required. While the industry-driven Continua Health Alliance developed a corresponding Personal Health ecosystem, the ongoing European project universAAL aims at a universal platform for both AAL and Personal Health applications.

A five-year self-sustainability analysis of nurse-administered HIV rapid testing in Veterans Affairs primary care.

PubMed

Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

2014-10-01

In 2008, nurse-administered HIV oral rapid testing (RT) was introduced at the Veterans Affairs Primary Care Clinic in Downtown Los Angeles. Analysis at five years revealed variable yet increasing rates of HIV RT at that facility despite the fact that no post-launch support was provided by the implementation team. Qualitative interviews among stakeholders conducted at five years revealed the pre-existing implementation practices endemic to this clinic that facilitated this unprecedented success (e.g. history of positive quality improvement implementations, leadership support, clinician involvement at each step of the process to facilitate empowerment, ownership and feasible customisation of the implementation, cohesive communication among clinicians and leadership, training, efficient supply pathway, progressive performance feedback and ongoing encouragement). © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Discoursive Humanity as a Transcendental Basis for Cognitive (Dis)Ability Ethics and Policies.

PubMed

Häyry, Matti

2016-04-01

This article explicates two approaches to the basis of moral worth and status: Eva Kittay's relational view and Jeff McMahan's psychological personhood view. It is argued that these theories alone do not provide adequate support for the conclusions Kittay and McMahan want to draw concerning individuals whose entitlement to fundamental protections can be challenged-infants with severe cognitive disabilities and infants without the support of their families and social environments. The real justification can in each case be found in deeply held convictions regarding entities that must and entities that must not be included in the core community of moral equals. Philosophical discussions about these convictions would be more useful for the advancement of our moral thinking than vain attempts to show that the absolute truth lies on either side of the ongoing debate.

Using online learning in a traditional face-to-face environment.

PubMed

Kozlowski, Dawn

2002-01-01

A model for designing online learning was developed and implemented in a Registered Nurse-to-Bachelor of Science in Nursing course using online and face-to-face methodologies. The combination of online and face-to-face learning modalities may help the student who is a novice Internet explorer or seasoned Web navigator by offering technological support as well as providing constant in-person feedback regarding course requirements. The face-to-face component facilitates a sense of community and peer support that sometimes is lacking in an entirely online course. During the 2 semesters this model was used, students expressed satisfaction with having the course facilitator/professor physically available for consultation and advisement. Evaluation of this online/on-site course is ongoing and uses computer-administered qualitative questionnaires, a facilitator-moderated focus group, and Likert-type course evaluations.

A conceptual model for analysing informal learning in online social networks for health professionals.

PubMed

Li, Xin; Gray, Kathleen; Chang, Shanton; Elliott, Kristine; Barnett, Stephen

2014-01-01

Online social networking (OSN) provides a new way for health professionals to communicate, collaborate and share ideas with each other for informal learning on a massive scale. It has important implications for ongoing efforts to support Continuing Professional Development (CPD) in the health professions. However, the challenge of analysing the data generated in OSNs makes it difficult to understand whether and how they are useful for CPD. This paper presents a conceptual model for using mixed methods to study data from OSNs to examine the efficacy of OSN in supporting informal learning of health professionals. It is expected that using this model with the dataset generated in OSNs for informal learning will produce new and important insights into how well this innovation in CPD is serving professionals and the healthcare system.

Impact of four training conditions on physician use of a web-based clinical decision support system.

PubMed

Kealey, Edith; Leckman-Westin, Emily; Finnerty, Molly T

2013-09-01

Training has been identified as an important barrier to implementation of clinical decision support systems (CDSSs), but little is known about the effectiveness of different training approaches. Using an observational retrospective cohort design, we examined the impact of four training conditions on physician use of a CDSS: (1) computer lab training with individualized follow-up (CL-FU) (n=40), (2) computer lab training without follow-up (CL) (n=177), (3) lecture demonstration (LD) (n=16), or (4) no training (NT) (n=134). Odds ratios of any use and ongoing use under training conditions were compared to no training over a 2-year follow-up period. CL-FU was associated with the highest percent of active users and odds for any use (90.0%, odds ratio (OR)=10.2, 95% confidence interval (CI): 3.2-32.9) and ongoing use (60.0%, OR=6.1 95% CI: 2.6-13.7), followed by CL (any use=81.4%, OR=5.3, CI: 2.9-9.6; ongoing use=28.8%, OR=1.7, 95% CI: 1.0-3.0). LD was not superior to no training (any use=47%, ongoing use=22.4%). Training format may have differential effects on initial and long-term follow-up of CDSSs use by physicians. Copyright © 2013 Elsevier B.V. All rights reserved.

Using web technology and Java mobile software agents to manage outside referrals.

PubMed Central

Murphy, S. N.; Ng, T.; Sittig, D. F.; Barnett, G. O.

1998-01-01

A prototype, web-based referral application was created with the objective of providing outside primary care providers (PCP's) the means to refer patients to the Massachusetts General Hospital and the Brigham and Women's Hospital. The application was designed to achieve the two primary objectives of providing the consultant with enough data to make decisions even at the initial visit, and providing the PCP with a prompt response from the consultant. The system uses a web browser/server to initiate the referral and Java mobile software agents to support the workflow of the referral. This combination provides a light client implementation that can run on a wide variety of hardware and software platforms found in the office of the PCP. The implementation can guarantee a high degree of security for the computer of the PCP. Agents can be adapted to support the wide variety of data types that may be used in referral transactions, including reports with complex presentation needs and scanned (faxed) images Agents can be delivered to the PCP as running applications that can perform ongoing queries and alerts at the office of the PCP. Finally, the agent architecture is designed to scale in a natural and seamless manner for unforeseen future needs. PMID:9929190

Eliciting Provider and Patient Perspectives on New Obesity Management Services in a Team-Based Primary Care Organization.

PubMed

Royall, Dawna; Brauer, Paula; Atta-Konadu, Edwoba; Dwyer, John J M; Edwards, A Michelle; Hussey, Tracy; Kates, Nick

2017-09-01

Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices). Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo. Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy). The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.

A randomized double-blinded controlled trial of hCG as luteal phase support in natural cycle frozen embryo transfer.

PubMed

Lee, Vivian Chi Yan; Li, Raymond Hang Wun; Yeung, William Shu Biu; Pak Chung, H O; Ng, Ernest Hung Yu

2017-05-01

Does the use of hCG as luteal phase support in natural cycle frozen embryo transfer (FET) increase the ongoing pregnancy rate? The use of hCG in natural cycle FET did not improve the ongoing pregnancy rate. The use of luteal phase support in stimulated cycles has been associated with higher live-birth rates and the results are similar when using hCG or progesterone. This is a randomized double-blinded controlled trial of 450 women recruited between August 2013 and October 2015. Women with regular cycles undergoing natural cycle FET were recruited. Serial serum hormonal concentrations were used to time natural ovulation and at least Day 2 cleavage embryos were replaced. Patients were randomized into either: (i) the treatment group, receiving 1500 IU hCG on the day of FET and 6 days after FET, or (ii) the control group, receiving normal saline on these 2 days. The ongoing pregnancy rate [60/225 (26.7%) in the treatment group vs 70/225 (31.3%) in the control group, odds ratio 1.242 (95% CI 0.825-1.869)], implantation rate and miscarriage rate were comparable between the two groups. In the treatment group, there were significantly more cycles with top quality embryos transferred and a significantly higher serum oestradiol level, but a comparable serum progesterone level, 6 days after FET. However, no significant differences were observed in serum oestradiol and progesterone levels 6 days after FET between the pregnant and non-pregnant women. In the multivariate logistic regression, the number of embryos transferred was the only significant factor predictive of the ongoing pregnancy rate after natural cycle FET. This study only included FET with cleavage stage embryos and only hCG, not vaginal progesterone, was used as luteal phase support. The findings in this study do not support the use of hCG for luteal phase support in natural cycle FET. No external funding was used and there were no competing interests. clinicaltrial.gov identifier: NCT01931384. 23/8/2013. 30/8/2013. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Supporting Tertiary Students with a Disability or Mental Illness. Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

Having a disability or ongoing ill health (including mental health conditions) can significantly disrupt an individual's educational attainment and employment prospects, potentially creating lifelong social and economic disadvantage. These students may need additional support to help them successfully complete their studies. In addition, education…

A Relationship Marketing Approach to Academic Initiative Planning: A Case in Point

ERIC Educational Resources Information Center

Mobley, Mary F.; Basciano, Peter

2012-01-01

Many higher education initiatives are dependent upon the development of multiple relationships across academic and support functions. The probability of achieving superior initiative outcomes rests, in part, on the construction of an infrastructure that supports the goals, strategies, tactics, and ongoing mission of a defined project. Through…

Attachment Theory and Primary Caregiving

ERIC Educational Resources Information Center

Colmer, Kaye; Rutherford, Lynne; Murphy, Pam

2011-01-01

Offering intensive parent support programs within an early childhood setting recognises that early childhood educators are uniquely placed to form highly supportive and ongoing relationships with children and their families as part of their everyday work. This feature of early childhood programs can be utilised to include educators as partners in…

Understanding, Evaluating, and Supporting Self-Regulated Learning Using Learning Analytics

ERIC Educational Resources Information Center

Roll, Ido; Winne, Philip H.

2015-01-01

Self-regulated learning is an ongoing process rather than a single snapshot in time. Naturally, the field of learning analytics, focusing on interactions and learning trajectories, offers exciting opportunities for analyzing and supporting self-regulated learning. This special section highlights the current state of research at the intersection of…

Ongoing behavior predicts perceptual report of interval duration

PubMed Central

Gouvêa, Thiago S.; Monteiro, Tiago; Soares, Sofia; Atallah, Bassam V.; Paton, Joseph J.

2014-01-01

The ability to estimate the passage of time is essential for adaptive behavior in complex environments. Yet, it is not known how the brain encodes time over the durations necessary to explain animal behavior. Under temporally structured reinforcement schedules, animals tend to develop temporally structured behavior, and interval timing has been suggested to be accomplished by learning sequences of behavioral states. If this is true, trial to trial fluctuations in behavioral sequences should be predictive of fluctuations in time estimation. We trained rodents in an duration categorization task while continuously monitoring their behavior with a high speed camera. Animals developed highly reproducible behavioral sequences during the interval being timed. Moreover, those sequences were often predictive of perceptual report from early in the trial, providing support to the idea that animals may use learned behavioral patterns to estimate the duration of time intervals. To better resolve the issue, we propose that continuous and simultaneous behavioral and neural monitoring will enable identification of neural activity related to time perception that is not explained by ongoing behavior. PMID:24672473

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

PubMed

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

2014-01-01

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

Strengthening pre-service training for skilled birth attendance - An evaluation of the maternal and child health aide training programme in Sierra Leone.

PubMed

Jones, Susan A; Sam, Betty; Bull, Florence; James, Margaret; Ameh, Charles A; van den Broek, Nynke R

2016-06-01

The high maternal mortality rate in Sierra Leone combined with an ongoing shortage of midwives has led to the introduction of new cadres of healthcare workers. Maternal and Child Health Aides are one such cadre and now provide 56% of patient care. The quality of the education training programme for MCHA is therefore of paramount importance if high quality maternal care is to be provided. To conduct an evaluation of the MCHAide training programme in Sierra Leone. Mapping of programme and focus group discussions (FGDs) with key informants. Analysis of data using a thematic approach and formulation of recommendations for national, district and individual levels. All 14 MCHAide schools across Sierra Leone. The National Coordinator, Coordinators from 14 MCHAide schools and District Health Sisters from District Health Management Teams. Focus group discussions were held with tutors facilitated by a group member to encourage a free flowing discussion. Participants were divided into 4 groups, one for each province, with 5-8 participants per group and 50min for the discussion. Strengths, weaknesses and opportunities of the MCHAide training programme were identified. Four major themes were identified; the need for autonomy and support within the programme from stakeholders; the effect of poor infrastructure on teaching and student learning; the need to ensure rigorous academic quality including teaching quality, curricula content and the academic ability of the students; and the benefits of community support. It is important that the key personnel be involved in the development and introduction of training programmes for new cadres of staff from the earliest stages of development. On-going programme review and development is essential and those implementing the programme are the best placed to lead and contribute to this. Gathering the experiences and perceptions of key informants helps provide an in-depth examination that can inform recommendations. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Transmission models and management of lymphatic filariasis elimination.

PubMed

Michael, Edwin; Gambhir, Manoj

2010-01-01

The planning and evaluation of parasitic control programmes are complicated by the many interacting population dynamic and programmatic factors that determine infection trends under different control options. A key need is quantification about the status of the parasite system state at any one given timepoint and the dynamic change brought upon that state as an intervention program proceeds. Here, we focus on the control and elimination of the vector-borne disease, lymphatic filariasis, to show how mathematical models of parasite transmission can provide a quantitative framework for aiding the design of parasite elimination and monitoring programs by their ability to support (1) conducting rational analysis and definition of endpoints for different programmatic aims or objectives, including transmission endpoints for disease elimination, (2) undertaking strategic analysis to aid the optimal design of intervention programs to meet set endpoints under different endemic settings and (3) providing support for performing informed evaluations of ongoing programs, including aiding the formation of timely adaptive management strategies to correct for any observed deficiencies in program effectiveness. The results also highlight how the use of a model-based framework will be critical to addressing the impacts of ecological complexities, heterogeneities and uncertainties on effective parasite management and thereby guiding the development of strategies to resolve and overcome such real-world complexities. In particular, we underscore how this approach can provide a link between ecological science and policy by revealing novel tools and measures to appraise and enhance the biological controllability or eradicability of parasitic diseases. We conclude by emphasizing an urgent need to develop and apply flexible adaptive management frameworks informed by mathematical models that are based on learning and reducing uncertainty using monitoring data, apply phased or sequential decision-making to address extant uncertainty and focus on developing ecologically resilient management strategies, in ongoing efforts to control or eliminate filariasis and other parasitic diseases in resource-poor communities.

Building Bridges between healthcare professionals, patients and families: A coproduced and integrated approach to self-management support in stroke.

PubMed

Jones, Fiona; Pöstges, Heide; Brimicombe, Lucinda

2016-10-14

Programmes providing self-management support for patients and families are gaining attention and have shown promising outcomes with regards to reducing long-term unmet needs post stroke. However, notions of what good self-management support looks like can differ depending on professional opinion, individual preferences, skills and experiences of patients and their families as well as on how care and rehabilitation is organised in a particular healthcare setting. This resonates with the perspective of patient-centred care, according to which the meaning of good care is not universal, but rather jointly shaped between healthcare professionals and patients in everyday interactions. While self-management support is continuously co-produced in care and rehabilitation practices, most self-management programmes are typically provided as an 'add-on' to existing statutory care. This paper aims to deepen the understanding of how self-management support can be made an integral part of everyday care and rehabilitation using Bridges methodology. The authors provide a self-reflective account on 'Bridges' an integrated approach to self-management support, which is used by healthcare professionals within acute and community stroke rehabilitation across the UK, and in some parts of New Zealand and Australia. Bridges is based on self-efficacy principles, but has a central aim of professionals sharing decision-making and expertise with patients and families in every healthcare interaction. Methodologically, the co-production of a Bridges support package with local healthcare professionals and patients is critical. The authors present the values articulated by the support package and how it engages professionals, patients and Bridges training facilitators in a continuous process of adjusting and re-adjusting situated self-management support practices. Our reflections reveal the need to consider development and implementation of self-management support as one and the same on-going process, if we are to facilitate successful engagement and interest from healthcare professionals as well as their patients and families.

Environmental control medical support team

NASA Technical Reports Server (NTRS)

Crump, William J.; Kilgore, Melvin V., Jr.

1988-01-01

The activities conducted in support of the Environmental Control and Life Support Team during December 7, 1987 through September 30, 1988 are summarized. The majority of the ongoing support has focused on the ECLSS area. Through a series of initial meetings with the ECLSS team and technical literature review, an initial list of critical topics was developed. Subtasks were then identified or additional related tasks received as action items from the ECLSS group meetings. Although most of the efforts focused on providing MSFC personnel with information regarding specific questions and problems related to ECLSS issues, other efforts regarding identifying an ECLSS Medical Support Team and constructing data bases of technical information were also initiated and completed. The specific tasks are as follows: (1) Provide support to the mechanical design and integration of test systems as related to microbiological concerns; (2) Assist with design of Human Subjects Test Protocols; (3) Interpretation and recommendations pertaining to air/water quality requirements; (4) Assist in determining the design specifications required as related to the Technical Demonstration Program; (5) Develop a data base of all microorganisms recovered from previous subsystem testing; (6) Estimates of health risk of individual microbes to test subjects; (7) Assist with setting limits for safety of test subjects; (8) Health monitoring of test subjects; (9) Assist in the preparation of test plans; (10) Assist in the development of a QA/QC program to assure the validity, accuracy and precision of the analyses; and (11) Assist in developing test plans required for future man in the loop testing.

Provider-identified barriers and facilitators to implementing a supported employment program in spinal cord injury.

PubMed

Cotner, Bridget A; Ottomanelli, Lisa; O'Connor, Danielle R; Trainor, John K

2018-06-01

In a 5-year study, individual placement and support (IPS) significantly increased employment rate of United States Veterans with spinal cord injury (SCI), a historically underemployed population. In a follow-up study, data on barriers and facilitators to IPS implementation were identified. Over 24 months of implementation, 82 key medical and vocational staff underwent semi-structured interviews (n = 130). Interviews were digitally recorded and qualitatively analyzed (ATLAS.ti v0.7) using a constant comparative method to generate themes. Some barriers to implementation occurred throughout the study, such as Veterans' lack of motivation and providers' difficulty integrating vocational and medical rehabilitation. Other barriers emerged at specific stages, for example, early barriers included a large geographic service area and a large patient caseload, and late barriers included need for staff education. Facilitators were mostly constant throughout implementation and included leadership support and successful integration of vocational staff into the medical care team. Implementation strategies need to be adjusted as implementation progresses and matures. The strategies that succeeded in this setting, which were situated in a real-world context of providing IPS as a part of SCI medical care, may inform implementation of IPS for other populations with physical disabilities. Implications for Rehabilitation Key facilitators to IPS in SCI implementation are integrating vocational staff with expertise in IPS and SCI on clinical rehabilitation teams and providing leadership support. Ongoing barriers to IPS in SCI include patient specific and program administration factors such as caseload size and staffing patterns. Varying implementation strategies are needed to address barriers as they arise and facilitate successful implementation.

Implementation of a Transdisciplinary Team for the Transition Support of Medically and Socially Complex Youth.

PubMed

Ciccarelli, Mary R; Gladstone, Erin B; Armstrong Richardson, Eprise A J

2015-01-01

This article reports the ongoing work of a statewide transition support program which serves youth ages 11 to 22 with medically complex conditions and socially complex lives. Seven years of transition support services have led to program evolution demonstrated via a descriptive summary of the patients along with both families' and primary care providers' responses to satisfaction surveys. An illustrative case is used to highlight the types of expertise needed in specialized transition service delivery for patients with significant complexity. The team's analysis of their transdisciplinary work processes further explains the work. Nearly three hundred youth with complex needs are served yearly. Families and primary care providers express high satisfaction with the support of the services. The case example shows the broad array of transition-specific services engaged beyond the usual skill set of pediatric or adult care coordination teams. Transdisciplinary team uses skills in collaboration, support, learning, and compromise within a trusting and respectful environment. They describe the shared responsibility and continuous learning of the whole team. Youth with complex medical conditions and complex social situations are at higher risk for problems during transition. Serving this population with a transdisciplinary model is time consuming and requires advanced expertise but, with those investments, we can meet the expectations of the youth, their families and primary care providers. Successful transdisciplinary teamwork requires sustained and focused investment. Further work is needed to describe the complexity of this service delivery along with distinct transition outcomes and costs comparisons. Copyright © 2015 Elsevier Inc. All rights reserved.

On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap.

PubMed

Cooke, Jo; Ariss, Steven; Smith, Christine; Read, Jennifer

2015-05-07

International policy suggests that collaborative priority setting (CPS) between researchers and end users of research should shape the research agenda, and can increase capacity to address the research-practice translational gap. There is limited research evidence to guide how this should be done to meet the needs of dynamic healthcare systems. One-off priority setting events and time-lag between decision and action prove problematic. This study illustrates the use of CPS in a UK research collaboration called Collaboration and Leadership in Applied Health Research and Care (CLAHRC). Data were collected from a north of England CLAHRC through semi-structured interviews with 28 interviewees and a workshop of key stakeholders (n = 21) including academics, NHS clinicians, and managers. Documentary analysis of internal reports and CLAHRC annual reports for the first two and half years was also undertaken. These data were thematically coded. Methods of CPS linked to the developmental phase of the CLAHRC. Early methods included pre-existing historical partnerships with on-going dialogue. Later, new platforms for on-going discussions were formed. Consensus techniques with staged project development were also used. All methods demonstrated actual or potential change in practice and services. Impact was enabled through the flexibility of research and implementation work streams; 'matched' funding arrangements to support alignment of priorities in partner organisations; the size of the collaboration offering a resource to meet project needs; and the length of the programme providing stability and long term relationships. Difficulties included tensions between being responsive to priorities and the possibility of 'drift' within project work, between academics and practice, and between service providers and commissioners in the health services. Providing protected 'matched' time proved difficult for some NHS managers, which put increasing work pressure on them. CPS is more time consuming than traditional approaches to project development. CPS can produce needs-led projects that are bedded in services using a variety of methods. Contributing factors for effective CPS include flexibility in use and type of available resources, flexible work plans, and responsive leadership. The CLAHRC model provides a translational infrastructure that enables CPS that can impact on healthcare systems.

Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria

PubMed Central

Jürgens, Ralf; Lim, Hyeyoung; Timberlake, Susan; Smith, Matthew

2017-01-01

Abstract The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to greatly expand access to basic services to address the three diseases in its name. From its beginnings, its governance embodied some human rights principles: civil society is represented on its board, and the country coordination mechanisms that oversee funding requests to the Global Fund include representatives of people affected by the diseases. The Global Fund’s core strategies recognize that the health services it supports would not be effective or cost-effective without efforts to reduce human rights-related barriers to access and utilization of health services, particularly those faced by socially marginalized and criminalized persons. Basic human rights elements were written into Global Fund grant agreements, and various technical support measures encouraged the inclusion in funding requests of programs to reduce human rights-related barriers. A five-year initiative to provide intensive technical and financial support for the scaling up of programs to reduce these barriers in 20 countries is ongoing. PMID:29302175

The 37-day flight of CREAM during the 2009-2010 austral summer

NASA Astrophysics Data System (ADS)

Seo, Eun-Suk

The balloon-borne Cosmic Ray Energetics And Mass (CREAM) experiment was launched from McMurdo Station Antarctica on December 1, 2009, an early-launch record for Antarctic Long Duration Balloon (LDB) flights. A cumulative exposure of ˜ 156 days was achieved when this 37-day fifth flight of CREAM was terminated over the Ross Ice Shelf on January 8, 2010. Combining a sampling calorimeter for energy measurement with multiple charge detectors for particle identification, CREAM-V provided a large data sample to measure elemental spectra for 1 ≤ Z ≤ 26 in energies above 1014 eV. This was the first time that CREAM was supported with the standard Support Instrumentation Package (SIP) for LDB payloads. The first four flights were supported by the Command and Data Module (CDM) developed by the NASA Wallops Flight Facility for Ultra Long Duration Balloon (ULDB) flights. The instrument performance, results from the ongoing data analysis, and future plans will be presented.

Oak Ridge National Laboratory Support of Non-light Water Reactor Technologies: Capabilities Assessment for NRC Near-term Implementation Action Plans for Non-light Water Reactors

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

Belles, Randy; Jain, Prashant K.; Powers, Jeffrey J.

The Oak Ridge National Laboratory (ORNL) has a rich history of support for light water reactor (LWR) and non-LWR technologies. The ORNL history involves operation of 13 reactors at ORNL including the graphite reactor dating back to World War II, two aqueous homogeneous reactors, two molten salt reactors (MSRs), a fast-burst health physics reactor, and seven LWRs. Operation of the High Flux Isotope Reactor (HFIR) has been ongoing since 1965. Expertise exists amongst the ORNL staff to provide non-LWR training; support evaluation of non-LWR licensing and safety issues; perform modeling and simulation using advanced computational tools; run laboratory experiments usingmore » equipment such as the liquid salt component test facility; and perform in-depth fuel performance and thermal-hydraulic technology reviews using a vast suite of computer codes and tools. Summaries of this expertise are included in this paper.« less

Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

PubMed

Wood, Siri; Foster, Jennifer; Kols, Adrienne

2012-08-01

In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not simply its cost. Further research is planned to investigate questions raised about patterns of ongoing use. Copyright © 2011 Elsevier Ltd. All rights reserved.

Subcortical processing of speech regularities underlies reading and music aptitude in children

PubMed Central

2011-01-01

Background Neural sensitivity to acoustic regularities supports fundamental human behaviors such as hearing in noise and reading. Although the failure to encode acoustic regularities in ongoing speech has been associated with language and literacy deficits, how auditory expertise, such as the expertise that is associated with musical skill, relates to the brainstem processing of speech regularities is unknown. An association between musical skill and neural sensitivity to acoustic regularities would not be surprising given the importance of repetition and regularity in music. Here, we aimed to define relationships between the subcortical processing of speech regularities, music aptitude, and reading abilities in children with and without reading impairment. We hypothesized that, in combination with auditory cognitive abilities, neural sensitivity to regularities in ongoing speech provides a common biological mechanism underlying the development of music and reading abilities. Methods We assessed auditory working memory and attention, music aptitude, reading ability, and neural sensitivity to acoustic regularities in 42 school-aged children with a wide range of reading ability. Neural sensitivity to acoustic regularities was assessed by recording brainstem responses to the same speech sound presented in predictable and variable speech streams. Results Through correlation analyses and structural equation modeling, we reveal that music aptitude and literacy both relate to the extent of subcortical adaptation to regularities in ongoing speech as well as with auditory working memory and attention. Relationships between music and speech processing are specifically driven by performance on a musical rhythm task, underscoring the importance of rhythmic regularity for both language and music. Conclusions These data indicate common brain mechanisms underlying reading and music abilities that relate to how the nervous system responds to regularities in auditory input. Definition of common biological underpinnings for music and reading supports the usefulness of music for promoting child literacy, with the potential to improve reading remediation. PMID:22005291

Key recovery factors for the August 24, 2014, South Napa Earthquake

USGS Publications Warehouse

Hudnut, Kenneth W.; Brocher, Thomas M.; Prentice, Carol S.; Boatwright, John; Brooks, Benjamin A.; Aagaard, Brad T.; Blair, James Luke; Fletcher, Jon Peter B.; Erdem, Jemile; Wicks, Chuck; Murray, Jessica R.; Pollitz, Fred F.; Langbein, John O.; Svarc, Jerry L.; Schwartz, David P.; Ponti, Daniel J.; Hecker, Suzanne; DeLong, Stephen B.; Rosa, Carla M.; Jones, Brenda; Lamb, Rynn M.; Rosinski, Anne M.; McCrink, Timothy P.; Dawson, Timothy E.; Seitz, Gordon G.; Glennie, Craig; Hauser, Darren; Ericksen, Todd; Mardock, Dan; Hoirup, Don F.; Bray, Jonathan D.; Rubin, Ron S.

2014-01-01

Through discussions between the Federal Emergency Management Agency (FEMA) and the U.S. Geological Survey (USGS) following the South Napa earthquake, it was determined that several key decision points would be faced by FEMA for which additional information should be sought and provided by USGS and its partners. This report addresses the four tasks that were agreed to. These tasks are (1) assessment of ongoing fault movement (called afterslip) especially in the Browns Valley residential neighborhood, (2) assessment of the shaking pattern in the downtown area of the City of Napa, (3) improvement of information on the fault hazards posed by the West Napa Fault System (record of past earthquakes and slip rate, for example), and (4) imagery acquisition and data processing to provide overall geospatial information support to FEMA.

Rural Australian women's legal help seeking for intimate partner violence: women intimate partner violence victim survivors' perceptions of criminal justice support services.

PubMed

Ragusa, Angela T

2013-03-01

Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study applies a sociological lens by framing the IPV and legal help-seeking experiences of rural Australian women gained from 36 in-depth face-to-face interviews as socially contextualized interactions. Findings reveal police and court responses reflect broader social inequalities and rurality exacerbates concerns such as anonymity and lack of service. Cultural differences and power imbalances between survivors and formal support providers are manifested to inform future research seeking to improve survivors' willingness to engage and satisfaction with formal services. Finally, the important role police and the criminal justice system play in de-stigmatizing IPV and legitimating its unacceptability is argued a crucial, yet unrecognized, key to social change.

Gender Dysphoria in the Military.

PubMed

Ford, Shannon; Schnitzlein, Carla

2017-11-07

With the announcement that members of the military who identify as transgender are allowed to serve openly, the need for Department of Defense behavioral health providers to be comfortable in the assessment, diagnosis, and treatment of this population becomes quickly evident. This population has been seeking care in the community and standards have been developed to help guide decision-making, but a comparable document does not exist for the military population. Previously published papers were written in anticipation of the policy allowing for open service. The civilian sector has treatment guidelines and evidence supporting the same for reference. There is no similar document for the military population, likely due to the recent change and ongoing development. This paper attempts to provide an overview of the recent Department of Defense policy and walks the reader through key considerations when providing care to a transgender member of the military as it relates to those who are currently serving in the military through the use of a case example. The military transgender population faces some unique challenges due to the need to balance readiness and deployability with medically necessary health care. Also complicating patient care is that policy development is ongoing-as of this publication, the decision has not yet been made regarding how people who identify as transgender will access into the military nor is there final approval regarding coverage for surgical procedures. Unique circumstances of this population are brought up to generate more discussion and encourage further evaluation and refinement of the process.

Positive selection on sociobiological traits in invasive fire ants.

PubMed

Privman, Eyal; Cohen, Pnina; Cohanim, Amir B; Riba-Grognuz, Oksana; Shoemaker, DeWayne; Keller, Laurent

2018-06-19

The fire ant Solenopsis invicta and its close relatives are highly invasive. Enhanced social cooperation may facilitate invasiveness in these and other invasive ant species. We investigated whether invasiveness in Solenopsis fire ants was accompanied by positive selection on sociobiological traits by applying a phylogenomics approach to infer ancient selection, and a population genomics approach to infer recent and ongoing selection in both native and introduced S. invicta populations. A combination of whole-genome sequencing of 40 haploid males and reduced-representation genomic sequencing of 112 diploid workers identified 1,758,116 and 169,682 polymorphic markers, respectively. The resulting high-resolution maps of genomic polymorphism provide high inference power to test for positive selection. Our analyses provide evidence of positive selection on putative ion channel genes, which are implicated in neurological functions, and on vitellogenin, which is a key regulator of development and caste determination. Furthermore, molecular functions implicated in pheromonal signaling have experienced recent positive selection. Genes with signatures of positive selection were significantly more often those over-expressed in workers compared with queens and males, suggesting that worker traits are under stronger selection than queen and male traits. These results provide insights into selection pressures and ongoing adaptation in an invasive social insect and support the hypothesis that sociobiological traits are under more positive selection than traits related to non-social traits in such invasive species. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial.

PubMed

McKay, James R; Gustafson, David H; Ivey, Megan; McTavish, Fiona; Pe-Romashko, Klaren; Curtis, Brenda; Oslin, David A; Polsky, Daniel; Quanbeck, Andrew; Lynch, Kevin G

2018-01-30

New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. To address this question, the study will feature a 2 × 2 design (A-CHESS for 12 months [yes/no] × TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile automated recovery support and counselor contact. ClinicalTrials.gov, NCT02681406 . Registered on 2 September 2016.

Rural Australian Women's Legal Help Seeking for Intimate Partner Violence: Women Intimate Partner Violence Victim Survivors' Perceptions of Criminal Justice Support Services

ERIC Educational Resources Information Center

Ragusa, Angela T.

2013-01-01

Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study…

Perspective on the Ongoing Replacement of Artificial and Animal-Based Dyes with Alternative Natural Pigments in Foods and Beverages.

PubMed

Schweiggert, Ralf M

2018-03-28

This perspective highlights current trends, advances, and challenges related to the replacement of artificial dyes and the insect-based carmine with alternative natural pigments. Briefly reviewing the history of food coloration, key publications and public events leading to diverse concerns about artificial dyes and carmine will be summarized. An overview about promising alternatives in the market and those under development is provided, including a separate section on coloring foodstuffs. The perspective aims at supporting readers to keep abreast with the enormous efforts undertaken by the food and beverage industry to replace certain food dyes.

Melodic Intonation Therapy: Shared Insights on How it is Done and Why it Might Help

PubMed Central

Norton, Andrea; Zipse, Lauryn; Marchina, Sarah; Schlaug, Gottfried

2009-01-01

For over 100 years, clinicians have noted that patients with nonfluent aphasia are capable of singing words that they cannot speak. Thus, the use of melody and rhythm has long been recommended for improving aphasic patients’ fluency, but it was not until 1973 that a music-based treatment (Melodic Intonation Therapy, (MIT)) was developed. Our ongoing investigation of MIT’s efficacy has provided valuable insight into this therapy’s effect on language recovery. Here we share those observations, our additions to the protocol that aim to enhance MIT’s benefit, and the rationale that supports them. PMID:19673819

Dissemination and Implementation of Evidence-Based Practices: Training and Consultation as Implementation Strategies

PubMed Central

Edmunds, Julie M.; Beidas, Rinad S.; Kendall, Philip C.

2013-01-01

To provide effective treatment for individuals with mental health needs, there is a movement to deploy evidence-based practices (EBPs) developed in research settings into community settings. Training clinicians in EBPs is often used as the primary implementation strategy in these efforts, despite evidence suggesting that training alone does not change therapist behavior. A promising implementation strategy that can be combined with training is consultation, or ongoing support. This paper reviews the literature on consultation following initial training. A model of consultation is presented as well as preliminary findings regarding effective consultation techniques. Future directions are offered. PMID:24072959

Cultural diversity in nanotechnology ethics.

PubMed

Schummer, Joachim

2011-01-01

Along with the rapid worldwide advance of nanotechnology, debates on associated ethical issues have spread from local to international levels. However unlike science and engineering issues, international perceptions of ethical issues are very diverse. This paper provides an analysis of how sociocultural factors such as language, cultural heritage, economics and politics can affect how people perceive ethical issues of nanotechnology. By attempting to clarify the significance of sociocultural issues in ethical considerations my aim is to support the ongoing international dialogue on nanotechnology. At the same time I pose the general question of ethical relativism in engineering ethics, that is to say whether or not different ethical views are irreconcilable on a fundamental level.

Advanced Stirling Convertor Testing at GRC

NASA Technical Reports Server (NTRS)

Schifer, Nick; Oriti, Salvatore M.

2013-01-01

NASA Glenn Research Center (GRC) has been supporting development of the Advanced Stirling Radioisotope Generator (ASRG) since 2006. A key element of the ASRG project is providing life, reliability, and performance testing of the Advanced Stirling Convertor (ASC). The latest version of the ASC, deemed ASC-E3, is of a design identical to the forthcoming flight convertors. The first pair of ASC-E3 units was delivered in December 2012. GRC has begun the process of adding these units to the catalog of ongoing Stirling convertor operation. This process includes performance verification, which examines the data from various tests to validate the convertors performance to the product specification.

Re-modelled CT unit quickly up to speed.

PubMed

2011-06-01

Medical turnkey pre-installation specialist Canute International Medical Services (CIMS) recently supported provider of managed equipment services Asteral in a project to re-model the Rowan Bentall wing of Surrey's Kingston Hospital. The new CT scanning facility was developed by Asteral via an MES agreement, elements of which included two new CT scanners, major refurbishment of the existing building, and ongoing maintenance and finance. As HEJ editor Jonathan Baillie reports, despite a tight two-month schedule, the project team's expertise, and meticulous co-ordination and planning, enabled the delivery of a significantly enhanced facility on time and on budget with minimal disruption and without a single day's scanning being lost.

Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

PubMed

Carpenter, Christopher R; Platts-Mills, Timothy F

2013-02-01

Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. Copyright © 2013 Elsevier Inc. All rights reserved.

A review of recent literature - nurse case managers in diabetes care: equivalent or better outcomes compared to primary care providers.

PubMed

Watts, Sharon A; Lucatorto, Michelle

2014-07-01

Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers.

A visiting scientist program for the burst and transient source experiment

NASA Technical Reports Server (NTRS)

Kerr, Frank J.

1995-01-01

During this project, Universities Space Research Association provided program management and the administration for overseeing the performance of the total contractual effort. The program director and administrative staff provided the expertise and experience needed to efficiently manage the program.USRA provided a program coordinator and v visiting scientists to perform scientific research with Burst and Transient Source Experiment (BATSE) data. This research was associated with the primary scientific objectives of BATSE and with the various BATSE collaborations which were formed in response to the Compton Gamma Ray Observatory Guest Investigator Program. USRA provided administration for workshops, colloquia, the preparation of scientific documentation, etc. and also provided flexible program support in order to meet the on-going needs of MSFC's BATSE program. USRA performed tasks associated with the recovery, archiving, and processing of scientific data from BATSE. A bibliography of research in the astrophysics discipline is attached as Appendix 1. Visiting Scientists and Research Associates performed activities on this project, and their technical reports are attached as Appendix 2.

Active and Passive Supplier Assessment Program (ASAP & PSAP) WWW Sites http://nepp.nasa.gov/imd/asap http://nepp.nasa.gov/imd/psap

NASA Technical Reports Server (NTRS)

Brusse, Jay

2000-01-01

The Active and Passive Supplier Assessment Programs (ASAP and PSAP) WWW Sites provide general information to the electronic parts community regarding the availability of electronic parts. They also provide information to NASA regarding modifications to commonly used procurement specifications and test methods. The ASAP and PSAP www sites are ongoing resources produced by Code 562 in support of the NASA HQ funded NASA Electronic Parts and Packaging (NEPP) Program. These WWW sites do not provide information pertaining to patented or proprietary information. All of the information contained in these www sites is available through various other public domain resources such as US Military Qualified Producers Listings (QPLs) and Qualified Manufacturer Listings (QMLs) and industry working groups such as the Electronics Industry Alliance (EIA) and the Space Parts Working Group (SPWG).

Instrument Development of Integrative Health and Wellness Assessment™.

PubMed

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

2017-12-01

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

The role of the neonatal nurse practitioner in the community hospital level I nursery.

PubMed

Hatch, Julie

2012-01-01

Neonatal nurse practitioners (NNPs) have played a significant role in providing medical coverage to many of the country's Level III neonatal intensive care units (NICUs). Extensive education and experience are required for a nurse practitioner (NP) to become competent in caring for these critically ill newborns. The NNP can take this competence and experience and expand her role out into the community Level I nurseries. Clinical care of the infants and close communication with parents, pediatricians, and the area tertiary center provide a community service with the goal of keeping parents and babies together in the community hospital without compromising the health of the baby. The NNP service, with 24-hour nursery and delivery coverage, supports an ongoing obstetric service to the community hospital. The NNP's experience enables her to provide a neonatal service that encompasses a multitude of advanced practice nursing roles.

Enhanced Primary Care Treatment of Behavioral Disorders With ECHO Case-Based Learning.

PubMed

Komaromy, Miriam; Bartlett, Judy; Manis, Kathryn; Arora, Sanjeev

2017-09-01

The Extension for Community Healthcare Outcomes (ECHO) model offers a way for primary care providers to develop expertise in addressing behavioral health issues of primary care patients. It provides an alternative to traditional continuing medical education (CME) for ongoing training and support for health care providers. ECHO uses videoconferencing to connect multiple primary care teams simultaneously with academic specialists and builds capacity via mentorship and case-based learning. ECHO aims to expand access to care by developing capacity to treat common, complex conditions in underserved areas. Participants in an integrated addictions and psychiatry teleECHO program reported that when they presented a patient case, the feedback they received was highly valuable and led them to change their care plans more than 75% of the time. ECHO is an effective model for teaching primary care teams about behavioral health and may be more effective than traditional CME approaches.

Program planning for a community pharmacy residency support service using the nominal group technique.

PubMed

Rupp, Michael T

2002-01-01

To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. Group consensus on the priority needs of CPRPs was determined through rank order voting. The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

Early life factors initiate a ‘vicious circle’ of affective and gastrointestinal symptoms: A longitudinal study

PubMed Central

Van Oudenhove, Lukas; Koloski, Natasha; Tack, Jan; Talley, Nicholas J

2013-01-01

Objective Functional gastrointestinal disorders (FGID) have been shown to be associated with both comorbid mood disorders and traumatic events such as abuse earlier in life. In a longitudinal study, we tested a model that hypothesized: (i) childhood abuse was associated with subsequent mood disorder and pain or interference in life by bowel symptoms both directly and indirectly via neurotic personality; and (ii) an ongoing cycle of mood disorder impacts on bowel symptoms. Design Subjects from the general population classified as irritable bowel syndrome and/or functional dyspepsia (IBS/FD, n = 207) or free of FGID (n = 100) were prospectively studied every 6 months over 18 months. In addition to bowel symptom interference and abdominal pain, measures of personality (neuroticism), childhood abuse history, depression, and anxiety were obtained. The hypothesized model was tested via Path Modelling. Results Childhood abuse was found to be directly associated with neuroticism but only indirectly associated with baseline interference and mood disorders (via neuroticism). The data further supported an ongoing cycle of elevations in mood disorders and pain/interference by bowel symptoms. The data supported direct effects of interference at one time point on interference at the subsequent time point in addition to indirect effects of prior anxiety and depression. Repeating the model with pain frequency as the outcome yielded almost identical findings which suggests the findings are generalized across domains of symptoms and quality-of-life. Conclusion Our data provide support for a model characterized by a ‘vicious circle’ between mood disorders and FGID symptoms in adulthood, with initial input from early life factors. PMID:24917988

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes

PubMed Central

Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

2017-01-01

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. PMID:28277206

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes.

PubMed

Poss, Jeffrey W; Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

2017-02-01

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. Copyright © 2017 Longwoods Publishing.

Technology Estimating: A Process to Determine the Cost and Schedule of Space Technology Research and Development

NASA Technical Reports Server (NTRS)

Cole, Stuart K.; Reeves, John D.; Williams-Byrd, Julie A.; Greenberg, Marc; Comstock, Doug; Olds, John R.; Wallace, Jon; DePasquale, Dominic; Schaffer, Mark

2013-01-01

NASA is investing in new technologies that include 14 primary technology roadmap areas, and aeronautics. Understanding the cost for research and development of these technologies and the time it takes to increase the maturity of the technology is important to the support of the ongoing and future NASA missions. Overall, technology estimating may help provide guidance to technology investment strategies to help improve evaluation of technology affordability, and aid in decision support. The research provides a summary of the framework development of a Technology Estimating process where four technology roadmap areas were selected to be studied. The framework includes definition of terms, discussion for narrowing the focus from 14 NASA Technology Roadmap areas to four, and further refinement to include technologies, TRL range of 2 to 6. Included in this paper is a discussion to address the evaluation of 20 unique technology parameters that were initially identified, evaluated and then subsequently reduced for use in characterizing these technologies. A discussion of data acquisition effort and criteria established for data quality are provided. The findings obtained during the research included gaps identified, and a description of a spreadsheet-based estimating tool initiated as a part of the Technology Estimating process.

Use of NCLEX preparation strategies in a hospital orientation program for graduate nurses.

PubMed

Wray, Karen; Whitehead, Tanya; Setter, Robyn; Treas, Leslie

2006-01-01

This article describes outcomes from the first year of a hospital orientation program for graduate nurses that was expanded to systematize and enrich preparation of graduate nurses for success on the NCLEX-RN licensure examination. The study protocol provided the Assessment Technologies Institute predictor examination to assess risk for licensure examination failure, review materials, and a meeting with an education specialist to identify and prioritize study needs. Those at highest risk for failure were also provided an in-depth written study plan and ongoing follow-up and support until the licensure examination was taken. The study sample consisted of 90 graduate nurses who were hired from May through August of 2005 at the University of Kansas Hospital. The pass rate for participants was 86.7% on the first attempt in year 1 of the program. At-risk graduates who reported that the predictor results impacted their study habits and followed the study recommendations were more likely to pass the licensure examination. Graduate nurses reported a high level of satisfaction with the support provided. Specific challenges faced by hospital nurse administrators in recruitment and retention and return on investment over a 3-year improvement plan are described.

Partnerships for Quality project: closing the gap in care of children with ADHD.

PubMed

Lannon, Carole; Dolins, Judith; Lazorick, Suzanne; Crowe, Virginia Leigh Hamilton; Butts-Dion, Sue; Schoettker, Pamela J

2007-12-01

The Partnerships for Quality project was designed to close the gap between knowledge and care for children with attention deficit hyperactivity disorder by fostering a partnership between a major medical specialty society, a professional certifying body, a national family-based advocacy organization, and a child health improvement organization. Ten American Academy of Pediatrics chapters conducted training workshops for practicing pediatricians and their office teams. Assistance was provided in the form of feedback of data, ongoing communication via conference calls, and a listserve. Two national workshops were conducted to disseminate learnings and promote sustainability. Participation in the intervention resulted in greater involvement in quality improvement activities by practice teams and improved care outcomes. The training workshops facilitated collaboration among providers, parents, and the educational, mental health, and legal systems. The partnership structure used demonstrated what professional societies can do to support improvement at the local level and what component chapters need to do to support improvement at the practice level. The integration of quality improvement infrastructure and policy changes at the national and local levels suggest that the quality efforts are likely to be sustained, providing long-term improvement in care and outcomes for children and families.

Seventeen years of progress for supportive care services: A resurvey of National Cancer Institute-designated comprehensive cancer centers.

PubMed

Hammer, Sheila L; Clark, Karen; Grant, Marcia; Loscalzo, Matthew J

2015-08-01

We replicated a 1994 study that surveyed the state of supportive care services due to changes in the field and the increased need for such services. We provide an updated assessment, comparing the changes that have occurred and describing the current status of supportive care services in comprehensive cancer settings. We used Coluzzi and colleague's 60-question survey from their 1995 Journal of Clinical Oncology article to frame the 98-question survey employed in the current study. Medical and palliative care directors for the 2011 National Cancer Institute (NCI) comprehensive cancer centers were surveyed regarding their supportive care services and their subjective review of the overall effectiveness of the services provided. We achieved a 76% response rate (n = 31). The data revealed increases in the number of cancer beds in the hospitals, the degree of integration of supportive care services, the availability of complementary services, and the number of pain and palliative care services offered. There was also an overall shift toward centers becoming more patient centered, as 65% reported now having a patient and family advisory council. Our findings revealed a growing trend to offer distress screening for both outpatients and inpatients. Medical and palliative care directors' evaluations of the supportive care services they offered also significantly improved. However, the results revealed an ongoing gap in services for end-of-life care and timely referrals for hospice services. Overall, both the quantity and quality of supportive care services in the surveyed NCI-designated cancer centers has improved.

NASA CEV Reference Entry GN&C System and Analysis

NASA Technical Reports Server (NTRS)

Munday, S.; Madsen, C.; Broome, J.; Gay, R.; Tigges, M.; Strahan, A.

2007-01-01

As part of its overall objectives, the Orion spacecraft will be required to perform entry and Earth landing functions for Low Earth Orbit (LEO) and Lunar missions. Both of these entry scenarios will begin with separation of the Service Module (SM), making them unique from other Orion mission phases in that only the Command Module (CM) portion of the Crew Exploration Vehicle (CEV) will be involved, requiring a CM specific Guidance, Navigation and Control (GN&C) system. Also common to these mission scenarios will be the need for GN&C to safely return crew (or cargo) to earth within the dynamic thermal and structural constraints of entry and within acceptable accelerations on the crew, utilizing the limited aerodynamic performance of the CM capsule. The lunar return mission could additionally require an initial atmospheric entry designed to support a precision skip and second entry, all to maximize downrange performance and ensure landing in the United States. This paper describes the Entry GN&C reference design, developed by the NASA-led team, that supports these entry scenarios and that was used to validate the Orion System requirements. Description of the reference design will include an overview of the GN&C functions, avionics, and effectors and will relate these to the specific design drivers of the entry scenarios, as well as the desire for commonality in vehicle systems to support the different missions. The discussion will also include the requirement for an Emergency Entry capability beyond that of the nominal performance of the multi-string GNC system, intended to return the crew to the earth in a survivable but unguided manner. Finally, various analyses will be discussed, including those completed to support validation efforts of the current CEV requirements, along with those on-going and planned with the intention to further refine the requirements and to support design development work in conjunction with the prime contractor. Some of these ongoing analyses will include work to size effectors (jets) and fuel budgets, to refine skip entry concepts, to characterize navigation performance and uncertainties, to provide for SM disposal offshore and to identify requirements to support target site selection.

The Politics of Information: Building a Relational Database To Support Decision-Making at a Public University.

ERIC Educational Resources Information Center

Friedman, Debra; Hoffman, Phillip

2001-01-01

Describes creation of a relational database at the University of Washington supporting ongoing academic planning at several levels and affecting the culture of decision making. Addresses getting started; sharing the database; questions, worries, and issues; improving access to high-demand courses; the advising function; management of instructional…

Effectiveness of the Civil Aviation Security Program.

DTIC Science & Technology

1980-05-22

SECURITY. - CONTINUED TRAINING OF LAW ENFORCEMENT OFFICERS SUPPORTING AIRPORT SECURITY ACTIVITIES. - SECURITY PROGRAMS IMPLEMENTED BY AIR FREIGHT...cooperation by all concerned. (See Exhibit 14) Airport Security - Ongoing activities which contributed significantly to airport security included full...implementation of the revised Federal Aviation Regulations (FAR) Part 107 governing airport security , training of law enforcement officers supporting

77 FR 3781 - Pediatric Medical Devices; Public Workshop; Reopening of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... discussion of how to determine when it is appropriate to use, and how to use, existing scientific research... use of scientific research data to support pediatric medical device efficacy claims. This is part of an on-going effort to address the ways scientific research data can be used to support pediatric...

Connections: Facilitating Social Supports for Students with Deaf-Blindness in General Education Classrooms.

ERIC Educational Resources Information Center

Goetz, Lori; O'Farrell, Nora

1999-01-01

This article describes a three-component package to facilitate social supports for students who are deaf-blind in general education classes. The components are: ongoing provision of information, provision of interactive, multiple communication media, and facilitation of social interactions. Case studies of four students with deaf-blindness…

Video-Stimulated Recall as a Catalyst for Teacher Professional Learning

ERIC Educational Resources Information Center

Geiger, Vince; Muir, Tracey; Lamb, Janeen

2016-01-01

The purpose of this article is to examine the potential of video-catalysed reflective practice for supporting ongoing teacher professional learning in numeracy. We explore this potential through a synthesis of two case studies that investigated different approaches to supporting teacher reflection on practice through the use of video-stimulated…

The Effect of Oral Feedback on Perceived Classroom Community in Undergraduate Students

ERIC Educational Resources Information Center

Boyles, Jennifer L.

2017-01-01

The ongoing trend in research regarding feedback has been to explore quantitative assessment. Garnering support more recently is qualitative narrative feedback in support of formative assessment. This type of feedback offers insight into expectations as well as offer additional knowledge gained. It enables students to improve their performance…

75 FR 39950 - Proposed Collection; Comment Request; Cancer Trials Support Unit (CTSU) Public Use Forms and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... Request; Cancer Trials Support Unit (CTSU) Public Use Forms and Customer Satisfaction Surveys (NCI... of customer satisfaction for clinical site staff using the CTSU Help Desk and the CTSU web site. An ongoing user satisfaction survey is in place for the Oncology Patient Enrollment Network (OPEN). User...

Not a One-Way Street: Bidirectional Relations between Procedural and Conceptual Knowledge of Mathematics

ERIC Educational Resources Information Center

Rittle-Johnson, Bethany; Schneider, Michael; Star, Jon R.

2015-01-01

There is a long-standing and ongoing debate about the relations between conceptual and procedural knowledge (i.e., knowledge of concepts and procedures). Although there is broad consensus that conceptual knowledge supports procedural knowledge, there is controversy over whether procedural knowledge supports conceptual knowledge and how instruction…

The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change

PubMed Central

2013-01-01

Background Despite growth in implementation research, limited scientific attention has focused on understanding and improving sustainability of health interventions. Models of sustainability have been evolving to reflect challenges in the fit between intervention and context. Discussion We examine the development of concepts of sustainability, and respond to two frequent assumptions —'voltage drop,’ whereby interventions are expected to yield lower benefits as they move from efficacy to effectiveness to implementation and sustainability, and 'program drift,’ whereby deviation from manualized protocols is assumed to decrease benefit. We posit that these assumptions limit opportunities to improve care, and instead argue for understanding the changing context of healthcare to continuously refine and improve interventions as they are sustained. Sustainability has evolved from being considered as the endgame of a translational research process to a suggested 'adaptation phase’ that integrates and institutionalizes interventions within local organizational and cultural contexts. These recent approaches locate sustainability in the implementation phase of knowledge transfer, but still do not address intervention improvement as a central theme. We propose a Dynamic Sustainability Framework that involves: continued learning and problem solving, ongoing adaptation of interventions with a primary focus on fit between interventions and multi-level contexts, and expectations for ongoing improvement as opposed to diminishing outcomes over time. Summary A Dynamic Sustainability Framework provides a foundation for research, policy and practice that supports development and testing of falsifiable hypotheses and continued learning to advance the implementation, transportability and impact of health services research. PMID:24088228

Conflicts at work--the relationship with workplace factors, work characteristics and self-rated health.

PubMed

Oxenstierna, Gabriel; Magnusson Hanson, Linda L; Widmark, Maria; Finnholm, Kristina; Stenfors, Cecilia; Elofsson, Stig; Theorell, Töres

2011-01-01

Few studies have considered the work environment in relation to workplace conflicts and those who have been published have included relatively few psychosocial work environment factors. Little research has been published on the consequences of workplace conflicts in terms of employee health. In this study, the statistical relationships between work and workplace characteristics on one hand and conflicts on the other hand are examined. In addition, the relationship between conflicts at work and self-rated health are described. The study population was derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2006; n=5,141. Among employees at workplaces with more than 20 employees (n=3,341), 1,126 (33.7%) responded that they had been involved in some type of conflict during the two years preceding the survey. Among the work and workplace characteristics studied, the following factors were independently associated with increased likelihood of ongoing conflicts: Conflicting demands, emotional demands, risk of transfer or dismissal, poor promotion prospects, high level of employee influence and good freedom of expression. Factors that decreased the likelihood of ongoing conflicts were: Good resources, good relations with management, good confidence in management, good procedural justice (fairness of decisions) and good social support. After adjustment for socioeconomic conditions the odds ratio for low self-rated health associated with ongoing conflict at work was 2.09 (1.60-2.74). The results provide a good starting point for intervention and prevention work.

An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

PubMed

Woo, Ann; Hittell, Jodi; Beardsley, Carrie; Noh, Charles; Stoukides, Cheryl A; Kaul, Alan F

2004-01-01

The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools. Hill Physicians tabulated results for patients who completed 2649 SCORE tests, screened 978 patients with PIXI tests, and identified 338 osteopenic and 124 osteoporotic patients. The preliminary results of this unique six-year ongoing educational initiative are slow but promising. New physician offices express interest in participating and those offices that have participated in the program continue to screen for osteoporosis. Hill Physicians' message is consistent and is communicated to the physicians repeatedly in different ways in accordance with the principles of educational outreach. Physicians who have conducted the program have positive feedback from their patients and office staff and have begun to communicate their experience to their peers.

The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change.

PubMed

Chambers, David A; Glasgow, Russell E; Stange, Kurt C

2013-10-02

Despite growth in implementation research, limited scientific attention has focused on understanding and improving sustainability of health interventions. Models of sustainability have been evolving to reflect challenges in the fit between intervention and context. We examine the development of concepts of sustainability, and respond to two frequent assumptions -'voltage drop,' whereby interventions are expected to yield lower benefits as they move from efficacy to effectiveness to implementation and sustainability, and 'program drift,' whereby deviation from manualized protocols is assumed to decrease benefit. We posit that these assumptions limit opportunities to improve care, and instead argue for understanding the changing context of healthcare to continuously refine and improve interventions as they are sustained. Sustainability has evolved from being considered as the endgame of a translational research process to a suggested 'adaptation phase' that integrates and institutionalizes interventions within local organizational and cultural contexts. These recent approaches locate sustainability in the implementation phase of knowledge transfer, but still do not address intervention improvement as a central theme. We propose a Dynamic Sustainability Framework that involves: continued learning and problem solving, ongoing adaptation of interventions with a primary focus on fit between interventions and multi-level contexts, and expectations for ongoing improvement as opposed to diminishing outcomes over time. A Dynamic Sustainability Framework provides a foundation for research, policy and practice that supports development and testing of falsifiable hypotheses and continued learning to advance the implementation, transportability and impact of health services research.

Rhythms of Consciousness: Binocular Rivalry Reveals Large-Scale Oscillatory Network Dynamics Mediating Visual Perception

PubMed Central

Doesburg, Sam M.; Green, Jessica J.; McDonald, John J.; Ward, Lawrence M.

2009-01-01

Consciousness has been proposed to emerge from functionally integrated large-scale ensembles of gamma-synchronous neural populations that form and dissolve at a frequency in the theta band. We propose that discrete moments of perceptual experience are implemented by transient gamma-band synchronization of relevant cortical regions, and that disintegration and reintegration of these assemblies is time-locked to ongoing theta oscillations. In support of this hypothesis we provide evidence that (1) perceptual switching during binocular rivalry is time-locked to gamma-band synchronizations which recur at a theta rate, indicating that the onset of new conscious percepts coincides with the emergence of a new gamma-synchronous assembly that is locked to an ongoing theta rhythm; (2) localization of the generators of these gamma rhythms reveals recurrent prefrontal and parietal sources; (3) theta modulation of gamma-band synchronization is observed between and within the activated brain regions. These results suggest that ongoing theta-modulated-gamma mechanisms periodically reintegrate a large-scale prefrontal-parietal network critical for perceptual experience. Moreover, activation and network inclusion of inferior temporal cortex and motor cortex uniquely occurs on the cycle immediately preceding responses signaling perceptual switching. This suggests that the essential prefrontal-parietal oscillatory network is expanded to include additional cortical regions relevant to tasks and perceptions furnishing consciousness at that moment, in this case image processing and response initiation, and that these activations occur within a time frame consistent with the notion that conscious processes directly affect behaviour. PMID:19582165

ARL Support of NRL Rocket Experiments to Investigate Ionospheric Phenomena

DTIC Science & Technology

2010-08-31

reallocate the funds to support NRL’s ongoing efforts to develop an ionospheric tomography network in South America to support the C/NOFS satellite...of NRL Rocket Experiments to Investigate Ionospheric Phenomena 5a. CONTRACT NUMBER N00173-09-1-G036 5b. GRANT NUMBER N00173-09-1-G036 5c...1-G036 ARL Support of NRL Rocket Experiments to Investigate Ionospheric Phenomena BY DR. TREVOR W. GARNER APPLIED RESEARCH LABORATORIES THE

Retooling Institutional Support Infrastructure for Clinical Research

PubMed Central

Snyder, Denise C.; Brouwer, Rebecca N.; Ennis, Cory L.; Spangler, Lindsey L.; Ainsworth, Terry L.; Budinger, Susan; Mullen, Catherine; Hawley, Jeffrey; Uhlenbrauck, Gina; Stacy, Mark

2016-01-01

Clinical research activities at academic medical centers are challenging to oversee. Without effective research administration, a continually evolving set of regulatory and institutional requirements can detract investigator and study team attention away from a focus on scientific gain, study conduct, and patient safety. However, even when the need for research administration is recognized, there can be struggles over what form it should take. Central research administration may be viewed negatively, with individual groups preferring to maintain autonomy over processes. Conversely, a proliferation of individualized approaches across an institution can create inefficiencies or invite risk. This article describes experiences establishing a unified research support office at the Duke University School of Medicine based on a framework of customer support. The Duke Office of Clinical Research was formed in 2012 with a vision that research administration at academic medical centers should help clinical investigators navigate the complex research environment and operationalize research ideas. The office provides an array of services that have received high satisfaction ratings. The authors describe the ongoing culture change necessary for success of the unified research support office. Lessons learned from implementation of the Duke Office of Clinical Research may serve as a model for other institutions undergoing a transition to unified research support. PMID:27125563

Collaborative Commercial Space Situational Awareness

NASA Astrophysics Data System (ADS)

Kelso, T. S.; Hendrix, D.; Sibert, D.; Hall, R. A.; Therien, W.

2013-09-01

There is an increasing recognition by commercial and civil space operators of the need for space situational awareness (SSA) data to support ongoing conjunction analysis, maneuver planning, and radio frequency interference mitigation as part of daily operations. While some SSA data is available from the Joint Space Operations Center via the Space Track web site, access to raw observations and photometric data is limited due to national security considerations. These data, however, are of significant value in calibrating intra- and inter-operator orbit determination results, determining inter-system biases, and assessing operating profiles in the geostationary orbit. This paper details an ongoing collaborative effort to collect and process optical observations and photometric data using a network of low-cost telescope installations and shows how these data are being used to support ongoing operations in the Space Data Center. This presentation will demonstrate how by leveraging advance photometric processing algorithms developed for Missile Defense Agency and the Ballistic Missile Defense (BMD) mission ExoAnalytic and AGI have been able to provide actionable SSA for satellite operators from small telescopes in less than optimal viewing conditions. Space has become an increasingly cluttered environment requiring satellite operators to remain forever vigilant in order to prevent collisions to preserve their assets and prevent further cluttering the space environment. The Joint Space Operations Center (JSpOC), which tracks all objects in earth orbit, reports possible upcoming conjunctions to operators by providing Conjunction Summary Messages (CSMs). However due to large positional uncertainties in the forward predicted position of space objects at the time closest approach the volume of CSMs is excessive to the point that maneuvers in response to CSMs without additional screening is cost prohibitive. CSSI and the Space Data Association have been able to screen most CSMs by using more accurate operator ephemeris. By screening with operator ephemeris alone they have been able to demonstrate that safety limits will not be exceeded in a good number of these encounters and that extra delta-V need to not be expended in a Collision Avoidance (COLA) maneuver. However there remains a decent portion of alerts that may warrant action especially when the secondary object is an uncontrolled space object such as a dead satellite or rocket body. By dynamically tasking the ESpOC observatories to provide real-time tracking and photometric characterization of the secondary objects in response to these CSMs satellite operators benefit from an additional method of conjunction screening. The refined tracks and conjunction assessments obtained by ESpOC screening allows operators to safely reduce the number of COLAs performed in response to safe close approaches and provide optimized COLA maneuver planning in response to validated threats.

Hardware Progress Made in the Early Flight Fission Test Facilities (EFF-TF) To Support Near-Term Space Fission Systems

NASA Astrophysics Data System (ADS)

Van Dyke, Melissa; Martin, James

2005-02-01

The NASA Marshall Space Flight Center's Early Flight Fission Test Facility (EFF-TF), provides a facility to experimentally evaluate nuclear reactor related thermal hydraulic issues through the use of non-nuclear testing. This facility provides a cost effective method to evaluate concepts/designs and support mitigation of developmental risk. Electrical resistance thermal simulators can be used to closely mimic the heat deposition of the fission process, providing axial and radial profiles. A number of experimental and design programs were underway in 2004 which include the following. Initial evaluation of the Department of Energy Los Alamos National Laboratory 19 module stainless steel/sodium heat pipe reactor with integral gas heat exchanger was operated at up to 17.5 kW of input power at core temperatures of 1000 K. A stainless steel sodium heat pipe module was placed through repeated freeze/thaw cyclic testing accumulating over 200 restarts to a temperature of 1000 K. Additionally, the design of a 37- pin stainless steel pumped sodium/potassium (NaK) loop was finalized and components procured. Ongoing testing at the EFF-TF is geared towards facilitating both research and development necessary to support future decisions regarding potential use of space nuclear systems for space exploration. All efforts are coordinated with DOE laboratories, industry, universities, and other NASA centers. This paper describes some of the 2004 efforts.

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

PubMed

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-10-01

Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.

Integrating tobacco dependence counseling into electronic dental records: a multi-method approach.

PubMed

Rush, William A; Schleyer, Titus K L; Kirshner, Michael; Boyle, Raymond; Thoele, Merry Jo; Lenton, P A; Asche, Steve; Thyvalikakath, Thankam; Spallek, Heiko; Durand, Emily C; Enstad, Chris J; Huntley, Charles L; Rindal, D Brad

2014-01-01

Dentistry has historically seen tobacco dependence as a medical problem. As a consequence, dentistry has not adopted or developed effective interventions to deal with tobacco dependence. With the expanded use of electronic dental records, the authors identified an opportunity to incorporate standardized expert support for tobacco dependence counseling during the dental visit. Using qualitative results from observations and focus groups, a decision support system was designed that suggested discussion topics based on the patient's desire to quit and his or her level of nicotine addiction. Because dental providers are always pressed for time, the goal was a three-minute average intervention interval. To fulfill the provider's need for an easy way to track ongoing interventions, script usage was recorded. This process helped the provider track what he or she had said to the patient about tobacco dependence during previous encounters and to vary the messages. While the individual elements of the design process were not new, the combination of them proved to be very effective in designing a usable and accepted intervention. The heavy involvement of stakeholders in all components of the design gave providers and administrators ownership of the final product, which was ultimately adopted for use in all the clinics of a large dental group practice in Minnesota.

Sustaining employment after vocational rehabilitation in acquired brain injury.

PubMed

Macaden, Ashish Stephen; Chandler, Barbara J; Chandler, Colin; Berry, Alister

2010-01-01

To explore factors affecting sustaining employment in people with acquired brain injury (ABI). A multiple case study approach using semi-structured interviews in eight cases (29 individuals). Each case included an individual with ABI, a family member, a job coach and a co-worker (triangulation). The eight individuals with ABI had completed vocational rehabilitation and were purposely selected based on whether they had sustained employment (4) or not (4). Similarity between pre-injury work or leisure interest and post-injury work, unconditional motivation, insight and the ability to cope with cognitive and behavioural sequelae were beneficial in sustaining employment. Post-injury instances of poor cognitive or behavioural function did not necessarily affect sustained employment. The vocational rehabilitation programme was beneficial in building up confidence, providing continued follow up and providing co-worker 'twins' in the work place. Employers with a personal experience of disability helped individuals with ABI to sustain employment. Similarities between pre-injury work or leisure interests and post-injury work improved motivation. Factors associated with sustained employment were insightful, unconditional, internal motivation providing an ability to cope, confidence provided by ongoing vocational rehabilitation support through job coaches, supportive co-workers and employers with a personal experience of disability. People with ABI can be outstanding employees.

Clinical Trials | Division of Cancer Prevention

Cancer.gov

Information about actively enrolling, ongoing, and completed clinical trials of cancer prevention, early detection, and supportive care, including phase I, II, and III agent and action trials and clinical trials management. |

A Modular Repository-based Infrastructure for Simulation Model Storage and Execution Support in the Context of In Silico Oncology and In Silico Medicine.

PubMed

Christodoulou, Nikolaos A; Tousert, Nikolaos E; Georgiadi, Eleni Ch; Argyri, Katerina D; Misichroni, Fay D; Stamatakos, Georgios S

2016-01-01

The plethora of available disease prediction models and the ongoing process of their application into clinical practice - following their clinical validation - have created new needs regarding their efficient handling and exploitation. Consolidation of software implementations, descriptive information, and supportive tools in a single place, offering persistent storage as well as proper management of execution results, is a priority, especially with respect to the needs of large healthcare providers. At the same time, modelers should be able to access these storage facilities under special rights, in order to upgrade and maintain their work. In addition, the end users should be provided with all the necessary interfaces for model execution and effortless result retrieval. We therefore propose a software infrastructure, based on a tool, model and data repository that handles the storage of models and pertinent execution-related data, along with functionalities for execution management, communication with third-party applications, user-friendly interfaces to access and use the infrastructure with minimal effort and basic security features.

A Modular Repository-based Infrastructure for Simulation Model Storage and Execution Support in the Context of In Silico Oncology and In Silico Medicine

PubMed Central

Christodoulou, Nikolaos A.; Tousert, Nikolaos E.; Georgiadi, Eleni Ch.; Argyri, Katerina D.; Misichroni, Fay D.; Stamatakos, Georgios S.

2016-01-01

The plethora of available disease prediction models and the ongoing process of their application into clinical practice – following their clinical validation – have created new needs regarding their efficient handling and exploitation. Consolidation of software implementations, descriptive information, and supportive tools in a single place, offering persistent storage as well as proper management of execution results, is a priority, especially with respect to the needs of large healthcare providers. At the same time, modelers should be able to access these storage facilities under special rights, in order to upgrade and maintain their work. In addition, the end users should be provided with all the necessary interfaces for model execution and effortless result retrieval. We therefore propose a software infrastructure, based on a tool, model and data repository that handles the storage of models and pertinent execution-related data, along with functionalities for execution management, communication with third-party applications, user-friendly interfaces to access and use the infrastructure with minimal effort and basic security features. PMID:27812280

NASA/WVU Software Research Laboratory, 1995

NASA Technical Reports Server (NTRS)

Sabolish, George J.; Callahan, John R.

1995-01-01

In our second year, the NASA/WVU Software Research Lab has made significant strides toward analysis and solution of major software problems related to V&V activities. We have established working relationships with many ongoing efforts within NASA and continue to provide valuable input into policy and decision-making processes. Through our publications, technical reports, lecture series, newsletters, and resources on the World-Wide-Web, we provide information to many NASA and external parties daily. This report is a summary and overview of some of our activities for the past year. This report is divided into 6 chapters: Introduction, People, Support Activities, Process, Metrics, and Testing. The Introduction chapter (this chapter) gives an overview of our project beginnings and targets. The People chapter focuses on new people who have joined the Lab this year. The Support chapter briefly lists activities like our WWW pages, Technical Report Series, Technical Lecture Series, and Research Quarterly newsletter. Finally, the remaining four chapters discuss the major research areas that we have made significant progress towards producing meaningful task reports. These chapters can be regarded as portions of drafts of our task reports.

SO2 plume height retrieval from UV satellite measurements in support to aviation control

NASA Astrophysics Data System (ADS)

van Gent, Jeroen; Brenot, Hugues; Lerot, Christophe; Theys, Nicolas; Van Roozendael, Michel

2014-05-01

The Support to Aviation Control Service (SACS), operated at our institute, uses multi-sensor UV-visible and infrared satellite measurements to provide near real-time information on volcanic ash and SO2 concentrations. In case of enhanced SO2 concentrations, notifications are send out to subscribing organisations and individuals, with details regarding the volcanic event. This information may be used by aviation control organisations to judge the risc to air traffic and provide possible alternative routing. One of the latest additions to the system is information on the altitude of SO2 plumes, based on UV measurements of the GOME-2 sensors on the platforms METOP-A and METOP-B. Further improvement of this system is ongoing. This poster shows examples of plume height retrieval from GOME-2 (METOP-A and -B) and OMI (EOS-AURA). Results are shown for a number of recent major volcanic eruptions, each with different characteristics. The applied technique to retrieve altitude information will be discussed, as well as the applicability, quality and limitations of the method.

A user's manual for the NASA/JPL synthetic aperture radar and the NASA/JPL L and C band scatterometers

NASA Technical Reports Server (NTRS)

Thompson, T. W.

1983-01-01

Airborne synthetic aperture radars and scatterometers are operated with the goals of acquiring data to support shuttle imaging radars and support ongoing basic active microwave remote sensing research. The aircraft synthetic aperture radar is an L-band system at the 25-cm wavelength and normally operates on the CV-990 research aircraft. This radar system will be upgraded to operate at both the L-band and C-band. The aircraft scatterometers are two independent radar systems that operate at 6.3-cm and 18.8-cm wavelengths. They are normally flown on the C-130 research aircraft. These radars will be operated on 10 data flights each year to provide data to NASA-approved users. Data flights will be devoted to Shuttle Imaging Radar-B (SIR-B) underflights. Standard data products for the synthetic aperture radars include both optical and digital images. Standard data products for the scatterometers include computer compatible tapes with listings of radar cross sections (sigma-nought) versus angle of incidence. An overview of these radars and their operational procedures is provided by this user's manual.

Seeking lower prices where providers are consolidated: an examination of market and policy strategies.

PubMed

Ginsburg, Paul B; Pawlson, L Gregory

2014-06-01

The ongoing consolidation between and among hospitals and physicians tends to raise prices for health care services, which poses increasing challenges for private purchasers and payers. This article examines strategies that these purchasers and payers can pursue to combat provider leverage to increase prices. It also examines opportunities for governments to either support or constrain these strategies. In response to higher prices, payers are developing new approaches to benefit and network design, some of which may be effective in moderating prices and, in some cases, volume. These approaches interact with public policy because regulation can either facilitate or constrain them. Federal and state governments also have opportunities to limit consolidation's effect on prices by developing antitrust policies that better address current market environments and by fostering the development of physician organizations that can increase competition and contract with payers under shared-savings approaches. The success of these private- and public-sector initiatives likely will determine whether governments shift from supporting competition to directly regulating payment rates. Project HOPE—The People-to-People Health Foundation, Inc.

The ambiguity of patient-centred practices: the case of a Dutch fertility clinic.

PubMed

Gerrits, Trudie

2014-01-01

When in-vitro fertilization (IVF) was introduced in the 1970s, doctors were criticized for not properly informing prospective users about its possible risks and limited success rates as well as for medicalizing fertility problems. Nowadays, many fertility clinics are seeking to improve their accountability to stakeholders through patient-centred practices. Based on an ethnographic study of a Dutch fertility clinic, outspoken in its aims to provide patient-centred medicine and to empower clients, this paper addresses how patient-centred medicine affects couples' decision-making to use IVF and related reproductive technologies. The author contends that while patient-centred practices facilitate informed decision-making and support couples emotionally, they may also have unintended disciplining and normalizing effects. The information and support provided, the trust couples have in clinic staff, the ongoing visualization of conception mediated by medical technology--all can be seen as practices that strengthen lay people's 'medical gaze' in how they come to view their bodies, fertility problems and possible solutions. These unintended effects are labelled 'the ambiguity of patient-centeredness' as they (may) interfere with processes of autonomous decision-making.

The role of health promotion: between global thinking and local action.

PubMed

King, Lesley

2006-12-01

The persistence of health inequities provides an ongoing challenge for health promotion. The dictum 'think globally, act locally' fails to recognise the significance of infrastructure and policy in linking global issues and local practices as a means of addressing health inequities. Commentary and opinion. Through analytic tools and methods, health promotion has much to contribute to facilitating health-improving changes in social, economic and physical environments. Local actions provide excellent illustrations of organisational change and intersectoral action, and present the possibility that such actions could be widely implemented. While this has occurred on some issues, this is not usually the case. Political support, policy and infrastructure are required to link global ideas and local actions and overcome the impasse. Media advocacy is one example of an approach with potential to make these links and mobilise political support. Reframing media and political discussion, away from the dichotomy of individual responsibility and government intervention and towards acknowledging the social context of human behaviour, could contribute to policy and social environments with greater capacity to address inequities.

Communication Simulations for Power System Applications

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

Fuller, Jason C.; Ciraci, Selim; Daily, Jeffrey A.

2013-05-29

New smart grid technologies and concepts, such as dynamic pricing, demand response, dynamic state estimation, and wide area monitoring, protection, and control, are expected to require considerable communication resources. As the cost of retrofit can be high, future power grids will require the integration of high-speed, secure connections with legacy communication systems, while still providing adequate system control and security. While considerable work has been performed to create co-simulators for the power domain with load models and market operations, limited work has been performed in integrating communications directly into a power domain solver. The simulation of communication and power systemsmore » will become more important as the two systems become more inter-related. This paper will discuss ongoing work at Pacific Northwest National Laboratory to create a flexible, high-speed power and communication system co-simulator for smart grid applications. The framework for the software will be described, including architecture considerations for modular, high performance computing and large-scale scalability (serialization, load balancing, partitioning, cross-platform support, etc.). The current simulator supports the ns-3 (telecommunications) and GridLAB-D (distribution systems) simulators. Ongoing and future work will be described, including planned future expansions for a traditional transmission solver. A test case using the co-simulator, utilizing a transactive demand response system created for the Olympic Peninsula and AEP gridSMART demonstrations, requiring two-way communication between distributed and centralized market devices, will be used to demonstrate the value and intended purpose of the co-simulation environment.« less

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

PubMed

DeLeo, Annemarie; Geraghty, Sadie

2017-12-18

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

An approach to the design of operations systems

NASA Technical Reports Server (NTRS)

Chafin, Roy L.; Curran, Patrick S.

1993-01-01

The MultiMission Control Team (MMCT) consists of mission controllers which provides Real-Time operations support for the Mars Observer project. The Real-Time Operations task is to insure the integrity of the ground data system, to insure that the configuration is correct to support the mission, and to monitor the spacecraft for the Spacecraft Team. Operations systems are typically developed by adapting operations systems from previous projects. Problems tend to be solved empirically when they are either anticipated or observed in testing. This development method has worked in the past when time was available for extensive Ops testing. In the present NASA budget environment, a more cost conscious design approach has become necessary. Cost is a concern because operations is an ongoing, continuous activity. Reducing costs entails reducing staff. Reducing staffing levels potentially increases the risk of mission failure. Therefore, keeping track of the risk level is necessary.

Immigrating to the US: what Brazilian, Latin American and Haitian women have to say about changes to their lifestyle that may be associated with obesity.

PubMed

Tovar, Alison; Must, Aviva; Metayer, Nesly; Gute, David M; Pirie, Alex; Hyatt, Raymond R; Economos, Christina D

2013-04-01

Our goal was to explore the perceived determinants of obesity in Brazilian, Latin American and Haitian women. This is part of an ongoing community-based participatory intervention. Focus groups by immigrant group were conducted and themes extracted. Women expressed differences in beliefs, attitudes, and barriers regarding diet and physical activity in the US versus their home country. Participants thought food in the US is "less natural," there is less time for preparation, and there is more variety. The weather is a barrier to physical activity in the US and work is more physically demanding. Job-related efforts were not considered physical activity. They reported higher levels of stress, less control of their time and less social support in the US. Providing immigrants with appropriate support and education early in the acculturation process has the potential to help prevent obesity.

Knowledge-based assistance in costing the space station DMS

NASA Technical Reports Server (NTRS)

Henson, Troy; Rone, Kyle

1988-01-01

The Software Cost Engineering (SCE) methodology developed over the last two decades at IBM Systems Integration Division (SID) in Houston is utilized to cost the NASA Space Station Data Management System (DMS). An ongoing project to capture this methodology, which is built on a foundation of experiences and lessons learned, has resulted in the development of an internal-use-only, PC-based prototype that integrates algorithmic tools with knowledge-based decision support assistants. This prototype Software Cost Engineering Automation Tool (SCEAT) is being employed to assist in the DMS costing exercises. At the same time, DMS costing serves as a forcing function and provides a platform for the continuing, iterative development, calibration, and validation and verification of SCEAT. The data that forms the cost engineering database is derived from more than 15 years of development of NASA Space Shuttle software, ranging from low criticality, low complexity support tools to highly complex and highly critical onboard software.

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

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Krishnamurthy, Karthik

2004-01-01

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

Restraint and the question of validity.

PubMed

Paterson, Brodie; Duxbury, Joy

2007-07-01

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy.

A Multidimensional Data Warehouse for Community Health Centers

PubMed Central

Kunjan, Kislaya; Toscos, Tammy; Turkcan, Ayten; Doebbeling, Brad N.

2015-01-01

Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in the development of this repository that may help other researchers, managers and leaders in health informatics. The resulting multidimensional data warehouse is highly practical and is designed to provide a foundation for wide-ranging healthcare data analytics over time and across the community health research enterprise. PMID:26958297

A Multidimensional Data Warehouse for Community Health Centers.

PubMed

Kunjan, Kislaya; Toscos, Tammy; Turkcan, Ayten; Doebbeling, Brad N

2015-01-01

Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in the development of this repository that may help other researchers, managers and leaders in health informatics. The resulting multidimensional data warehouse is highly practical and is designed to provide a foundation for wide-ranging healthcare data analytics over time and across the community health research enterprise.

Smartkadaster: Observing Beyond Traditional Cadastre Capabilities for Malaysia

NASA Astrophysics Data System (ADS)

Isa, M. N. Bin; Hua, T. C.; Halim, N. Z. Binti Abdul

2015-10-01

The digital age for cadastral surveying started in stages, more than 20 years ago in Malaysia and JUPEM played a vital role in its successful implementation nationwide. One of the key products of cadastral survey is cadastral maps, which provide useful information for any land information system. However, as technology evolved and simplicity is familiarised, better services are anticipated and have affected how cadastral survey information are perceived. A paradigm shift is necessary where enriched cadastral information is required for multiple usage and allow real cadastral information based services to users. On that note, JUPEM is intrigued to develop a system where National Digital Cadastral Database is value added with other geospatial information for a smart and multipurpose environment and clearly be interpreted as a decision making tool with the aids of 3D realistic spatial data, namely SmartKADASTER. The SmartKADASTER is an ongoing project developed by JUPEM with the aim to establish a realistic and SMART cadastral-based spatial analysis platform for an effective planning, decision making, enabling efficiencies and enhancing communication and management to support SMART services towards SMART City enablement in Malaysia. It is developed in phases with the Federal Territory of Putrajaya and Kuala Lumpur as the initial project implementation area. This paper provides awareness and insights of the on-going development of the project and how it could benefit potential users and stakeholders.

The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

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

Schultz, Courtney A., E-mail: courtney.schultz@colostate.edu

Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is donemore » under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.« less

Using SCOR as a Supply Chain Management Framework for Government Agency Contract Requirements

NASA Technical Reports Server (NTRS)

Paxton, Joseph; Tucker, Brian

2010-01-01

This paper will present a model that uses the Supply-Chain Operations Reference (SCOR) model as a foundation for a framework to illustrate the information needed throughout a product lifecycle to support a healthy supply chain management function and the subsequent contract requirements to enable it. It will also show where in the supply chain the information must be extracted. The ongoing case study used to exemplify the model is NASA's (National Aeronautics and Space Administration) Ares I program for human spaceflight. Effective supply chain management and contract requirements are ongoing opportunities for continuous improvement within government agencies, specifically development of systems for human spaceflight operations. Multiple reports from the Government Accountability Office (GAO) reinforce this importance. The SCOR model is a framework for describing a supply chain with process building blocks and business activities. It provides a set of metrics for measuring supply chain performance and best practices for continuously improving. This paper expands the application of the SCOR to also provide the framework for defining information needed from different levels of the supply chain and at different phases of the lifecycle. These needs can be incorporated into contracts to enable more effective supply chain management. Depending on the phase of the lifecycle, effective supply chain management will require involvement from different levels of the organization and different levels of the supply chain.

Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support.

PubMed

Nahum-Shani, Inbal; Smith, Shawna N; Spring, Bonnie J; Collins, Linda M; Witkiewitz, Katie; Tewari, Ambuj; Murphy, Susan A

2018-05-18

The just-in-time adaptive intervention (JITAI) is an intervention design aiming to provide the right type/amount of support, at the right time, by adapting to an individual's changing internal and contextual state. The availability of increasingly powerful mobile and sensing technologies underpins the use of JITAIs to support health behavior, as in such a setting an individual's state can change rapidly, unexpectedly, and in his/her natural environment. Despite the increasing use and appeal of JITAIs, a major gap exists between the growing technological capabilities for delivering JITAIs and research on the development and evaluation of these interventions. Many JITAIs have been developed with minimal use of empirical evidence, theory, or accepted treatment guidelines. Here, we take an essential first step towards bridging this gap. Building on health behavior theories and the extant literature on JITAIs, we clarify the scientific motivation for JITAIs, define their fundamental components, and highlight design principles related to these components. Examples of JITAIs from various domains of health behavior research are used for illustration. As we enter a new era of technological capacity for delivering JITAIs, it is critical that researchers develop sophisticated and nuanced health behavior theories capable of guiding the construction of such interventions. Particular attention has to be given to better understanding the implications of providing timely and ecologically sound support for intervention adherence and retention.

Orion Entry Flight Control Stability and Performance

NASA Technical Reports Server (NTRS)

Strahan, Alan L.; Loe, Greg R.; Seiler, Pete

2007-01-01

The Orion Spacecraft will be required to perform entry and landing functions for both Low Earth Orbit (LEO) and Lunar return missions, utilizing only the Command Module (CM) with its unique systems and GN&C design. This paper presents the current CM Flight Control System (FCS) design to support entry and landing, with a focus on analyses that have supported its development to date. The CM FCS will have to provide for spacecraft stability and control while following guidance or manual commands during exo-atmospheric flight, after Service Module separation, translational powered flight required of the CM, atmospheric flight supporting both direct entry and skip trajectories down to drogue chute deploy, and during roll attitude reorientation just prior to touchdown. Various studies and analyses have been performed or are on-going supporting an overall FCS design with reasonably sized Reaction Control System (RCS) jets, that minimizes fuel usage, that provides appropriate command following but with reasonable stability and control margin. Results from these efforts to date are included, with particular attention on design issues that have emerged, such as the struggle to accommodate sub-sonic pitch and yaw control without using excessively large jets that could have a detrimental impact on vehicle weight. Apollo, with a similar shape, struggled with this issue as well. Outstanding CM FCS related design and analysis issues, planned for future effort, are also briefly be discussed.

Operation Joint Endeavor in Bosnia: telemedicine systems and case reports.

PubMed

Calcagni, D E; Clyburn, C A; Tomkins, G; Gilbert, G R; Cramer, T J; Lea, R K; Ehnes, S G; Zajtchuk, R

1996-01-01

For the last several years the U.S. Department of Defense (DoD) has operated a telemedicine test bed at the U.S. Army Medical Research and Material Command's Medical Advanced Technology Management Office. The goal of this test bed is to reengineer the military health service system from the most forward deployed forces to tertiary care teaching medical centers within the United States by exploiting emerging telemedicine technologies. The test bed has conducted numerous proof-of-concept telemedicine demonstrations as part of military exercises and in support of real-world troop deployments. The most ambitious of those demonstrations is Primetime III, an ongoing effort to provide telemedicine and other advanced technology support to medical units supporting Operation Joint Endeavor in Bosnia. Several of the first instances of the clinical use of the Primetime III systems are presented as case reports in this paper. These reports demonstrate capabilities and limitations of telemedicine. The Primetime III system demonstrates the technical ability to provide current telecommunications capabilities to medical units stationed in the remote, austere, difficult-to-serve environment of Bosnia. Telemedicine capabilities cannot be used without adequate training, operations, and sustainment support. Video consultations have eliminated the need for some evacuations. The system has successfully augmented the clinical capability of physicians assigned to these medical units. Fullest clinical utilization of telemedicine technologies requires adjustment of conventional clinical practice patterns.

The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment.

PubMed

McEwen, Jean E; Boyer, Joy T; Sun, Kathie Y; Rothenberg, Karen H; Lockhart, Nicole C; Guyer, Mark S

2014-01-01

For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

Implementation of evidence-based patient navigation programs.

PubMed

Freund, Karen M

2017-02-01

Patient navigation refers to a direct patient care role that links patients with clinical providers and their support system and provides individualized support during cancer care, ensuring that patients have access to the knowledge and resources necessary to complete recommended treatment. While most reports have studied the role of patient navigators during the cancer screening or diagnostic process, emerging evidence indicates the benefits of patient navigation during active cancer treatment. Reports in the literature are conflicting on the impact of patient navigation during cancer care and on the benefits to timely or quality care in all populations. Recent sub-analyses of the Patient Navigation Research Program data demonstrated specifically the benefits of targeting patient navigation to the most vulnerable populations, including those with low educational attainment, low income and unstable housing, less social support, multiple comorbidities, and minority race/ethnicity. The implications of the Patient Navigation Research Program are that this resource is best utilized when directed to support the care of patients at locations with known challenges to timely care and for specific patients with risk factors for delays in care, including comorbidities, low educational attainment and low income. Implementation of patient navigation programs requires the following processes: needs assessment, selection of a navigator to meet the community and care needs, supervision and integration of the navigator into clinical processes, and systems support to facilitate the identification and tracking of those patients requiring patient navigation. There is a need for ongoing research on methods to fund and sustain patient navigation programs.

34 CFR 363.6 - What definitions apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... for individuals with the most severe disabilities due to mental illness. (2) As used in the definition... to mental illness. In transitional employment, the provision of on-going support services must...

Better Decisions through Consultation and Collaboration

EPA Pesticide Factsheets

This manual discusses the benefits of public involvement to agency decision makers, including expanding shared baseline knowledge, generating support for the decision, and developing ongoing relationships that will help in implementing decisions.

PRomotion Of Physical activity through structured Education with differing Levels of ongoing Support for people at high risk of type 2 diabetes (PROPELS): study protocol for a randomized controlled trial.

PubMed

Yates, Tom; Griffin, Simon; Bodicoat, Danielle H; Brierly, Gwen; Dallosso, Helen; Davies, Melanie J; Eborall, Helen; Edwardson, Charlotte; Gillett, Mike; Gray, Laura; Hardeman, Wendy; Hill, Sian; Morton, Katie; Sutton, Stephen; Troughton, Jacqui; Khunti, Kamlesh

2015-07-02

The prevention of type 2 diabetes is recognised as a health care priority. Lifestyle change has proven effective at reducing the risk of type 2 diabetes, but limitations in the current evidence have been identified in: the promotion of physical activity; availability of interventions that are suitable for commissioning and implementation; availability of evidence-based interventions using new technologies; and physical activity promotion among ethnic minorities. We aim to investigate whether a structured education programme with differing levels of ongoing support, including text-messaging, can increase physical activity over a 4 year period in a multi-ethnic population at high risk of diabetes. A multi-centre randomised controlled trial, with follow-up at 12 and 48 months. The primary outcome is change in ambulatory activity at 48 months. Secondary outcomes include changes to markers of metabolic, cardiovascular, anthropometric and psychological health along with cost-effectiveness. Participants aged 40-74 years for White European, or 25-74 years for South Asians, with an HbA1c value of between 6.0 and < 6.4% (42 and 47 mmol/mol) or with a previously recorded plasma glucose level or HbA1c value within the high risk (prediabetes) range within the last five years, are invited to take part in the trial. Participants are identified through primary care, using an automated diabetes risk score within their practice database, or from a database of previous research participants. Participants are randomly assigned to either: 1) the control group who receive a detailed advice leaflet; 2) the Walking Away group, who receive the same leaflet and attend a 3 hour structured education programme with annual maintenance sessions delivered in groups; or 3) the Walking Away Plus group, who receive the leaflet, attend the structured education programme with annual maintenance sessions, plus receive follow-on support through highly-tailored text-messaging and telephone calls to help to aid pedometer use and behaviour change. This study will provide new evidence for the long-term effectiveness of a structured education programme focused on physical activity, conducted within routine care in a multi-ethnic population in the UK. It will also investigate the impact of different levels of ongoing support and the cost-effectiveness of each intervention. ISRCTN83465245 Trial registration date: 14/06/2012.

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

PubMed Central

2009-01-01

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

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

PubMed

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

2009-12-16

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

Resilience: The Role of Optimism, Perceived Parental Autonomy Support and Perceived Social Support in First Year University Students

ERIC Educational Resources Information Center

Dawson, Michelle; Pooley, Julie Ann

2013-01-01

Throughout our lifespan we face many challenges which are often referred to as transitions. The move to university is one such transition which may place individuals at risk of suffering ongoing significant life stress, anxiety and uncertainty. Optimism, promotion of independent functioning (PIF), promotion of volitional functioning (PVF) and…

Using Narrative-Based Design Scaffolds within a Mobile Learning Environment to Support Learning Outdoors with Young Children

ERIC Educational Resources Information Center

Seely, Brian J.

2015-01-01

This study aims to advance learning outdoors with mobile devices. As part of the ongoing Tree Investigators design-based research study, this research investigated a mobile application to support observation, identification, and explanation of the tree life cycle within an authentic, outdoor setting. Recognizing the scientific and conceptual…

IN Like Flint: How the Innovation Incubator at UM-Flint Fosters Social Entrepreneurship in a City Remaking Itself

ERIC Educational Resources Information Center

Custer, Nic

2015-01-01

This paper focuses on how the University of Michigan-Flint's Innovation Incubator supports emerging for-profit businesses and nonprofit organizations through programming, business plan development, and ongoing mentorship. The Incubator is especially interested in supporting start-ups that address key social issues in the surrounding community,…

Supporting Concrete Visual Thinking in Multiplicative Reasoning: Difficulties and Opportunities. Technical Report 88-16.

ERIC Educational Resources Information Center

Kaput, James J.

The Educational Technology Center has attempted to develop a series of computer based learning environments to support the learning and application of multiplicative reasoning. The work and software described in this paper, including the teaching experiment that generated the error phenomena examined, is part of a larger ongoing research project.…

Investigating University Educators' Design Thinking and the Implications for Design Support Tools

ERIC Educational Resources Information Center

Bennett, Sue; Agostinho, Shirley; Lockyer, Lori

2016-01-01

All university educators perform design work as they prepare and plan learning experiences for their students. How such design work is undertaken, conceptualised, and optimally supported is the focus of ongoing research for the authors. The purpose of this article is to present the results of a research study that sought to gain a richer…

From Checklists to Heuristics: Designing MOOCs to Support Teacher Learning

ERIC Educational Resources Information Center

Brennan, Karen; Blum-Smith, Sarah; Yurkofsky, Maxwell M.

2018-01-01

Background: Although much is known from educational research about factors that support K-12 teacher professional learning, it has been an ongoing challenge to incorporate these factors into practice in new contexts and environments. We argue that these factors are too often treated like a checklist of discrete elements, either present or not,…

Guidelines for Evaluating Truancy Reduction Programs. Truancy Prevention in Action

ERIC Educational Resources Information Center

Wesley, Ted; Duttweiler, Patricia Cloud

2006-01-01

This monograph is intended as a guide to support self-evaluation of truancy reduction and prevention programs by those involved in their ongoing operations. It is one of four in a series addressing various aspects of truancy, was published by the National Dropout Prevention Center at Clemson University with support from the South Carolina…

75 FR 66767 - Submission for OMB Review; Comment Request; Cancer Trials Support Unit (CTSU) Public Use Forms...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

...; Comment Request; Cancer Trials Support Unit (CTSU) Public Use Forms and Customer Satisfaction Surveys (NCI...: CTSU collects annual surveys of customer satisfaction for clinical site staff using the CTSU Help Desk and the CTSU Web site. An ongoing user satisfaction survey is in place for the Oncology Patient...