Collinearity Impairs Local Element Visual Search

ERIC Educational Resources Information Center

Jingling, Li; Tseng, Chia-Huei

2013-01-01

In visual searches, stimuli following the law of good continuity attract attention to the global structure and receive attentional priority. Also, targets that have unique features are of high feature contrast and capture attention in visual search. We report on a salient global structure combined with a high orientation contrast to the…

78 FR 76126 - Application for New Awards; High School Equivalency Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... DEPARTMENT OF EDUCATION Application for New Awards; High School Equivalency Program AGENCY: Office... an application can receive under this competition is 15 points. This priority is: Prior Experience of... in Grants.gov and before you can submit an application through Grants.gov . If you are currently...

Cave Conservation Priority Index to Adopt a Rapid Protection Strategy: A Case Study in Brazilian Atlantic Rain Forest

NASA Astrophysics Data System (ADS)

Souza Silva, Marconi; Martins, Rogério Parentoni; Ferreira, Rodrigo Lopes

2015-02-01

Cave environments are characterized by possessing specialized fauna living in high environmental stability with limited food conditions. These fauna are highly vulnerable to impacts, because this condition can frequently be easily altered. Moreover, environmental determinants of the biodiversity patterns of caves remain poorly understood and protected. Therefore, the main goal of this work is to propose a cave conservation priority index (CCPi) for a rapid assessment for troglobiotic and troglophile protection. Furthermore, the troglobiotic diversity, distribution and threats have been mapped in the Brazilian Atlantic forest. To propose the CCPi, the human impacts and richness of troglobiotic and troglophile species of 100 caves were associated. Data related to troglomorphic/troglobiotic fauna from another 200 caves were used to map the troglobiotic diversity and distribution. The CCPi reveals extremely high conservation priority for 15 % of the caves, high for 36 % and average for 46 % of the caves. Fourteen caves with extremely high priorities should have urgent conservation and management actions. The geographical distribution of the 221 known troglobiotic/troglomorphic species allowed us to select 19 karst areas that need conservation actions. Seven areas were considered to have urgent priority for conservation actions. The two richest areas correspond to the "iron quadrangle" with iron ore caves (67 spp.) and the "Açungui limestone group" (56 spp.). Both areas have several caves and are important aquifers. The use of the CCPi can prevent future losses because it helps assessors to select caves with priorities for conservation which should receive emergency attention in relation to protection, management and conservation actions.

Marketing Higher Education.

ERIC Educational Resources Information Center

Knight, Brent; Johnson, Dennis

1981-01-01

In a successful college marketing program, students and high-quality instruction are top priorities. Marketing research should investigate student needs and frustrations, the products offered, value received for time and money invested, physical convenience and appeal, and promotional strategies. Program research and development suggestions are…

Investments in tuberculosis research - what are the gaps?

PubMed

Khan, Mishal S; Fletcher, Helen; Coker, Richard

2016-08-25

Through decades of research, numerous studies have generated robust evidence about effective interventions for tuberculosis control. Yet, the global annual decline in incidence of approximately 1 % is evidence that current approaches and investment strategies are not sufficient. In this article, we assess recent tuberculosis research funding and discuss two critical gaps in funding and in scientific evidence from topics that have been left off the research priority agenda.We first examine research and development funding goals in the 2011-2015 Global Plan to Stop Tuberculosis and analyze disbursements to different research areas by funders worldwide in 2014. We then summarize, through a compilation of published literature and consultation with 35 researchers across multiple disciplines in the London School of Hygiene and Tropical Medicine TB Centre, priorities identified by the tuberculosis research community. Finally, we compare researchers' priority areas to the global funding agendas and activities.Our analysis shows that, among the five key research areas defined in the 2011-2015 Global Plan - namely drugs, basic science, vaccines, diagnostics and operational research - drug discovery and basic science on Mycobacterium tuberculosis accounted for 60 % of the $2 billion annual funding target. None of the research areas received the recommended level of funding. Operational research, which had the lowest target, received 66 % of its target funding, whereas new diagnostics received only 19 %. Although many of the priority research questions identified by researchers fell within the Global Plan categories, our analysis highlights important areas that are not explicitly mentioned in the current plan. These priority research areas included improved understanding of tuberculosis transmission dynamics, the role of social protection and social determinants, and health systems and policy research.While research priorities are increasingly important in light of the limited funding for tuberculosis, there is a risk that we neglect important research areas and encourage the formation of research silos. To ensure that funding priorities, researchers' agendas and national tuberculosis control policies are better coordinated, there should be more, and wider, dialogue between stakeholders in high tuberculosis burden countries, researchers, international policymakers and funders.

Analysis of Nursing Clinical Decision Support Requests and Strategic Plan in a Large Academic Health System.

PubMed

Whalen, Kimberly; Bavuso, Karen; Bouyer-Ferullo, Sharon; Goldsmith, Denise; Fairbanks, Amanda; Gesner, Emily; Lagor, Charles; Collins, Sarah

2016-01-01

To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs. We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making. A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. "Risk Assessments/Risk Reduction/Promotion of Healthy Habits" (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse. Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan.

FDA publishes checklist of Y2K high-risk devices.

PubMed

1999-09-01

Key points. The federal Food and Drug Administration (FDA) has developed a list of types of medical devices that have the potential for the most serious consequences for patients should they fail because of Y2K-related problems. This list of computer-controlled potentially high-risk devices can provide a guide to health care facilities regarding the types of devices that should receive priority in their assessment and remediation of medical devices. The list may change as the FDA receives comments on the types of devices included in the list.

Depth distribution of exchangeable aluminum in acid soils: A study from subtropical Brazil

USDA-ARS?s Scientific Manuscript database

High exchangeable aluminum (Al3+) requires greater attention when preparing agricultural soils. However, research examining the relationship between natural levels of soil Al3+ and pedogenetic processes receives little priority, particularly regarding the number of soil profiles investigated. To rep...

Future Research Priorities for Morbidity Control of Lymphedema.

PubMed

Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V

2017-01-01

Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients' priorities. One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP.

Future Research Priorities for Morbidity Control of Lymphedema

PubMed Central

Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V

2017-01-01

Background: Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. Methods: A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients’ priorities. Results: One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. Conclusion: A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP. PMID:28216723

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

PubMed

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

2012-07-30

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

HALONITROMETHANE DRINKING WATER DISINFECTION BY-PRODUCTS: CHEMICAL CHARACTERIZATION AND MAMMALIAN CELL CYTOTOXICITY AND GENOTOXICITY

EPA Science Inventory

Halonitromethanes are drinking water disinfection by-products that have recently received a high priority for health effects research from the U.S. Environmental Protection Agency. Our purpose was to identify and synthesize where necessary the mixed halonitromethanes and to deter...

Evaluation of data from test application of optical speed bars to highway work zones

DOT National Transportation Integrated Search

2004-08-01

The proximity of traffic and workers in highway work zones demand that safety be a high priority. : The issue of traffic speeds in highway work zones has long been an issue receiving much attention. Over the : past three decades, many different measu...

Three Es for Teachers: Economics, Enterprise and Entrepreneurship

ERIC Educational Resources Information Center

Fagan, Catherine

2006-01-01

Schools in Scotland have recently received a resources boost, from high-profile entrepreneurs working with the Scottish Executive Education Department, to raise the priority of enterprise education in both primary and secondary schools. At the same time, current policy documentation is clear about intentions to develop more entrepreneurs from the…

Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments

PubMed Central

Vigil, Jacob M.; Coulombe, Patrick; Alcock, Joe; Kruger, Eric; Stith, Sarah S.; Strenth, Chance; Parshall, Mark; Cichowski, Sara B.

2016-01-01

Abstract Ethnic minority patients receive lower priority triage assignments in Veteran's Affairs (VA) emergency departments (EDs) compared to White patients, but it is currently unknown whether this disparity arises from generalized biases across the triage assessment process or from differences in how objective and/or subjective institution-level or person-level information is incorporated into the triage assessment process, thus contributing to disparate treatment. The VA database of electronic medical records of patients who presented to the VA ED from 2008 to 2012 was used to measure patient ethnicity, self-reported pain intensity (PI) levels, heart rate (HR), respiratory rate (RR), and nurse-provided triage assignment, the Emergency Severity Index (ESI) score. Multilevel, random effects linear modeling was used to control for demographic and clinical characteristics of patients as well as age, gender, and experience of triage nurses. A total of 359,642 patient/provider encounters between 129,991 VA patients and 774 nurses were included in the study. Patients were 61% non-Hispanic White [NHW], 28% African-American, 7% Hispanic, 2% Asian-American, <1% American Indian/Alaska Native, and 1% mixed ethnicity. After controlling for demographic characteristics of nurses and patients, African-American, Hispanic, and mixed-ethnicity patients reported higher average PI scores but lower HRs and RRs than NHW patients. NHW patients received higher priority ESI ratings with lower PI when compared against African-American patients. NHW patients with low to moderate HRs also received higher priority ESI scoring than African-American, Hispanic, Asian-American, and Mixed-ethnicity patients; however, when HR was high NHWs received lower priority ESI ratings than each of the minority groups (except for African-Americans). This study provides evidence for systemic differences in how patients’ vital signs are applied for determining ESI scores for different ethnic groups. Additional prospective research will be needed to determine how this specific person-level mechanism affects healthcare quality and outcomes. PMID:27057847

Phylogenetic Analysis of Conservation Priorities for Aquatic Mammals and Their Terrestrial Relatives, with a Comparison of Methods

PubMed Central

May-Collado, Laura J.; Agnarsson, Ingi

2011-01-01

Background Habitat loss and overexploitation are among the primary factors threatening populations of many mammal species. Recently, aquatic mammals have been highlighted as particularly vulnerable. Here we test (1) if aquatic mammals emerge as more phylogenetically urgent conservation priorities than their terrestrial relatives, and (2) if high priority species are receiving sufficient conservation effort. We also compare results among some phylogenetic conservation methods. Methodology/Principal Findings A phylogenetic analysis of conservation priorities for all 620 species of Cetartiodactyla and Carnivora, including most aquatic mammals. Conservation priority ranking of aquatic versus terrestrial species is approximately proportional to their diversity. However, nearly all obligated freshwater cetartiodactylans are among the top conservation priority species. Further, ∼74% and 40% of fully aquatic cetartiodactylans and carnivores, respectively, are either threatened or data deficient, more so than their terrestrial relatives. Strikingly, only 3% of all ‘high priority’ species are thought to be stable. An overwhelming 97% of these species thus either show decreasing population trends (87%) or are insufficiently known (10%). Furthermore, a disproportional number of highly evolutionarily distinct species are experiencing population decline, thus, such species should be closely monitored even if not currently threatened. Comparison among methods reveals that exact species ranking differs considerably among methods, nevertheless, most top priority species consistently rank high under any method. While we here favor one approach, we also suggest that a consensus approach may be useful when methods disagree. Conclusions/Significance These results reinforce prior findings, suggesting there is an urgent need to gather basic conservation data for aquatic mammals, and special conservation focus is needed on those confined to freshwater. That evolutionarily distinct—and thus ‘biodiverse’—species are faring relatively poorly is alarming and requires further study. Our results offer a detailed guide to phylogeny-based conservation prioritization for these two orders. PMID:21799899

38 CFR 61.32 - Ranking non-capital grant recipients for per diem.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Availability will be reviewed and grouped in categories according to the funding priorities set forth in the... available, within highest priority funding category if applicable, will be conditionally selected for eligibility to receive per diem payments in accordance with their ranked order. If funding priorities have...

15 CFR 200.110 - Priorities and time of completion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Priorities and time of completion. 200..., SERVICES, PROCEDURES, AND FEES § 200.110 Priorities and time of completion. Schedule work assignments for calibrations and other tests will generally be made in the order in which confirmed requests are received...

An Approach for Casual Drug Users. Technical Paper.

ERIC Educational Resources Information Center

Bloom, Erwin S., Ed.

This publication was written to respond to the fact that many drug treatment centers receive inappropriate referrals of casual or recreational marihuana users from the courts for "treatment" as an alternative to jail. A drug abuse task force recommended that agencies give priority to abusers of the high-risk categories and to compulsive users of…

Colorado: Youth Risk Behavior Survey, 1991.

ERIC Educational Resources Information Center

Colorado Univ. Health Sciences Center, Denver.

In April 1991, the Youth Risk Behavior Survey was administered to a sample of 1,412 high school students in Colorado public schools to collect information about priority health-risk behaviors among adolescents. Questionnaires were received from 1,170 students, a response rate of 83%. Classes in Colorado's 280 public schools were also selected to…

Analysis of Nursing Clinical Decision Support Requests and Strategic Plan in a Large Academic Health System

PubMed Central

Bavuso, Karen; Bouyer-Ferullo, Sharon; Goldsmith, Denise; Fairbanks, Amanda; Gesner, Emily; Lagor, Charles; Collins, Sarah

2016-01-01

Summary Objectives To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs. Materials and Methods We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making. Results A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. “Risk Assessments/Risk Reduction/Promotion of Healthy Habits” (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse. Conclusion Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan. PMID:27437036

Balancing efficiency, equity and feasibility of HIV treatment in South Africa – development of programmatic guidance

PubMed Central

2013-01-01

South Africa, the country with the largest HIV epidemic worldwide, has been scaling up treatment since 2003 and is rapidly expanding its eligibility criteria. The HIV treatment programme has achieved significant results, and had 1.8 million people on treatment per 2011. Despite these achievements, it is now facing major concerns regarding (i) efficiency: alternative treatment policies may save more lives for the same budget; (ii) equity: there are large inequalities in who receives treatment; (iii) feasibility: still only 52% of the eligible population receives treatment. Hence, decisions on the design of the present HIV treatment programme in South Africa can be considered suboptimal. We argue there are two fundamental reasons to this. First, while there is a rapidly growing evidence-base to guide priority setting decisions on HIV treatment, its included studies typically consider only one criterion at a time and thus fail to capture the broad range of values that stakeholders have. Second, priority setting on HIV treatment is a highly political process but it seems no adequate participatory processes are in place to incorporate stakeholders’ views and evidences of all sorts. We propose an alternative approach that provides a better evidence base and outlines a fair policy process to improve priority setting in HIV treatment. The approach integrates two increasingly important frameworks on health care priority setting: accountability for reasonableness (A4R) to foster procedural fairness, and multi-criteria decision analysis (MCDA) to construct an evidence-base on the feasibility, efficiency, and equity of programme options including trade-offs. The approach provides programmatic guidance on the choice of treatment strategies at various decisions levels based on a sound conceptual framework, and holds large potential to improve HIV priority setting in South Africa. PMID:24107435

The Implementation of a Collaborative Action Research Programme for Developing Inclusive Practices: Social Learning in Small Internal Networks

ERIC Educational Resources Information Center

Angelides, Panayiotis; Georgiou, Renos; Kyriakou, Kyriaki

2008-01-01

The idea of inclusive education has featured very highly in the educational priorities of many educational systems. However, the same educational systems are very often criticised because of the difficulties of their teachers to respond to inclusive environments of learning, where all children, despite their abilities, receive equal opportunities…

The Impact of Candid Versus Legally Defensible Language on the Persuasiveness of Environmental Self-Assessments.

ERIC Educational Resources Information Center

Clark, Thomas

1998-01-01

Finds that managers were more likely to recommend that environmental remediation proposals receive priority for funding when they read proposals written in candid language than when they read proposals written in legally defensible language. Shows that threats and a negative tone are highly persuasive in internal environmental compliance reports.…

75 FR 5824 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

.... Those public customers who continue to receive priority in the execution algorithm are called Priority... standard execution algorithm: \\3\\ Securities Exchange Act Release No. 59287 (January 23, 2009), 74 FR 5694...

National Rules for Drug–Drug Interactions: Are They Appropriate for Tertiary Hospitals?

PubMed Central

2016-01-01

The application of appropriate rules for drug–drug interactions (DDIs) could substantially reduce the number of adverse drug events. However, current implementations of such rules in tertiary hospitals are problematic as physicians are receiving too many alerts, causing high override rates and alert fatigue. We investigated the potential impact of Korean national DDI rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Using lists of high-priority DDIs developed with the support of the U.S. government, we evaluated 706 contraindicated DDI pairs released in May 2015. We evaluated clinical log data from one tertiary hospital and prescription data from two other tertiary hospitals. The measured parameters were national DDI rule coverage for high-priority DDIs, alert override rate, and number of prescription pairs. The coverage rates of national DDI rules were 80% and 3.0% at the class and drug levels, respectively. The analysis of the system log data showed an overall override rate of 79.6%. Only 0.3% of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5%, which was much lower than for the overall DDI rules. We also found 342 and 80 unmatched high-priority DDI pairs which were absent in national rules in inpatient orders from the other two hospitals. The national DDI rules are not complete in terms of their coverage of severe DDIs. They also lack clinical efficiency in tertiary settings, suggesting improved systematic approaches are needed. PMID:27822925

Exploring end of life priorities in Saudi males: usefulness of Q-methodology.

PubMed

Hammami, Muhammad M; Al Gaai, Eman; Hammami, Safa; Attala, Sahar

2015-11-26

Quality end-of-life care depends on understanding patients' end-of-life choices. Individuals and cultures may hold end-of-life priorities at different hierarchy. Forced ranking rather than independent rating, and by-person factor analysis rather than averaging may reveal otherwise masked typologies. We explored Saudi males' forced-ranked, end-of-life priorities and dis-priorities. Respondents (n = 120) rank-ordered 47 opinion statements on end-of-life care following a 9-category symmetrical distribution. Statements' scores were analyzed by averaging analysis and factor analysis (Q-methodology). Respondents' mean age was 32.1 years (range, 18-65); 52% reported average religiosity, 88 and 83% ≥ very good health and life-quality, respectively, and 100% ≥ high school education. Averaging analysis revealed that the extreme five end-of-life priorities were to, be at peace with God, be able to say the statement of faith, maintain dignity, resolve conflicts, and have religious death rituals respected, respectively. The extreme five dis-priorities were to, die in the hospital, not receive intensive care if in coma, die at peak of life, be informed about impending death by family/friends rather than doctor, and keep medical status confidential from family/friends, respectively. Q-methodology classified 67% of respondents into five highly transcendent opinion types. Type-I (rituals-averse, family-caring, monitoring-coping, life-quality-concerned) and Type-V (rituals-apt, family-centered, neutral-coping, life-quantity-concerned) reported the lowest and highest religiosity, respectively. Type-II (rituals-apt, family-dependent, monitoring-coping, life-quantity-concerned) and Type-III (rituals-silent, self/family-neutral, avoidance-coping, life-quality & quantity-concerned) reported the best and worst life-quality, respectively. Type-I respondents were the oldest with the lowest general health, in contrast to Type-IV (rituals-apt, self-centered, monitoring-coping, life-quality/quantity-neutral). Of the extreme 14 priorities/dis-priorities for the five types, 29, 14, 14, 50, and 36%, respectively, were not among the extreme 20 priorities/dis-priorities identified by averaging analysis for the entire cohort. 1) Transcendence was the extreme end-of-life priority, and dying in the hospital was the extreme dis-priority. 2) Quality of life was conceptualized differently with less emphasize on its physiological aspects. 3) Disclosure of terminal illness to family/close friends was preferred as long it is through the patient. 4) Q-methodology identified five types of constellations of end-of-life priorities and dis-priorities that may be related to respondents' demographics and are partially masked by averaging analysis.

29 CFR 1990.122 - Response to petitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Priority Setting § 1990.122 Response to petitions. Whenever the Secretary receives any information submitted in... publishing the Candidate List and Priority Lists and to reconsider the criteria used in establishing the...

System and Method for Network Bandwidth, Buffers and Timing Management Using Hybrid Scheduling of Traffic with Different Priorities and Guarantees

NASA Technical Reports Server (NTRS)

Bonk, Ted (Inventor); Hall, Brendan (Inventor); Smithgall, William Todd (Inventor); Varadarajan, Srivatsan (Inventor); DeLay, Benjamin F. (Inventor)

2017-01-01

Systems and methods for network bandwidth, buffers and timing management using hybrid scheduling of traffic with different priorities and guarantees are provided. In certain embodiments, a method of managing network scheduling and configuration comprises, for each transmitting end station, reserving one exclusive buffer for each virtual link to be transmitted from the transmitting end station; for each receiving end station, reserving exclusive buffers for each virtual link to be received at the receiving end station; and for each switch, reserving a exclusive buffer for each virtual link to be received at an input port of the switch. The method further comprises determining if each respective transmitting end station, receiving end station, and switch has sufficient capability to support the reserved buffers; and reporting buffer infeasibility if each respective transmitting end station, receiving end station, and switch does not have sufficient capability to support the reserved buffers.

Threatened species and the potential loss of phylogenetic diversity: conservation scenarios based on estimated extinction probabilities and phylogenetic risk analysis.

PubMed

Faith, Daniel P

2008-12-01

New species conservation strategies, including the EDGE of Existence (EDGE) program, have expanded threatened species assessments by integrating information about species' phylogenetic distinctiveness. Distinctiveness has been measured through simple scores that assign shared credit among species for evolutionary heritage represented by the deeper phylogenetic branches. A species with a high score combined with a high extinction probability receives high priority for conservation efforts. Simple hypothetical scenarios for phylogenetic trees and extinction probabilities demonstrate how such scoring approaches can provide inefficient priorities for conservation. An existing probabilistic framework derived from the phylogenetic diversity measure (PD) properly captures the idea of shared responsibility for the persistence of evolutionary history. It avoids static scores, takes into account the status of close relatives through their extinction probabilities, and allows for the necessary updating of priorities in light of changes in species threat status. A hypothetical phylogenetic tree illustrates how changes in extinction probabilities of one or more species translate into changes in expected PD. The probabilistic PD framework provided a range of strategies that moved beyond expected PD to better consider worst-case PD losses. In another example, risk aversion gave higher priority to a conservation program that provided a smaller, but less risky, gain in expected PD. The EDGE program could continue to promote a list of top species conservation priorities through application of probabilistic PD and simple estimates of current extinction probability. The list might be a dynamic one, with all the priority scores updated as extinction probabilities change. Results of recent studies suggest that estimation of extinction probabilities derived from the red list criteria linked to changes in species range sizes may provide estimated probabilities for many different species. Probabilistic PD provides a framework for single-species assessment that is well-integrated with a broader measurement of impacts on PD owing to climate change and other factors.

Survey of Laboratories and Implementation of the Federal Defense Laboratory Diversification Program. Annex B. Department of the Navy Domestic Technology Transfer

DTIC Science & Technology

1993-10-01

received on a periodic basis that is the equivalent of a royalty. By that CRADA, a hybridoma producing an antibody useful in analytic...played an active role are: ( a ) The Annual High Tech Conference for Small Business sponsored by the New Jersey Commission on Science and Technology. 39...legally required. The new administration has made DTT a high priority, resulting in an increase in DTT

Priority Questions and Horizon Scanning for Conservation: A Comparative Study

PubMed Central

Kark, Salit; Sutherland, William J.; Shanas, Uri; Klass, Keren; Achisar, Hila; Dayan, Tamar; Gavrieli, Yael; Justo-Hanani, Ronit; Mandelik, Yael; Orion, Nir; Pargament, David; Portman, Michelle; Reisman-Berman, Orna; Safriel, Uriel N.; Schaffer, Gad; Steiner, Noa; Tauber, Israel; Levin, Noam

2016-01-01

Several projects aimed at identifying priority issues for conservation with high relevance to policy have recently been completed in several countries. Two major types of projects have been undertaken, aimed at identifying (i) policy-relevant questions most imperative to conservation and (ii) horizon scanning topics, defined as emerging issues that are expected to have substantial implications for biodiversity conservation and policy in the future. Here, we provide the first overview of the outcomes of biodiversity and conservation-oriented projects recently completed around the world using this framework. We also include the results of the first questions and horizon scanning project completed for a Mediterranean country. Overall, the outcomes of the different projects undertaken (at the global scale, in the UK, US, Canada, Switzerland and in Israel) were strongly correlated in terms of the proportion of questions and/or horizon scanning topics selected when comparing different topic areas. However, some major differences were found across regions. There was large variation among regions in the percentage of proactive (i.e. action and response oriented) versus descriptive (non-response oriented) priority questions and in the emphasis given to socio-political issues. Substantial differences were also found when comparing outcomes of priority questions versus horizon scanning projects undertaken for the same region. For example, issues related to climate change, human demography and marine ecosystems received higher priority as horizon scanning topics, while ecosystem services were more emphasized as current priority questions. We suggest that future initiatives aimed at identifying priority conservation questions and horizon scanning topics should allow simultaneous identification of both current and future priority issues, as presented here for the first time. We propose that further emphasis on social-political issues should be explicitly integrated into future related projects. PMID:26815653

National Communications System: Ensuring Essential Communications for the Homeland

DTIC Science & Technology

2002-01-01

EP calls receive priority in the Signaling System 7 ( SS7 ) networks that manage calls in the carrier trunk networks. In 1993, the American National...the application of available GETS features. In 1996, ANSI modified the SS7 standards so that NS/EP traffic would have a higher signaling priority...facilitate industry migration to the standard related to SS7 message priority. GETS representatives worked with the GETS interexchange and local

Randomized, Controlled Trial of CBT Training for PTSD Providers

DTIC Science & Technology

2015-10-01

design, implement and evaluate a cost effective, web based self paced training program to provide skills-oriented continuing education for mental...but has received little systematic evaluation to date. Noting the urgency and high priority of this issue, Fairburn and Cooper (2011) have... evaluate scalable and cost-effective new methods for training of mental health clinicians providing treatment services to veterans with PTSD. The

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

M. Ono; Jaworski, M.; Kaita, R.

Developing a reactor compatible divertor and managing the associated plasma material interaction (PMI) has been identified as a high priority research area for magnetic confinement fusion. Accordingly on NSTX-U, the PMI research has received a strong emphasis. Moreover, with ˜15 MW of auxiliary heating power, NSTX-U will be able to test the PMI physics with the peak divertor plasma facing component (PFC) heat loads of up to 40-60 MW/m 2.

Generation of national political priority for surgery: a qualitative case study of three low-income and middle-income countries.

PubMed

Dare, Anna J; Bleicher, Josh; Lee, Katherine C; Elobu, Alex E; Kamara, Thaim B; Liko, Osborne; Luboga, Samuel; Danlop, Akule; Kune, Gabriel; Hagander, Lars; Leather, Andrew J M; Yamey, Gavin

2015-04-27

Surgical conditions exert a major health burden in low-income and middle-income countries (LMICs), yet surgery remains a low priority on national health agendas. Little is known about the national factors that influence whether surgery is prioritised in LMICs. We investigated factors that could facilitate or prevent surgery from being a health priority in three LMICs. We undertook three country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. In total 72 semi-structured interviews were conducted between March and June, 2014, in the three countries. Interviews were designed to query informants' attitudes, values, and beliefs about how and why different health issues, including surgical care, were prioritised within their country. Informants were providers, policy makers, civil society, funders, and other stakeholders involved with health agenda setting and surgical care. Interviews were analysed with Dedoose, a qualitative data analysis tool. Themes were organised into a conceptual framework adapted from Shiffman and Smith to assess the factors that affected whether surgery was prioritised. In all three countries, effective political and surgical leadership, access to country-specific surgical disease indicators, and higher domestic health expenditures are facilitating factors that promote surgical care on national health agendas. Competing health and policy interests and poor framing of the need for surgery prevent the issue from receiving more attention. In Papua New Guinea, surgical care is a moderate-to-high health priority. Surgical care is embedded in the national health plan and there are influential leaders with surgical interests. Surgical care is a low-to-moderate health priority in Uganda. Ineffectively used policy windows and little national data on surgical disease have impeded efforts to increase priority for surgery. Surgical care remains a low health priority in Sierra Leone. Resource constraints and competing health priorities, such as infectious disease challenges, prevent surgery from receiving attention. Priority for surgery on national health agendas varies across LMICs. Increasing dialogue between surgical providers and political leaders can increase the power of actors who advocate for surgical care. Greater emphasis on the importance of surgical care in achieving national health goals can strengthen internal and external framing of the issue. Growing political recognition of non-communicable diseases provides a favourable political context to increase attention for surgery. Lastly, increasing internally generated issue characteristics, such as improved tracking of national surgical indicators, could increase the priority given to surgery within LMICs. The Bill & Melinda Gates Foundation, King's Health Partners/King's College London, and Lund University. Copyright © 2015 Elsevier Ltd. All rights reserved.

75 FR 47798 - Office of Special Education and Rehabilitative Services-Special Demonstration Programs-Model...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... Security Disability Insurance (SSDI) Served by State Vocational Rehabilitation (VR) Agencies AGENCY: Office... vocational rehabilitation (VR) agencies. The Assistant Secretary may use this priority for competitions in... beneficiaries receiving services from State VR agencies. DATES: Effective Date: This priority is effective...

Feasibility Study on High Concentrating Photovoltaic Power Towers

NASA Astrophysics Data System (ADS)

Frohberger, Dirk; Jaus, Joachim; Wiesenfarth, Maike; Schramek, Philipp; Bett, Andreas W.

2010-10-01

This paper presents an analysis on the concept of high concentrating PV power towers. A feasibility study is conducted in order to evaluate the future potential of this technology. Objective of the analysis is to provide an improved basis for establishing research and development priorities for the PV power tower concept. Performance assessments and cost calculations for a 1 MW prototype PV tower power are derived. Based on the assumption of a highly homogeneously illuminated receiver, levelized costs of electricity of 0.29 €/kWh have been calculated for a prototype PV tower power.

Sexual Violence in America: Public Funding and Social Priority.

PubMed

Waechter, Randall; Ma, Van

2015-12-01

We compared lifetime risk, annual incidence, and annual economic burden of sexual violence with other major public health issues in the United States: cardiovascular disease, cancer, diabetes, and HIV/AIDS. With public funding data from 2013, we examined how much public funding is allocated to these public health issues as a proxy of the social priority of addressing each of them. Although sexual violence is as prevalent as and more costly than are these other major public health issues, it receives a fraction of the public funds that they receive.

Eliminating livelock by assigning the same priority state to each message that is input into a flushable routing system during N time intervals

DOEpatents

Faber, V.

1994-11-29

Livelock-free message routing is provided in a network of interconnected nodes that is flushable in time T. An input message processor generates sequences of at least N time intervals, each of duration T. An input register provides for receiving and holding each input message, where the message is assigned a priority state p during an nth one of the N time intervals. At each of the network nodes a message processor reads the assigned priority state and awards priority to messages with priority state (p-1) during an nth time interval and to messages with priority state p during an (n+1) th time interval. The messages that are awarded priority are output on an output path toward the addressed output message processor. Thus, no message remains in the network for a time longer than T. 4 figures.

Eliminating livelock by assigning the same priority state to each message that is inputted into a flushable routing system during N time intervals

DOEpatents

Faber, Vance

1994-01-01

Livelock-free message routing is provided in a network of interconnected nodes that is flushable in time T. An input message processor generates sequences of at least N time intervals, each of duration T. An input register provides for receiving and holding each input message, where the message is assigned a priority state p during an nth one of the N time intervals. At each of the network nodes a message processor reads the assigned priority state and awards priority to messages with priority state (p-1) during an nth time interval and to messages with priority state p during an (n+1) th time interval. The messages that are awarded priority are output on an output path toward the addressed output message processor. Thus, no message remains in the network for a time longer than T.

Sustaining Changes that Support Student Success in Community College

ERIC Educational Resources Information Center

Burdman, Pamela

2009-01-01

Because of the increasingly prominent role of foundations in supporting improved opportunities for community college students, it may be helpful to understand how foundations set priorities and make decisions. Some foundations engage in responsive grant making, whereby they outline priority areas and then respond to proposals received from the…

Local allocation of lung donors results in transplanting lungs in lower priority transplant recipients.

PubMed

Russo, Mark J; Meltzer, David; Merlo, Aurelie; Johnson, Elizabeth; Shariati, Nazly M; Sonett, Joshua R; Gibbons, Robert

2013-04-01

Under the current lung allocation system, if organs are accepted for a candidate within the local donor service area (DSA), they are never offered to candidates at the broader regional level who are potentially more severely ill, even if the nonlocal candidate has a higher lung allocation score (LAS). The purpose of this study was to determine the frequency with which organs were allocated to a local lung recipient while a blood group-matched and size-matched candidate with a higher LAS existed in the same region. United Network for Organ Sharing (UNOS) provided deidentified patient-level data. The study population included all locally allocated organs for double-lung transplants (DLTs) performed in 2009 in the United States (n=580). All occurrences of an ABO blood group-matched, height-matched (±10 cm), double-lung candidate in the same region, with a higher LAS than the local candidate who actually received the organs, were calculated; these occurrences were termed events. In 2009, 3,454 events occurred when a local DLT recipient candidate received a DLT while a DLT candidate in the same region had a higher LAS. With a mean of 5.96 events per transplant, this impacted 480 (82.8%) of the 580 DLTs. Further, 555 (16.1%) of these events involved 1 (or more) of the 185 regional candidates who ultimately did not receive transplants and died while on the waiting list. This analysis suggests that the locally based lung allocation system results in a high frequency of events whereby an organ is allocated to a lower-priority candidate while an appropriately matched higher priority candidate exists regionally. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Total knee arthroplasty: good agreement of clinical severity scores between patients and consultants.

PubMed

Ebinesan, Ananthan D; Sarai, Bhupinder S; Walley, Gayle; Bridgman, Stephen; Maffulli, Nicola

2006-07-31

Nearly 20,000 patients per year in the UK receive total knee arthroplasty (TKA). One of the problems faced by the health services of many developed countries is the length of time patients spend waiting for elective treatment. We therefore report the results of a study in which the Salisbury Priority Scoring System (SPSS) was used by both the surgeon and their patients to ascertain whether there were differences between the surgeon generated and patient generated Salisbury Priority Scores. The Salisbury Priority Scoring System (SPSS) was used to assign relative priority to patients with knee osteoarthritis as part of a randomised controlled trial comparing the standard medial parapatellar approach versus the sub-vastus approach in TKA. The operating surgeons and each patient completed the SPSS at the same pre-assessment clinic. The SPSS assesses four criteria, namely progression of disease, pain or distress, disability or dependence on others, and loss of usual occupation. Crosstabs and agreement measures (Cohen's kappa) were performed. Overall, the four SPSS criteria showed a kappa value of 0.526, 0.796, 0.813, and 0.820, respectively, showing moderate to very good agreement between the patient and the operating consultant. Male patients showed better agreement than female patients. The Salisbury Priority Scoring System is a good means of assessing patients' needs in relation to elective surgery, with high agreement between the patient and the operating surgeon.

Discrimination and Health among Lesbian, Gay, Bisexual and Trans People in Puerto Rico.

PubMed

Rodríguez-Díaz, Carlos E; Jovet-Toledo, Gerardo G; Vélez-Vega, Carmen M; Ortiz-Sánchez, Edgardo J; Santiago-Rodríguez, Edda I; Vargas-Molina, Ricardo L; Rodríguez Madera, Sheilla L; Mulinelli-Rodríguez, José J

2016-09-01

To identify the experiences of discrimination among and the perceived priorities for the health of lesbian, gay, bisexual, and trans (LGBT) people in Puerto Rico (PR). Data were collected during the 2013 LGBT Pride Parade in San Juan, using a brief self-administered survey that included questions on sociodemographic characteristics, the disclosure of sexual orientation/gender identity, experiences of discrimination, experiences while receiving social and health services, and perceived healthcare priorities and needs. Most participants reported that they had disclosed their sexual orientation to at least one person. Discrimination due to sexual orientation/gender identity was most frequently reported to have occurred in school settings. At least 25% of the sample reported regular or negative experiences based on sexual orientation/gender identity when receiving government services and when looking for support from relatives. HIV/AIDS, mental health, and sexual health were identified as healthcare priorities. In bivariate analyses, mental health services and aging were the priorities most frequently reported among older participants. HIV/AIDS was the main priority only for gay men; sexual health was the main priority for bisexuals; and mental health was the main priority for lesbians. Most participants reported that their preferred modalities for health service provision were support groups and health education. The experiences of discrimination among LGBT people in PR were consistent across age groups and sexual orientation/gender identity. Policies and interventions to address discrimination in different settings are necessary. The findings also suggest the need to prioritize HIV services among gay men and to address mental and sexual health needs among lesbian and bisexual people.

Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists.

PubMed

Hand, Kieran S; Cumming, Debbie; Hopkins, Susan; Ewings, Sean; Fox, Andy; Theminimulle, Sandya; Porter, Robert J; Parker, Natalie; Munns, Joanne; Sheikh, Adel; Keyser, Taryn; Puleston, Richard

2017-04-01

The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. A questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann-Whitney U -test. Responses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). Of the pharmacists, 59% had experience of EPMA in their hospitals compared with 35% of microbiologists. Pharmacists assigned higher priority to indication prompt ( P  <   0.001), allergy checker ( P  =   0.003), treatment protocols ( P  =   0.003), drug-indication mismatch alerts ( P  =   0.031) and prolonged course alerts ( P  =   0.041) and lower priority to a dose checker for adults ( P  =   0.02) and an interaction checker ( P  <   0.05) than microbiologists. A 'soft stop' functionality was rated essential or high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection, antimicrobial resistance and drug expenditure. The survey demonstrates key differences in health professionals' opinions of potential healthcare benefits of EPMA, but a consensus of anticipated positive impact on patient safety and AMS. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Priority arbitration mechanism

DOEpatents

Garmire, Derrick L [Kingston, NY; Herring, Jay R [Poughkeepsie, NY; Stunkel, Craig B [Bethel, CT

2007-03-06

A method is provided for selecting a data source for transmission on one of several logical (virtual) lanes embodied in a single physical connection. Lanes are assigned to either a high priority class or to a low priority class. One of six conditions is employed to determine when re-arbitration of lane priorities is desired. When this occurs a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent after a lower priority transmission has been interrupted. Alternatively, a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent while a lower priority packet is waiting. If initialized correctly, the arbiter keeps all of the packets of a high priority packet contiguous, while allowing lower priority packets to be interrupted by the higher priority packets, but not to the point of starvation of the lower priority packets.

Establishing and agreeing on research priorities

Treesearch

Ian de Ia Roche

1999-01-01

The organizers asked me to share with you my experiences in developing and implementing a process for establishing and agreeing on research priorities in a multi-stakeholder research institute such as Forintek. The mechanism we have in place has been well received by Forintek's membership and certain aspects have been adopted by other research organizations. While...

47 CFR Appendix A to Part 64 - Telecommunications Service Priority (TSP) System for National Security Emergency Preparedness (NSEP)

Code of Federal Regulations, 2014 CFR

2014-10-01

..., emission, or reception of signals, signs, writing, images, sounds, or intelligence of any nature, by wire... System which includes: (a) Receiving, processing, and evaluating requests for priority actions from... doubt. However, processing of Emergency NSEP service requests will not be delayed for verification...

47 CFR Appendix A to Part 64 - Telecommunications Service Priority (TSP) System for National Security Emergency Preparedness (NSEP)

Code of Federal Regulations, 2012 CFR

2012-10-01

..., emission, or reception of signals, signs, writing, images, sounds, or intelligence of any nature, by wire... System which includes: (a) Receiving, processing, and evaluating requests for priority actions from... doubt. However, processing of Emergency NSEP service requests will not be delayed for verification...

77 FR 2287 - FFP Project 17, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... drawing to determine the filing priority of the applicants identified in this notice. The Commission will... priority established by this drawing will be used to determine which applicant, among those with identical...

77 FR 2289 - FFP Project 41, LLC, Northland Power Mississippi River LLC; Notice Announcing Preliminary Permit...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Permit Drawing The Commission has received two preliminary permit applications deemed filed on February 1... drawing to determine the filing priority of the applicants identified in this notice. The Commission will... priority established by this drawing will be used to determine which applicant, among those with identical...

77 FR 2287 - FFP Project 32, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... drawing to determine the filing priority of the applicants identified in this notice. The Commission will... priority established by this drawing will be used to determine which applicant, among those with identical...

77 FR 2287 - FFP Project 40, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011..., or her designee, will conduct a random drawing to determine the filing priority of the applicants... section 4.37 of its regulations.\\2\\ The priority established by [[Page 2288

77 FR 2289 - FFP Project 39, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... drawing to determine the filing priority of the applicants identified in this notice. The Commission will... priority established by this drawing will be used to determine which applicant, among those with identical...

77 FR 2288 - Free Flow Power Corporation and Northland Power Mississippi River LLC; Notice Announcing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Permit Drawing The Commission has received two preliminary permit applications deemed filed on February 1... conduct a random drawing to determine the filing priority of the applicants identified in this notice. The...\\ The priority established by this drawing will be used to determine which applicant, among those with...

77 FR 2288 - FFP Project 21, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... drawing to determine the filing priority of the applicants identified in this notice. The Commission will... priority established by this drawing will be used to determine which applicant, among those with identical...

77 FR 2290 - FFP Project 30, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... drawing to determine the filing priority of the applicants identified in this notice. The Commission will... priority established by this drawing will be used to determine which applicant, among those with identical...

Understanding public preferences for prioritizing health care interventions in England: does the type of health gain matter?

PubMed

Mason, Helen; Baker, Rachel; Donaldson, Cam

2011-04-01

Health care budgets are finite and decisions must be made about which interventions to provide and, by implication, which will not be provided. The aim of this study was to investigate what features of health care interventions, including the type of health gain, are important to members of the public in England in making priority-setting decisions and to understand why. Q methodology was used with 52 members of the public in north east England. Respondents rank ordered 36 health care interventions from those they would give highest priority to through to those they would give lowest priority to. A form of factor analysis was used to reveal a small number of shared viewpoints. Five factors emerged: 'life saving to maximize the size of the health gain', 'everyone deserves a chance at life', '(potential for) own benefit', 'maximum benefit for (perceived) lowest cost' and 'quality of life and social responsibility'. There were different views about which interventions should be given priority. Respondents considered not only the type of health gain received from an intervention as important, but also the size of the health gain, who received the health gain and an individual's personal responsibility. Aspects other than health gain need to be considered when soliciting the public's views of priorities for health care interventions.

Priorities of Legislatively-Active Veteran Services Organizations: A Content Analysis and Review for Health Promotion Initiatives

PubMed Central

Jahnke, Sara A.; Haddock, Christopher K.; Carlos Poston, Walker S.; Jitnarin, Nattinee

2014-01-01

Military and Veterans Service Organizations (MVSOs) have a unique opportunity to influence legislation and advocate for the interests of their members. However, little is known about what legislative priorities MVSOs see as important. Understanding the legislative priorities of MVSOs can inform efforts by health scientists to promote policy and laws designed to improve the health of our nation’s veterans. Using a mixed methods approach, we conducted a thematic analysis of legislative priorities MVSOs promote with their legislative agendas. Most commonly, MVSOs addressed issues related to disability evaluations and ratings with the Veterans Administration (VA) and access to VA services. Other common themes identified as priorities include benefits such as retirement, education, housing assistance for veterans, and TRICARE benefits. Findings highlight the broad range of topics MVSOs identify as legislative priorities as well as some health issues that receive relatively limited attention. PMID:25373063

Setting priorities for reducing risk and advancing patient safety.

PubMed

Gaffey, Ann D

2016-04-01

We set priorities every day in both our personal and professional lives. Some decisions are easy, while others require much more thought, participation, and resources. The difficult or less appealing priorities may not be popular, may receive push-back, and may be resource intensive. Whether personal or professional, the urgency that accompanies true priorities becomes a driving force. It is that urgency to ensure our patients' safety that brings many of us to work each day. This is not easy work. It requires us to be knowledgeable about the enterprise we are working in and to have the professional skills and competence to facilitate setting the priorities that allow our organizations to minimize risk and maximize value. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

24 CFR 248.157 - Voluntary sale of housing not in excess of Federal cost limit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... costs; (5) Receive a distribution equal to an 8 percent annual return on any actual cash investment made... by a priority purchaser seeking to make an offer during either 6-month priority purchaser marketing...-based nonprofit and the offer is submitted within the marketing period established in paragraph (c)(1...

78 FR 6155 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... directed order flow to the Exchange. RMMs are not eligible to receive Directed Orders and therefore will... Priority Customer Accounts There will be no transaction fees assessed to EEMs entering orders for the account(s) of Priority Customers.\\10\\ Similarly, NYSEAmex and PHLX do not charge transaction fees for non...

77 FR 2288 - FFP Project 7, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... conduct a random drawing to determine the filing priority of the applicants identified in this notice. The...\\ The priority established by this drawing will be used to determine which applicant, among those with...

77 FR 2289 - FFP Project 33, LLC and Northland Power Mississippi River LLC; Notice Announcing Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Drawing The Commission has received two preliminary permit applications deemed filed on February 1, 2011... conduct a random drawing to determine the filing priority of the applicants identified in this notice. The...\\ The priority established by this drawing will be used to determine which applicant, among those with...

78 FR 35001 - Applications for New Awards; Charter Schools Program (CSP) Grants to Non-State Educational Agency...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... applications (NIA) announces competitions for two different grants: (1) Planning, Program Design, and Initial... on how well the application meets Competitive Preference Priority 1, up to an additional two points... respond to one, two, or three of the priority areas but, in order to receive the maximum available points...

Defining conservation priorities for freshwater fishes according to taxonomic, functional, and phylogenetic diversity

USGS Publications Warehouse

Strecker, A.L.; Olden, J.D.; Whittier, Joanna B.; Paukert, C.P.

2011-01-01

To date, the predominant use of systematic conservation planning has been to evaluate and conserve areas of high terrestrial biodiversity. Although studies in freshwater ecosystems have received recent attention, research has rarely considered the potential tradeoffs between protecting different dimensions of biodiversity and the ecological processes that maintain diversity. We provide the first systematic prioritization for freshwaters (focusing on the highly threatened and globally distinct fish fauna of the Lower Colorado River Basin, USA) simultaneously considering scenarios of: taxonomic, functional, and phylogenetic diversity;contemporary threats to biodiversity (including interactions with nonnative species);and future climate change and human population growth. There was 75% congruence between areas of highest conservation priority for different aspects of biodiversity, suggesting that conservation efforts can concurrently achieve strong complementarity among all types of diversity. However, sizable fractions of the landscape were incongruent across conservation priorities for different diversity scenarios, underscoring the importance of considering multiple dimensions of biodiversity and highlighting catchments that contribute disproportionately to taxonomic, functional, and phylogenetic diversity in the region. Regions of projected human population growth were not concordant with conservation priorities;however, higher human population abundance will likely have indirect effects on native biodiversity by increasing demand for water. This will come in direct conflict with projected reductions in precipitation and warmer temperatures, which have substantial overlap with regions of high contemporary diversity. Native and endemic fishes in arid ecosystems are critically endangered by both current and future threats, but our results highlight the use of systematic conservation planning for the optimal allocation of limited resources that incorporates multiple and complementary conservation values describing taxonomic, functional, and phylogenetic diversity. ??2011 by the Ecological Society of America.

Defining conservation priorities for freshwater fishes according to taxonomic, functional, and phylogenetic diversity

USGS Publications Warehouse

Strecker, Angela L.; Olden, Julian D.; Whittier, Joanna B.; Paukert, Craig P.

2011-01-01

To date, the predominant use of systematic conservation planning has been to evaluate and conserve areas of high terrestrial biodiversity. Although studies in freshwater ecosystems have received recent attention, research has rarely considered the potential trade-offs between protecting different dimensions of biodiversity and the ecological processes that maintain diversity. We provide the first systematic prioritization for freshwaters (focusing on the highly threatened and globally distinct fish fauna of the Lower Colorado River Basin, USA) simultaneously considering scenarios of: taxonomic, functional, and phylogenetic diversity; contemporary threats to biodiversity (including interactions with nonnative species); and future climate change and human population growth. There was 75% congruence between areas of highest conservation priority for different aspects of biodiversity, suggesting that conservation efforts can concurrently achieve strong complementarity among all types of diversity. However, sizable fractions of the landscape were incongruent across conservation priorities for different diversity scenarios, underscoring the importance of considering multiple dimensions of biodiversity and highlighting catchments that contribute disproportionately to taxonomic, functional, and phylogenetic diversity in the region. Regions of projected human population growth were not concordant with conservation priorities; however, higher human population abundance will likely have indirect effects on native biodiversity by increasing demand for water. This will come in direct conflict with projected reductions in precipitation and warmer temperatures, which have substantial overlap with regions of high contemporary diversity. Native and endemic fishes in arid ecosystems are critically endangered by both current and future threats, but our results highlight the use of systematic conservation planning for the optimal allocation of limited resources that incorporates multiple and complementary conservation values describing taxonomic, functional, and phylogenetic diversity.

There's Waldo! A Normalization Model of Visual Search Predicts Single-Trial Human Fixations in an Object Search Task

PubMed Central

Miconi, Thomas; Groomes, Laura; Kreiman, Gabriel

2016-01-01

When searching for an object in a scene, how does the brain decide where to look next? Visual search theories suggest the existence of a global “priority map” that integrates bottom-up visual information with top-down, target-specific signals. We propose a mechanistic model of visual search that is consistent with recent neurophysiological evidence, can localize targets in cluttered images, and predicts single-trial behavior in a search task. This model posits that a high-level retinotopic area selective for shape features receives global, target-specific modulation and implements local normalization through divisive inhibition. The normalization step is critical to prevent highly salient bottom-up features from monopolizing attention. The resulting activity pattern constitues a priority map that tracks the correlation between local input and target features. The maximum of this priority map is selected as the locus of attention. The visual input is then spatially enhanced around the selected location, allowing object-selective visual areas to determine whether the target is present at this location. This model can localize objects both in array images and when objects are pasted in natural scenes. The model can also predict single-trial human fixations, including those in error and target-absent trials, in a search task involving complex objects. PMID:26092221

Decision-making process of patients with gynecological cancer regarding their cancer treatment choices using the analytic hierarchy process.

PubMed

Kitamura, Yuko

2010-12-01

In order to support patients' decision-making regarding cancer treatments, it is important to clarify which criteria that cancer patients use to set priorities in their treatment choices. Using the analytic hierarchy process (AHP), a mathematical decision-making method, this article investigates the criteria and the priorities of patients with gynecological cancer. In the AHP, multiple and hierarchical criteria in the decision-making process were organized by a repeated pairwise judgment of the participants so as to serialize the alternatives along with the rational order of the priorities. For the alternatives "to receive treatment" and "to not receive treatment," the following five criteria were set: "anxiety about relapse and metastasis", "distress about side-effects", "advice of family", "advice of medical staff", and "economic burden". The participants determined a pairwise priority scale, as well as a priority scale between the alternatives for every criterion. The logical consistency of their answers was checked by a consistency index (CI). The participants were 31 patients with ovarian or endometrial cancer who were being followed up after undergoing surgery and adjuvant chemotherapy. Of the participants who answered the questionnaire, 17 satisfied the logical consistency. Of the five criteria for the treatment choices, "anxiety about relapse and metastasis" and "advice of medical staff" were found to be the important factors for treatment choice; however, the weight attached to the priority criteria differed much among the patients. The AHP made it possible to support patients' decision-making in order to clarify their priority criteria and to quantitatively present their decision-making process. © 2010 The Author. Journal compilation © 2010 Japan Academy of Nursing Science.

Stormwater Retention Ponds and Constructed Wetlands Research at NRMRL’s Urban Watershed Research Facility

EPA Science Inventory

Microorganisms are priority stressors to receiving water bodies. Practitioners often consider structural stormwater management practices as effective tools to mitigate stormwater-carried bacteria before reaching receiving waters. The performance of these controls for microbial ...

12 CFR 627.2752 - Priority of claims-other Farm Credit institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... wages and salaries, including vacation pay, earned prior to the appointment of the receiver by an... engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the appointment of the receiver, up to a maximum of three...

Setting priorities for research in medical nutrition education: an international approach.

PubMed

Ball, Lauren; Barnes, Katelyn; Laur, Celia; Crowley, Jennifer; Ray, Sumantra

2016-12-14

To identify the research priorities for medical nutrition education worldwide. A 5-step stakeholder engagement process based on methodological guidelines for identifying research priorities in health. 277 individuals were identified as representatives for 30 different stakeholder organisations across 86 countries. The stakeholder organisations represented the views of medical educators, medical students, doctors, patients and researchers in medical education. Each stakeholder representative was asked to provide up to three research questions that should be deemed as a priority for medical nutrition education. Research questions were critically appraised for answerability, sustainability, effectiveness, potential for translation and potential to impact on disease burden. A blinded scoring system was used to rank the appraised questions, with higher scores indicating higher priority (range of scores possible 36-108). 37 submissions were received, of which 25 were unique research questions. Submitted questions received a range of scores from 62 to 106 points. The highest scoring questions focused on (1) increasing the confidence of medical students and doctors in providing nutrition care to patients, (2) clarifying the essential nutrition skills doctors should acquire, (3) understanding the effectiveness of doctors at influencing dietary behaviours and (4) improving medical students' attitudes towards the importance of nutrition. These research questions can be used to ensure future projects in medical nutrition education directly align with the needs and preferences of research stakeholders. Funders should consider these priorities in their commissioning of research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Prioritized LT Codes

NASA Technical Reports Server (NTRS)

Woo, Simon S.; Cheng, Michael K.

2011-01-01

The original Luby Transform (LT) coding scheme is extended to account for data transmissions where some information symbols in a message block are more important than others. Prioritized LT codes provide unequal error protection (UEP) of data on an erasure channel by modifying the original LT encoder. The prioritized algorithm improves high-priority data protection without penalizing low-priority data recovery. Moreover, low-latency decoding is also obtained for high-priority data due to fast encoding. Prioritized LT codes only require a slight change in the original encoding algorithm, and no changes at all at the decoder. Hence, with a small complexity increase in the LT encoder, an improved UEP and low-decoding latency performance for high-priority data can be achieved. LT encoding partitions a data stream into fixed-sized message blocks each with a constant number of information symbols. To generate a code symbol from the information symbols in a message, the Robust-Soliton probability distribution is first applied in order to determine the number of information symbols to be used to compute the code symbol. Then, the specific information symbols are chosen uniform randomly from the message block. Finally, the selected information symbols are XORed to form the code symbol. The Prioritized LT code construction includes an additional restriction that code symbols formed by a relatively small number of XORed information symbols select some of these information symbols from the pool of high-priority data. Once high-priority data are fully covered, encoding continues with the conventional LT approach where code symbols are generated by selecting information symbols from the entire message block including all different priorities. Therefore, if code symbols derived from high-priority data experience an unusual high number of erasures, Prioritized LT codes can still reliably recover both high- and low-priority data. This hybrid approach decides not only "how to encode" but also "what to encode" to achieve UEP. Another advantage of the priority encoding process is that the majority of high-priority data can be decoded sooner since only a small number of code symbols are required to reconstruct high-priority data. This approach increases the likelihood that high-priority data is decoded first over low-priority data. The Prioritized LT code scheme achieves an improvement in high-priority data decoding performance as well as overall information recovery without penalizing the decoding of low-priority data, assuming high-priority data is no more than half of a message block. The cost is in the additional complexity required in the encoder. If extra computation resource is available at the transmitter, image, voice, and video transmission quality in terrestrial and space communications can benefit from accurate use of redundancy in protecting data with varying priorities.

Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

PubMed

Engels, Melanie J; Chaffee, Bruce W; Clark, John S

2015-12-01

An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Research priority setting for integrated early child development and violence prevention (ECD+) in low and middle income countries: An expert opinion exercise.

PubMed

Tomlinson, Mark; Jordans, Mark; MacMillan, Harriet; Betancourt, Theresa; Hunt, Xanthe; Mikton, Christopher

2017-10-01

Child development in low and middle income countries (LMIC) is compromised by multiple risk factors. Reducing children's exposure to harmful events is essential for early childhood development (ECD). In particular, preventing violence against children - a highly prevalent risk factor that negatively affects optimal child development - should be an intervention priority. We used the Child Health and Nutrition Initiative (CHNRI) method for the setting of research priorities in integrated Early Childhood Development and violence prevention programs (ECD+). An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of Community Health Workers (CHW's) to deliver ECD+ interventions effectively and whether ECD+ interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The priority research questions can direct new research initiatives, mainly in focusing on the effectiveness of an ECD+ approach, as well as on service delivery questions. To the best of our knowledge, this is the first systematic exercise of its kind in the field of ECD+. The findings from this research priority setting exercise can help guide donors and other development actors towards funding priorities for important future research related to ECD and violence prevention. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

PubMed

Turner, S; Ollerhead, E; Cook, A

2017-10-09

In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others contributed further potential topic areas instead. Delphi-like survey methods are practical and productive as a means of obtaining opinions from a wide number of relevant experts identifying potential priority topic areas for research; however, this method is less appropriate for framing tractable research questions.

Priorities of legislatively active veteran services organizations: a content analysis and review for health promotion initiatives.

PubMed

Jahnke, Sara A; Haddock, Christopher K; Carlos Poston, Walker S; Jitnarin, Nattinee

2014-11-01

Military and Veterans Service Organizations (MVSOs) have a unique opportunity to influence legislation and advocate for the interests of their members. However, little is known about what legislative priorities MVSOs see as important. Understanding the legislative priorities of MVSOs can inform efforts by health scientists to promote policy and laws designed to improve the health of our nation's veterans. Using a mixed methods approach, we conducted a thematic analysis of legislative priorities MVSOs promote with their legislative agendas. Most commonly, MVSOs addressed issues related to disability evaluations and ratings with the Veterans Administration and access to Veterans Administration services. Other common themes identified as priorities include benefits such as retirement, education, housing assistance for veterans, and TRICARE benefits. Findings highlight the broad range of topics MVSOs identify as legislative priorities as well as some health issues that receive relatively limited attention. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

77 FR 64148 - Postal Rate and Classification Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-18

... of free tracking. Priority Mail Flat Rate Box prices change to the following: Small ($5.80), Medium.... Several international ancillary services and paper money orders receive price increases. Certificates of.... International Return Receipt also receives price increases, and International Postal Money Order prices increase...

User’s Manual for the Defense Priority Model Version 2.0 Revision

DTIC Science & Technology

1989-01-01

Mountian Home AFB TAC MOUNT 10 37 0.97 Francis E. Warren SAC FEWRN 14 41 1.37 Ellsworth AFB SAC ELSWH 14 41 1.60 Grand Forks AFB SAC GRDFK 20 27 1.8...DC 20024 Brooks AFB TX 78235 &a. NAME OF FUNDING ISPONSORING 8b. OFFICE SYMBOL 9 PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (If...if they were equally mobile. As a result, a site contaminated with polychlorinated biphenyls (PCBs) or dioxin might receive a high score on a ground

Overview of innovative PMI research on NSTX-U and associated PMI facilities at PPPL

DOE PAGES

M. Ono; Jaworski, M.; Kaita, R.; ...

2013-05-01

Developing a reactor compatible divertor and managing the associated plasma material interaction (PMI) has been identified as a high priority research area for magnetic confinement fusion. Accordingly on NSTX-U, the PMI research has received a strong emphasis. Moreover, with ˜15 MW of auxiliary heating power, NSTX-U will be able to test the PMI physics with the peak divertor plasma facing component (PFC) heat loads of up to 40-60 MW/m 2.

5 CFR 302.401 - Selection and appointment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... reemployment, reemployment, or regular list on which candidates have not received numerical scores, an agency... candidates have received numerical scores, the agency must make its selection for each vacancy from not more... method, an agency is not required to— (1) Accord an applicant on its priority reemployment or...

Providing health information for culturally and linguistically diverse women: priorities and preferences of new migrants and refugees.

PubMed

Lee, Susan K; Sulaiman-Hill, Cheryl M R; Thompson, Sandra C

2013-08-01

Preferences for topics and means of access to health information among newly arrived, culturally and linguistically diverse women in Perth, Western Australia, were explored. A mixed-methods approach was adopted. Qualitative material obtained from focus groups and interviews with 22 service providers and 26 migrant women was used to develop a questionnaire, which was then administered to 268 newly arrived migrant and refugee women from 50 countries. Participants' information and support priorities were ascertained from a ranking exercise conducted in a non-threatening context. Responses of migrant and refugee women were compared quantitatively. Women's top priorities for information and support included employment advice, as well as information regarding mental health issues, women's health, exercise and nutrition, family violence and alcohol and other drug issues. Their preferred methods for receiving information were interactive talks or presentations, with written material support. Audiovisual and Web-based material were also considered useful. There were differences between refugee women's and other migrants' preferences for means of receiving information and topics of most concern. The use of a non-threatening ranking process encouraged women to prioritise sensitive topics, such as family violence, and revealed a need for such topics to be incorporated within general health information presentations. Internet-based technologies are becoming increasingly important methods for disseminating information to migrant women. SO WHAT? Differences between migrant and refugee women's priority health issues and their preferred methods for receiving information highlight the desirability of tailoring information to particular groups. Although advice on employment pathways and mental health concerns were top priorities, the study revealed a need for more discussion on other sensitive topics, such as family violence and alcohol-related issues, and that ideally these should be incorporated into general information sessions to destigmatise attendance The increasing relevance of computer technology and social media for information dissemination was also of note.

Work preferences, life values, and personal views of top math/science graduate students and the profoundly gifted: Developmental changes and gender differences during emerging adulthood and parenthood.

PubMed

Ferriman, Kimberley; Lubinski, David; Benbow, Camilla P

2009-09-01

Work preferences, life values, and personal views of top math/science graduate students (275 men, 255 women) were assessed at ages 25 and 35 years. In Study 1, analyses of work preferences revealed developmental changes and gender differences in priorities: Some gender differences increased over time and increased more among parents than among childless participants, seemingly because the mothers' priorities changed. In Study 2, gender differences in the graduate students' life values and personal views at age 35 were compared with those of profoundly gifted participants (top 1 in 10,000, identified by age 13 and tracked for 20 years: 265 men, 84 women). Again, gender differences were larger among parents. Across both cohorts, men appeared to assume a more agentic, career-focused perspective than women did, placing more importance on creating high-impact products, receiving compensation, taking risks, and gaining recognition as the best in their fields. Women appeared to favor a more communal, holistic perspective, emphasizing community, family, friendships, and less time devoted to career. Gender differences in life priorities, which intensify during parenthood, anticipated differential male-female representation in high-level and time-intensive careers, even among talented men and women with similar profiles of abilities, vocational interests, and educational experiences. (c) 2009 APA, all rights reserved).

High Leverage Technologies for In-Space Assembly of Complex Structures

NASA Technical Reports Server (NTRS)

Hamill, Doris; Bowman, Lynn M.; Belvin, W. Keith; Gilman, David A.

2016-01-01

In-space assembly (ISA), the ability to build structures in space, has the potential to enable or support a wide range of advanced mission capabilities. Many different individual assembly technologies would be needed in different combinations to serve many mission concepts. The many-to-many relationship between mission needs and technologies makes it difficult to determine exactly which specific technologies should receive priority for development and demonstration. Furthermore, because enabling technologies are still immature, no realistic, near-term design reference mission has been described that would form the basis for flowing down requirements for such development and demonstration. This broad applicability without a single, well-articulated mission makes it difficult to advance the technology all the way to flight readiness. This paper reports on a study that prioritized individual technologies across a broad field of possible missions to determine priority for future technology investment.

12 CFR 627.2750 - Priority of claims-banks.

Code of Federal Regulations, 2011 CFR

2011-01-01

... authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the... of the receivership to engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the appointment of the...

12 CFR 650.45 - Priority of claims.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to... in the best interest of the receivership to engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the...

12 CFR 627.2745 - Priority of claims-associations.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to... in the best interest of the receivership to engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the...

5 CFR 330.702 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Received a reduction in force (RIF) separation notice under part 351 of this chapter and has not declined... record was at least fully successful (Level 3) or equivalent who was either: (i) Separated by RIF under... appointment eligibility and selection priority for competitive service positions; and (ii) Has received a RIF...

5 CFR 330.702 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Received a reduction in force (RIF) separation notice under part 351 of this chapter and has not declined... record was at least fully successful (Level 3) or equivalent who was either: (i) Separated by RIF under... appointment eligibility and selection priority for competitive service positions; and (ii) Has received a RIF...

5 CFR 330.702 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Received a reduction in force (RIF) separation notice under part 351 of this chapter and has not declined... record was at least fully successful (Level 3) or equivalent who was either: (i) Separated by RIF under... appointment eligibility and selection priority for competitive service positions; and (ii) Has received a RIF...

Partition of pollution between dissolved and particulate phases: what about emerging substances in urban stormwater catchments?

PubMed

Zgheib, Sally; Moilleron, Régis; Saad, Mohamed; Chebbo, Ghassan

2011-01-01

This paper presents results about the occurrence, the concentrations of urban priority substances on both the dissolved and the particulate phases in stormwater. Samples were collected at the outlet of a dense urban catchment in Paris suburb (2.30 km(2)). 13 chemical groups were investigated including 88 individual substances. Results showed that stormwater discharges contained 45 substances among them some metals, organotins, PAHs, PCBs, alkylphenols, pesticides, phthalates, cholorophenols and one volatile organic compound, i.e. methylene chloride. With respect to the European Water Framework Directive, these substances included 47% of the priority hazardous substances (n = 8), 38% of the priority substances (n = 10). The remaining substances (n = 27) belong to a list of others specific urban substances not included in the Water Framework Directive but monitored during this work. Finally, stormwater quality was evaluated by comparing the substance concentrations to environmental quality standards (EQS) and the particulate content to Canadian sediment quality guidelines. This showed that stormwater was highly contaminated and should be treated before being discharged to receiving waters in order to avoid any adverse impact on the river quality. Copyright © 2010 Elsevier Ltd. All rights reserved.

Breastfeeding Problems Following Anesthetic Administration

PubMed Central

Howie, William O.; McMullen, Patricia C.

2006-01-01

Research literature supports the notion that maternal comfort should be considered a priority and that mothers should receive adequate information regarding any drug prior to receiving that drug. Some studies indicate that difficulties with breastfeeding may be related to the amount of the anesthetic or analgesic that is administered to the mother. Thus, it seems wise to administer the lowest possible dose to the mother in order to minimize the amount of drug (or metabolite) exposure to the nursing infant. Infant exposure can be further reduced if breastfeeding is avoided during the times when the mother receives high doses of anesthetics and analgesics. However, because relatively small amounts of the drug are excreted into the breast milk, some mothers may opt to continue nursing after weighing the benefits of breastfeeding against the potential risk to the infant. Others may choose to “pump and dump” breast milk while they receive anesthetic or analgesic agents. Any concerns in this regard should be discussed with the anesthesia provider, preferably prior to labor or to any surgeries while breastfeeding. PMID:17541461

Breastfeeding problems following anesthetic administration.

PubMed

Howie, William O; McMullen, Patricia C

2006-01-01

Research literature supports the notion that maternal comfort should be considered a priority and that mothers should receive adequate information regarding any drug prior to receiving that drug. Some studies indicate that difficulties with breastfeeding may be related to the amount of the anesthetic or analgesic that is administered to the mother. Thus, it seems wise to administer the lowest possible dose to the mother in order to minimize the amount of drug (or metabolite) exposure to the nursing infant. Infant exposure can be further reduced if breastfeeding is avoided during the times when the mother receives high doses of anesthetics and analgesics. However, because relatively small amounts of the drug are excreted into the breast milk, some mothers may opt to continue nursing after weighing the benefits of breastfeeding against the potential risk to the infant. Others may choose to "pump and dump" breast milk while they receive anesthetic or analgesic agents. Any concerns in this regard should be discussed with the anesthesia provider, preferably prior to labor or to any surgeries while breastfeeding.

75 FR 14582 - Office of Special Education and Rehabilitative Services-Special Demonstration Programs-Model...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-26

... Security Disability Insurance (SSDI) Served by State Vocational Rehabilitation (VR) Agencies AGENCY: Office... Rehabilitation (VR) agencies. The Assistant Secretary may use this priority for competitions in fiscal year (FY... receiving services from State VR agencies. DATES: We must receive your comments on or before April 26, 2010...

Ten-year assessment of the 100 priority questions for global biodiversity conservation.

PubMed

Jucker, Tommaso; Wintle, Bonnie; Shackelford, Gorm; Bocquillon, Pierre; Geffert, Jan Laurens; Kasoar, Tim; Kovacs, Eszter; Mumby, Hannah S; Orland, Chloé; Schleicher, Judith; Tew, Eleanor R; Zabala, Aiora; Amano, Tatsuya; Bell, Alexandra; Bongalov, Boris; Chambers, Josephine M; Corrigan, Colleen; Durán, América P; Duvic-Paoli, Leslie-Anne; Emilson, Caroline; da Silva, Jéssica Fonseca; Garnett, Emma E; Green, Elizabeth J; Guth, Miriam K; Hacket-Pain, Andrew; Hinsley, Amy; Igea, Javier; Kunz, Martina; Luke, Sarah H; Lynam, William; Martin, Philip A; Nunes, Matheus H; Ockendon, Nancy; Pavitt, Aly; Payne, Charlotte L R; Plutshack, Victoria; Rademacher, Tim T; Robertson, Rebecca J; Rose, David C; Serban, Anca; Simmons, Benno I; Emilson, Erik J S; Tayleur, Catherine; Wordley, Claire F R; Mukherjee, Nibedita

2018-06-20

In 2008, a group of conservation scientists compiled a list of 100 priority questions for the conservation of the world's biodiversity [Sutherland et al. (2009) Conservation Biology, 23, 557-567]. However, now almost a decade later, no one has yet published a study gauging how much progress has been made in addressing these 100 high-priority questions in the peer-reviewed literature. Here we take a first step toward re-examining the 100 questions and identify key knowledge gaps that still remain. Through a combination of a questionnaire and a literature review, we evaluated each of the 100 questions on the basis of two criteria: relevance and effort. We defined highly-relevant questions as those which - if answered - would have the greatest impact on global biodiversity conservation, while effort was quantified based on the number of review publications addressing a particular question, which we used as a proxy for research effort. Using this approach we identified a set of questions that, despite being perceived as highly relevant, have been the focus of relatively few review publications over the past ten years. These questions covered a broad range of topics but predominantly tackled three major themes: the conservation and management of freshwater ecosystems, the role of societal structures in shaping interactions between people and the environment, and the impacts of conservation interventions. We see these questions as important knowledge gaps that have so far received insufficient attention and may need to be prioritised in future research. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Setting the global health agenda: The influence of advocates and ideas on political priority for maternal and newborn survival.

PubMed

Smith, Stephanie L; Shiffman, Jeremy

2016-10-01

This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The role of support staff in promoting the social inclusion of persons with an intellectual disability.

PubMed

McConkey, R; Collins, S

2010-08-01

Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention. In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job. Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks. Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities.

Vital Directions for Health and Health Care: Priorities From a National Academy of Medicine Initiative.

PubMed

Dzau, Victor J; McClellan, Mark B; McGinnis, J Michael; Burke, Sheila P; Coye, Molly J; Diaz, Angela; Daschle, Thomas A; Frist, William H; Gaines, Martha; Hamburg, Margaret A; Henney, Jane E; Kumanyika, Shiriki; Leavitt, Michael O; Parker, Ruth M; Sandy, Lewis G; Schaeffer, Leonard D; Steele, Glenn D; Thompson, Pamela; Zerhouni, Elias

2017-04-11

Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity. Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings. The US health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress. The action priorities and essential infrastructure needs represent major opportunities to improve health outcomes and increase efficiency and value in the health system. As the new US administration and Congress chart the future of health and health care for the United States, and as health leaders across the country contemplate future directions for their programs and initiatives, their leadership and strategic investment in these priorities will be essential for achieving significant progress.

How Nurse Gender Influences Patient Priority Assignments in U.S. Emergency Departments

PubMed Central

Vigil, Jacob Miguel; Coulombe, Patrick; Alcock, Joe; Stith, Sarah See; Kruger, Eric; Cichowski, Sara

2016-01-01

The goals of this study were to compare whether emergency department (ED) patients’ pain intensity (PI) is measured differently by male and female nurses and to determine whether PI, heart rate (HR) and respiratory rate (RR) we’re used to prioritize patient urgency differently by male and female nurses. The associations between patients’ PI|HR|RR and the Emergency Severity Index (ESI) scores they were assigned by attending nurses were analyzed using a national database of electronic medical records of U.S. Veterans Affairs ED patients from 2008 to 2012. A total of 129,991 patients presenting for emergency care (Mage = 59.5, 92% males) and their triage nurses (n = 774, Mage = 47.5, 18% males) were analyzed, resulting in a total of 359,642 patient/provider interactions. Patients’ PI did not differ by nurse’s gender; however a cross-classified mixed-effects model showed that nurse gender influenced how PI and RR measurements informed the ESI levels that male patients received. Higher PI levels were associated with more urgent (higher priority) ESI levels by female nurses, yet less urgent ESI levels by male nurses. In contrast, male patients with high RR received more urgent ESI levels by male nurses, while nurse gender did not influence ESI assignments for female patients. These findings show that ED patients receive disparate treatment based on inherent characteristics of their triage nurses, and more standardized (e.g., automated) protocols that can account for implicit social factors on healthcare practice for reliably assessing and prioritizing ED patients may be currently warranted. PMID:28187101

Enhanced Handover Decision Algorithm in Heterogeneous Wireless Network

PubMed Central

Abdullah, Radhwan Mohamed; Zukarnain, Zuriati Ahmad

2017-01-01

Transferring a huge amount of data between different network locations over the network links depends on the network’s traffic capacity and data rate. Traditionally, a mobile device may be moved to achieve the operations of vertical handover, considering only one criterion, that is the Received Signal Strength (RSS). The use of a single criterion may cause service interruption, an unbalanced network load and an inefficient vertical handover. In this paper, we propose an enhanced vertical handover decision algorithm based on multiple criteria in the heterogeneous wireless network. The algorithm consists of three technology interfaces: Long-Term Evolution (LTE), Worldwide interoperability for Microwave Access (WiMAX) and Wireless Local Area Network (WLAN). It also employs three types of vertical handover decision algorithms: equal priority, mobile priority and network priority. The simulation results illustrate that the three types of decision algorithms outperform the traditional network decision algorithm in terms of handover number probability and the handover failure probability. In addition, it is noticed that the network priority handover decision algorithm produces better results compared to the equal priority and the mobile priority handover decision algorithm. Finally, the simulation results are validated by the analytical model. PMID:28708067

76 FR 17629 - Applications for New Awards; Transition to Teaching Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-30

... teachers in high-need schools operated by high-need local educational agencies (LEAs), including charter schools that operate as high-need LEAs. Priorities: This notice contains two competitive preference... Preference Priorities: Competitive Preference Priority 1 is from section 2313(c) of the Elementary and...

Evaluating the operational risks of biomedical waste using failure mode and effects analysis.

PubMed

Chen, Ying-Chu; Tsai, Pei-Yi

2017-06-01

The potential problems and risks of biomedical waste generation have become increasingly apparent in recent years. This study applied a failure mode and effects analysis to evaluate the operational problems and risks of biomedical waste. The microbiological contamination of biomedical waste seldom receives the attention of researchers. In this study, the biomedical waste lifecycle was divided into seven processes: Production, classification, packaging, sterilisation, weighing, storage, and transportation. Twenty main failure modes were identified in these phases and risks were assessed based on their risk priority numbers. The failure modes in the production phase accounted for the highest proportion of the risk priority number score (27.7%). In the packaging phase, the failure mode 'sharp articles not placed in solid containers' had the highest risk priority number score, mainly owing to its high severity rating. The sterilisation process is the main difference in the treatment of infectious and non-infectious biomedical waste. The failure modes in the sterilisation phase were mainly owing to human factors (mostly related to operators). This study increases the understanding of the potential problems and risks associated with biomedical waste, thereby increasing awareness of how to improve the management of biomedical waste to better protect workers, the public, and the environment.

What do young people with rheumatic disease believe to be important to research about their condition? A UK-wide study.

PubMed

Parsons, Suzanne; Thomson, Wendy; Cresswell, Katharine; Starling, Bella; McDonagh, Janet E

2017-07-03

The involvement of people of all ages including young people in research is now widely advocated but prioritisation of research topics is still driven largely by professional agendas. Evidence from adult literature has reported a mismatch between a researcher and patient generated list of research topics. There have been no studies to date exploring the priorities of young people with long term conditions other than in SLE. The study aimed to explore the research priorities of young people across the UK with respect to rheumatic conditions. Focus groups were undertaken with young people aged 11-24 years with rheumatic conditions recruited across the UK via members of the Barbara Ansell National Network for Adolescent Rheumatology BANNAR and relevant national charities. Data was analysed using a Framework approach. Participants discussed their beliefs about what should be researched in: Basic Science; Clinical Medicine; Health Services, Psychosocial, and Public Health. They were then invited to prioritize these areas in terms of how much funding they should receive. Thirteen focus groups were held involving 63 participants (18 males: 45 females, mean age 16 years, range 10 to 24) in all four nations of the UK. Young people's research priorities were influenced by whether they felt research would achieve benefits for all or just some patients and long or short term goals. Another influence was whether participants felt that research areas were already well funded. Across all groups, Basic Science was a key priority and participants felt that psychosocial research should be prioritized more. Health Services Research was a lower priority, as the majority of participants were happy with their care. Clinical medicine was not a high priority as young people were happy with their medication or uncomfortable with trying new ones. Finally, for nearly all groups, Public Health was a low priority. Differences were also observed between the two age groups and across the geographically diverse focus groups. Understanding young people's research priorities is important to develop research that is in tune with their needs. The results highlight the importance of considering the whole age range of adolescence and young adulthood as well as geographical diversity. The findings from this work will inform the future research of the Barbara Ansell National Network for Adolescent Rheumatology BANNAR in the UK.

Patient priorities and needs for diabetes care among urban African American adults.

PubMed

Batts, M L; Gary, T L; Huss, K; Hill, M N; Bone, L; Brancati, F L

2001-01-01

This study was conducted to determine diabetes care priorities and needs in a group of urban African American adults with type 2 diabetes mellitus. One hundred nineteen African American adults with type 2 diabetes, aged 35 to 75, received behavioral/educational interventions from a nurse case manager, a community health worker, or both. Priorities and needs were assessed during 3 intervention visits. The most frequently reported priorities for diabetes care were glucose self-monitoring (61%), medication adherence (47%), and healthy eating (36%). The most frequently addressed diabetes needs were glucose self-monitoring and medication adherence. Most of the intervention visits (77%) addressed non-diabetes-related health issues such as cardiovascular disease (36%) and social issues such as family responsibilities (30%). Participants' self-reported priorities for diabetes care directly reflected the diabetes needs addressed. Needs beyond the focus of traditional diabetes care (social issues and insurance) are important to address in urban African Americans with type 2 diabetes. Interventions designed to address comprehensive health and social needs should be included in treatment and educational plans for this population.

Setting priorities for zinc-related health research to reduce children's disease burden worldwide: an application of the Child Health and Nutrition Research Initiative's research priority-setting method.

PubMed

Brown, Kenneth H; Hess, Sonja Y; Boy, Erick; Gibson, Rosalind S; Horton, Susan; Osendarp, Saskia J; Sempertegui, Fernando; Shrimpton, Roger; Rudan, Igor

2009-03-01

To make the best use of limited resources for supporting health-related research to reduce child mortality, it is necessary to apply a suitable method to rank competing research options. The Child Health and Nutrition Research Initiative (CHNRI) developed a new methodology for setting health research priorities. To broaden experience with this priority-setting technique, we applied the method to rank possible research priorities concerning the control of Zn deficiency. Although Zn deficiency is not generally recognized as a direct cause of child mortality, recent research indicates that it predisposes children to an increased incidence and severity of several of the major direct causes of morbidity and mortality. Leading experts in the field of Zn research in child health were identified and invited to participate in a technical working group (TWG) to establish research priorities. The individuals were chosen to represent a wide range of expertise in Zn nutrition. The seven TWG members submitted a total of ninety research options, which were then consolidated into a final list of thirty-one research options categorized by the type of resulting intervention. The identified priorities were dominated by research investment options targeting Zn supplementation, and were followed by research on Zn fortification, general aspects of Zn nutrition, dietary modification and other new interventions. In general, research options that aim to improve the efficiency of an already existing intervention strategy received higher priority scores. Challenges identified during the implementation of the methodology and suggestions to modify the priority-setting procedures are discussed.

The View of Nurses toward Prioritizing the Caring Behaviors in Cancer Patients

PubMed Central

Valizadeh, Leila; Zamanzadeh, Vahid; Azimzadeh, Roghaieh; Rahmani, Azad

2012-01-01

Introduction: There are many opportunities for nurses to assist improving patient’s ex-perience of cancer. In fact, in every stage of cancer process, nurses can provide the re-quired and necessary cares and supports by representing substantial caring behaviors. Thus, by identifying and understanding the importance of caring behaviors which led to nurse-patient effective interactions, nurses would be able to care better for patients and so to enhance patients’ satisfaction toward nursing services. However, a few studies have ever been done about perception of oncology nurses about prioritization of caring behaviors. Methods: This was a descriptive study done among all the nurses of oncology wards (n = 40) in Shahid-Ghazi-Tabatabaei Hospital of Tabriz in 2009. Data collection performed using Larson’s CARE-Q tool that assessed the importance of caring beha-viors in six subscales as the following: “Monitors and follows through”, “Explains and facilitates”, “Physical and emotional comforts”, “Trusting relationship”, “Anticipates” and “Being accessible”. Results: In this study, the importance of caring behaviors was evaluated in moderate to high level and the priorities of care dimensions were deter-mined. “Monitors and follows through” and “Being accessible” received a high priority and “Anticipates”, “Explains and facilitates”, “Physical and emotional comforts” and “Trusting relationship” were given the low priority by nurses. Conclusion: The difference of caring prioritization by the nurses of this study compared to other studies can be attributed to the influence of cultural background on caring. Considering the high prioritizing of “Monitors and follows through” and “Being accessible”, nursing service officials and planners are recommended to attempt providing prerequisites of these two caring aspects. PMID:25276670

High-priority and low-priority drug-drug interactions in different international electronic health record systems: A comparative study.

PubMed

Cornu, Pieter; Phansalkar, Shobha; Seger, Diane L; Cho, Insook; Pontefract, Sarah; Robertson, Alexandra; Bates, David W; Slight, Sarah P

2018-03-01

To investigate whether alert warnings for high-priority and low-priority drug-drug interactions (DDIs) were present in five international electronic health record (EHR) systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden. We conducted a comparative, retrospective, multinational study using a convenience sample of 5 EHRs from the U.S., U.K., Republic of Korea and Belgium. Of the 15 previously defined, high-priority, class-based DDIs, alert warnings were found to exist for 11 in both the Korean and UK systems, 9 in the Belgian system, and all 15 in the two US systems. The specific combinations that were included in these class-based DDIs varied considerably in number, type and level of severity amongst systems. Alerts were only active for 8.4% (52/619) and 52.4% (111/212) of the specific drug-drug combinations contained in the Belgian and UK systems, respectively. Hard stops (not possible to override) existed in the US and UK systems only. The override rates for high-priority alerts requiring provider action ranged from 56.7% to 83.3%. Of the 33 previously defined low-priority DDIs, active alerts existed only in the US systems, for three class-based DDIs. The majority were non-interruptive. Alert warnings existed for most of the high-priority DDIs in the different EHRs but overriding them was easy in most of the systems. In addition to validating the high- and low-priority DDIs, this study reported a lack of standardization in DDI levels across different international knowledge bases. Copyright © 2017. Published by Elsevier B.V.

15 CFR 200.110 - Priorities and time of completion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... calibrations and other tests will generally be made in the order in which confirmed requests are received... considerably longer, particularly if their abnormal behavior requires reruns to check reliability. The customer...

77 FR 33201 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

..., Development, Test and Evaluation Priorities for Battlefield Trauma Care from the Trauma and Injury Subcommittee. Additionally, the Board will receive information briefs from the National Trauma Institute and U...

Updated Priorities Among Effective Clinical Preventive Services

PubMed Central

Maciosek, Michael V.; LaFrance, Amy B.; Dehmer, Steven P.; McGree, Dana A.; Flottemesch, Thomas J.; Xu, Zack; Solberg, Leif I.

2017-01-01

PURPOSE The Patient Protection and Affordable Care Act’s provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services. METHODS We assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures—cost-effectiveness and clinically preventable burden—for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally. RESULTS The 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesity-related behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations. CONCLUSIONS This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives. PMID:28376457

The priority group index: a proposed new method incorporating high risk and population burden to identify target populations for public health interventions.

PubMed

Zhang, Bo; Cohen, Joanna E; OʼConnor, Shawn

2014-01-01

Selection of priority groups is important for health interventions. However, no quantitative method has been developed. To develop a quantitative method to support the process of selecting priority groups for public health interventions based on both high risk and population health burden. Secondary data analysis of the 2010 Canadian Community Health Survey. Canadian population. Survey respondents. We identified priority groups for 3 diseases: heart disease, stroke, and chronic lower respiratory diseases. Three measures--prevalence, population counts, and adjusted odds ratios (OR)--were calculated for subpopulations (sociodemographic characteristics and other risk factors). A Priority Group Index (PGI) was calculated by summing the rank scores of these 3 measures. Of the 30 priority groups identified by the PGI (10 for each of the 3 disease outcomes), 7 were identified on the basis of high prevalence only, 5 based on population count only, 3 based on high OR only, and the remainder based on combinations of these. The identified priority groups were all in line with the literature as risk factors for the 3 diseases, such as elderly people for heart disease and stroke and those with low income for chronic lower respiratory diseases. The PGI was thus able to balance both high risk and population burden approaches in selecting priority groups, and thus it would address health inequities as well as disease burden in the overall population. The PGI is a quantitative method to select priority groups for public health interventions; it has the potential to enhance the effective use of limited public resources.

Effective stakeholder participation in setting research priorities using a Global Evidence Mapping approach.

PubMed

Clavisi, Ornella; Bragge, Peter; Tavender, Emma; Turner, Tari; Gruen, Russell L

2013-05-01

We present a multistep process for identifying priority research areas in rehabilitation and long-term care of traumatic brain-injured (TBI) patients. In particular, we aimed to (1) identify which stakeholders should be involved; (2) identify what methods are appropriate; (3) examine different criteria for the generation of research priority areas; and (4) test the feasibility of linkage and exchange among researchers, decision makers, and other potential users of the research. Potential research questions were identified and developed using an initial scoping meeting and preliminary literature search, followed by a facilitated mapping workshop and an online survey. Identified research questions were then prioritized against specific criteria (clinical importance, novelty, and controversy). Existing evidence was then mapped to the high-priority questions using usual processes for search, screening, and selection. A broad range of stakeholders were then brought together at a forum to identify priority research themes for future research investment. Using clinical and research leaders, smaller targeted planning workshops prioritized specific research projects for each of the identified themes. Twenty-six specific questions about TBI rehabilitation were generated, 14 of which were high priority. No one method identified all high-priority questions. Methods that relied solely on the views of clinicians and researchers identified fewer high-priority questions compared with methods that used broader stakeholder engagement. Evidence maps of these high-priority questions yielded a number of evidence gaps. Priority questions and evidence maps were then used to inform a research forum, which identified 12 priority themes for future research. Our research demonstrates the value of a multistep and multimethod process involving many different types of stakeholders for prioritizing research to improve the rehabilitation outcomes of people who have suffered TBI. Enhancing stakeholder representation can be augmented using a combination of methods and a process of linkage and exchange. This process can inform decisions about prioritization of research areas. Copyright © 2013 Elsevier Inc. All rights reserved.

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... the maximum allowable for a loan of its size (5 points). (5) High impact business investment priorities. The priority score for high impact business investment will be the total score for the following...

Consumers' reports on the health effects of direct-to-consumer drug advertising.

PubMed

Weissman, Joel S; Blumenthal, David; Silk, Alvin J; Zapert, Kinga; Newman, Michael; Leitman, Robert

2003-01-01

We conducted a national telephone survey about health care experiences associated with direct-to-consumer advertising (DTCA) of prescription drugs. Among the 35 percent of our sample who had a physician visit during which DTCA was discussed, 25 percent received a new diagnosis, of which 43 percent were considered high priority according to authoritative sources. More than half also reported actions taken by their physician other than prescribing the advertised drug. Despite concerns about DTCA's negative consequences, we found no differences in health effects between patients who took advertised drugs and those who took other prescription drugs.

Master Environmental Plan for Fort Devens, Massachusetts

DTIC Science & Technology

1992-04-01

sites located in proximity to each other were grouped together. The rationale for the order of priority assigned to the study areas in this section is...following priority categories: 1. High priority for action. All group 1 study areas have known contamination. Group IA includes sites that have ongoing...remedial investigations. Group 1B includes sites that have ongoing site inspections. 2. Moderate to high priority for action. Study areas in groups 3

76 FR 69246 - Application for New Awards; High School Equivalency Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... could include, for example, participation in training on intensive science teaching techniques presented...)). The third priority is an invitational priority for applications that promote science, technology... preference over other applications. These priorities are: Invitational Priority 1--Science, Technology...

Legislation.

ERIC Educational Resources Information Center

Florio, David H.

1981-01-01

Nearly all educational programs which receive federal funding are vulnerable to budget cuts. Educators need to view budget reductions in terms of economic priorities. Education must be seen as part of the economic productivity, social fabric, and security of the nation. (JN)

25 CFR 170.209 - How will IRRHPP applications be ranked and funded?

Code of Federal Regulations, 2010 CFR

2010-04-01

... matches); (5) Amount of funds requested (smaller requests receive greater priority); (6) Challenges caused... IRR transportation facility up to a maximum of $1 million per application. (c) A project submitted as...

Maternal and perinatal health research priorities beyond 2015: an international survey and prioritization exercise.

PubMed

Souza, Joao Paulo; Widmer, Mariana; Gülmezoglu, Ahmet Metin; Lawrie, Theresa Anne; Adejuyigbe, Ebunoluwa Aderonke; Carroli, Guillermo; Crowther, Caroline; Currie, Sheena M; Dowswell, Therese; Hofmeyr, Justus; Lavender, Tina; Lawn, Joy; Mader, Silke; Martinez, Francisco Eulógio; Mugerwa, Kidza; Qureshi, Zahida; Silvestre, Maria Asuncion; Soltani, Hora; Torloni, Maria Regina; Tsigas, Eleni Z; Vowles, Zoe; Ouedraogo, Léopold; Serruya, Suzanne; Al-Raiby, Jamela; Awin, Narimah; Obara, Hiromi; Mathai, Matthews; Bahl, Rajiv; Martines, José; Ganatra, Bela; Phillips, Sharon Jelena; Johnson, Brooke Ronald; Vogel, Joshua P; Oladapo, Olufemi T; Temmerman, Marleen

2014-08-07

Maternal mortality has declined by nearly half since 1990, but over a quarter million women still die every year of causes related to pregnancy and childbirth. Maternal-health related targets are falling short of the 2015 Millennium Development Goals and a post-2015 Development Agenda is emerging. In connection with this, setting global research priorities for the next decade is now required. We adapted the methods of the Child Health and Nutrition Research Initiative (CHNRI) to identify and set global research priorities for maternal and perinatal health for the period 2015 to 2025. Priority research questions were received from various international stakeholders constituting a large reference group, and consolidated into a final list of research questions by a technical working group. Questions on this list were then scored by the reference working group according to five independent and equally weighted criteria. Normalized research priority scores (NRPS) were calculated, and research priority questions were ranked accordingly. A list of 190 priority research questions for improving maternal and perinatal health was scored by 140 stakeholders. Most priority research questions (89%) were concerned with the evaluation of implementation and delivery of existing interventions, with research subthemes frequently concerned with training and/or awareness interventions (11%), and access to interventions and/or services (14%). Twenty-one questions (11%) involved the discovery of new interventions or technologies. Key research priorities in maternal and perinatal health were identified. The resulting ranked list of research questions provides a valuable resource for health research investors, researchers and other stakeholders. We are hopeful that this exercise will inform the post-2015 Development Agenda and assist donors, research-policy decision makers and researchers to invest in research that will ultimately make the most significant difference in the lives of mothers and babies.

Research priorities on ending child marriage and supporting married girls.

PubMed

Svanemyr, Joar; Chandra-Mouli, Venkatraman; Raj, Anita; Travers, Ellen; Sundaram, Lakshmi

2015-09-03

Over the past few years the issue of child marriage has received growing political and programmatic attention. In spite of some progress in a number of countries, global rates have not declined over the past decade. Knowledge gaps remain in understanding trends, drivers and approaches to ending child marriage, especially to understand what is needed to achieve results on a large scale. This commentary summarizes the outcomes of an Expert Group Meeting organized by World Health Organization to discuss research priorities on Ending Child Marriage and Supporting Married Girls. It presents research gaps and recommends priorities for research in five key areas; (i) prevalence and trends of child marriage; (ii) causes of child marriage (iii) consequences of child marriage; (iv) efforts to prevent child marriage; (v) efforts to support married girls.

25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...

25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...

25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...

25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...

75 FR 73054 - Office of Elementary and Secondary Education; Overview Information; High School Equivalency...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

...' participation in training on intensive science teaching techniques presented by a professionally credentialed...)). The third priority is an invitational priority for applications that promote science, technology... priorities are: Invitational Priority 1--Science, Technology, Engineering and Mathematics (STEM) Education...

A Fair Contention Access Scheme for Low-Priority Traffic in Wireless Body Area Networks

PubMed Central

Sajeel, Muhammad; Bashir, Faisal; Asfand-e-yar, Muhammad; Tauqir, Muhammad

2017-01-01

Recently, wireless body area networks (WBANs) have attracted significant consideration in ubiquitous healthcare. A number of medium access control (MAC) protocols, primarily derived from the superframe structure of the IEEE 802.15.4, have been proposed in literature. These MAC protocols aim to provide quality of service (QoS) by prioritizing different traffic types in WBANs. A contention access period (CAP)with high contention in priority-based MAC protocols can result in higher number of collisions and retransmissions. During CAP, traffic classes with higher priority are dominant over low-priority traffic; this has led to starvation of low-priority traffic, thus adversely affecting WBAN throughput, delay, and energy consumption. Hence, this paper proposes a traffic-adaptive priority-based superframe structure that is able to reduce contention in the CAP period, and provides a fair chance for low-priority traffic. Simulation results in ns-3 demonstrate that the proposed MAC protocol, called traffic- adaptive priority-based MAC (TAP-MAC), achieves low energy consumption, high throughput, and low latency compared to the IEEE 802.15.4 standard, and the most recent priority-based MAC protocol, called priority-based MAC protocol (PA-MAC). PMID:28832495

20 CFR 663.310 - Who may receive training services?

Code of Federal Regulations, 2012 CFR

2012-04-01

... whose services are provided through the adult funding stream, are determined eligible in accordance with the State and local priority system, if any, in effect for adults under WIA section 134(d)(4)(E) and...

75 FR 45114 - Determination of Insufficient Assets To Satisfy Claims Against Financial Institution in Receivership

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... FDIC as Receiver of Downey Savings and Loan Association, F.A., Attention: Claims Agent, 1601 Bryan... insured depository institution to pay claims. Under the statutory order of priority, administrative...

Establishing research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus.

PubMed

Turner, Grace M; Backman, Ruth; McMullan, Christel; Mathers, Jonathan; Marshall, Tom; Calvert, Melanie

2018-01-01

What is the problem and why is this important? Mini-strokes are similar to full strokes, but symptoms last less than 24 h. Many people (up to 70%) have long-term problems after a mini-stroke, such as anxiety; depression; problems with brain functioning (like memory loss); and fatigue (feeling tired). However, the current healthcare pathway only focuses on preventing another stroke and care for other long-term problems is not routinely given. Without proper treatment, people with long-term problems after a mini-stroke could have worse quality of life and may find it difficult to return to work and their social activities. What is the aim of the research? We wanted to understand the research priorities of patients, health care professionals and key stakeholders relating to the long-term impact of mini-stroke. How did we address the problem? We invited patients, clinicians, researchers and other stakeholders to attend a meeting. At the meeting people discussed the issues relating to the long-term impact of mini-stroke and came to an agreement on their research priorities. There were three stages: (1) people wrote down their individual research suggestions; (2) in smaller groups people came to an agreement on what their top research questions were; and (3) the whole group agreed final research priorities. What did we find? Eleven people attended who were representatives for patients, GPs, stroke consultants, stroke nurses, psychologists, the Stroke Association (charity) and stroke researchers, The group agreed on eleven research questions which they felt were the most important to improve health and well-being for people who have had a mini-stroke.The eleven research questions encompass a range of categories, including: understanding the existing care patients receive (according to diagnosis and geographical location); exploring what optimal care post-TIA/minor stroke should comprise (identifying and treating impairments, information giving and support groups) and how that care should be delivered (clinical setting and follow-up pathway); impact on family members; and education/training for health care professionals. Background Clinical management after transient ischaemic attack (TIA) and minor stroke focuses on stroke prevention. However, evidence demonstrates that many patients experience ongoing residual impairments. Residual impairments post-TIA and minor stroke may affect patients' quality of life and return to work or social activities. Research priorities of patients, health care professionals and key stakeholders relating to the long-term impact of TIA and minor stroke are unknown. Methods Our objective was to establish the top shared research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus. A one-day priority setting consensus meeting took place with representatives from different stakeholder groups in October 2016 (Birmingham, UK). Nominal group technique was used to establish research priorities. This involved three stages: (i) gathering research priorities from individual stakeholders; (ii) interim prioritisation in three subgroups; and (iii) final priority setting. Results The priority setting consensus meeting was attended by 11 stakeholders. The individual stakeholders identified 34 different research priorities. During the interim prioritisation exercise, the three subgroups generated 24 unique research priorities which were discussed as a whole group. Following the final consensus discussion, 11 shared research priorities were unanimously agreed.The 11 research questions encompass a range of categories, including: understanding the existing care patients receive (according to diagnosis and geographical location); exploring what optimal care post-TIA/minor stroke should comprise (identifying and treating impairments, information giving and support groups) and how that care should be delivered (clinical setting and follow-up pathway); impact on family members; and education/training for health care professionals. Conclusions Eleven different research priorities were established through stakeholder-centred consensus. These research questions could usefully inform the research agenda and policy decisions for TIA and minor stroke. Inclusion of stakeholders in setting research priorities is important to increase the relevance of research and reduce research waste.

Improved early outcome for end-stage dilated cardiomyopathy in children.

PubMed

McMahon, Anne-Marie; van Doorn, Carin; Burch, Michael; Whitmore, Pauline; Neligan, Sophie; Rees, Philip; Radley-Smith, Rosemary; Goldman, Allan; Brown, Katherine; Cohen, Gordon; Tsang, Victor; Elliott, Martin; de Leval, Marc R

2003-12-01

To review the impact of management changes on the early outcomes of end-stage dilated cardiomyopathy in children. We conducted a retrospective study of all consecutive children with end-stage dilated cardiomyopathy who received hospital treatment since 1992. Over the past 3 years the following management changes were made: (1) more aggressive use of mechanical cardiac assistance; (2) high priority listing for transplantation; and (3) ABO incompatible transplants for infants. Outcomes for 46 patients admitted between 1992 and 1999 (group I) were compared with 53 patients between 2000 and March 2003 (group II). In group I, 12 (26%) patients received mechanical support with recovery in 3 and transplantation in 5 (1 died). In group II, 19 (36%) patients received extracorporeal membrane oxygenation, with recovery in 5 and transplantation in 12 (all survived). The use of mechanical assistance was associated with high morbidity related to bleeding, end-organ failure, and long-term mechanical ventilation. Five patients in group II received ABO incompatible transplants and all survived. There have been no episodes of rejection or need for increased immunosuppressive therapy. Hospital mortality has been significantly reduced (group I, 37% vs group II, 11%; P <.05). Recent refinements in the management of end-stage dilated cardiomyopathy in children have significantly reduced early mortality. Identification of markers of early myocardial recovery and development of mechanical devices for longer term and more physiologic support are essential to achieve further improvements in outcome.

23 CFR 1205.2 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... HIGHWAY SAFETY PROGRAMS; DETERMINATIONS OF EFFECTIVENESS § 1205.2 Purpose. The purpose of this part is to establish national highway safety priorities and establish program areas within which highway safety programs developed by the states would be eligible to receive Federal funding. ...

23 CFR 1205.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HIGHWAY SAFETY PROGRAMS; DETERMINATIONS OF EFFECTIVENESS § 1205.2 Purpose. The purpose of this part is to establish national highway safety priorities and establish program areas within which highway safety programs developed by the states would be eligible to receive Federal funding. ...

Children: Special Consumers but Not Special Treatment.

ERIC Educational Resources Information Center

Doran, Lee Anne; Dolan, Elizabeth M.

1989-01-01

Reviews several child-related consumer protection issues subject to industry short-sightedness and regulatory manipulation. Indicates that although it may be unrealistic to believe that child-related consumer protection should receive priority, children do merit special consideration as consumers. (JOW)

Flood Insurance Reform Priorities Act of 2010

THOMAS, 111th Congress

Rep. Waters, Maxine [D-CA-35

2010-04-22

Senate - 07/19/2010 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Current Development Status of an Integrated Tool for Modeling Quasi-static Deformation in the Solid Earth

NASA Astrophysics Data System (ADS)

Williams, C. A.; Dicaprio, C.; Simons, M.

2003-12-01

With the advent of projects such as the Plate Boundary Observatory and future InSAR missions, spatially dense geodetic data of high quality will provide an increasingly detailed picture of the movement of the earth's surface. To interpret such information, powerful and easily accessible modeling tools are required. We are presently developing such a tool that we feel will meet many of the needs for evaluating quasi-static earth deformation. As a starting point, we begin with a modified version of the finite element code TECTON, which has been specifically designed to solve tectonic problems involving faulting and viscoelastic/plastic earth behavior. As our first priority, we are integrating the code into the GeoFramework, which is an extension of the Python-based Pyre modeling framework. The goal of this framework is to provide simplified user interfaces for powerful modeling codes, to provide easy access to utilities such as meshers and visualization tools, and to provide a tight integration between different modeling tools so they can interact with each other. The initial integration of the code into this framework is essentially complete, and a more thorough integration, where Python-based drivers control the entire solution, will be completed in the near future. We have an evolving set of priorities that we expect to solidify as we receive more input from the modeling community. Current priorities include the development of linear and quadratic tetrahedral elements, the development of a parallelized version of the code using the PETSc libraries, the addition of more complex rheologies, realistic fault friction models, adaptive time stepping, and spherical geometries. In this presentation we describe current progress toward our various priorities, briefly describe the structure of the code within the GeoFramework, and demonstrate some sample applications.

Three years experience with forward-site mass casualty triage-, evacuation-, operating room-, ICU-, and radiography-enabled disaster vehicles: development of usage strategies from drills and deployments.

PubMed

Griffiths, Jane L; Kirby, Neil R; Waterson, James A

2014-01-01

Delineation of the advantages and problems related to the use of forward-site operating room-, Intensive Care Unit (ICU)-, radiography-, and mass casualty-enabled disaster vehicles for site evacuation, patient stabilization, and triage. The vehicles discussed have six ventilated ICU spaces, two ORs, on-site radiography, 21 intermediate acuity spaces with stretchers, and 54 seated minor acuity spaces. Each space has piped oxygen with an independent vehicle-loaded supply. The vehicles are operated by the Dubai Corporate Ambulance Services. Their support hospital is the main trauma center for the Emirate of Dubai and provides the vehicles' surgical, intensivist, anesthesia, and nursing staff. The disaster vehicles have been deployed 264 times in the last 5 years (these figures do not include deployments for drills). Introducing this new service required extensive initial planning and ongoing analysis of the performance of the disaster vehicles that offer ambulance services and receiving hospitals a large array of possibilities in terms of triage, stabilization of priority I and II patients, and management of priority III patients. In both drills and in disasters, the vehicles were valuable in forward triage and stabilization and in the transport of large numbers of priority III patients. This has avoided the depletion of emergency transport available for priority I and II patients. The successful utilization of disaster vehicles requires seamless cooperation between the hospital staffing the vehicles and the ambulance service deploying them. They are particularly effective during preplanned deployments to high-risk situations. These vehicles also potentially provide self-sufficient refuges for forward teams in hostile environments.

Setting Quality Improvement Priorities for Women Receiving Systemic Therapy for Early-Stage Breast Cancer by Using Population-Level Administrative Data.

PubMed

Enright, Katherine A; Taback, Nathan; Powis, Melanie Lynn; Gonzalez, Alejandro; Yun, Lingsong; Sutradhar, Rinku; Trudeau, Maureen E; Booth, Christopher M; Krzyzanowska, Monika K

2017-10-01

Purpose Routine evaluation of quality measures (QMs) can drive improvement in cancer systems by highlighting gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact at the population level. We developed an approach that uses both variation in performance and number of patients affected by the QM to set priorities for improving the quality of systemic therapy for women with early-stage breast cancer (EBC). Patients and Methods Patients with EBC diagnosed from 2006 to 2010 in Ontario, Canada, were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases. Individual QMs within a panel of 15 QMs previously developed to assess the quality of systemic therapy across four domains (access, treatment delivery, toxicity, and safety) were ranked on interinstitutional variation in performance (using interquartile range) and the number of patients who were affected; then the two rankings were averaged for a summative priority ranking. Results We identified 28,427 patients with EBC who were treated at 84 institutions. The use of computerized physician electronic order entry for chemotherapy, emergency room visits or hospitalizations during chemotherapy, and timely receipt of chemotherapy were identified as the QMs that had the largest potential to improve quality of care at a system level within this cohort. Conclusion A simple ranking system based on interinstitutional variation in performance and patient volume can be used to identify high-priority areas for quality improvement from a population perspective. This approach is generalizable to other health care systems that use QMs to drive improvement.

76 FR 33726 - National Ocean Council; Strategic Action Plan Content Outlines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

...On July 19, 2010, President Obama signed Executive Order 13547 establishing a National Policy for the Stewardship of the Ocean, our Coasts, and the Great Lakes (``National Ocean Policy''). The National Ocean Policy provides an implementation strategy, which describes nine priority objectives that seek to address some of the most pressing challenges facing the ocean, our coasts, and the Great Lakes. The National Ocean Council is responsible for developing strategic action plans for each of the nine priority objectives. As a first step, Federal interagency writing teams have developed content outlines for each draft strategic action plan. The NOC is seeking public review and comment of these content outlines. The purpose of the draft content outlines (outlines) is to provide the public with an initial view of potential actions that could be taken to further the national priority objectives. As such, they are an interim step toward development of the first full draft of each strategic action plan. In developing the outlines, the writing teams were informed by the comments received during an initial public scoping period that closed on April 29. Each outline presents in bulleted form potential actions to further the particular priority objective. It describes the reasons for taking the action, expected outcomes and milestones, gaps and needs in science and technology, and the timeframe for completing the action. The outlines also provide an overview of the priority objective, greater context for the strategic action plan in implementing the National Ocean Policy, and an overview of the preparation of the plan . Public comments received on the outlines will be collated and posted on the NOC Web site. The comments on the outlines will inform the preparation of full draft strategic action plans, which will be released for public review in the fall of 2011, allowing additional opportunity for the public to provide comments. Final strategic action plans are expected to be completed by early 2012.

A survey of time management and particular tasks undertaken by consultant microbiologists in the UK.

PubMed

Riordan, Terry; Cartwright, Keith; Cunningham, Richard; Logan, Margaret; Wright, Paul

2007-05-01

Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. To obtain a professional consensus on what are high-priority and low-priority activities, and to identify the time spent on low-priority activities. National survey. Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward-based work was inadequate. Timesaving could also be achieved through better prioritisation of infection-control activities. CMMs should apportion their time at work focusing on high-priority activities identified through professional consensus.

Genetic basis of priority effects: insights from nectar yeast

PubMed Central

Hartwig, Thomas

2016-01-01

Priority effects, in which the order of species arrival dictates community assembly, can have a major influence on species diversity, but the genetic basis of priority effects remains unknown. Here, we suggest that nitrogen scavenging genes previously considered responsible for starvation avoidance may drive priority effects by causing rapid resource depletion. Using single-molecule sequencing, we de novo assembled the genome of the nectar-colonizing yeast, Metschnikowia reukaufii, across eight scaffolds and complete mitochondrion, with gap-free coverage over gene spaces. We found a high rate of tandem gene duplication in this genome, enriched for nitrogen metabolism and transport. Both high-capacity amino acid importers, GAP1 and PUT4, present as tandem gene arrays, were highly expressed in synthetic nectar and regulated by the availability and quality of amino acids. In experiments with competitive nectar yeast, Candida rancensis, amino acid addition alleviated suppression of C. rancensis by early arrival of M. reukaufii, corroborating that amino acid scavenging may contribute to priority effects. Because niche pre-emption via rapid resource depletion may underlie priority effects in a broad range of microbial, plant and animal communities, nutrient scavenging genes like the ones we considered here may be broadly relevant to understanding priority effects. PMID:27708148

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

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

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

DOE PAGES

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu; ...

2017-10-11

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Research priorities for conservation and natural resource management in Oceania's small-island developing states.

PubMed

Weeks, R; Adams, V M

2018-02-01

For conservation science to effectively inform management, research must focus on creating the scientific knowledge required to solve conservation problems. We identified research questions that, if answered, would increase the effectiveness of conservation and natural resource management practice and policy in Oceania's small-island developing states. We asked conservation professionals from academia, governmental, and nongovernmental organizations across the region to propose such questions and then identify which were of high priority in an online survey. We compared the high-priority questions with research questions identified globally and for other regions. Of 270 questions proposed by respondents, 38 were considered high priority, including: What are the highest priority areas for conservation in the face of increasing resource demand and climate change? How should marine protected areas be networked to account for connectivity and climate change? What are the most effective fisheries management policies that contribute to sustainable coral reef fisheries? High-priority questions related to the particular challenges of undertaking conservation on small-island developing states and the need for a research agenda that is responsive to the sociocultural context of Oceania. Research priorities for Oceania relative to elsewhere were broadly similar but differed in specific issues relevant to particular conservation contexts. These differences emphasize the importance of involving local practitioners in the identification of research priorities. Priorities were reasonably well aligned among sectoral groups. Only a few questions were widely considered answered, which may indicate a smaller-than-expected knowledge-action gap. We believe these questions can be used to strengthen research collaborations between scientists and practitioners working to further conservation and natural resource management in this region. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Impact of a postgraduate six-month rotation in palliative care on knowledge and attitudes of junior residents.

PubMed

Duong, Phuc H; Zulian, Gilbert B

2006-07-01

Fifty junior residents completed a six-month training period. An anonymous postal questionnaire was sent to collect the residents' opinions on improvements in their knowledge, perception of priorities and usefulness of training. Responses were rated from 5 (a great deal) to 1 (not at all improved). A total of 33 (66%) questionnaires were returned. A mean score of 4.48 was obtained on general improvement of knowledge, 4.91 +/- 0.29 on pain control, 4.17 +/- 0.58 on neurological symptoms, 4.09 +/- 0.77 on psychological symptoms, 4.64 +/- 0.60 on communication skills and 4.4 +/- 0.91 on physician attitudes. Some 58% of residents began the training with apprehension, 85% outlined their priorities and 76% reached these objectives. A total of 70% were fully satisfied with the tuition and support received and 98% recommended such clinical rotation. Data suggest that a six-month rotation in palliative care results in high levels of perception of improvement in knowledge and satisfaction. Exposure to palliative care patients during clinical rotations in specialized centres must be encouraged.

Telemedicine in acute plastic surgical trauma and burns.

PubMed Central

Jones, S. M.; Milroy, C.; Pickford, M. A.

2004-01-01

BACKGROUND: Telemedicine is a relatively new development within the UK, but is increasingly useful in many areas of medicine including plastic surgery. Plastic surgery centres often work on a hub-and-spoke basis with many district hospitals referring to one tertiary centre. The Queen Victoria Hospital is one such centre receiving calls from more than 28 hospitals in the Southeast of England resulting in approximately 20 referrals a day. OBJECTIVE: A telemedicine system was developed to improve trauma management. This study was designed to establish whether digital images were sufficiently accurate enough to aid decision-making. A store-and-forward telemedicine system was devised and the images of 150 trauma referrals evaluated in terms of injury severity and operative priority by each member of the plastic surgical team. RESULTS: Correlation scores for assessed images were high. Accuracy of "transmitted image" in comparison to injury on examination scored > 97%. Operative priority scores tended to be higher than injury severity. CONCLUSIONS: Telemedicine is an accurate method by which to transfer information on plastic surgical trauma including burns. PMID:15239862

Open to All? Nationwide Evaluation of High-Priority Web Accessibility Considerations among Higher Education Websites

ERIC Educational Resources Information Center

Kimmons, Royce

2017-01-01

This study seeks to evaluate the basic Priority 1 web accessibility of all college and university websites in the US (n = 3141). Utilizing web scraping and automated content analysis, the study establishes that even in the case of high-priority, simple-to-address accessibility requirements, colleges and universities generally fail to make their…

75 FR 59803 - Endangered and Threatened Wildlife and Plants; Determination for the Gunnison Sage-grouse as a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... higher priority listing activities. A listing priority of 5 is assigned to species with high magnitude... number for Gunnison sage-grouse as a 2. A listing priority number of 2 is assigned to species with high... that are rich in calcium, phosphorous, and protein to meet the nutritional needs of females during the...

The Tropical Disease Priority Review Voucher: A Game-Changer for Tropical Disease Products

PubMed Central

Berman, Jonathan; Radhakrishna, Tanya

2017-01-01

The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals–artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis–have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. PMID:27573627

7 CFR 3560.154 - Tenant selection.

Code of Federal Regulations, 2011 CFR

2011-01-01

... discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial... (iii) Moderate-income applicants. (g) Priorities and preferences for admission. (1) Eligible applicants...) Borrowers receiving Section 8 project-based assistance may establish preferences in accordance with U.S...

A Study of Professional Nurses' Perceptions of Patient Education.

ERIC Educational Resources Information Center

Marcum, Julie; Ridenour, Maureen; Shaff, Gaye; Hammons, Mary; Taylor, Monica

2002-01-01

Of 124 acute care nurses, 97% felt that patient education was a priority. Inhibiting factors were time, staffing, and patient receptiveness. Enhancers included having time to teach, receiving effective teaching guidance materials, and having access to teaching resources. (SK)

Hovercraft transportation in Alaska : CZM & NEPA hurdles.

DOT National Transportation Integrated Search

2001-05-31

The United States Postal Service (USPS) received an unsolicited proposal from Alaska Hovercraft Joint Venture for a two-year demonstration program for the transport of : bypass and non-priority mail by Hovercraft on a year-round basis from the city o...

A Social Marketing Approach to 1% Milk Use: Resonance Is the Key.

PubMed

Finnell, Karla Jaye; John, Robert

2018-05-01

The U.S. Dietary Guidelines recommend low-fat milk consumption, and Supplemental Nutrition Assistance Program Education (SNAP-Ed) programs follow these guidelines to develop health education programs for SNAP recipients. This study evaluated a multilevel media intervention promoting low-fat milk use among Oklahoma SNAP recipients, a population often missed. Behavior change was measured with pre- and postintervention telephone interviews with SNAP recipients ( n = 860). Immediately following the intervention, self-reported purchases of 1% milk, the focus of behavior change, significantly increased to 7.9% from 4.1%-a relative improvement of 92.7%, χ 2 (1, n = 824) = 5.8, p = .02. Milk nutrition knowledge scores significantly improved as well, t(846) = 2.9, p = .004, and low-fat milk users exhibited more milk nutrition knowledge than high-fat milk users, t(437) = 4.0, p = .000. The intervention, which resonated with the priority audience, was well received ( Mdn = 6, 1, 7). Factors contributing to its success included a gain-based message strategy and clearly articulating the desired behavior. Salient messages personalized the issues and concerns raised by the priority audience-all the vitamins and minerals without the fat. Findings suggest that matching gender and ethnicity mediated the effect among those most resistant to substituting low-fat for high-fat milk.

Prioritizing government funding of adolescent vaccinations: recommendations from young people on a citizens' jury.

PubMed

Parrella, Adriana; Braunack-Mayer, Annette; Collins, Joanne; Clarke, Michelle; Tooher, Rebecca; Ratcliffe, Julie; Marshall, Helen

2016-06-30

Adolescents' views, and preferences are often over-looked when public health policies that affect them are designed and implemented. The purpose of this study was to describe young people's views and preferences for determining government funding priorities for adolescent immunization programs. In 2015 we conducted a youth jury in metropolitan Adelaide, South Australia to deliberate on the question "What criteria should we use to decide which vaccines for young people in Australia should receive public funding?" Fifteen youth aged 15-19 years participated in the jury. Jury members were recruited from the general community through a market research company using a stratified sampling technique. The jury's key priorities for determining publically funded vaccines were: Disease severity - whether the vaccine preventable disease (VPD) was life threatening and impacted on quality of life. Transmissibility - VPDs with high/fast transmission and high prevalence. Demonstration of cost-effectiveness, taking into account purchase price, program administration, economic and societal gain. The jury's recommendations for vaccine funding policy were strongly underpinned by the belief that it was critical to ensure that funding was targeted to not only population groups who would be medically at risk from vaccine preventable diseases, but also to socially and economically disadvantaged population groups. A novel recommendation proposed by the jury was that there should be a process for establishing criteria to remove vaccines from publically funded programs as a complement to the process for adding new vaccines. Young people have valuable contributions to make in priority setting for health programs and their views should be incorporated into the framing of health policies that directly affect them. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants of quality of life in HIV-infected patients receiving highly active antiretroviral treatment at a medical college ART center in Kolkata, India.

PubMed

Talukdar, Arunansu; Ghosal, Malay Kumar; Sanyal, Debasish; Talukdar, Payel Sengupta; Guha, Prathama; Guha, Subhasis Kamal; Basu, Saugata

2013-01-01

Health-related quality of life (QOL) has become a high priority of long-term management of HIV-infected individuals. The newly diagnosed HIV cases were assessed to obtain sociodemographic and clinical findings. Eyesenk Personality Questionnaire (EPQ), World Health Organization Quality of Life Brief (WHOQOL-BREF) for HIV-infected patients, and Beck Depression Inventory (BDI) were used to get data regarding personality traits, QOL, and depression scores. A total of 175 patients were included in the study, 128 (73.1%) men and 47 (26.9%) women. Overall 56% of patients screened positive for depression. Presence of depression and high neuroticism score in the personality profile of HIV-infected patients are significantly associated with poorer QOL. High neuroticism score was a strong predictor of poorer QOL in psychological and spiritual domain. Management of HIV-infected patients therefore needs to address these psychological issues.

Data collection and simulation of high range resolution laser radar for surface mine detection

NASA Astrophysics Data System (ADS)

Steinvall, Ove; Chevalier, Tomas; Larsson, Håkan

2006-05-01

Rapid and efficient detection of surface mines, IED's (Improvised Explosive Devices) and UXO (Unexploded Ordnance) is of high priority in military conflicts. High range resolution laser radars combined with passive hyper/multispectral sensors offer an interesting concept to help solving this problem. This paper reports on laser radar data collection of various surface mines in different types of terrain. In order to evaluate the capability of 3D imaging for detecting and classifying the objects of interest a scanning laser radar was used to scan mines and surrounding terrain with high angular and range resolution. These data were then fed into a laser radar model capable of generating range waveforms for a variety of system parameters and combinations of different targets and backgrounds. We can thus simulate a potential system by down sampling to relevant pixel sizes and laser/receiver characteristics. Data, simulations and examples will be presented.

Water quality monitoring for high-priority water bodies in the Sonoran Desert network

Treesearch

Terry W. Sprouse; Robert M. Emanuel; Sara A. Strorrer

2005-01-01

This paper describes a network monitoring program for “high priority” water bodies in the Sonoran Desert Network of the National Park Service. Protocols were developed for monitoring selected waters for ten of the eleven parks in the Network. Park and network staff assisted in identifying potential locations of testing sites, local priorities, and how water quality...

77 FR 29317 - Fiscal Year 2012 Draft Work Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-17

..., the Commission determines its own basic operating principles and funding criteria on an annual federal fiscal year (October 1 to September 30) basis. The Commission outlines these priorities and funding... 2012 Appropriations Summary The Denali Commission has historically received several federal funding...

5 CFR 330.1203 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND... Employees § 330.1203 Eligibility. (a) In order to be eligible for special selection priority, an eligible displaced employee of the former Panama Canal Zone must: (1) Have received a specific notice of separation...

Dynamic autonomous routing technology for IP-based satellite ad hoc networks

NASA Astrophysics Data System (ADS)

Wang, Xiaofei; Deng, Jing; Kostas, Theresa; Rajappan, Gowri

2014-06-01

IP-based routing for military LEO/MEO satellite ad hoc networks is very challenging due to network and traffic heterogeneity, network topology and traffic dynamics. In this paper, we describe a traffic priority-aware routing scheme for such networks, namely Dynamic Autonomous Routing Technology (DART) for satellite ad hoc networks. DART has a cross-layer design, and conducts routing and resource reservation concurrently for optimal performance in the fluid but predictable satellite ad hoc networks. DART ensures end-to-end data delivery with QoS assurances by only choosing routing paths that have sufficient resources, supporting different packet priority levels. In order to do so, DART incorporates several resource management and innovative routing mechanisms, which dynamically adapt to best fit the prevailing conditions. In particular, DART integrates a resource reservation mechanism to reserve network bandwidth resources; a proactive routing mechanism to set up non-overlapping spanning trees to segregate high priority traffic flows from lower priority flows so that the high priority flows do not face contention from low priority flows; a reactive routing mechanism to arbitrate resources between various traffic priorities when needed; a predictive routing mechanism to set up routes for scheduled missions and for anticipated topology changes for QoS assurance. We present simulation results showing the performance of DART. We have conducted these simulations using the Iridium constellation and trajectories as well as realistic military communications scenarios. The simulation results demonstrate DART's ability to discriminate between high-priority and low-priority traffic flows and ensure disparate QoS requirements of these traffic flows.

Prevention and self-management interventions are top priorities for osteoarthritis systematic reviews.

PubMed

Jaramillo, Alejandra; Welch, Vivian A; Ueffing, Erin; Gruen, Russell L; Bragge, Peter; Lyddiatt, Anne; Tugwell, Peter

2013-05-01

To identify high-priority research questions for osteoarthritis systematic reviews with consideration of health equity and the social determinants of health (SDH). We consulted with experts and conducted a literature search to identify a priority-setting method that could be adapted to address the health equity and SDH. We selected the Global Evidence Mapping priority-setting method, and through consultations and consensus, we adapted the method to meet our objectives. This involves developing an evidence map of the existing systematic reviews on osteoarthritis; conducting one face-to-face workshop with patients and another one with clinicians, researchers, and patients; and conducting an online survey of patients to rank the top 10 research questions. We piloted the adapted method with the Cochrane Musculoskeletal Review Group to set research priorities for osteoarthritis. Our focus was on systematic reviews: we identified 34 high-priority research questions for osteoarthritis systematic reviews. Prevention and self-management interventions, mainly diet and exercise, are top priorities for osteoarthritis systematic reviews. Evaluation against our predefined objectives showed that this method did prioritize SDH (50% of the research questions considered SDH). There were marked gaps: no high-priority topics were identified for access to care until patients had advanced disease-lifestyle changes once the disease was diagnosed. This method was felt feasible if conducted annually. We confirmed the utility of an adapted priority-setting method that is feasible and considers SDH. Further testing of this method is needed to assess whether considerations of health equity are prioritized and involve disadvantaged groups of the population. Copyright © 2013 Elsevier Inc. All rights reserved.

Recommended Priorities for NASA's Gamma Ray Astronomy Program 1999-2013

NASA Technical Reports Server (NTRS)

Carol, Ladd

1999-01-01

The Gamma-Ray Astronomy Program Working Group (GRAPWG) recommends priorities for the NASA Gamma-Ray Astronomy Program. The highest priority science topic is nuclear astrophysics and sites of gamma ray line emission. Other high priority topics are gamma ray bursts, hard x-ray emission from accreting black holes and neutron stars, the Advanced Compton Telescope (ACT), the High-resolution Spectroscopic Imager (HSI), and the Energetic X-ray Imaging Survey Telescope (EXIST). The recommendations include special consideration for technology development, TeV astronomy, the ultra-long duration balloon (ULDB) program, the International Space Station, optical telescope support, and data analysis and theory.

Rehabilitation priorities for individuals with Prader-Willi Syndrome.

PubMed

Pituch, Keenan A; Green, Vanessa A; Didden, Robert; Lang, Russell; O'Reilly, Mark F; Lancioni, Giulio E; Whittle, Lisa; Hodis, Flaviu; Sigafoos, Jeff

2010-01-01

To identify rehabilitation priorities that parents have for their children, including their adult-aged children, with Prader-Willi Syndrome (PWS) and to determine the relation between these priorities and the child's levels of adaptive behaviour functioning. Parents involved in organisations related to PWS were invited to complete an online survey. The survey listed 54 skills/behaviours (e.g. toileting, expresses wants and needs and tantrums) representing 10 adaptive functioning domains (e.g. self-care, communication and problem behaviour). Parents rated their child's current level of ability/performance with respect to each skill/behaviour and indicated the extent to which training/treatment was a priority. Fifty-eight surveys were completed during the 4-month data collection period. Parents identified nine high-priority skills/behaviours from five different adaptive functioning domains. For most domains, parent priorities showed a significant linear relation to the children's adaptive behaviour deficits, in that priorities reflected areas where the child had the greatest deficits and the most problematic behaviours. Rehabilitation professionals should focus on the eating issues that arise in PWS and identify the adaptive functioning deficits of these individuals because such deficits are high-priority areas for parents.

Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis.

PubMed

Tacconelli, Evelina; Carrara, Elena; Savoldi, Alessia; Harbarth, Stephan; Mendelson, Marc; Monnet, Dominique L; Pulcini, Céline; Kahlmeter, Gunnar; Kluytmans, Jan; Carmeli, Yehuda; Ouellette, Marc; Outterson, Kevin; Patel, Jean; Cavaleri, Marco; Cox, Edward M; Houchens, Chris R; Grayson, M Lindsay; Hansen, Paul; Singh, Nalini; Theuretzbacher, Ursula; Magrini, Nicola

2018-03-01

The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs. We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority ranking of the antibiotic-resistant bacteria was established after a preference-based survey was used to obtain expert weighting of criteria. We selected 20 bacterial species with 25 patterns of acquired resistance and ten criteria to assess priority: mortality, health-care burden, community burden, prevalence of resistance, 10-year trend of resistance, transmissibility, preventability in the community setting, preventability in the health-care setting, treatability, and pipeline. We stratified the priority list into three tiers (critical, high, and medium priority), using the 33rd percentile of the bacterium's total scores as the cutoff. Critical-priority bacteria included carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistant Enterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistant Campylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier. Future development strategies should focus on antibiotics that are active against multidrug-resistant tuberculosis and Gram-negative bacteria. The global strategy should include antibiotic-resistant bacteria responsible for community-acquired infections such as Salmonella spp, Campylobacter spp, N gonorrhoeae, and H pylori. World Health Organization. Copyright © 2018 Elsevier Ltd. All rights reserved.

Why prioritize when there isn't enough money?

PubMed

Wikler, Daniel

2003-02-26

In an informal address to the 4th International Conference on Priorities in Health (Oslo, 23 September 2002), Professor Jeffrey Sachs - Chairperson of the WHO Commission on Macroeconomics and Health - maintained that the real causes of the inability of the world's poorest people to receive help for the lethal diseases that burden them did not include the "usual suspects" (corruption, mismanagement, and wrong priorities). Rather, the root cause was argued to be an inherent lack of money, indicating that the burden of disease would be lifted only if rich countries gave more money to poor ones.Without taking exception to anything that Sachs said in his address, there nevertheless remain a number of justifications for efforts to improve priority setting in the face of severely shortages of resources, including the following three defenses: prioritization is needed if we are to know that prioritization is insufficient; prioritization is most important when there is little money; prioritization can itself increase resources.

Factors affecting family satisfaction with inpatient end-of-life care.

PubMed

Sadler, Erin; Hales, Brigette; Henry, Blair; Xiong, Wei; Myers, Jeff; Wynnychuk, Lesia; Taggar, Ru; Heyland, Daren; Fowler, Robert

2014-01-01

Little data exists addressing satisfaction with end-of-life care among hospitalized patients, as they and their family members are systematically excluded from routine satisfaction surveys. It is imperative that we closely examine patient and institution factors associated with quality end-of-life care and determine high-priority target areas for quality improvement. Between September 1, 2010 and January 1, 2012 the Canadian Health care Evaluation Project (CANHELP) Bereavement Questionnaire was mailed to the next-of-kin of recently deceased inpatients to seek factors associated with satisfaction with end-of-life care. The primary outcome was the global rating of satisfaction. Secondary outcomes included rates of actual versus preferred location of death, associations between demographic factors and global satisfaction, and identification of targets for quality improvement. Response rate was 33% among 275 valid addresses. Overall, 67.4% of respondents were very or completely satisfied with the overall quality of care their relative received. However, 71.4% of respondents who thought their relative did not die in their preferred location favoured an out-of-hospital location of death. A common location of death was the intensive care unit (45.7%); however, this was not the preferred location of death for 47.6% of such patients. Multivariate Poisson regression analysis showed respondents who believed their relative died in their preferred location were 1.7 times more likely to be satisfied with the end-of-life care that was provided (p = 0.001). Items identified as high-priority targets for improvement included: relationships with, and characteristics of health care professionals; illness management; communication; and end-of-life decision-making. Nearly three-quarters of recently deceased inpatients would have preferred an out-of-hospital death. Intensive care units were a common, but not preferred, location of in-hospital deaths. Family satisfaction with end-of-life care was strongly associated with their relative dying in their preferred location. Improved communication regarding end-of-life care preferences should be a high-priority quality improvement target.

25 CFR 170.205 - What is an IRR High Priority Project (IRRHPP)?

Code of Federal Regulations, 2010 CFR

2010-04-01

... RESERVATION ROADS PROGRAM Indian Reservation Roads Program Funding Irr High Priority Project (irrhpp) § 170... applications. (c) IRRHPP funds cannot be used for transportation planning, research, routine maintenance...

Radio Links for the NASA ABTS

NASA Technical Reports Server (NTRS)

Jeutter, Dean C.

1996-01-01

Goals Determine Out-Link FSK Bandwidth Develop FSK Outlink Transmitter Develop Wideband Outlink FSK Receiver Develop OOK In-Link Transmitter Develop OOK In-Link Receiver Marry Out-Link & In-Link Components Outlink FSK Bandwidth preliminary inlink transmitter were accomplished in Summer 1995 visit. The calculation of FSK bandwidth is repeated in these notes. Spectrum analyzer measurements of the actual FSK spectrum agree well with the calculations. The goal to develop a wideband FSK receiver for outlink data was given first priority for end of Summer 1996 completion. The goal of developing OOK inlink transmitter and receiver system components and interfacing all outlink and inlink components into an operating closed loop prototypical system was given a December 1, 1996 completion date.

Framing research for state policymakers who place a priority on cancer.

PubMed

Brownson, Ross C; Dodson, Elizabeth A; Kerner, Jon F; Moreland-Russell, Sarah

2016-08-01

Despite the potential for reducing the cancer burden via state policy change, few data exist on how best to disseminate research information to influence state legislators' policy choices. We explored: (1) the relative importance of core framing issues (source, presentation, timeliness) among policymakers who prioritize cancer and those who do not prioritize cancer and (2) the predictors of use of research in policymaking. Cross-sectional data were collected from US state policymakers (i.e., legislators elected to state houses or senates) from January through October 2012 (n = 862). One-way analysis of variance was performed to investigate the association of the priority of cancer variable with outcome variables. Multivariate logistic regression models examined predictors of the influence of research information. Legislators who prioritized cancer tended to rate characteristics that make research information useful higher than those who did not prioritize cancer. Among differences that were statistically significant were three items in the "source" domain (relevance, delivered by someone respected, supports one's own position), one item in the "presentation" domain (telling a story related to constituents) and two items in the "timeliness" domain (high current state priority, feasible when information is received). Participants who prioritized cancer risk factors were 80 % more likely to rate research information as one of their top reasons for choosing an issue on which to work. Our results suggest the importance of narrative forms of communication and that research information needs to be relevant to the policymakers' constituents in a brief, concise format.

The Tropical Disease Priority Review Voucher: A Game-Changer for Tropical Disease Products.

PubMed

Berman, Jonathan; Radhakrishna, Tanya

2017-01-11

The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals-artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis-have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. © The American Society of Tropical Medicine and Hygiene.

36 CFR 230.4 - State program administration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and set priorities for achieving the goals and objectives identified for the State for each year. (2... planting, maintenance, and improvement, and other high priority practices within the State that will result... appropriate Service Representative; (9) Guidelines for establishing annual priorities for the approval of...

Apparatus for fixing latency

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

Hall, David R; Bartholomew, David B; Moon, Justin

2009-09-08

An apparatus for fixing computational latency within a deterministic region on a network comprises a network interface modem, a high priority module and at least one deterministic peripheral device. The network interface modem is in communication with the network. The high priority module is in communication with the network interface modem. The at least one deterministic peripheral device is connected to the high priority module. The high priority module comprises a packet assembler/disassembler, and hardware for performing at least one operation. Also disclosed is an apparatus for executing at least one instruction on a downhole device within a deterministic region,more » the apparatus comprising a control device, a downhole network, and a downhole device. The control device is near the surface of a downhole tool string. The downhole network is integrated into the tool string. The downhole device is in communication with the downhole network.« less

Microgravity

NASA Image and Video Library

1998-09-30

The Electrostatic Levitator (ESL) Facility established at Marshall Space Flight Center (MSFC) supports NASA's Microgravity Materials Science Research Program. NASA materials science investigations include ground-based, flight definition and flight projects. Flight definition projects, with demanding science concept review schedules, receive highest priority for scheduling experiment time in the Electrostatic Levitator (ESL) Facility.

Sitting in "Motion"

ERIC Educational Resources Information Center

Brinks, Kathrin

2009-01-01

For children, the urge to move is a basic need. Movement is essential for the development of physical and mental abilities. Quite often, for children with intellectual and physical disabilities who require special supportive seating, other considerations receive priority over movement in seats. The result is an even greater reduction of their…

Gender Differences in Work Adjustment of Prison Employees.

ERIC Educational Resources Information Center

Fry, Lincoln J.; Glaser, Daniel

1987-01-01

Examined 1,300 employees at three California prisons. Fieldwork supported claim that male staff are negatively oriented toward female employees and that women staff and women's prisons receive low priority from male-dominated state agencies. Survey of employees revealed little gender differences in work adjustment. (Author/NB)

5 CFR 330.708 - Application and selection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... to be well-qualified, any of these eligible employees may be selected. (3) If no eligible employees... Employees § 330.708 Application and selection. (a) Application. (1) To receive this special selection priority, eligible employees must apply directly to agencies for specific vacancies in the local commuting...

Approaches for Development of Nutrient Criteria in Oregon Estuaries

EPA Science Inventory

Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

7 CFR 761.210 - CL funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false CL funds. 761.210 Section 761.210 Agriculture... SPECIAL PROGRAMS GENERAL PROGRAM ADMINISTRATION Allocation of Farm Loan Programs Funds to State Offices § 761.210 CL funds. (a) The following applicants and conservation projects will receive priority for CL...

Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

PubMed

2014-08-14

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

Addressing critical gaps in the treatment of eating disorders.

PubMed

Kazdin, Alan E; Fitzsimmons-Craft, Ellen E; Wilfley, Denise E

2017-03-01

Remarkable progress has been made in developing psychosocial interventions for eating disorders and other mental disorders. Two priorities in providing treatment consist of addressing the research-practice gap and the treatment gap. The research-practice gap pertains to the dissemination of evidence-based treatments from controlled settings to routine clinical care. Closing the gap between what is known about effective treatment and what is actually provided to patients who receive care is crucial in improving mental health care, particularly for conditions such as eating disorders. The treatment gap pertains to extending treatments in ways that will reach the large number of people in need of clinical care who currently receive nothing. Currently, in the United States (and worldwide), the vast majority of individuals in need of mental health services for eating disorders and other mental health problems do not receive treatment. This article discusses the approaches required to better ensure: (1) that more people who are receiving treatment obtain high-quality, evidence-based care, using such strategies as train-the-trainer, web-centered training, best-buy interventions, electronic support tools, higher-level support and policy; and (2) that a higher proportion of those who are currently underserved receive treatment, using such strategies as task shifting and disruptive innovations, including treatment delivery via telemedicine, the Internet, and mobile apps. © 2017 Wiley Periodicals, Inc.

Norepinephrine ignites local hotspots of neuronal excitation: How arousal amplifies selectivity in perception and memory.

PubMed

Mather, Mara; Clewett, David; Sakaki, Michiko; Harley, Carolyn W

2016-01-01

Emotional arousal enhances perception and memory of high-priority information but impairs processing of other information. Here, we propose that, under arousal, local glutamate levels signal the current strength of a representation and interact with norepinephrine (NE) to enhance high priority representations and out-compete or suppress lower priority representations. In our "glutamate amplifies noradrenergic effects" (GANE) model, high glutamate at the site of prioritized representations increases local NE release from the locus coeruleus (LC) to generate "NE hotspots." At these NE hotspots, local glutamate and NE release are mutually enhancing and amplify activation of prioritized representations. In contrast, arousal-induced LC activity inhibits less active representations via two mechanisms: 1) Where there are hotspots, lateral inhibition is amplified; 2) Where no hotspots emerge, NE levels are only high enough to activate low-threshold inhibitory adrenoreceptors. Thus, LC activation promotes a few hotspots of excitation in the context of widespread suppression, enhancing high priority representations while suppressing the rest. Hotspots also help synchronize oscillations across neural ensembles transmitting high-priority information. Furthermore, brain structures that detect stimulus priority interact with phasic NE release to preferentially route such information through large-scale functional brain networks. A surge of NE before, during, or after encoding enhances synaptic plasticity at NE hotspots, triggering local protein synthesis processes that enhance selective memory consolidation. Together, these noradrenergic mechanisms promote selective attention and memory under arousal. GANE not only reconciles apparently contradictory findings in the emotion-cognition literature but also extends previous influential theories of LC neuromodulation by proposing specific mechanisms for how LC-NE activity increases neural gain.

Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

PubMed

Plint, Amy C; Stang, Antonia S; Calder, Lisa A

2015-01-01

Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for improving patient safety (five priorities). This study established expert, consensus-based research priorities for patient safety in emergency medicine. This framework could be used by researchers and health-care funders and represents an essential guiding step towards enhancing quality of care and patient safety in the ED.

Defining Priorities for Future Research: Results of the UK Kidney Transplant Priority Setting Partnership

PubMed Central

Metcalfe, Leanne; O’Donoghue, Katriona; Ball, Simon T.; Beale, Angela; Beale, William; Hilton, Rachel; Hodkinson, Keith; Lipkin, Graham W.; Loud, Fiona; Marson, Lorna P.; Morris, Peter J.

2016-01-01

Background It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. Methods The PSP methodology is as outlined by the James Lind Alliance. An initial survey collected unanswered research questions from patients, carers and clinicians. Duplicate and out-of-scope topics were excluded and the existing literature searched to identify topics answered by current evidence. An interim prioritisation survey asked patients and professionals to score the importance of the remaining questions to create a ranked long-list. These were considered at a final consensus workshop using a modified nominal group technique to agree a final top ten. Results The initial survey identified 497 questions from 183 respondents, covering all aspects of transplantation from assessment through to long-term follow-up. These were grouped into 90 unanswered “indicative” questions. The interim prioritisation survey received 256 responses (34.8% patients/carers, 10.9% donors and 54.3% professionals), resulting in a ranked list of 25 questions that were considered during the final workshop. Participants agreed a top ten priorities for future research that included optimisation of immunosuppression (improved monitoring, choice of regimen, personalisation), prevention of sensitisation and transplanting the sensitised patient, management of antibody-mediated rejection, long-term risks to live donors, methods of organ preservation, induction of tolerance and bioengineering of organs. There was evidence that patient and carer involvement had a significant impact on shaping the final priorities. Conclusions The final list of priorities relates to all stages of the transplant process, including access to transplantation, living donation, organ preservation, post-transplant care and management of the failing transplant. This list of priorities will provide an invaluable resource for researchers and funders to direct future activity. PMID:27776143

Defining Priorities for Future Research: Results of the UK Kidney Transplant Priority Setting Partnership.

PubMed

Knight, Simon R; Metcalfe, Leanne; O'Donoghue, Katriona; Ball, Simon T; Beale, Angela; Beale, William; Hilton, Rachel; Hodkinson, Keith; Lipkin, Graham W; Loud, Fiona; Marson, Lorna P; Morris, Peter J

2016-01-01

It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. The PSP methodology is as outlined by the James Lind Alliance. An initial survey collected unanswered research questions from patients, carers and clinicians. Duplicate and out-of-scope topics were excluded and the existing literature searched to identify topics answered by current evidence. An interim prioritisation survey asked patients and professionals to score the importance of the remaining questions to create a ranked long-list. These were considered at a final consensus workshop using a modified nominal group technique to agree a final top ten. The initial survey identified 497 questions from 183 respondents, covering all aspects of transplantation from assessment through to long-term follow-up. These were grouped into 90 unanswered "indicative" questions. The interim prioritisation survey received 256 responses (34.8% patients/carers, 10.9% donors and 54.3% professionals), resulting in a ranked list of 25 questions that were considered during the final workshop. Participants agreed a top ten priorities for future research that included optimisation of immunosuppression (improved monitoring, choice of regimen, personalisation), prevention of sensitisation and transplanting the sensitised patient, management of antibody-mediated rejection, long-term risks to live donors, methods of organ preservation, induction of tolerance and bioengineering of organs. There was evidence that patient and carer involvement had a significant impact on shaping the final priorities. The final list of priorities relates to all stages of the transplant process, including access to transplantation, living donation, organ preservation, post-transplant care and management of the failing transplant. This list of priorities will provide an invaluable resource for researchers and funders to direct future activity.

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.

PubMed

Silva, Diego S; Gibson, Jennifer L; Robertson, Ann; Bensimon, Cécile M; Sahni, Sachin; Maunula, Laena; Smith, Maxwell J

2012-03-26

Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

Research priorities for respiratory nursing: a UK-wide Delphi study.

PubMed

Kelly, Carol Ann; Kirkcaldy, Andrew J; Pilkington, Melissa; Hodson, Matthew; Welch, Lindsay; Yorke, Janelle; Knighting, Katherine

2018-04-01

Respiratory nurses make a significant contribution to the delivery of respiratory healthcare, but there is a dearth of nurse-led, practice-focused, published research. Using a modified three-round Delphi, this study sought to identify research priorities for respiratory nursing to inform a national research strategy. Study information and the survey link were sent electronically to members of UK professional respiratory organisations. Round 1 had 78 items across 16 topics, informed by a systematic literature review. Respondents suggested additional items which were content analysed to inform Round 2. Respondents rated all items and ranked the topics in all rounds. To ensure rigour, rounds had an explicit focus with pre-determined criteria for consensus (70%). In total, 363 responses were received across Rounds 1, 2 and 3 (n=183, 95 and 85, respectively). The top five research priorities were: 1) "Patient understanding of asthma control"; 2) "The clinical and cost-effectiveness of respiratory nurse interventions"; 3) "The impact of nurse-led clinics on patient care"; 4) "Inhaler technique"; and 5) two topics jointly scored: "Prevention of exacerbations" and "Symptom management". With potential international significance, this is the first UK study to identify research priorities for respiratory nursing, providing direction for those planning or undertaking research.

Priority setting and evidence based purchasing.

PubMed

Frith, L

1999-01-01

The purpose of this paper is to consider the role that values play in priority setting through the use of EBP. It is important to be clear about the role of values at all levels of the decision making process. At one level, society as a whole has to make decisions about the kind of health provision that it wants. As is generally accepted, these priority setting questions cannot be answered by medical science alone but involve important judgements of value. However, as I hope to show values come into priority setting questions at another level, one not often explicitly recognised in much of the literature: that of the very definition of the effectiveness of treatments. This has important consequences for patient care. If we do not recognise that the effectiveness of a treatment involve subjective elements--a patient's own assessment of the value of the treatment--then this could lead to the belief that we can purchase one treatment that is the most effective for all patients. This might result in a detrimental reduction in the range of options that a patient is given with some patients not receiving the treatment that is most effective for them.

Factors explaining priority setting at community mental health centres: a quantitative analysis of referral assessments.

PubMed

Grepperud, Sverre; Holman, Per Arne; Wangen, Knut Reidar

2014-12-14

Clinicians at Norwegian community mental health centres assess referrals from general practitioners and classify them into three priority groups (high priority, low priority, and refusal) according to need where need is defined by three prioritization criteria (severity, effect, and cost-effectiveness). In this study, we seek to operationalize the three criteria and analyze to what extent they have an effect on clinical-level priority setting after controlling for clinician characteristics and organisational factors. Twenty anonymous referrals were rated by 42 admission team members employed at 14 community mental health centres in the South-East Health Region of Norway. Intra-class correlation coefficients were calculated and logistic regressions were performed. Variation in clinicians' assessments of the three criteria was highest for effect and cost-effectiveness. An ordered logistic regression model showed that all three criteria for prioritization, three clinician characteristics (education, being a manager or not, and "guideline awareness"), and the centres themselves (fixed effects), explained priority decisions. The relative importance of the explanatory factors, however, depended on the priority decision studied. For the classification of all admitted patients into high- and low-priority groups, all clinician characteristics became insignificant. For the classification of patients, into those admitted and non-admitted, one criterion (effect) and "being a manager or not" became insignificant, while profession ("being a psychiatrist") became significant. Our findings suggest that variation in priority decisions can be reduced by: (i) reducing the disagreement in clinicians' assessments of cost-effectiveness and effect, and (ii) restricting priority decisions to clinicians with a similar background (education, being a manager or not, and "guideline awareness").

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... vacation and sick leave pay and contributions to employee benefit plans, earned prior to the appointment of... interests of the receivership to engage or retain for a reasonable period of time; (4) If authorized by the receiver, claims for wages and salaries, including vacation and sick leave pay and contributions to...

Southern California Priority Corridor Showcase Program evaluation : Corridor-wide Rideshare Data Exchange Project evaluation report

DOT National Transportation Integrated Search

2004-11-01

As required by federal law, all Intelligent Transportation System (ITS) projects that : receive federal funding must undergo an evaluation to help assess the costs and benefits : of ITS. This document is one of 23 reports produced as part of the Sout...

75 FR 27539 - Office of Special Education and Rehabilitative Services: Overview Information: National...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... consumers of vocational rehabilitation (VR) services. The National Center funded under this priority must do... VR agencies that received information related to the activities of both the National and Regional..., trainings, and publications improved the quality of interpreters. The percentage of all State VR agencies...

Socioeconomic research in agroforestry: progress, prospects, priorities

Treesearch

D. Evan Mercer; R.P. Miller

1998-01-01

Fourteen years after the birth of the journal Agroforestry Systems, biophysical studies continue to dominate agroforestry research while other important areas have not received the attention they deserve. This paper reviews the progress in one of these under-researched areas, socioeconomics. A quantitative and qualitative analysis of published socioeconomic research...

78 FR 5424 - Applications for New Awards; Indian Education-Professional Development Grants Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

... various institutions of higher education and reviewing State certification and licensure requirements, we... by an Indian tribe, Indian organization, or Indian institution of higher education that is eligible... institution of higher education will be considered eligible to receive the five priority points. The...

77 FR 6096 - Applications for New Awards; Indian Education-Professional Development Grants Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... various institutions of higher education and reviewing State certification and licensure requirements, we... submitted by an Indian tribe, Indian organization, or Indian institution of higher education that is... Indian institution of higher education will be considered eligible to receive the five priority points...

77 FR 69925 - Assessment of Hazardous Materials Incident Data Collection, Analysis, Reporting, and Use

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... posted without change to the Federal Docket Management System (FDMS), including any personal information... effectiveness; 2. Determine the need for regulatory changes to address changing transportation safety problems; 3. Identify major problem or risk areas that should receive priority attention; 4. Chart trends; 5...

Special Education Professional Development Needs in Zimbabwe

ERIC Educational Resources Information Center

Chitiyo, Morgan; Hughes, Elizabeth M.; Changara, Darlington M.; Chitiyo, George; Montgomery, Kristen M.

2017-01-01

Since 1980 when Zimbabwe obtained political independence, special education has not received the same priority as the entire education system. One of the manifestations of this discrepancy is the shortage of qualified special education teachers in the country. In order to address this trend and promote the development of special education,…

Priorities for Action-Oriented Psychological Studies of Television and Behavior.

ERIC Educational Resources Information Center

Comstock, George

Violence and advertising are the most visible of many issues receiving attention in the formulation of policy by govermental agencies, the television industry, and advocacy groups. The role in policy formulation of empirical research that identifies relationships between television viewing, individual thought, and behavior is growing in several…

Reference Condition Approach for Numeric Nutrient Criteria for Oregon Estuaries

EPA Science Inventory

Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

42 CFR 476.78 - Responsibilities of health care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... furnished to Medicare beneficiaries must maintain a written agreement with a QIO operating in the area in... information within 30 days of a request. QIOs pay providers paid under the prospective payment system for the... receive retrospective prepayment review, according to the review priority established by the QIO. (c...

Advanced In-Space Propulsion: "Exploring the Solar System"

NASA Technical Reports Server (NTRS)

Johnson, Les

2003-01-01

This viewgraph presentation reviews a number of advanced propulsion technologies for interplanetary spacecraft. The objective of the In Space Propulsion Technology Projects Office is to develop in-space propulsion technologies that can enable and/or benefit near and mid-term NASA science missions by significantly reducing cost, mass, and/or travel times. The technologies profiled are divided into several categories: High Priority (aerocapture, next generation ion propulsion, solar sails); Medium Priority (advanced chemical propulsion, solar electric propulsion, Hall thrusters); Low Priority (solar thermal propulsion); and High Payoff/High Risk (1 g/sq m solar sails, momentum exchange tethers, and plasma sails).

Strategic workload management and decision biases in aviation

NASA Technical Reports Server (NTRS)

Raby, Mireille; Wickens, Christopher D.

1994-01-01

Thirty pilots flew three simulated landing approaches under conditions of low, medium, and high workload. Workload conditions were created by varying time pressure and external communications requirements. Our interest was in how the pilots strategically managed or adapted to the increasing workload. We independently assessed the pilot's ranking of the priority of different discrete tasks during the approach and landing. Pilots were found to sacrifice some aspects of primary flight control as workload increased. For discrete tasks, increasing workload increased the amount of time in performing the high priority tasks, decreased the time in performing those of lowest priority, and did not affect duration of performance episodes or optimality of scheduling of tasks of any priority level. Individual differences analysis revealed that high-performing subjects scheduled discrete tasks earlier in the flight and shifted more often between different activities.

Patient-reported assessment of quality care at end of life: development and validation of Quality Care Questionnaire-End of Life (QCQ-EOL).

PubMed

Yun, Young Ho; Kim, Soo-Hyun; Lee, Kyoung-Min; Park, Sang Min; Lee, Chang Geol; Choi, Youn Seon; Lee, Won Sup; Kim, Si-Young; Heo, Dae Seog

2006-09-01

Our goal was to validate an instrument with which terminally ill patients could evaluate the quality of care they receive at the end of life (EOL). Questionnaire development followed a four-phase process: item generation and reduction, construction, pilot testing, and field-testing. Using relevance and priority criteria and pilot testing, we developed a 16-item questionnaire. Factor analyses of data from 235 patients resulted in the Quality Care Questionnaire-End of Life (QCQ-EOL) covering dignity-conserving care, care by health care professionals, individualised care, and family relationships. All subscales and total scores showed high internal consistency (Cronbach alpha range, 0.73-0.89). The ability of total score and selective subscale scores clearly differentiated patients on the basis of clinical situation, sense of dignity, and general rating of care quality. Correlations of scores between patients and caregivers were substantial. The QCQ-EOL can be adopted to assess the quality of care received by terminally ill patients.

Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary.

PubMed

Cairns, Georgina; Angus, Kathryn; Hastings, Gerard; Caraher, Martin

2013-03-01

A 2009 systematic review of the international evidence on food and beverage marketing to children is the most recent internationally comprehensive review of the evidence base. Its findings are consistent with other independent, rigorous reviews conducted during the period 2003-2012. Food promotions have a direct effect on children's nutrition knowledge, preferences, purchase behaviour, consumption patterns and diet-related health. Current marketing practice predominantly promotes low nutrition foods and beverages. Rebalancing the food marketing landscape' is a recurring policy aim of interventions aimed at constraining food and beverage promotions to children. The collective review evidence on marketing practice indicates little progress towards policy aims has been achieved during the period 2003-2012. There is a gap in the evidence base on how substantive policy implementation can be achieved. We recommend a priority for future policy relevant research is a greater emphasis on translational research. A global framework for co-ordinated intervention to constrain unhealthy food marketing which has received high level support provides valuable insight on some aspects of immediate implementation research priorities. Copyright © 2012 Elsevier Ltd. All rights reserved.

Priority Techniques for High Occupancy Vehicles : State-of-the-Art Overview

DOT National Transportation Integrated Search

1975-11-01

The report, part of a series of publications based on research and development efforts is a concise state-of-the-art overview of priority techniques for high occupancy vehicles (buses, carpools, and vanpools). The report identifies and summarizes sel...

Assessment of Quality of Life of HIV-Positive People Receiving ART: An Indian Perspective.

PubMed

Anand, Deepika; Puri, Seema; Mathew, Minnie

2012-07-01

HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. The purpose of the present study is to evaluate the quality of life (QOL) of people living with HIV/AIDS (PLHIV) receiving ART and its association with Body mass index (BMI) and CD4 count. An observational study was performed on PLHIV receiving ART in Orissa, India. Data on sociodemographic profile, BMI, and CD4 were gathered from 153 HIV-positive subjects. QOL was assessed using WHOQOL-HIV BREF scale. The overall QOL score of the subjects was moderate; PLHIV with lower BMI also had poorer QOL (P<0.05). Employment affected only the social health domain of the subjects. Men reported poorer level of independence and physical health while women reported poorer social relationships and environment. All the six domains correlated significantly with the overall QOL indicated by the G-facet. Attention toward improving the nutritional status of PLHIV should be accorded high priority to ensure improvement in the overall QOL of PLHIV.

Stanford Synchrotron Radiation Laboratory. Activity report for 1989

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

NONE

1996-01-01

The April, 1990 SPEAR synchrotron radiation run was one of the two or three best in SSRL`s history. High currents were accumulated, ramping went easily, lifetimes were long, beam dumps were infrequent and the average current was 42.9 milliamps. In the one month of operation, 63 different experiments involving 208 scientists from 50 institutions received beam. The end-of-run summary forms completed by the experimenters indicated high levels of user satisfaction with the beam quality and with the outstanding support received from the SSRL technical and scientific staffs. These fine experimental conditions result largely from the SPEAR repairs and improvements performedmore » during the past year and described in Section I. Also quite significant was Max Cornacchia`s leadership of the SLAG staff. SPEAR`s performance this past April stands in marked contrast to that of the January-March, 1989 run which is also described in Section I. It is, we hope, a harbinger of the operation which will be provided in FY `91, when the SPEAR injector project is completed and SPEAR is fully dedicated to synchrotron radiation research. Over the coming years, SSRL intends to give highest priority to increasing the effectiveness of SPEAR and its various beam lines. The beam line and facility improvements performed during 1989 are described in Section III. In order to concentrate effort on SSRL`s three highest priorities prior to the March-April run: (1) to have a successful run, (2) to complete and commission the injector, and (3) to prepare to operate, maintain and improve the SPEAR/injector system, SSRL was reorganized. In the new organization, all the technical staff is contained in three groups: Accelerator Research and Operations Division, Injector Project and Photon Research and Operations Division, as described in Section IV. In spite of the limited effectiveness of the January-March, 1989 run, SSRL`s users made significant scientific progress, as described in Section V of this report.« less

Are the poor differentially benefiting from provision of priority public health services? A benefit incidence analysis in Nigeria

PubMed Central

2012-01-01

Background The paper presents evidence about the distribution of the benefits of public expenditures on a subset of priority public health services that are supposed to be provided free of charge in the public sector, using the framework of benefit incidence analysis. Methods The study took place in 2 rural and 2 urban Local Government Areas from Enugu and Anambra states, southeast Nigeria. A questionnaire was used to collect data on use of the priority public health services by all individuals in the households (n=22,169). The level of use was disaggregated by socio-economic status (SES), rural-urban location and gender. Benefits were valued using the cost of providing the service. Net benefit incidence was calculated by subtracting payments made for services from the value of benefits. Results The results showed that 3,281 (14.8%) individuals consumed wholly free services. There was a greater consumption of most free services by rural dwellers, females and those from poorer SES quintiles (but not for insecticide-treated nets and ante-natal care services). High levels of payment were observed for immunisation services, insecticide-treated nets, anti-malarial medicines, antenatal care and childbirth services, all of which are supposed to be provided for free. The net benefits were significantly higher for the rural residents, males and the poor compared to the urban residents, females and better-off quintiles. Conclusion It is concluded that coverage of all of these priority public health services fell well below target levels, but the poorer quintiles and rural residents that are in greater need received more benefits, although not so for females. Payments for services that are supposed to be delivered free of charge suggests that there may have been illegal payments which probably hindered access to the public health services. PMID:23158434

Interactions between visual working memory representations.

PubMed

Bae, Gi-Yeul; Luck, Steven J

2017-11-01

We investigated whether the representations of different objects are maintained independently in working memory or interact with each other. Observers were shown two sequentially presented orientations and required to reproduce each orientation after a delay. The sequential presentation minimized perceptual interactions so that we could isolate interactions between memory representations per se. We found that similar orientations were repelled from each other whereas dissimilar orientations were attracted to each other. In addition, when one of the items was given greater attentional priority by means of a cue, the representation of the high-priority item was not influenced very much by the orientation of the low-priority item, but the representation of the low-priority item was strongly influenced by the orientation of the high-priority item. This indicates that attention modulates the interactions between working memory representations. In addition, errors in the reported orientations of the two objects were positively correlated under some conditions, suggesting that representations of distinct objects may become grouped together in memory. Together, these results demonstrate that working-memory representations are not independent but instead interact with each other in a manner that depends on attentional priority.

Radiation countermeasure agents: an update (2011 – 2014)

PubMed Central

Newman, Victoria L; Romaine, Patricia LP; Wise, Stephen Y; Seed, Thomas M

2014-01-01

Introduction Despite significant scientific advances over the past 60 years towards the development of a safe, nontoxic and effective radiation countermeasure for the acute radiation syndrome (ARS), no drug has been approved by the US FDA. A radiation countermeasure to protect the population at large from the effects of lethal radiation exposure remains a significant unmet medical need of the US citizenry and, thus, has been recognized as a high priority area by the government. Area covered This article reviews relevant publications and patents for recent developments and progress for potential ARS treatments in the area of radiation countermeasures. Emphasis is placed on the advanced development of existing agents since 2011 and new agents identified as radiation countermeasure for ARS during this period. Expert opinion A number of promising radiation countermeasures are currently under development, seven of which have received US FDA investigational new drug status for clinical investigation. Four of these agents, CBLB502, Ex-RAD, HemaMax and OrbeShield, are progressing with large animal studies and clinical trials. G-CSF has high potential and well-documented therapeutic effects in countering myelosuppression and may receive full licensing approval by the US FDA in the future. PMID:25315070

Bioterrorism and biological threats dominate federal health security research; other priorities get scant attention.

PubMed

Shelton, Shoshana R; Connor, Kathryn; Uscher-Pines, Lori; Pillemer, Francesca Matthews; Mullikin, James M; Kellermann, Arthur L

2012-12-01

The federal government plays a critical role in achieving national health security by providing strategic guidance and funding research to help prevent, respond to, mitigate, and recover from disasters, epidemics, and acts of terrorism. In this article we describe the first-ever inventory of nonclassified national health security-related research funded by civilian agencies of the federal government. Our analysis revealed that the US government's portfolio of health security research is currently weighted toward bioterrorism and emerging biological threats, laboratory methods, and development of biological countermeasures. Eight of ten other priorities identified in the Department of Health and Human Services' National Health Security Strategy-such as developing and maintaining a national health security workforce or incorporating recovery into planning and response-receive scant attention. We offer recommendations to better align federal spending with health security research priorities, including the creation of an interagency working group charged with minimizing research redundancy and filling persistent gaps in knowledge.

Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.

PubMed

Danis, Marion; Kotwani, Namrata; Garrett, Joanne; Rivera, Ivonne; Davies-Cole, John; Carter-Nolan, Pamela

2010-11-01

To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.

Why prioritize when there isn't enough money?

PubMed Central

Wikler, Daniel

2003-01-01

In an informal address to the 4th International Conference on Priorities in Health (Oslo, 23 September 2002), Professor Jeffrey Sachs – Chairperson of the WHO Commission on Macroeconomics and Health – maintained that the real causes of the inability of the world's poorest people to receive help for the lethal diseases that burden them did not include the "usual suspects" (corruption, mismanagement, and wrong priorities). Rather, the root cause was argued to be an inherent lack of money, indicating that the burden of disease would be lifted only if rich countries gave more money to poor ones. Without taking exception to anything that Sachs said in his address, there nevertheless remain a number of justifications for efforts to improve priority setting in the face of severely shortages of resources, including the following three defenses: prioritization is needed if we are to know that prioritization is insufficient; prioritization is most important when there is little money; prioritization can itself increase resources. PMID:12773216

Understanding the effects of different social data on selecting priority conservation areas.

PubMed

Karimi, Azadeh; Tulloch, Ayesha I T; Brown, Greg; Hockings, Marc

2017-12-01

Conservation success is contingent on assessing social and environmental factors so that cost-effective implementation of strategies and actions can be placed in a broad social-ecological context. Until now, the focus has been on how to include spatially explicit social data in conservation planning, whereas the value of different kinds of social data has received limited attention. In a regional systematic conservation planning case study in Australia, we examined the spatial concurrence of a range of spatially explicit social values and land-use preferences collected using a public participation geographic information system and biological data. We used Zonation to integrate the social data with the biological data in a series of spatial-prioritization scenarios to determine the effect of the different types of social data on spatial prioritization compared with biological data alone. The type of social data (i.e., conservation opportunities or constraints) significantly affected spatial prioritization outcomes. The integration of social values and land-use preferences under different scenarios was highly variable and generated spatial prioritizations 1.2-51% different from those based on biological data alone. The inclusion of conservation-compatible values and preferences added relatively few new areas to conservation priorities, whereas including noncompatible economic values and development preferences as costs significantly changed conservation priority areas (48.2% and 47.4%, respectively). Based on our results, a multifaceted conservation prioritization approach that combines spatially explicit social data with biological data can help conservation planners identify the type of social data to collect for more effective and feasible conservation actions. © 2017 Society for Conservation Biology.

Framing research for state policymakers who place a priority on cancer

PubMed Central

Brownson, Ross C.; Dodson, Elizabeth A.; Kerner, Jon F.; Moreland-Russell, Sarah

2016-01-01

Purpose Despite the potential for reducing the cancer burden via state policy change, few data exist on how best to disseminate research information to influence state legislators' policy choices. We explored: 1) the relative importance of core framing issues (source, presentation, timeliness) among policymakers who prioritize cancer and those who do not prioritize cancer and 2) the predictors of use of research in policymaking. Methods Cross-sectional data were collected from US state policymakers (i.e., legislators elected to state Houses or Senates) from January through October 2012 (n=862). One-way analysis of variance was performed to investigate the association of the priority of cancer variable with outcome variables. Multivariate logistic regression models examined predictors of the influence of research information. Results Legislators who prioritized cancer tended to rate characteristics that make research information useful higher than those who did not prioritize cancer. Among differences that were statistically significant were three items in the “source” domain (relevance, delivered by someone respected, supports one's own position), one item in the “presentation” domain (telling a story related to constituents), and two items in the “timeliness” domain (high current state priority, feasible when information is received). Participants who prioritized cancer risk factors were 80% more likely to rate research information as one of their top reasons for choosing an issue on which to work. Conclusions Our results suggest the importance of narrative forms of communication and that research information needs to be relevant to the policymakers' constituents in a brief, concise format. PMID:27299656

Effective coverage of essential inpatient care for small and sick newborns in a high mortality urban setting: a cross-sectional study in Nairobi City County, Kenya.

PubMed

Murphy, Georgina A V; Gathara, David; Mwachiro, Jacintah; Abuya, Nancy; Aluvaala, Jalemba; English, Mike

2018-05-22

Effective coverage requires that those in need can access skilled care supported by adequate resources. There are, however, few studies of effective coverage of facility-based neonatal care in low-income settings, despite the recognition that improving newborn survival is a global priority. We used a detailed retrospective review of medical records for neonatal admissions to public, private not-for-profit (mission) and private-for-profit (private) sector facilities providing 24×7 inpatient neonatal care in Nairobi City County to estimate the proportion of small and sick newborns receiving nationally recommended care across six process domains. We used our findings to explore the relationship between facility measures of structure and process and estimate effective coverage. Of 33 eligible facilities, 28 (four public, six mission and 18 private), providing an estimated 98.7% of inpatient neonatal care in the county, agreed to partake. Data from 1184 admission episodes were collected. Overall performance was lowest (weighted mean score 0.35 [95% confidence interval or CI: 0.22-0.48] out of 1) for correct prescription of fluid and feed volumes and best (0.86 [95% CI: 0.80-0.93]) for documentation of demographic characteristics. Doses of gentamicin, when prescribed, were at least 20% higher than recommended in 11.7% cases. Larger (often public) facilities tended to have higher process and structural quality scores compared with smaller, predominantly private, facilities. We estimate effective coverage to be 25% (estimate range: 21-31%). These newborns received high-quality inpatient care, while almost half (44.5%) of newborns needed care but did not receive it and a further 30.4% of newborns received an inadequate service. Failure to receive services and gaps in quality of care both contribute to a shortfall in effective coverage in Nairobi City County. Three-quarters of small and sick newborns do not have access to high-quality facility-based care. Substantial improvements in effective coverage will be required to tackle high neonatal mortality in this urban setting with high levels of poverty.

20 CFR 1010.210 - In which Department job training programs do covered persons receive priority of service?

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Any such program or service that uses technology to assist individuals to access workforce development programs (such as job and training opportunities, labor market information, career assessment tools, and..., One-Stop Career Centers, the Workforce Investment Act of 1998, a demonstration or other temporary...

Babies on Campus: Service to Infants and Families among Competing Priorities in University Child Care Programs

ERIC Educational Resources Information Center

McMullen, Mary Benson; Lash, Martha

2012-01-01

University early childhood programs attempt to balance a traditional tri-part mission: service to children and families; professional development of caregivers/teachers, clinicians, and researchers; and research on child development, learning, and/or education. Increasingly, infants receive care and education on university campuses, yet little is…

Human Relations Procedures Relevant to University Environmental Change.

ERIC Educational Resources Information Center

American Personnel and Guidance Association, Washington, DC.

The present college scene is in a state of flux and confusion. Several problems are receiving major priority: (1) student stress, (2) alienation of students, and (3) activism among students. Reasons for the above problems could include: (1) individual and inter-group stress, and (2) tension between groups. Procedures which have been utilized on…

77 FR 4663 - Final Revisions to Certain Data Collection and Reporting Requirements, Final Priority; State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

... into data reciprocity agreements with contiguous States or States with which it has tuition reciprocity... activities as: (1) Entering into data reciprocity agreements with private in-state IHEs that receive any... into data reciprocity agreements with private in-state IHEs over which the State exercises significant...

Community Support for Basic Education in Sub-Saharan Africa. Africa Region Human Development Working Paper Series.

ERIC Educational Resources Information Center

Watt, Patrick

Currently, Africa stands out as the world's poorest and most educationally deprived region. Where communities are empowered to identify their own needs and priorities, participate in decisions about resource allocation, and hold education providers accountable for ensuring that children receive a minimum acceptable standard of education, schooling…

20 CFR 1010.210 - In which Department job training programs do covered persons receive priority of service?

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Any such program or service that uses technology to assist individuals to access workforce development programs (such as job and training opportunities, labor market information, career assessment tools, and... program; any workforce development program targeted to specific groups; and those programs implemented by...

20 CFR 1010.210 - In which Department job training programs do covered persons receive priority of service?

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Any such program or service that uses technology to assist individuals to access workforce development programs (such as job and training opportunities, labor market information, career assessment tools, and... program; any workforce development program targeted to specific groups; and those programs implemented by...

A new approach to public engagement : capturing better ideas and representative priorities from the public for the Illinois Department of Transportation.

DOT National Transportation Integrated Search

2017-08-15

In recent years, the Illinois Department of Transportation (IDOT) has devoted time and resources to improving its public engagement program and the quantity and quality of the feedback and ideas it receives from residents of Illinois. In 2016, as par...

Putting College and Career Readiness at the Forefront of District Priorities in Dallas

ERIC Educational Resources Information Center

Hall, Shane

2013-01-01

Dallas Independent School District's (ISD) efforts to develop a system of college readiness indicators began in 2008, when they received a Bill & Melinda Gates Foundation grant under the foundation's College-Ready Education initiative. With this grant, Dallas ISD's Performance Management and Analytics department developed a college readiness…

78 FR 32533 - Sentencing Guidelines for United States Courts

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... the amendment cycle ending May 1, 2014. DATES: Public comment should be received on or before July 15... Commission provides this notice to identify tentative priorities for the amendment cycle ending May 1, 2014... work on any or all of these issues beyond the amendment cycle ending on May 1, 2014. As so prefaced...

Approaches for Development of Nutrient Criteria in Oregon Estuaries With a Focus on Tillamook Estuary

EPA Science Inventory

Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

Listening--A New Priority In Small Group Process?

ERIC Educational Resources Information Center

Brack, Harold A.

Although listening is a major activity in small group communication, it has received minimal attention. Examination of several books and journals reveals a very sparse treatment of the subject. More attention should be given to listening because it is a key factor in a democratic leadership style and requires different skills than does listening…

75 FR 76473 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... technology. Proposed Project: Data Collection Tool for Rural Health Community-Based Grant Programs (OMB No... based on the feedback received from grantees and to reflect ORHP and HRSA's current priorities and... collection and analysis in an effort to strengthen the value of the data collection tool. There are currently...

Improving contraceptive choice: fidelity of implementation and the gap between effectiveness and efficacy.

PubMed

Garbers, Samantha; Flandrick, Kathleen; Bermudez, Dayana; Meserve, Allison; Chiasson, Mary Ann

2014-11-01

Interventions to reduce unintended pregnancy through improved contraceptive use are a public health priority. A comprehensive process evaluation of a contraceptive assessment module intervention with demonstrated efficacy was undertaken. The 12-month process evaluation goal was to describe the extent to which the intervention was implemented as intended over time, and to identify programmatic adjustments to improve implementation fidelity. Quantitative and qualitative methods included staff surveys, electronic health record data, usage monitoring, and observations. Fidelity of implementation was low overall (<10% of eligible patients completed the entire module [dose received]). Although a midcourse correction making the module available in clinical areas led to increased dose delivered (23% vs. 30%, chi-square test p = .006), dose received did not increase significantly after this adjustment. Contextual factors including competing organizational and staff priorities and staff buy-in limited the level of implementation and precluded adoption of some strategies such as adjusting patient flow. Using a process evaluation framework enabled the research team to identify and address complexities inherent in effectiveness studies and facilitated the alignment of program and context. © 2014 Society for Public Health Education.

Market segmentation using perceived constraints

Treesearch

Jinhee Jun; Gerard Kyle; Andrew Mowen

2008-01-01

We examined the practical utility of segmenting potential visitors to Cleveland Metroparks using their constraint profiles. Our analysis identified three segments based on their scores on the dimensions of constraints: Other priorities--visitors who scored the highest on 'other priorities' dimension; Highly Constrained--visitors who scored relatively high on...

Final priority; National Institute on Disability and Rehabilitation Research--Research Fellowships Program (also known as the Mary E. Switzer Research Fellowships). Final priority.

PubMed

2014-07-28

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Research Fellowships Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice announces a priority for a Distinguished Residential Disability and Rehabilitation Policy Fellowship. We take this action to focus attention on an area of national need. We intend the priority to build research capacity by providing support to highly qualified, experienced researchers, including those who are individuals with disabilities, to conduct policy research in the areas of disability and rehabilitation.

The Big Rocks: Priority Management for Principals

ERIC Educational Resources Information Center

Marshall, Kim

2008-01-01

How can a dedicated principal work really, really hard but fail to get significant gains in student achievement? The answer is obvious: by spending too much time on the wrong things and not enough on the right things. The principal's number-one priority is zeroing in on the highest-priority activities for bringing all students to high levels of…

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives

PubMed Central

2012-01-01

Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans. PMID:22449119

Identifying management and disease priorities of Canadian dairy industry stakeholders.

PubMed

Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

2016-12-01

The objective of this study was to identify the key management and disease issues affecting the Canadian dairy industry. An online questionnaire (FluidSurveys, http://fluidsurveys.com/) was conducted between March 1 and May 31, 2014. A total of 1,025 responses were received from across Canada of which 68% (n=698) of respondents were dairy producers, and the remaining respondents represented veterinarians, university researchers, government personnel, and other allied industries. Participants were asked to identify their top 3 management and disease priorities from 2 lists offered. Topics were subsequently ranked from highest to lowest using 3 different ranking methods based on points: 5-3-1 (5 points for first priority, 3 for second, and 1 for first), 3-2-1, and 1-1-1 (equal ranking). The 5-3-1 point system was selected because it minimized the number of duplicate point scores. Stakeholder groups showed general agreement with the top management issue identified as animal welfare and the number one health concern as lameness. Other areas identified as priorities were reproductive health, antibiotic use, bovine viral diarrhea, and Staphylococcus aureus mastitis with these rankings influenced by region, herd size, and stakeholder group. This is the first national comprehensive assessment of priorities undertaken in the Canadian dairy industry and will assist researchers, policymakers, program developers, and funding agencies make future decisions based on direct industry feedback. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Personalized Medicine Tackles Clinical Resistance: Alectinib in ALK-Positive Non-Small Cell Lung Cancer Progressing on First-Generation ALK Inhibitor.

PubMed

Skoulidis, Ferdinandos; Papadimitrakopoulou, Vassiliki A

2016-11-01

Over the last 2 years, our therapeutic armamentarium against genomically defined subgroups of non-small cell lung cancer (NSCLC) has extended to patients with acquired resistance to front-line targeted therapy. Alectinib (Alecensa; Roche/Genentech), a second-generation, orally active, potent, and highly selective inhibitor of anaplastic lymphoma kinase (ALK), is indicated for patients with metastatic, ALK rearrangement-positive NSCLC whose disease has worsened after treatment with crizotinib or who became intolerant to the drug. Alectinib received orphan drug designation, breakthrough therapy designation, priority review status, and accelerated approval by the FDA. Clin Cancer Res; 22(21); 5177-82. ©2016 AACR. ©2016 American Association for Cancer Research.

Is the prevalence of mental disorders a good measure of the need for services?

PubMed

Mechanic, David

2003-01-01

Mental disorders are highly prevalent, but prevalence is different from need for treatment. Some mental disorders are a major source of distress, disability, and social burden, and many people who could benefit from treatment do not receive it. Need is typically self-defined or defined by clinicians who are motivated to bring treatment to those who could benefit. Defining need appropriately requires consideration of the duration and reoccurrence of disorder, associated distress and disability, and the likelihood that treatment will be beneficial. Demand may be promoted inappropriately by clinicians and drug manufacturers who profit from expansion of demand. Future assessments of need must be based on evidence and take into account priorities for care and cost-effectiveness.

Integrated approach for prioritizing watersheds for management: a study of lidder catchment of kashmir himalayas.

PubMed

Malik, Mohammad Imran; Bhat, M Sultan

2014-12-01

The Himalayan watersheds are susceptible to various forms of degradation due to their sensitive and fragile ecological disposition coupled with increasing anthropogenic disturbances. Owing to the paucity of appropriate technology and financial resources, the prioritization of watersheds has become an inevitable process for effective planning and management of natural resources. Lidder catchment constitutes a segment of the western Himalayas with an area of 1,159.38 km(2). The study is based on integrated analysis of remote sensing, geographic information system, field study, and socioeconomic data. Multicriteria evaluation of geophysical, land-use and land-cover (LULC) change, and socioeconomic indicators is carried out to prioritize watersheds for natural resource conservation and management. Knowledge-based weights and ranks are normalized, and weighted linear combination technique is adopted to determine final priority value. The watersheds are classified into four priority zones (very high priority, high priority, medium priority, and low priority) on the basis of quartiles of the priority value, thus indicating their ecological status in terms of degradation caused by anthropogenic disturbances. The correlation between priority ranks of individual indicators and integrated indicators is drawn. The results reveal that socioeconomic indicators are the most important drivers of LULC change and environmental degradation in the catchment. Moreover, the magnitude and intensity of anthropogenic impact is not uniform in different watersheds of Lidder catchment. Therefore, any conservation and management strategy must be formulated on the basis of watershed prioritization.

Integrated Approach for Prioritizing Watersheds for Management: A Study of Lidder Catchment of Kashmir Himalayas

NASA Astrophysics Data System (ADS)

Malik, Mohammad Imran; Bhat, M. Sultan

2014-12-01

The Himalayan watersheds are susceptible to various forms of degradation due to their sensitive and fragile ecological disposition coupled with increasing anthropogenic disturbances. Owing to the paucity of appropriate technology and financial resources, the prioritization of watersheds has become an inevitable process for effective planning and management of natural resources. Lidder catchment constitutes a segment of the western Himalayas with an area of 1,159.38 km2. The study is based on integrated analysis of remote sensing, geographic information system, field study, and socioeconomic data. Multicriteria evaluation of geophysical, land-use and land-cover (LULC) change, and socioeconomic indicators is carried out to prioritize watersheds for natural resource conservation and management. Knowledge-based weights and ranks are normalized, and weighted linear combination technique is adopted to determine final priority value. The watersheds are classified into four priority zones (very high priority, high priority, medium priority, and low priority) on the basis of quartiles of the priority value, thus indicating their ecological status in terms of degradation caused by anthropogenic disturbances. The correlation between priority ranks of individual indicators and integrated indicators is drawn. The results reveal that socioeconomic indicators are the most important drivers of LULC change and environmental degradation in the catchment. Moreover, the magnitude and intensity of anthropogenic impact is not uniform in different watersheds of Lidder catchment. Therefore, any conservation and management strategy must be formulated on the basis of watershed prioritization.

Assessing the extent to which current clinical research is consistent with patient priorities: a scoping review using a case study in patients on or nearing dialysis.

PubMed

Jun, Min; Manns, Braden; Laupacis, Andreas; Manns, Liam; Rehal, Bhavdeep; Crowe, Sally; Hemmelgarn, Brenda R

2015-01-01

There is growing acknowledgement that engaging patients to identify their research priorities is important. Using a case study of patients on or nearing dialysis, we sought to assess the extent to which recently completed and ongoing clinical research was consistent with priorities identified by patients, caregivers, and clinicians. Over a 4-year sampling frame (January 2010 to December 2013), we systematically searched the medical literature (top 5 nephrology and top 10 general medicine journals accessed through MEDLINE via Ovid), international randomized controlled trial (RCT) registries, and national government and kidney research funding organizations (Canada, U.S., Australia, and U.K.) for published clinical studies, registered RCTs, and funded clinical studies, respectively. Published clinical studies, registered RCTs, and funded clinical studies were categorized as to whether or not they were consistent with the top 10 research priorities identified by patients, their caregivers, and clinicians in a recent comprehensive research priority setting exercise. The search yielded 4293 published articles, 688 RCTs, and 70 funded studies, of which 1116 articles, 315 RCTs, and 70 funded studies were eligible for inclusion. Overall 194 published studies (17.4 %), 71 RCTs (22.5 %), and 15 funded studies (21.4 %) included topics consistent with the top 10 research priorities identified by patients. Four of the top 10 research priorities, including strategies to improve the management of itching, increase access to kidney transplantation, assess the psychosocial impact of kidney failure, and determine the effects of dietary restriction received virtually no attention. The top 10 priorities we used to categorize included studies were identified by Canadian patients, caregivers, and clinicians. The top research priorities may vary across different countries. The proportion of published studies that are consistent with the top 10 priorities could be different in nephrology journals with lower impact factors. Studies related to kidney transplantation and the psychosocial impact of kidney failure may have been published in journals not included in our search strategy. The majority of recently completed or ongoing clinical studies in patients on or nearing dialysis do not address the top research priorities of patients, raising concerns that current clinical research may not be meeting the needs of the ultimate consumer, in this case, patients on or nearing dialysis. Greater involvement of patients in research is required to bridge the gap between research and patients' needs.

Sensitivity and specificity of the Manchester Triage System in risk prioritization of patients with acute myocardial infarction who present with chest pain.

PubMed

Nishi, Fernanda A; Polak, Catarina; Cruz, Diná de Almeida Lopes Monteiro da

2018-05-01

The purpose of the Manchester Triage System is to clinically prioritize each patient seeking care in an emergency department. Patients with suspected acute myocardial infarction who have typical symptoms including chest pain should be classified in the highest priority groups, requiring immediate medical assistance or care within 10 min. As such, the Manchester Triage System should present adequate sensitivity and specificity. This study estimated the sensitivity and specificity of the Manchester Triage System in the triage of patients with chest pain related to the diagnosis of acute myocardial infarction, and the associations between the performance of the Manchester Triage System and selected variables. This was an observational, analytical, cross-sectional, retrospective study. The sensitivity and specificity of the Manchester Triage System were estimated by verifying the triage classification received by these patients and their established medical diagnoses. The sample was composed of 10,087 triage episodes, in which 139 (1.38%) patients had a diagnosis of acute myocardial infarction. In 49 episodes, confirmation of medical diagnosis was not possible. The estimated sensitivity of the Manchester Triage System was 44.60% (36.18-53.27%) and the estimated specificity was 91.30% (90.73-91.85%). Of the 10,038 episodes in which the diagnosis of acute myocardial infarction was confirmed or excluded, 938 patients (9.34%) received an incorrect classification - undertriage or overtriage. This study showed that the specificity of the Manchester Triage System was very good. However, the low sensitivity based on the Manchester Triage System indicated that patients in high priority categories were undertriaged, leading to longer wait times and associated increased risks of adverse events.

Factors Associated With Success of Clinician-Researchers Receiving Career Development Awards From the National Institutes of Health: A Longitudinal Cohort Study.

PubMed

Jagsi, Reshma; Griffith, Kent A; Jones, Rochelle D; Stewart, Abigail; Ubel, Peter A

2017-10-01

Understanding the careers of recent career development awardees is essential to guide interventions to ensure gender equity and success in academic medicine. In 2010-2011 (T1) and 2014 (T2), 1,719 clinician-researchers who received new K08 and K23 awards in 2006-2009 were longitudinally surveyed. Multivariable analyses evaluated the influence of factors on success, including demographics, job characteristics, work environment, priorities, and domestic responsibilities. Of 1,275 respondents at T1, 1,066 (493 women; 573 men) responded at T2. Men and women differed in job characteristics, work environment, priorities, and domestic responsibilities. By T2, women had less funding (mean $780,000 vs. $1,120,000, P = .002) and published fewer papers (mean 33 vs. 45). Using a composite measure that considered funding, publications, or leadership to define success, 53.5% (264/493) of women and 67.0% (384/573) of men were successful. Gender differences in success persisted after accounting for other significant predictors-K award type, specialty, award year, work hours, funding institute tier, feeling responsible for participating in department/division administration, importance of publishing prolifically, feeling responsible for contributing to clinical care, importance of publishing high-quality research, collegiality of the mentoring relationship, adequacy of research equipment, and departmental climate. A significant interaction existed between K award type and gender; the gender difference in success was most pronounced among K23 researchers (among whom the odds ratio for females = 0.32). Men and women continue to have different experiences and career outcomes, with important implications for the design of interventions to promote equity and success.

Economical ground data delivery

NASA Technical Reports Server (NTRS)

Markley, Richard W.; Byrne, Russell H.; Bromberg, Daniel E.

1994-01-01

Data delivery in the Deep Space Network (DSN) involves transmission of a small amount of constant, high-priority traffic and a large amount of bursty, low priority data. The bursty traffic may be initially buffered and then metered back slowly as bandwidth becomes available. Today both types of data are transmitted over dedicated leased circuits. The authors investigated the potential of saving money by designing a hybrid communications architecture that uses leased circuits for high-priority network communications and dial-up circuits for low-priority traffic. Such an architecture may significantly reduce costs and provide an emergency backup. The architecture presented here may also be applied to any ground station-to-customer network within the range of a common carrier. The authors compare estimated costs for various scenarios and suggest security safeguards that should be considered.

Specific transfer effects following variable priority dual-task training in older adults.

PubMed

Lussier, Maxime; Bugaiska, Aurélia; Bherer, Louis

2017-01-01

Past divided attention training studies in older adults have suggested that variable priority training (VPT) tends to show larger improvement than fixed priority training (FPT). However, it remains unclear whether VPT leads to larger transfer effects. In this study, eighty-three older adults aged between 55 and 65 received five 1-hour sessions of VPT, FPT or of an active placebo. VPT and FPT subjects trained on a complex dual-task condition with variable stimulus timings in order to promote more flexible and self-guided strategies with regard to attentional priority devoted to the concurrent tasks. Real-time individualized feedback was provided to encourage improvement. The active placebo group attended computer classes. Near and far modality transfer tasks were used to assess the generalization of transfer effects. Results showed that VPT induced significantly larger transfer effects than FPT on a near modality transfer task. Evidence for larger transfer effects in VPT than FPT on a far modality transfer task was also observed. Furthermore, the superiority of VPT on FPT in transfer effects was specific to the ability to coordinate two concurrent tasks. Results of this study help better understand the benefits of VPT attentional training on transfer effects, which is an essential outcome for cognitive training effectiveness and relevancy.

Research priorities for respiratory nursing: a UK-wide Delphi study

PubMed Central

Pilkington, Melissa; Hodson, Matthew; Welch, Lindsay; Yorke, Janelle

2018-01-01

Respiratory nurses make a significant contribution to the delivery of respiratory healthcare, but there is a dearth of nurse-led, practice-focused, published research. Using a modified three-round Delphi, this study sought to identify research priorities for respiratory nursing to inform a national research strategy. Study information and the survey link were sent electronically to members of UK professional respiratory organisations. Round 1 had 78 items across 16 topics, informed by a systematic literature review. Respondents suggested additional items which were content analysed to inform Round 2. Respondents rated all items and ranked the topics in all rounds. To ensure rigour, rounds had an explicit focus with pre-determined criteria for consensus (70%). In total, 363 responses were received across Rounds 1, 2 and 3 (n=183, 95 and 85, respectively). The top five research priorities were: 1) “Patient understanding of asthma control”; 2) “The clinical and cost-effectiveness of respiratory nurse interventions”; 3) “The impact of nurse-led clinics on patient care”; 4) “Inhaler technique”; and 5) two topics jointly scored: “Prevention of exacerbations” and “Symptom management”. With potential international significance, this is the first UK study to identify research priorities for respiratory nursing, providing direction for those planning or undertaking research. PMID:29692999

Parental Perception of the Importance of Friendship and Other Outcome Priorities in Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Petrina, Neysa; Carter, Mark; Stephenson, Jennifer

2015-01-01

Parental perceptions of the importance of friendship development in comparison to other outcome priorities are examined in this research. Parents of children with high functioning autism between the age of 5-10?years (N?=?74) were asked to rate and rank the importance of the following six outcome priorities: friendship, social skills, physical and…

Range-wide connectivity of priority areas for Greater Sage-Grouse: Implications for long-term conservation from graph theory

USGS Publications Warehouse

Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

2017-01-01

The delineation of priority areas in western North America for managing Greater Sage-Grouse (Centrocercus urophasianus) represents a broad-scale experiment in conservation biology. The strategy of limiting spatial disturbance and focusing conservation actions within delineated areas may benefit the greatest proportion of Greater Sage-Grouse. However, land use under normal restrictions outside priority areas potentially limits dispersal and gene flow, which can isolate priority areas and lead to spatially disjunct populations. We used graph theory, representing priority areas as spatially distributed nodes interconnected by movement corridors, to understand the capacity of priority areas to function as connected networks in the Bi-State, Central, and Washington regions of the Greater Sage-Grouse range. The Bi-State and Central networks were highly centralized; the dominant pathways and shortest linkages primarily connected a small number of large and centrally located priority areas. These priority areas are likely strongholds for Greater Sage-Grouse populations and might also function as refugia and sources. Priority areas in the Central network were more connected than those in the Bi-State and Washington networks. Almost 90% of the priority areas in the Central network had ≥2 pathways to other priority areas when movement through the landscape was set at an upper threshold (effective resistance, ER12). At a lower threshold (ER4), 83 of 123 priority areas in the Central network were clustered in 9 interconnected subgroups. The current conservation strategy has risks; 45 of 61 priority areas in the Bi-State network, 68 of 123 in the Central network, and all 4 priority areas in the Washington network had ≤1 connection to another priority area at the lower ER4threshold. Priority areas with few linkages also averaged greater environmental resistance to movement along connecting pathways. Without maintaining corridors to larger priority areas or a clustered group, isolation of small priority areas could lead to regional loss of Greater Sage-Grouse

Investments in respiratory infectious disease research 1997–2010: a systematic analysis of UK funding

PubMed Central

Head, Michael G; Fitchett, Joseph R; Cooke, Mary K; Wurie, Fatima B; Hayward, Andrew C; Lipman, Marc C; Atun, Rifat

2014-01-01

Objectives Respiratory infections are responsible for a large global burden of disease. We assessed the public and philanthropic investments awarded to UK institutions for respiratory infectious disease research to identify areas of underinvestment. We aimed to identify projects and categorise them by pathogen, disease and position along the research and development value chain. Setting The UK. Participants Institutions that host and carry out infectious disease research. Primary and secondary outcome measures The total amount spent and number of studies with a focus on several different respiratory pathogens or diseases, and to correlate these against the global burden of disease; also the total amount spent and number of studies relating to the type of science, the predominant funder in each category and the mean and median award size. Results We identified 6165 infectious disease studies with a total investment of £2·6 billion. Respiratory research received £419 million (16.1%) across 1192 (19.3%) studies. The Wellcome Trust provided greatest investment (£135.2 million; 32.3%). Tuberculosis received £155 million (37.1%), influenza £80 million (19.1%) and pneumonia £27.8 million (6.6%). Despite high burden, there was relatively little investment in vaccine-preventable diseases including diphtheria (£0.1 million, 0.03%), measles (£5.0 million, 1.2%) and drug-resistant tuberculosis. There were 802 preclinical studies (67.3%) receiving £273 million (65.2%), while implementation research received £81 million (19.3%) across 274 studies (23%). There were comparatively few phase I–IV trials or product development studies. Global health research received £68.3 million (16.3%). Relative investment was strongly correlated with 2010 disease burden. Conclusions The UK predominantly funds preclinical science. Tuberculosis is the most studied respiratory disease. The high global burden of pneumonia-related disease warrants greater investment than it has historically received. Other priority areas include antimicrobial resistance (particularly within tuberculosis), economics and proactive investments for emerging infectious threats. PMID:24670431

Investments in respiratory infectious disease research 1997-2010: a systematic analysis of UK funding.

PubMed

Head, Michael G; Fitchett, Joseph R; Cooke, Mary K; Wurie, Fatima B; Hayward, Andrew C; Lipman, Marc C; Atun, Rifat

2014-03-26

Respiratory infections are responsible for a large global burden of disease. We assessed the public and philanthropic investments awarded to UK institutions for respiratory infectious disease research to identify areas of underinvestment. We aimed to identify projects and categorise them by pathogen, disease and position along the research and development value chain. The UK. Institutions that host and carry out infectious disease research. The total amount spent and number of studies with a focus on several different respiratory pathogens or diseases, and to correlate these against the global burden of disease; also the total amount spent and number of studies relating to the type of science, the predominant funder in each category and the mean and median award size. We identified 6165 infectious disease studies with a total investment of £2·6 billion. Respiratory research received £419 million (16.1%) across 1192 (19.3%) studies. The Wellcome Trust provided greatest investment (£135.2 million; 32.3%). Tuberculosis received £155 million (37.1%), influenza £80 million (19.1%) and pneumonia £27.8 million (6.6%). Despite high burden, there was relatively little investment in vaccine-preventable diseases including diphtheria (£0.1 million, 0.03%), measles (£5.0 million, 1.2%) and drug-resistant tuberculosis. There were 802 preclinical studies (67.3%) receiving £273 million (65.2%), while implementation research received £81 million (19.3%) across 274 studies (23%). There were comparatively few phase I-IV trials or product development studies. Global health research received £68.3 million (16.3%). Relative investment was strongly correlated with 2010 disease burden. The UK predominantly funds preclinical science. Tuberculosis is the most studied respiratory disease. The high global burden of pneumonia-related disease warrants greater investment than it has historically received. Other priority areas include antimicrobial resistance (particularly within tuberculosis), economics and proactive investments for emerging infectious threats.

Climate change effects on water allocations with season dependent water rights.

PubMed

Null, Sarah E; Prudencio, Liana

2016-11-15

Appropriative water rights allocate surface water to competing users based on seniority. Often water rights vary seasonally with spring runoff, irrigation schedules, or other non-uniform supply and demand. Downscaled monthly Coupled Model Intercomparison Project multi-model, multi-emissions scenario hydroclimate data evaluate water allocation reliability and variability with anticipated hydroclimate change. California's Tuolumne watershed is a study basin, chosen because water rights are well-defined, simple, and include competing environmental, agricultural, and urban water uses representative of most basins. We assume that dedicated environmental flows receive first priority when mandated by federal law like the Endangered Species Act or hydropower relicensing, followed by senior agricultural water rights, and finally junior urban water rights. Environmental flows vary by water year and include April pulse flows, and senior agricultural water rights are 68% larger during historical spring runoff from April through June. Results show that senior water right holders receive the largest climate-driven reductions in allocated water when peak streamflow shifts from snowmelt-dominated spring runoff to mixed snowmelt- and rainfall-dominated winter runoff. Junior water right holders have higher uncertainty from inter-annual variability. These findings challenge conventional wisdom that water shortages are absorbed by junior water users and suggest that aquatic ecosystems may be disproportionally impaired by hydroclimate change, even when environmental flows receive priority. Copyright © 2016 Elsevier B.V. All rights reserved.

Priority gaps and promising areas in maternal health research in low- and middle-income countries: summary findings of a mapping of 2292 publications between 2000 and 2012.

PubMed

Chersich, Matthew F; Martin, Greg

2017-02-02

This commentary sums the findings of a series of papers on a study that mapped the global research agenda for maternal health. The mapping reviewed published interventional research across low- and middle-income countries (LMICs) from 2000 to 2012, specifically focusing on investigating the topics covered by this research, the methodologies applied, the funding landscape and trends in authorship attribution.The overarching aim underpinning the mapping activities was to evaluate whether research and funding align with causes of maternal mortality, and thereby highlight gaps in research priorities and governance. Fifteen reviewers from 8 countries screened 35,078 titles and abstracts, and extracted data from 2292 full-text articles.Over the period reviewed, the volume of publications rose several-fold, especially from 2004 to 2007. The methodologies broadened, increasingly encompassing qualitative research and systematic review. Malaria and HIV research dominated over other topics, while sexually-transmitted infection research progressively diminished. Health systems and health promotion research increased rapidly, but were less frequently evaluated in trials or published in high-impact journals. Relative to disease burden, hypertension had double the publications of haemorrhage. Many Latin American countries, China and Russia had relatively few papers per billion US dollars Gross Domestic Product. Total LMIC lead authorships rose substantially, but only a quarter of countries had a local first author lead on >75% of their research, with levels lowest in sub-Saharan Africa. The median Impact Factor of high-income country led papers was 3.1 and LMIC-led 1.8. The NIH, USAID and Gates Foundation constituted 40% of funder acknowledgements, and addressed similar topics and countries.The commentary notes that increases in outputs and broadening of methodologies suggest research capacity has expanded considerably, allowing for more nuanced, systems-based and context-specific studies. However, funders seemingly duplicate efforts, with topics and countries either receiving excessive or little attention. Better coordinated funding might reduce duplication and allow researchers to develop highly-specialised expertise. Repeated scrutiny of research agendas and funding may foment shifts in priorities. Building leadership capacity in LMICs and reconsidering authorship guidelines is needed.

Setting stroke research priorities: The consumer perspective.

PubMed

Sangvatanakul, Pukkaporn; Hillege, Sharon; Lalor, Erin; Levi, Christopher; Hill, Kelvin; Middleton, Sandy

2010-12-01

To test a method of engaging consumers in research priority-setting using a quantitative approach and to determine consumer views on stroke research priorities for clinical practice recommendations with lower levels of evidence (Level III and Level IV) and expert consensus opinion as published in the Australian stroke clinical practice guidelines. Survey Urban community Eighteen stroke survivors (n = 12) and carers (n = 6) who were members of the "Working Aged Group - Stroke" (WAGS) consumer support group. Phase I: Participants were asked whether recommendations were "worth" researching ("yes" or "no"); and, if researched, what potential impact they likely would have on patient outcomes. Phase II: Participants were asked to rank recommendations rated by more than 75% of participants in Phase I as "worth" researching and "highly likely" or "likely" to generate research with a significant effect on patient outcomes (n = 13) in order of priority for future stroke research. All recommendations were rated by at least half (n = 9, 50%) of participants as "worth" researching. The majority (67% to 100%) rated all recommendations as "highly likely" or "likely" that research would have a significant effect on patient outcomes. Thirteen out of 20 recommendations were ranked for their research priorities. Recommendations under the topic heading Getting to hospital were ranked highest and Organization of care and Living with stroke were ranked as a lower priority for research. This study provided an example of how to involve consumers in research priority setting successfully using a quantitative approach. Stroke research priorities from the consumer perspective were different from those of health professionals, as published in the literature; thus, consumer opinion should be considered when setting research priorities. Copyright © 2010 Society for Vascular Nursing, Inc. Published by Mosby, Inc. All rights reserved.

Priority setting in developing countries health care institutions: the case of a Ugandan hospital

PubMed Central

Kapiriri, Lydia; Martin, Douglas K

2006-01-01

Background Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. However, there is lack of literature that describes and evaluates priority setting in these contexts. The objective of this paper is to describe priority setting in a teaching hospital in Uganda and evaluate the description against an ethical framework for fair priority setting processes – Accountability for Reasonableness. Methods A case study in a 1,500 bed national referral hospital receiving 1,320 out patients per day and an average budget of US$ 13.5 million per year. We reviewed documents and carried out 70 in-depth interviews (14 health planners, 40 doctors, and 16 nurses working at the hospital). Interviews were recorded and transcribed. Data analysis employed the modified thematic approach to describe priority setting, and the description was evaluated using the four conditions of Accountability for Reasonableness: relevance, publicity, revisions and enforcement. Results Senior managers, guided by the hospital strategic plan make the hospital budget allocation decisions. Frontline practitioners expressed lack of knowledge of the process. Relevance: Priority is given according to a cluster of factors including need, emergencies and patient volume. However, surgical departments and departments whose leaders "make a lot of noise" are also prioritized. Publicity: Decisions, but not reasons, are publicized through general meetings and circulars, but this information does not always reach the frontline practitioners. Publicity to the general public was through ad hoc radio programs and to patients who directly ask. Revisions: There were no formal mechanisms for challenging the reasoning. Enforcement: There were no mechanisms to ensure adherence to the four conditions of a fair process. Conclusion Priority setting decisions at this hospital do not satisfy the conditions of fairness. To improve, the hospital should: (i) engage frontline practitioners, (ii) publicize the reasons for decisions both within the hospital and to the general public, and (iii) develop formal mechanisms for challenging the reasoning. In addition, capacity strengthening is required for senior managers who must accept responsibility for ensuring that the above three conditions are met. PMID:17026761

High-Priority Directions of Modernization of University Education in Innovational Society

ERIC Educational Resources Information Center

Sergeev, Nikolai

2017-01-01

Purpose: The purpose of this paper is to verify the offered hypothesis and to determine high-priority directions of modernization of university education in an innovational society by the example of modern Russia. Design/methodology/approach: During the empirical study of connection between university education and innovational development of…

25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix

Code of Federal Regulations, 2010 CFR

2010-04-01

...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate route 1 Severe X Moderate Minimal No accidents. Years since last IRR construction project completed... elements Addresses 1 element. 1 National Highway Traffic Safety Board standards. 2 Total funds requested...

Obligations to High Priority Target Groups: Philosophical Implications.

ERIC Educational Resources Information Center

Christmas, June Jackson

Community mental health center services must be most plentiful where the need is greatest and must be appropriate and available to meet these needs. The first high priority group, according to statistics on juvenile delinquency, and narcotics, is the black inner city. Socio-psychiatric services, numerous enough in quantity to begin to meet needs…

Restoring High Priority Habitats for Birds: Aspen and Pine in the Interior West

Treesearch

Rex Sallabanks; Nils D. Christoffersen; Whitney W. Weatherford; Ralph Anderson

2005-01-01

This paper describes a long-term habitat restoration project in the Blue Mountains ecoregion, northeast Oregon, that we initiated in May 2000. We focused our restoration activities on two habitats previously identified as being high priority for birds: quaking aspen (Populus tremuloides) and ponderosa pine (Pinus ponderosa). In...

Ephedrine QoS: An Antidote to Slow, Congested, Bufferless NoCs

PubMed Central

Fang, Juan; Yao, Zhicheng; Sui, Xiufeng; Bao, Yungang

2014-01-01

Datacenters consolidate diverse applications to improve utilization. However when multiple applications are colocated on such platforms, contention for shared resources like networks-on-chip (NoCs) can degrade the performance of latency-critical online services (high-priority applications). Recently proposed bufferless NoCs (Nychis et al.) have the advantages of requiring less area and power, but they pose challenges in quality-of-service (QoS) support, which usually relies on buffer-based virtual channels (VCs). We propose QBLESS, a QoS-aware bufferless NoC scheme for datacenters. QBLESS consists of two components: a routing mechanism (QBLESS-R) that can substantially reduce flit deflection for high-priority applications and a congestion-control mechanism (QBLESS-CC) that guarantees performance for high-priority applications and improves overall system throughput. We use trace-driven simulation to model a 64-core system, finding that, when compared to BLESS, a previous state-of-the-art bufferless NoC design, QBLESS, improves performance of high-priority applications by an average of 33.2% and reduces network-hops by an average of 42.8%. PMID:25250386

49 CFR 350.329 - How may a State or local agency qualify for High Priority or Border Activity Funds?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false How may a State or local agency qualify for High... How may a State or local agency qualify for High Priority or Border Activity Funds? (a) States must... with the State lead MCSAP agency to ensure the proposal is consistent with State and national CMV...

49 CFR 350.329 - How may a State or local agency qualify for High Priority or Border Activity Funds?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false How may a State or local agency qualify for High... How may a State or local agency qualify for High Priority or Border Activity Funds? (a) States must... with the State lead MCSAP agency to ensure the proposal is consistent with State and national CMV...

3 CFR 8820 - Proclamation 8820 of May 14, 2012. National Women’s Health Week, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... have made advancing gender equality in health care a top priority. Through the historic Affordable Care..., many insurers will no longer be allowed to charge women higher premiums simply because of their gender..., contraception, and well-woman visits under most plans. In 2011 alone, more than 20 million women received...

Parent Perspectives on the Individual Education Program Process and Product for the Child with Autism

ERIC Educational Resources Information Center

Brandt, Camille M.

2011-01-01

This study examined the perspectives of parents of children with autism receiving special education services in an upper Midwestern state. This study sought to determine parent perspectives of priorities for the child's IEP, parent perspectives of content of the child's IEP, and parent perspectives of their experiences at the school, comfort level…

Building Student Belonging and Engagement: Insights into Higher Education Students' Experiences of Participating and Learning Together

ERIC Educational Resources Information Center

Masika, Rachel; Jones, Jennie

2016-01-01

Student belonging and engagement has received increased attention in the context of an expanding and more diverse higher education student population. Student retention is regarded as a priority with many universities augmenting their retention strategies to instil a sense of belonging. This article provides insights into first year Business…

Pre-Kindergarten - Pre-Kindergarten - New York City Department of Education

Science.gov Websites

miss the March 30, 2018 application deadline. Read More Pre-K Admissions Overview In free, full-day priority to students who receive Free and Reduced Lunch (FRL), English Language Learners (ELLs), students qualify for Free and Reduced Lunch (FRL) for 67% of offers at every District 1 elementary school for

Educational Attainment and Earnings Inequality among US-Born Men: A Lifetime Perspective

ERIC Educational Resources Information Center

Mitchell, Josh

2014-01-01

Since the onset of the Great Recession over six years ago, restoring full employment has been the most urgent labor market priority. As the economy slowly recovers, long-term labor market challenges will receive renewed attention. Among the most significant is the growing earnings divide between different types of workers and the potential role of…

78 FR 11589 - National Oil and Hazardous Substance Pollution Contingency Plan; National Priorities List...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... Docket ID no. EPA-HQ- SFUND-1990-0011, by one of the following methods: http://www.regulations.gov... received will be included in the public docket without change and may be made available online at http... is placed in the public docket and made available on the Internet. If you submit an electronic...

Technical Vocational Education and Training for Micro-Enterprise Development in Ethiopia: A Solution or Part of the Problem?

ERIC Educational Resources Information Center

Gondo, Tendayi; Dafuleya, Gift

2010-01-01

Technical vocational education and training (TVET) programmes have recently received increased attention as an area of priority for stimulating growth in developed and developing countries. This paper considers the situation in Ethiopia where the promotion of micro and small-sized enterprises (MSEs) has been central to the development and…

12 CFR 360.2 - Federal Home Loan banks as secured creditors.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Federal Home Loan banks as secured creditors... OF GENERAL POLICY RESOLUTION AND RECEIVERSHIP RULES § 360.2 Federal Home Loan banks as secured... regulations, the receiver of a borrower from a Federal Home Loan Bank shall recognize the priority of any...

12 CFR 360.2 - Federal Home Loan banks as secured creditors.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Federal Home Loan banks as secured creditors... OF GENERAL POLICY RESOLUTION AND RECEIVERSHIP RULES § 360.2 Federal Home Loan banks as secured... regulations, the receiver of a borrower from a Federal Home Loan Bank shall recognize the priority of any...

12 CFR 360.2 - Federal Home Loan banks as secured creditors.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Federal Home Loan banks as secured creditors... OF GENERAL POLICY RESOLUTION AND RECEIVERSHIP RULES § 360.2 Federal Home Loan banks as secured... regulations, the receiver of a borrower from a Federal Home Loan Bank shall recognize the priority of any...

12 CFR 360.2 - Federal Home Loan banks as secured creditors.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Federal Home Loan banks as secured creditors... OF GENERAL POLICY RESOLUTION AND RECEIVERSHIP RULES § 360.2 Federal Home Loan banks as secured... regulations, the receiver of a borrower from a Federal Home Loan Bank shall recognize the priority of any...

Literacy in a 'Broad and Balanced' Primary School Curriculum: The Potential of a Disciplinary Approach in Irish Classrooms

ERIC Educational Resources Information Center

Burke, Patrick; Welsch, Jodi G.

2018-01-01

The prominence afforded to literacy in the Irish Primary School Curriculum has received considerable attention in recent years, spurred by Programme for International Student Assessment (PISA) rankings, governmental priorities, public commentary and academic debate. At times, this discourse has presented literacy as a separate and distinct entity…

Motivation in a MOOC: A Probabilistic Analysis of Online Learners' Basic Psychological Needs

ERIC Educational Resources Information Center

Durksen, Tracy L.; Chu, Man-Wai; Ahmad, Zaheen F.; Radil, Amanda I.; Daniels, Lia M.

2016-01-01

Self-determination theory (SDT) is one of the most well-known approaches to achievement motivation. However, the three basic psychological needs of SDT have not received equivalent attention in the literature: priority has been given to autonomy, followed by the need for competence, with research into relatedness lacking (Bachman and Stewart in…

38 CFR 17.90 - Medical care for veterans receiving vocational training under 38 U.S.C. chapter 15.

Code of Federal Regulations, 2010 CFR

2010-07-01

....S.C. chapter 15. Hospital care, nursing home care and medical services may be provided to any... and medical services means class V dental care, priority III medical services, nursing home care and... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Vocational Training and Health-Care Eligibility...

Range-wide network of priority areas for greater sage-grouse - a design for conserving connected distributions or isolating individual zoos?

USGS Publications Warehouse

Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

2015-09-08

The network of areas delineated in 11 Western States for prioritizing management of greater sage-grouse (Centrocercus urophasianus) represents a grand experiment in conservation biology and reserve design. We used centrality metrics from social network theory to gain insights into how this priority area network might function. The network was highly centralized. Twenty of 188 priority areas accounted for 80 percent of the total centrality scores. These priority areas, characterized by large size and a central location in the range-wide distribution, are strongholds for greater sage-grouse populations and also might function as sources. Mid-ranking priority areas may serve as stepping stones because of their location between large central and smaller peripheral priority areas. The current network design and conservation strategy has risks. The contribution of almost one-half (n = 93) of the priority areas combined for less than 1 percent of the cumulative centrality scores for the network. These priority areas individually are likely too small to support viable sage-grouse populations within their boundary. Without habitat corridors to connect small priority areas either to larger priority areas or as a clustered group within the network, their isolation could lead to loss of sage-grouse within these regions of the network. 

Patient Response to an Integrated Orthotic and Rehabilitation Initiative for Traumatic Injuries: The PRIORITI-MTF Study.

PubMed

Hsu, Joseph R; Owens, Johnny G; DeSanto, Jennifer; Fergason, John R; Kuhn, Kevin M; Potter, Benjamin K; Stinner, Daniel J; Sheu, Robert G; Waggoner, Sandra L; Wilken, Jason M; Huang, Yanjie; Scharfstein, Daniel O; MacKenzie, Ellen J

2017-04-01

Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation. It builds on earlier studies by testing the program at military treatment facilities beyond the Brooke Army Medical Center and the Center for the Intrepid where the device was developed. The PRIORITI-MTF study is a multicenter before-after program evaluation where participants at least 1 year out from a traumatic lower extremity injury serve as their own controls. Participants are evaluated before receiving the IDEO, immediately after 4 weeks of physical therapy with the IDEO and at 6 and 12 months after the completion of physical therapy. Primary outcomes include functional performance, measured using well-validated assessments of speed, agility, power, and postural stability and self-reported functioning using the Short Musculoskeletal Function Assessment (SMFA) and the Veterans Health Survey (VR-12). Secondary outcomes include pain, depression, posttraumatic stress, and satisfaction with the IDEO.

Fast simulation of packet loss rates in a shared buffer communications switch

NASA Technical Reports Server (NTRS)

Chang, Cheng-Shang; Heidelberger, Philip; Shahabuddin, Perwez

1993-01-01

This paper describes an efficient technique for estimating, via simulation, the probability of buffer overflows in a queueing model that arises in the analysis of ATM (Asynchronous Transfer Mode) communication switches. There are multiple streams of (autocorrelated) traffic feeding the switch that has a buffer of finite capacity. Each stream is designated as either being of high or low priority. When the queue length reaches a certain threshold, only high priority packets are admitted to the switch's buffer. The problem is to estimate the loss rate of high priority packets. An asymptotically optimal importance sampling approach is developed for this rare event simulation problem. In this approach, the importance sampling is done in two distinct phases. In the first phase, an importance sampling change of measure is used to bring the queue length up to the threshold at which low priority packets get rejected. In the second phase, a different importance sampling change of measure is used to move the queue length from the threshold to the buffer capacity.

SU-E-T-551: Monitor Unit Optimization in Stereotactic Body Radiation Therapy for Stage I Lung Cancer

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

Huang, B-T; Lu, J-Y

2015-06-15

Purpose: The study aims to reduce the monitor units (MUs) in the stereotactic body radiation therapy (SBRT) treatment for lung cancer by adjusting the optimizing parameters. Methods: Fourteen patients suffered from stage I Non-Small Cell Lung Cancer (NSCLC) were enrolled. Three groups of parameters were adjusted to investigate their effects on MU numbers and organs at risk (OARs) sparing: (1) the upper objective of planning target volume (UOPTV); (2) strength setting in the MU constraining objective; (3) max MU setting in the MU constraining objective. Results: We found that the parameters in the optimizer influenced the MU numbers in amore » priority, strength and max MU dependent manner. MU numbers showed a decreasing trend with the UOPTV increasing. MU numbers with low, medium and high priority for the UOPTV were 428±54, 312±48 and 258±31 MU/Gy, respectively. High priority for UOPTV also spared the heart, cord and lung while maintaining comparable PTV coverage than the low and medium priority group. It was observed that MU numbers tended to decrease with the strength increasing and max MU setting decreasing. With maximum strength, the MU numbers reached its minimum while maintaining comparable or improved dose to the normal tissues. It was also found that the MU numbers continued to decline at 85% and 75% max MU setting but no longer to decrease at 50% and 25%. Combined with high priority for UOPTV and MU constraining objectives, the MU numbers can be decreased as low as 223±26 MU/Gy. Conclusion:: The priority of UOPTV, MU constraining objective in the optimizer impact on the MU numbers in SBRT treatment for lung cancer. Giving high priority to the UOPTV, setting the strength to maximum value and the max MU to 50% in the MU objective achieves the lowest MU numbers while maintaining comparable or improved OAR sparing.« less

Threats from urban expansion, agricultural transformation and forest loss on global conservation priority areas.

PubMed

Veach, Victoria; Moilanen, Atte; Di Minin, Enrico

2017-01-01

Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss.

Threats from urban expansion, agricultural transformation and forest loss on global conservation priority areas

PubMed Central

Moilanen, Atte; Di Minin, Enrico

2017-01-01

Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss. PMID:29182662

Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

PubMed Central

Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

2013-01-01

Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study, understand and effectively address environmental issues, and are particularly relevant to developing effective community-based strategies in vulnerable populations. PMID:24239281

Research priorities in mental health occupational therapy: A study of clinician perspectives.

PubMed

Hitch, Danielle; Lhuede, Kate

2015-10-01

The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. This study provides an updated indication of research priorities for mental health occupational therapy in Australia. © 2015 Occupational Therapy Australia.

Two-dimensional priority-based dynamic resource allocation algorithm for QoS in WDM/TDM PON networks

NASA Astrophysics Data System (ADS)

Sun, Yixin; Liu, Bo; Zhang, Lijia; Xin, Xiangjun; Zhang, Qi; Rao, Lan

2018-01-01

Wavelength division multiplexing/time division multiplexing (WDM/TDM) passive optical networks (PON) is being viewed as a promising solution for delivering multiple services and applications. The hybrid WDM / TDM PON uses the wavelength and bandwidth allocation strategy to control the distribution of the wavelength channels in the uplink direction, so that it can ensure the high bandwidth requirements of multiple Optical Network Units (ONUs) while improving the wavelength resource utilization. Through the investigation of the presented dynamic bandwidth allocation algorithms, these algorithms can't satisfy the requirements of different levels of service very well while adapting to the structural characteristics of mixed WDM / TDM PON system. This paper introduces a novel wavelength and bandwidth allocation algorithm to efficiently utilize the bandwidth and support QoS (Quality of Service) guarantees in WDM/TDM PON. Two priority based polling subcycles are introduced in order to increase system efficiency and improve system performance. The fixed priority polling subcycle and dynamic priority polling subcycle follow different principles to implement wavelength and bandwidth allocation according to the priority of different levels of service. A simulation was conducted to study the performance of the priority based polling in dynamic resource allocation algorithm in WDM/TDM PON. The results show that the performance of delay-sensitive services is greatly improved without degrading QoS guarantees for other services. Compared with the traditional dynamic bandwidth allocation algorithms, this algorithm can meet bandwidth needs of different priority traffic class, achieve low loss rate performance, and ensure real-time of high priority traffic class in terms of overall traffic on the network.

Potential High Priority Subaerial Environments for Mars Sample Return

NASA Astrophysics Data System (ADS)

iMOST Team; Bishop, J. L.; Horgan, B.; Benning, L. G.; Carrier, B. L.; Hausrath, E. M.; Altieri, F.; Amelin, Y.; Ammannito, E.; Anand, M.; Beaty, D. W.; Borg, L. E.; Boucher, D.; Brucato, J. R.; Busemann, H.; Campbell, K. A.; Czaja, A. D.; Debaille, V.; Des Marais, D. J.; Dixon, M.; Ehlmann, B. L.; Farmer, J. D.; Fernandez-Remolar, D. C.; Fogarty, J.; Glavin, D. P.; Goreva, Y. S.; Grady, M. M.; Hallis, L. J.; Harrington, A. D.; Herd, C. D. K.; Humayun, M.; Kleine, T.; Kleinhenz, J.; Mangold, N.; Mackelprang, R.; Mayhew, L. E.; McCubbin, F. M.; Mccoy, J. T.; McLennan, S. M.; McSween, H. Y.; Moser, D. E.; Moynier, F.; Mustard, J. F.; Niles, P. B.; Ori, G. G.; Raulin, F.; Rettberg, P.; Rucker, M. A.; Schmitz, N.; Sefton-Nash, E.; Sephton, M. A.; Shaheen, R.; Shuster, D. L.; Siljestrom, S.; Smith, C. L.; Spry, J. A.; Steele, A.; Swindle, T. D.; ten Kate, I. L.; Tosca, N. J.; Usui, T.; Van Kranendonk, M. J.; Wadhwa, M.; Weiss, B. P.; Werner, S. C.; Westall, F.; Wheeler, R. M.; Zipfel, J.; Zorzano, M. P.

2018-04-01

The highest priority subaerial environments for Mars Sample Return include subaerial weathering (paleosols, periglacial/glacial, and rock coatings/rinds), wetlands (mineral precipitates, redox environments, and salt ponds), or cold spring settings.

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2013 CFR

2013-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2010 CFR

2010-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2014 CFR

2014-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2011 CFR

2011-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

A comparison of global conservation prioritization models with spatial spending patterns of conservation nongovernmental organizations.

PubMed

Holmes, George; Scholfield, Katherine; Brockington, Dan

2012-08-01

In recent decades, various conservation organizations have developed models to prioritize locations for conservation. Through a survey of the spending patterns of 281 conservation nongovernmental organizations (NGOs), we examined the relation between 2 such models and spatial patterns of spending by conservation NGOs in 44 countries in sub-Saharan Africa. We tested whether, at the country level, the proportion of a country designated as a conservation priority was correlated with where NGOs spent money. For one model (the combination of Conservation International's hotspots and High Biodiversity Wilderness Areas, which are areas of high endemism with high or low levels of vegetation loss respectively), there was no relation between the proportion of a country designated as a priority and levels of NGO spending, including by the NGO associated with the model. In the second model (Global 200), the proportion of a country designated as a priority and the amount of money spent by NGOs were significantly and positively related. Less money was spent in countries in northern and western sub-Saharan Africa than countries in southern and eastern Africa, relative to the proportion of the country designated as a conservation priority. We suggest that on the basis of our results some NGOs consider increasing their spending on the areas designated as of conservation priority which are currently relatively underfunded, although there are economic, political, cultural, historical, biological, and practical reasons why current spending patterns may not align with priority sites. ©2012 Society for Conservation Biology.

Should We Formulate an Incentivized Model Facilitating Kidney Donation from Living Donors? A Focus on Turkey's Current System.

PubMed

Avci, Ercan

2018-04-23

Kidney transplantation is a lifesaving medical treatment. However, very high demand for kidneys with low kidney donation causes a black market that exploits patients' desperation and donors' vulnerability. The current kidney donation programs fail to produce promising results to avoid illegal and unethical kidney trafficking and commercialism. Even though the primary goal of kidney donation is to increase the number of deceased organ donations, in some countries, like Turkey, due to religious or cultural concerns, it is impossible to supply adequate deceased kidney donations. In this view, the aim of this paper is to examine kidney trafficking in the scope of Turkey's current organ donation system and propose a new model, named the Incentivized Kidney Donation Model (IKDM), to increase kidney donation from living donors. The model encompasses the following benefits offered to kidney donors; lifetime health insurance, exemptions from copayments/contribution shares, priority when receiving an organ, priority when finding a job, income tax exemptions for salaried employees, and free or discounted public utilities. This normative model has the potential to promote donors' altruistic acts as well as the solidarity and loyalty among members of a society without violating ethical values and internationally accepted principles. © 2018 John Wiley & Sons Ltd.

Expanding Kenya's protected areas under the Convention on Biological Diversity to maximize coverage of plant diversity.

PubMed

Scherer, Laura; Curran, Michael; Alvarez, Miguel

2017-04-01

Biodiversity is highly valuable and critically threatened by anthropogenic degradation of the natural environment. In response, governments have pledged enhanced protected-area coverage, which requires scarce biological data to identify conservation priorities. To assist this effort, we mapped conservation priorities in Kenya based on maximizing alpha (species richness) and beta diversity (species turnover) of plant communities while minimizing economic costs. We used plant-cover percentages from vegetation surveys of over 2000 plots to build separate models for each type of diversity. Opportunity and management costs were based on literature data and interviews with conservation organizations. Species richness was predicted to be highest in a belt from Lake Turkana through Mount Kenya and in a belt parallel to the coast, and species turnover was predicted to be highest in western Kenya and along the coast. Our results suggest the expanding reserve network should focus on the coast and northeastern provinces of Kenya, where new biological surveys would also fill biological data gaps. Meeting the Convention on Biological Diversity target of 17% terrestrial coverage by 2020 would increase representation of Kenya's plant communities by 75%. However, this would require about 50 times more funds than Kenya has received thus far from the Global Environment Facility. © 2016 Society for Conservation Biology.

An energy saving mechanism of EPON networks for real time video transmission

NASA Astrophysics Data System (ADS)

Liu, Chien-Ping; Wu, Ho-Ting; Chiang, Yun-Ting; Chien, Shieh-Chieh; Ke, Kai-Wei

2015-07-01

Modern access networks are constructed widely by passive optical networks (PONs) to meet the growing bandwidth demand. However, higher bandwidth means more energy consumption. To save energy, a few research works propose the dual-mode energy saving mechanism that allows the ONU to operate between active and sleep modes periodically. However, such dual-mode energy saving design may induce unnecessary power consumption or packet delay increase in the case where only downstream data exist for most of the time. In this paper, we propose a new tri-mode energy saving scheme for Ethernet PON (EPON). The new tri-mode energy saving design, combining the dual-mode saving mechanism with the doze mode, allows the ONU to switch among these three modes alternatively. In the doze mode, the ONU may receive downstream data while keeping its transmitter close. Such scenario is often observed for real time video downstream transmission. Furthermore, the low packet delay of high priority upstream data can be attained through the use of early wake-up mechanism employed in both energy saving modes. The energy saving and system efficiency can thus be achieved jointly while maintaining the differentiated QoS for data with various priorities. Performance results via simulation have demonstrated the effectiveness of such mechanism.

Prioritizing pesticide compounds for analytical methods development

USGS Publications Warehouse

Norman, Julia E.; Kuivila, Kathryn; Nowell, Lisa H.

2012-01-01

The U.S. Geological Survey (USGS) has a periodic need to re-evaluate pesticide compounds in terms of priorities for inclusion in monitoring and studies and, thus, must also assess the current analytical capabilities for pesticide detection. To meet this need, a strategy has been developed to prioritize pesticides and degradates for analytical methods development. Screening procedures were developed to separately prioritize pesticide compounds in water and sediment. The procedures evaluate pesticide compounds in existing USGS analytical methods for water and sediment and compounds for which recent agricultural-use information was available. Measured occurrence (detection frequency and concentrations) in water and sediment, predicted concentrations in water and predicted likelihood of occurrence in sediment, potential toxicity to aquatic life or humans, and priorities of other agencies or organizations, regulatory or otherwise, were considered. Several existing strategies for prioritizing chemicals for various purposes were reviewed, including those that identify and prioritize persistent, bioaccumulative, and toxic compounds, and those that determine candidates for future regulation of drinking-water contaminants. The systematic procedures developed and used in this study rely on concepts common to many previously established strategies. The evaluation of pesticide compounds resulted in the classification of compounds into three groups: Tier 1 for high priority compounds, Tier 2 for moderate priority compounds, and Tier 3 for low priority compounds. For water, a total of 247 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods for monitoring and studies. Of these, about three-quarters are included in some USGS analytical method; however, many of these compounds are included on research methods that are expensive and for which there are few data on environmental samples. The remaining quarter of Tier 1 compounds are high priority as new analytes. The objective for analytical methods development is to design an integrated analytical strategy that includes as many of the Tier 1 pesticide compounds as possible in a relatively few, cost-effective methods. More than 60 percent of the Tier 1 compounds are high priority because they are anticipated to be present at concentrations approaching levels that could be of concern to human health or aquatic life in surface water or groundwater. An additional 17 percent of Tier 1 compounds were frequently detected in monitoring studies, but either were not measured at levels potentially relevant to humans or aquatic organisms, or do not have benchmarks available with which to compare concentrations. The remaining 21 percent are pesticide degradates that were included because their parent pesticides were in Tier 1. Tier 1 pesticide compounds for water span all major pesticide use groups and a diverse range of chemical classes, with herbicides and their degradates composing half of compounds. Many of the high priority pesticide compounds also are in several national regulatory programs for water, including those that are regulated in drinking water by the U.S. Environmental Protection Agency under the Safe Drinking Water Act and those that are on the latest Contaminant Candidate List. For sediment, a total of 175 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods available for monitoring and studies. More than 60 percent of these compounds are included in some USGS analytical method; however, some are spread across several research methods that are expensive to perform, and monitoring data are not extensive for many compounds. The remaining Tier 1 compounds for sediment are high priority as new analytes. The objective for analytical methods development for sediment is to enhance an existing analytical method that currently includes nearly half of the pesticide compounds in Tier 1 by adding as many additional Tier 1 compounds as are analytically compatible. About 35 percent of the Tier 1 compounds for sediment are high priority on the basis of measured occurrence. A total of 74 compounds, or 42 percent, are high priority on the basis of predicted likelihood of occurrence according to physical-chemical properties, and either have potential toxicity to aquatic life, high pesticide useage, or both. The remaining 22 percent of Tier 1 pesticide compounds were either degradates of Tier 1 parent compounds or included for other reasons. As with water, the Tier 1 pesticide compounds for sediment are distributed across the major pesticide-use groups; insecticides and their degradates are the largest fraction, making up 45 percent of Tier 1. In contrast to water, organochlorines, at 17 percent, are the largest chemical class for Tier 1 in sediment, which is to be expected because there is continued widespread detection in sediments of persistent organochlorine pesticides and their degradates at concentrations high enough for potential effects on aquatic life. Compared to water, there are fewer available benchmarks with which to compare contaminant concentrations in sediment, but a total of 19 Tier 1 compounds have at least one sediment benchmark or screening value for aquatic organisms. Of the 175 compounds in Tier 1, 77 percent have high aquatic-life toxicity, as defined for this process. This evaluation of pesticides and degradates resulted in two lists of compounds that are priorities for USGS analytical methods development, one for water and one for sediment. These lists will be used as the basis for redesigning and enhancing USGS analytical capabilities for pesticides in order to capture as many high-priority pesticide compounds as possible using an economically feasible approach.

End of life care preferences among people of advanced age: LiLACS NZ.

PubMed

Gott, Merryn; Frey, Rosemary; Wiles, Janine; Rolleston, Anna; Teh, Ruth; Moeke-Maxwell, Tess; Kerse, Ngaire

2017-12-19

Understanding end of life preferences amongst the oldest old is crucial to informing appropriate palliative and end of life care internationally. However, little has been reported in the academic literature about the end of life preferences of people in advanced age, particularly the preferences of indigenous older people, including New Zealand Māori. Data on end of life preferences were gathered from 147 Māori (aged >80 years) and 291 non- Māori aged (>85 years), during three waves of Te Puawaitangi O Nga Tapuwae Kia Ora Tonu, Life and Living in Advanced Age (LiLACs NZ). An interviewer-led questionnaire using standardised tools and including Māori specific subsections was used. The top priority for both Māori and non-Māori participants at end of life was 'not being a burden to my family'. Interestingly, a home death was not a high priority for either group. End of life preferences differed by gender, however these differences were culturally contingent. More female Māori participants wanted spiritual practices at end of life than male Māori participants. More male non-Māori participants wanted to be resuscitated than female non- Māori participants. That a home death was not in the top three end of life priorities for our participants is not consistent with palliative care policy in most developed countries where place of death, and particularly home death, is a central concern. Conversely our participants' top concern - namely not being a burden - has received little research or policy attention. Our results also indicate a need to pay attention to diversity in end of life preferences amongst people of advanced age, as well as the socio-cultural context within which preferences are formulated.

Tracking patterns of needs during a telephone follow-up programme for family caregivers of persons with stroke.

PubMed

Bakas, Tamilyn; Jessup, Nenette M; McLennon, Susan M; Habermann, Barbara; Weaver, Michael T; Morrison, Gwendolyn

2016-09-01

Programmes that address stroke family caregiver needs and skill-building are recommended based on the literature and patient care guidelines for stroke rehabilitation. The purpose of this study was to explore patterns of perceived needs and skill-building during a stroke caregiver intervention programme. Descriptive statistics were used to analyse data from 123 stroke caregivers enrolled in the intervention group of a randomised controlled clinical trial. Caregivers received eight weekly telephone sessions, with a booster session a month later. At each session, the Caregiver Needs and Concerns Checklist (CNCC) was used to identify and prioritise current needs that were then addressed through skill-building strategies. Perceived needs changed over time. Information about stroke was the highest priority need during Session 1. Managing survivor emotions and behaviours was the highest priority for Sessions 2 through 4. Caregivers generally waited until Sessions 5 through 9 to address their own emotional and physical health needs. Physical and instrumental care needs were relatively low but stable across all nine sessions. Skill-building was consistently high, though it peaked during Sessions 2 and 3. Tracking patterns of needs and skill-building suggest appropriate timing for targeting different types of family caregiver support during stroke rehabilitation. Implications for Rehabilitation Family caregivers of stroke survivors play an essential role in the rehabilitation process of the stroke survivor. Identifying and addressing the priority needs and concerns of stroke caregivers during the early discharge period enables caregivers to provide sustained support for the stroke survivor. Rehabilitation professionals are in a key position to address evolving caregiver needs and concerns as they transition to home settings with follow-up care.

40 CFR Appendix E to Part 300 - Oil Spill Response

Code of Federal Regulations, 2010 CFR

2010-07-01

..., other waters of the high seas subject to the NCP, and the land surface or land substrata, ground waters... response equipment; and a district response advisory team. Contiguous zone means the zone of the high seas... of the discharge. 2.2Priorities. (a) Safety of human life must be given the highest priority during...

State Strategies to Improve Low-Performing Schools: California's High Priority School Grants Program

ERIC Educational Resources Information Center

Timar, Thomas; Rodriguez, Gloria; Simon, Virginia Adams; Ferrario, Kim; Kim, Kris

2006-01-01

Central to California's school accountability system are programs to engage low-performing schools in improvement efforts. One of these is the High Priority Schools Program (HPSGP), created by Assembly Bill 961 (Chapter 747, "Statutes of 2001") to provide funds to the lowest performing schools in the state. To be eligible for funding,…

A framework for addressing bird conservation priorities in high-elevation vegetation communities of the Appalachian Mountains

Treesearch

Brian W. Smith; Dean Demarest; Ed. Laurent

2010-01-01

The Appalachian Mountains Joint Venture (AMJV) is a self-directed, nonregulatory bird conservation partnership with the mission of restoring and sustaining native bird populations and their habitats throughout Appalachia. In 2008, the AMJV formed an ad hoc "high-elevation" technical working group to identify and address conservation priorities of bird species...

Social support received by women with intellectual and developmental disabilities during pregnancy and childbirth: An exploratory qualitative study.

PubMed

Potvin, Lynne A; Brown, Hilary K; Cobigo, Virginie

2016-06-01

this study aims to contribute to the development of a conceptual framework that will inform maternity care improvements for expectant mothers with intellectual and developmental disabilities (IDD) by exploring the structure, functions, and perceived quality of social support received by women with IDD during pregnancy and childbirth. using a grounded theory approach, we conducted an exploratory study set in Ontario, Canada in 2015. the sample included four adult women with IDD who had given birth in the last five years. data were collected using semi-structured interviews. the structure of social support received by women with IDD consisted of both formal and informal sources, but few or no friendships. Women with IDD reported high levels of informational and instrumental support and low levels of emotional support and social companionship. However, a high level of available support was not always perceived as beneficial. Emergent core categories suggest that social support is perceived as most effective when three conditions are met: (1) support is accessible, (2) support is provided by individuals expressing positive attitudes towards the pregnancy, and (3) autonomy is valued. our study confirms and identifies important gaps in the social support received by expectant mothers with IDD. Women with IDD currently lack accessible informational support, emotional support, and social companionship during pregnancy and childbirth. Additional findings regarding the structure and functions of social support are presented, and a preliminary conceptual framework of effective social support during pregnancy and childbirth, as perceived by women with IDD is also proposed. Findings suggest that increasing support accessibility should be a social and clinical priority; however, maternity care providers should be aware of stigmatizing attitudes and respect the autonomy of pregnant women with IDD as they prepare for motherhood. Copyright © 2016 Elsevier Ltd. All rights reserved.

Research priorities by professional background - A detailed analysis of the James Lind Alliance Priority Setting Partnership.

PubMed

Arulkumaran, Nishkantha; Reay, Hannah; Brett, Stephen J

2016-05-01

The Intensive Care Foundation, in partnership with the James Lind Alliance, has supported a national project to identify and prioritise unanswered questions about adult intensive care that are important to people who have been critically ill, their families, and the health professionals who care for them. We conducted a secondary analysis to explore differences in priorities determined by different respondent groups in order to identify different groups' perceptions of gaps in knowledge. There were two surveys conducted as part of the original project. Survey 1 comprised a single open question to identify important research topics; survey 2 aimed to prioritise these topics using a 10-point Likert scale. In survey 1, despite clear differences in suggestions amongst the respondent groups, themes of comfort/communication and post-ICU rehabilitation were the within the top 2 suggestions across all groups. Patients and relatives suggested research topics to which they could easily relate, whereas there was a greater breadth of suggestions from clinicians. In survey 2, the number of research priorities that received a mode score of 10 varied from 1 to 36. Patients scored 36 out of the 37 topics with a mode score of 10. All other groups scored topics with more discrimination, with the number of topics with a mode score of 10 ranging from 1 to 20. Differences in the proportions of the representative groups are therefore unlikely to have translated to an impartial conclusion. Clinicians, patients, and family members have jointly identified the research priorities for UK ICM practice.

Protocol Architecture Model Report

NASA Technical Reports Server (NTRS)

Dhas, Chris

2000-01-01

NASA's Glenn Research Center (GRC) defines and develops advanced technology for high priority national needs in communications technologies for application to aeronautics and space. GRC tasked Computer Networks and Software Inc. (CNS) to examine protocols and architectures for an In-Space Internet Node. CNS has developed a methodology for network reference models to support NASA's four mission areas: Earth Science, Space Science, Human Exploration and Development of Space (REDS), Aerospace Technology. This report applies the methodology to three space Internet-based communications scenarios for future missions. CNS has conceptualized, designed, and developed space Internet-based communications protocols and architectures for each of the independent scenarios. The scenarios are: Scenario 1: Unicast communications between a Low-Earth-Orbit (LEO) spacecraft inspace Internet node and a ground terminal Internet node via a Tracking and Data Rela Satellite (TDRS) transfer; Scenario 2: Unicast communications between a Low-Earth-Orbit (LEO) International Space Station and a ground terminal Internet node via a TDRS transfer; Scenario 3: Multicast Communications (or "Multicasting"), 1 Spacecraft to N Ground Receivers, N Ground Transmitters to 1 Ground Receiver via a Spacecraft.

A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom.

PubMed

Perry, D C; Wright, J G; Cooke, S; Roposch, A; Gaston, M S; Nicolaou, N; Theologis, T

2018-05-01

Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes' disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children's orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680-4.

Binge Eating among Women Veterans in Primary Care: Comorbidities and Treatment Priorities.

PubMed

Rosenbaum, Diane L; Kimerling, Rachel; Pomernacki, Alyssa; Goldstein, Karen M; Yano, Elizabeth M; Sadler, Anne G; Carney, Diane; Bastian, Lori A; Bean-Mayberry, Bevanne A; Frayne, Susan M

2016-01-01

Little is known about the clinical profile and treatment priorities of women with binge eating disorder (BED), a diagnosis new to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. We identified comorbidities and patients' treatment priorities, because these may inform implementation of clinical services. Data were collected from women veteran primary care patients. Analyses compared those who screened positive for BED (BED+), and those without any binge eating symptoms (BED-). Frequencies of comorbid medical and psychological disorders were high in the BED+ group. The BED+ group's self-identified most common treatment priorities were mood concerns (72.2%), weight loss (66.7%), and body image/food issues (50%). Among those with obesity, a greater proportion of the BED+ group indicated body image/food issues was their top treatment priority (12.9% vs. 2.8%; p < .01), suggesting that these patients may be more apt to seek treatment beyond weight management for their problematic eating patterns. Women primary care patients with BED demonstrate high medical and psychological complexity; their subjective treatment priorities often match objective needs. These findings may inform the development of targeted BED screening practices for women with obesity in primary care settings, and the eventual adoption of patient-centered BED treatment resources. Published by Elsevier Inc.

Biodiversity hotspots house most undiscovered plant species.

PubMed

Joppa, Lucas N; Roberts, David L; Myers, Norman; Pimm, Stuart L

2011-08-09

For most organisms, the number of described species considerably underestimates how many exist. This is itself a problem and causes secondary complications given present high rates of species extinction. Known numbers of flowering plants form the basis of biodiversity "hotspots"--places where high levels of endemism and habitat loss coincide to produce high extinction rates. How different would conservation priorities be if the catalog were complete? Approximately 15% more species of flowering plant are likely still undiscovered. They are almost certainly rare, and depending on where they live, suffer high risks of extinction from habitat loss and global climate disruption. By using a model that incorporates taxonomic effort over time, regions predicted to contain large numbers of undiscovered species are already conservation priorities. Our results leave global conservation priorities more or less intact, but suggest considerably higher levels of species imperilment than previously acknowledged.

Evaluation of Pre-marketing Factors to Predict Post-marketing Boxed Warnings and Safety Withdrawals.

PubMed

Schick, Andreas; Miller, Kathleen L; Lanthier, Michael; Dal Pan, Gerald; Nardinelli, Clark

2017-06-01

An important goal in drug regulation is understanding serious safety issues with new drugs as soon as possible. Achieving this goal requires us to understand whether information provided during the Food and Drug Administration (FDA) drug review can predict serious safety issues that are usually identified after the product is approved. However, research on this topic remains understudied. In this paper, we examine whether any pre-marketing drug characteristics are associated with serious post-marketing safety actions. We study this question using an internal FDA database containing every new small molecule drug submitted to the FDA's Center for Drug Evaluation and Research (CDER) on or after November 21, 1997, and approved and commercially launched before December 31, 2009. Serious post-marketing safety actions include whether these drugs ever experienced either a post-marketing boxed warning or a withdrawal from the market due to safety concerns. A random effects logistic regression model was used to test whether any pre-marketing characteristics were associated with either post-marketing safety action. A total of 219 new molecular entities were analyzed. Among these drugs, 11 experienced a safety withdrawal and 30 received boxed warnings by July 31, 2016. Contrary to prevailing hypotheses, we find that neither clinical trial sample sizes nor review time windows are associated with the addition of a post-marketing boxed warning or safety withdrawal. However, we do find that new drugs approved with either a boxed warning or priority review are more likely to experience post-marketing boxed warnings. Furthermore, drugs approved with boxed warnings tend to receive post-marketing boxed warnings resulting from new safety information that are unrelated to the original warning. Drugs approved with a boxed warning are 3.88 times more likely to receive a post-marketing boxed warning, while drugs approved with a priority review are 3.51 times more likely to receive a post-marketing boxed warning. Although drugs approved with a boxed warning or priority review are more likely to experience serious post-marketing safety events, other information provided during the FDA drug review that is easy to quantify is generally not associated with post-marketing safety events. It appears that these post-marketing events are not discernible during a pre-marketing review and therefore might not be avoidable using current review data.

Combining occurrence and abundance distribution models for the conservation of the Great Bustard.

PubMed

Mi, Chunrong; Huettmann, Falk; Sun, Rui; Guo, Yumin

2017-01-01

Species distribution models (SDMs) have become important and essential tools in conservation and management. However, SDMs built with count data, referred to as species abundance models (SAMs), are still less commonly used to date, but increasingly receiving attention. Species occurrence and abundance do not frequently display similar patterns, and often they are not even well correlated. Therefore, only using information based on SDMs or SAMs leads to an insufficient or misleading conservation efforts. How to combine information from SDMs and SAMs and how to apply the combined information to achieve unified conservation remains a challenge. In this study, we introduce and propose a priority protection index (PI). The PI combines the prediction results of the occurrence and abundance models. As a case study, we used the best-available presence and count records for an endangered farmland species, the Great Bustard ( Otis tarda dybowskii ), in Bohai Bay, China. We then applied the Random Forest algorithm (Salford Systems Ltd. Implementation) with eleven predictor variables to forecast the spatial occurrence as well as the abundance distribution. The results show that the occurrence model had a decent performance (ROC: 0.77) and the abundance model had a RMSE of 26.54. It is noteworthy that environmental variables influenced bustard occurrence and abundance differently. The area of farmland, and the distance to residential areas were the top important variables influencing bustard occurrence. While the distance to national roads and to expressways were the most important influencing abundance. In addition, the occurrence and abundance models displayed different spatial distribution patterns. The regions with a high index of occurrence were concentrated in the south-central part of the study area; and the abundance distribution showed high populations occurrence in the central and northwestern parts of the study area. However, combining occurrence and abundance indices to produce a priority protection index (PI) to be used for conservation could guide the protection of the areas with high occurrence and high abundance (e.g., in Strategic Conservation Planning). Due to the widespread use of SDMs and the easy subsequent employment of SAMs, these findings have a wide relevance and applicability than just those only based on SDMs or SAMs. We promote and strongly encourage researchers to further test, apply and update the priority protection index (PI) elsewhere to explore the generality of these findings and methods that are now readily available.

Combining occurrence and abundance distribution models for the conservation of the Great Bustard

PubMed Central

Mi, Chunrong; Huettmann, Falk; Sun, Rui

2017-01-01

Species distribution models (SDMs) have become important and essential tools in conservation and management. However, SDMs built with count data, referred to as species abundance models (SAMs), are still less commonly used to date, but increasingly receiving attention. Species occurrence and abundance do not frequently display similar patterns, and often they are not even well correlated. Therefore, only using information based on SDMs or SAMs leads to an insufficient or misleading conservation efforts. How to combine information from SDMs and SAMs and how to apply the combined information to achieve unified conservation remains a challenge. In this study, we introduce and propose a priority protection index (PI). The PI combines the prediction results of the occurrence and abundance models. As a case study, we used the best-available presence and count records for an endangered farmland species, the Great Bustard (Otis tarda dybowskii), in Bohai Bay, China. We then applied the Random Forest algorithm (Salford Systems Ltd. Implementation) with eleven predictor variables to forecast the spatial occurrence as well as the abundance distribution. The results show that the occurrence model had a decent performance (ROC: 0.77) and the abundance model had a RMSE of 26.54. It is noteworthy that environmental variables influenced bustard occurrence and abundance differently. The area of farmland, and the distance to residential areas were the top important variables influencing bustard occurrence. While the distance to national roads and to expressways were the most important influencing abundance. In addition, the occurrence and abundance models displayed different spatial distribution patterns. The regions with a high index of occurrence were concentrated in the south-central part of the study area; and the abundance distribution showed high populations occurrence in the central and northwestern parts of the study area. However, combining occurrence and abundance indices to produce a priority protection index (PI) to be used for conservation could guide the protection of the areas with high occurrence and high abundance (e.g., in Strategic Conservation Planning). Due to the widespread use of SDMs and the easy subsequent employment of SAMs, these findings have a wide relevance and applicability than just those only based on SDMs or SAMs. We promote and strongly encourage researchers to further test, apply and update the priority protection index (PI) elsewhere to explore the generality of these findings and methods that are now readily available. PMID:29255652

Integrating economic costs and biological traits into global conservation priorities for carnivores.

PubMed

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-08-27

Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy.

Sense of security - searching for its meaning by using stories: a Participatory Action Research study in health and social care in Sweden.

PubMed

Petersson, Pia; Blomqvist, Kerstin

2011-03-01

The aim of this study was to make sense of the Swedish concept 'trygghet' by using stories from daily life in a Participatory Action Research project. In Sweden, attempts to implement core values to ensure high quality health and social care for older people are given high priority and concepts such as security and dignity are often used. As concepts are abstract they are difficult to transform into practical work. One group of six assistant nurses and one group of five Registered Nurses working in a municipality participated in Story Dialogue Method and four older women were interviewed. 'Trygghet' was found to be an internal sense - an intrinsic state based on faith and trust in oneself and others called Sense of security. External factors that strengthened Sense of security were to be part of a community, to recognize and be familiar with things and situations and to use various kinds of aids. A prerequisite for the professionals being able to support the care receivers adequately is that they have a sense of security themselves, and that they are allowed to operate in a system that facilitates for the care receivers to maintain trustworthy and reliable relations over time. © 2010 Blackwell Publishing Ltd.

A Survey of Educational Needs and Online Training Perceptions in the Wood Products Industry

ERIC Educational Resources Information Center

Quesada-Pineda, Henry J.; Conn, Samuel S.; Sanchez, L. Scarlett

2011-01-01

A sample of 651 wood products industries were surveyed to determine their educational needs and quantify their interest in receiving continuing education via an online format. In the survey, respondents were asked to rank, in order of priority, their educational needs. With a 15.2% response rate, survey respondents (n=99) indicated that an online…

The Budget and Priority Setting Process--Los Angeles Community College District.

ERIC Educational Resources Information Center

Koltai, Leslie

The nine-college Los Angeles Community College District, which has an enrollment of 135,000 and a payroll of 11,000 and which receives 80% of its operating budget from local property taxes, faced post-Proposition 13 cutbacks of 52% of its non-restricted operating revenue. Three types of alternative budgets based on state funding possibilities were…

A QoS scheme for a congestion core network based on dissimilar QoS structures in smart-phone environments.

PubMed

Hong, Sung-Ryong; Na, Wonshik; Kang, Jang-Mook

2010-01-01

This study suggests an approach to effective transmission of multimedia content in a rapidly changing Internet environment including smart-phones. Guaranteeing QoS in networks is currently an important research topic. When transmitting Assured Forwarding (AF) packets in a Multi-DiffServ network environment, network A may assign priority in an order AF1, AF2, AF3 and AF4; on the other hand, network B may reverse the order to a priority AF4, AF3, AF2 and AF1. In this case, the AF1 packets that received the best quality of service in network A will receive the lowest in network B, which may result in dropping of packets in network B and vice versa. This study suggests a way to guarantee QoS between hosts by minimizing the loss of AF packet class when one network transmits AF class packets to another network with differing principles. It is expected that QoS guarantees and their experimental value may be utilized as principles which can be applied to various mobile-web environments based on smart-phones.

A QoS Scheme for a Congestion Core Network Based on Dissimilar QoS Structures in Smart-Phone Environments

PubMed Central

Hong, Sung-Ryong; Na, Wonshik; Kang, Jang-Mook

2010-01-01

This study suggests an approach to effective transmission of multimedia content in a rapidly changing Internet environment including smart-phones. Guaranteeing QoS in networks is currently an important research topic. When transmitting Assured Forwarding (AF) packets in a Multi-DiffServ network environment, network A may assign priority in an order AF1, AF2, AF3 and AF4; on the other hand, network B may reverse the order to a priority AF4, AF3, AF2 and AF1. In this case, the AF1 packets that received the best quality of service in network A will receive the lowest in network B, which may result in dropping of packets in network B and vice versa. This study suggests a way to guarantee QoS between hosts by minimizing the loss of AF packet class when one network transmits AF class packets to another network with differing principles. It is expected that QoS guarantees and their experimental value may be utilized as principles which can be applied to various mobile-web environments based on smart-phones. PMID:22163453

Drinking in the last chance saloon: luck egalitarianism, alcohol consumption, and the organ transplant waiting list.

PubMed

Albertsen, Andreas

2016-06-01

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in distributive justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed.

Top 40 Priorities for Science to Inform US Conservation and Management Policy

EPA Science Inventory

We present a list of America's "Top 40" high-priority questions that, if answered, would help inform some of the most important current and future decisions about resource management in the United States

Development of a prototype land use model for statewide transportation planning activities : summary.

DOT National Transportation Integrated Search

2011-01-01

Developing computer models of land use and : integrated transportation-land use are high : priorities for Florida transportation planners. : Land use information is fundamental to siting : roadways, signaling, setting maintenance : priorities, routin...

Technological trends in health care: electronic health record.

PubMed

Abraham, Sam

2010-01-01

The most relevant technological trend affecting health care organizations and physician services is the electronic health record (EHR). Billions of dollars from the federal government stimulus bill are available for investment toward EHR. Based on the government directives, it is evident EHR has to be a high-priority technological intervention in health care organizations. Addressed in the following pages are the effects of the EHR trend on financial and human resources; analysis of advantages and disadvantages of EHR; action steps involved in implementing EHR, and a timeline for implementation. Medical facilities that do not meet the timetable for using EHR will likely experience reduction of Medicare payments. This article also identifies the strengths, weaknesses, opportunities, and threats of the EHR and steps to be taken by hospitals and physician medical groups to receive stimulus payment.

[Spatial analysis of gestational anemia in Peru, 2015].

PubMed

Hernández-Vásquez, Akram; Azañedo, Diego; Antiporta, Daniel A; Cortés, Sandra

2017-01-01

To establish regional prevalences of anemia in pregnant women receiving care at public clinics in Peru in 2015 and identify high-prevalence district conglomerates. An ecological study was carried out on data from pregnant women with anemia registered on the Nutritional Status Information System (SIEN) who received care in 7703 public clinics in 2015. Regional and district prevalences of gestational anemia were calculated. District conglomerates with a high prevalence of gestational anemia were identified using the Moran Index. Information was gathered from 311,521 pregnant women distributed in 1638 districts in Peru. The national prevalence of anemia was 24.2% (95% confidence interval [95% CI]: 24.0-24.3%), the rural prevalence was 30.5%, and the urban prevalence was 22.0%. The regions of Huancavelica (45.5%; 95% CI: 44.2-46.7%), Puno (42.8%; 95% CI: 41.9-43.7%), Pasco (38.5%; 95% CI: 36.9-40.0%), Cusco (36.0%; 95% CI: 35.3-36.8%), and Apurímac (32.0%; 95% CI: 30.8-33.1%) had the highest prevalences of anemia. The local Moran Index identified 202 high-priority districts (hot spots) (12.3% of total; 44 urban and 158 rural) located in Ancash, Apurímac, Arequipa, Ayacucho, Cajamarca, Cusco, Huancavelica, Huánuco, Junín, La Libertad, Lima, Pasco, and Puno containing high-prevalence district conglomerates. Gestational anemia in Peru has its highest prevalence rates in rural and southern mountainous areas. The district conglomerates with high prevalence rates of gestational anemia coincide with the areas of high regional prevalence.

Do People Taking Flu Vaccines Need Them the Most?

PubMed Central

Gu, Qian; Sood, Neeraj

2011-01-01

Background A well targeted flu vaccine strategy can ensure that vaccines go to those who are at the highest risk of getting infected if unvaccinated. However, prior research has not explicitly examined the association between the risk of flu infection and vaccination rates. Purpose This study examines the relationship between the risk of flu infection and the probability of getting vaccinated. Methods Nationally representative data from the US and multivariate regression models were used to estimate what individual characteristics are associated with (1) the risk of flu infection when unvaccinated and (2) flu vaccination rates. These results were used to estimate the correlation between the probability of infection and the probability of getting vaccinated. Separate analyses were performed for the general population and the high priority population that is at increased risk of flu related complications. Results We find that the high priority population was more likely to get vaccinated compared to the general population. However, within both the high priority and general populations the risk of flu infection when unvaccinated was negatively correlated with vaccination rates (r = −0.067, p<0.01). This negative association between the risk of infection when unvaccinated and the probability of vaccination was stronger for the high priority population (r = −0.361, p<0.01). Conclusions There is a poor match between those who get flu vaccines and those who have a high risk of flu infection within both the high priority and general populations. Targeting vaccination to people with low socioeconomic status, people who are engaged in unhealthy behaviors, working people, and families with kids will likely improve effectiveness of flu vaccine policy. PMID:22164202

Defining priorities for improving end-of-life care in Canada

PubMed Central

Heyland, Daren K.; Cook, Deborah J.; Rocker, Graeme M.; Dodek, Peter M.; Kutsogiannis, Demetrios J.; Skrobik, Yoanna; Jiang, Xuran; Day, Andrew G.; Cohen, S. Robin

2010-01-01

Background High-quality end-of-life care should be the right of every Canadian. The objective of this study was to identify aspects of end-of-life care that are high in priority as targets for improvement using feedback elicited from patients and their families. Methods We conducted a multicentre, cross-sectional survey involving patients with advanced, life-limiting illnesses and their family caregivers. We administered the Canadian Health Care Evaluation Project (CANHELP) questionnaire along with a global rating question to measure satisfaction with end-of-life care. We derived the relative importance of individual questions on the CANHELP questionnaire from their association with a global rating of satisfaction, as determined using Pearson correlation coefficients. To determine high-priority issues, we identified questions that had scores indicating high importance and low satisfaction. Results We approached 471 patients and 255 family members, of whom 363 patients and 193 family members participated, with response rates of 77% for patients and 76% for families. From the perspective of patients, high-priority areas needing improvement were related to feelings of peace, to assessment and treatment of emotional problems, to physician availability and to satisfaction that the physician took a personal interest in them, communicated clearly and consistently, and listened. From the perspective of family members, similar areas were identified as high in priority, along with the additional areas of timely information about the patient’s condition and discussions with the doctor about final location of care and use of end-of-life technology. Interpretation End-of-life care in Canada may be improved for patients and their families by providing better psychological and spiritual support, better planning of care and enhanced relationships with physicians, especially in aspects related to communication and decision-making. PMID:20921249

The Voices of Parents: Post-High School Expectations, Priorities, and Concerns for Children With Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Blustein, Carly L.; Carter, Erik W.; McMillan, Elise D.

2016-01-01

The expectations of parents can shape the post-school pathways of young people with intellectual and developmental disabilities (IDD). Yet little is known about how parents view the employment prospects and priorities of their sons and daughters after high school. We examined expectations, preferences, and concerns of 1,065 parents of children and…

Job Priorities on Peregrine | High-Performance Computing | NREL

Science.gov Websites

allocation when run with qos=high. Requesting a Node Reservation If you are doing work that requires real scheduler more efficiently plan resources for larger jobs. When projects reach their allocation limit, jobs associated with those projects will run at very low priority, which will ensure that these jobs run only when

Translator Plan: A Coordinated Vision for Fiscal Years 2018-2020

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

Riihimaki, Laura; Comstock, Jennifer; Collis, Scott

In June of 2017, the Translator Group met to develop this coordinated three-year vision plan, incorporating key feedback and aligning to ARM’s mission priorities. This plan responds to a shift in how we determine our priorities, given the new needs of the ARM Facility. In the past, individual Translators have determined priorities in conversation with individual DOE Atmospheric System Research (ASR) working groups. To better support ARM’s Decadal Vision (https://www.arm.gov/publications/programdocs/doe-sc-arm-14-029.pdf), however, the Translator Group is instead developing a coordinated response to needs from our user community to better balance resources and skills among participants. This approach agrees with direction frommore » ARM leadership and the ARM-ASR Coordination Team (AACT). To develop this plan the Translator Group reviewed feedback received from the User Executive Committee (UEC) and the Triennial Review, as well as priorities from ASR working groups and Principal Investigators (PIs), the LES ARM Symbiotic Simulation and Observation (LASSO) project, and new instrumentation and activities as described by the ARM Technical Director. In particular, we are responding to the advice that we were trying to do too much, and should focus on providing additional support to data quality, uncertainty assessment, a timeline for producing core VAPs from ARM Mobile Facility (AMF) campaigns, and supporting key aspects of the Decadal Vision.« less

High Priority Research Needs for Gestational Diabetes Mellitus

PubMed Central

Robinson, Karen A.; Saldanha, Ian J.; Wilson, Lisa M.; Nicholson, Wanda K.

2012-01-01

Abstract Objective Identification of unanswered research questions about the management of gestational diabetes mellitus (GDM) is necessary to focus future research endeavors. We developed a process for elucidating the highest priority research questions on GDM. Methods Using a systematic review on GDM as a starting point, we developed an eight-step process: (1) identification of research gaps, (2) feedback from the review's authors, (3) translation of gaps into researchable questions using population, intervention, comparators, outcomes, setting (PICOS) framework, (4) local institutions' stakeholders' refinement of research questions, (5) national stakeholders' use of Delphi method to develop consensus on the importance of research questions, (6) prioritization of outcomes, (7) conceptual framework, and (8) evaluation. Results We identified 15 high priority research questions for GDM. The research questions focused on medication management of GDM (e.g., various oral agents vs. insulin), delivery management for women with GDM (e.g., induction vs. expectant management), and identification of risk factors for, prevention of, and screening for type 2 diabetes in women with prior GDM. Stakeholders rated the development of chronic diseases in offspring, cesarean delivery, and birth trauma as high priority outcomes to measure in future studies. Conclusions We developed an eight-step process using a multidisciplinary group of stakeholders to identify 15 research questions of high clinical importance. Researchers, policymakers, and funders can use this list to direct research efforts and resources to the highest priority areas to improve care for women with GDM. PMID:22747422

Emission of heavy metals from an urban catchment into receiving water and possibility of its limitation on the example of Lodz city.

PubMed

Sakson, Grazyna; Brzezinska, Agnieszka; Zawilski, Marek

2018-04-14

Heavy metals are among the priority pollutants which may have toxic effects on receiving water bodies. They are detected in most of samples of stormwater runoff, but the concentrations are very variable. This paper presents results of study on the amount of heavy metals discharged from urban catchment in Lodz (Poland) in 2011-2013. The research was carried out to identify the most important sources of their emission and to assess the threats to receiving water quality and opportunities of their limitation. The city is equipped with a combined sewerage in the center with 18 combined sewer overflows and with separate system in other parts. Stormwater and wastewater from both systems are discharged into 18 small urban rivers. There is a need of restoration of water bodies in the city. Research results indicate that the main issue is high emission of heavy metals, especially zinc and copper, contained in stormwater. Annual mass loads (g/ha/year) from separate system were 1629 for Zn and 305 for Cu. It was estimated that about 48% of the annual load of Zn, 38% of Cu, 61% of Pb, and 40% of Cd discharged into receiving water came from separate system, respectively 4% of Zn and Cu, 10% of Pb and 11% of Cd from CSOs, and the remaining part from wastewater treatment plant. Effective reduction of heavy metals loads discharged into receiving water requires knowledge of sources and emissions for each catchment. Obtained data may indicate the need to apply centralized solution or decentralized by source control.

The effect of inquiry based science instruction on student understanding

NASA Astrophysics Data System (ADS)

Nail, Jessica Lynette

According to the TIMSS Study (2007), the United States is falling behind in the subjects of math and science. In order for the students in the United States to develop scientific literacy and remain competitive globally, inquiry must be the priority when teaching science (NRC, 1996; AAAS, 1990). The main purpose of this research was to see if inquiry-based instruction in the science classroom had a significant effect on student understanding and retention of information in a rural school in Virginia. The effect of inquiry-based science instruction on gender was also examined. The researcher implemented a four-week, inquiry-based unit on Virginia Sol 6.7, written in the 5 E learning style to 358 sixth-grade students and compared their posttest gains and delayed posttest scores to a control group consisting of 268 students. The control group received traditional teaching methods. The results for the posttest gains produced a p = 0.01. Therefore, there was a significant difference in the experimental group, which received the treatment, when compared to the control group, which did not receive treatment. A t test was also used to compare the delayed test scores of the experimental group to the control group. The results showed a p < 0.0001 when comparing the experimental group, which received the four-week inquiry-based science instruction treatment, to the control, which did not receive the treatment. This t test showed a very highly significant difference between the experimental group and the control group. Based on these results, it is imperative that Virginia begin implementing inquiry-based instruction in the science classroom.

Exploring spatial patterns of vulnerability for diverse biodiversity descriptors in regional conservation planning.

PubMed

Vimal, Ruppert; Pluvinet, Pascal; Sacca, Céline; Mazagol, Pierre-Olivier; Etlicher, Bernard; Thompson, John D

2012-03-01

In this study, we developed a multi-criteria assessment of spatial variability of the vulnerability of three different biodiversity descriptors: sites of high conservation interest by virtue of the presence of rare or remarkable species, extensive areas of high ecological integrity, and landscape diversity in grid cells across an entire region. We assessed vulnerability in relation to (a) direct threats in and around sites to a distance of 2 km associated with intensive agriculture, building and road infrastructure and (b) indirect effects of human population density on a wider scale (50 km). The different combinations of biodiversity and threat indicators allowed us to set differential priorities for biodiversity conservation and assess their spatial variation. For example, with this method we identified sites and grid cells which combined high biodiversity with either high threat values or low threat values for the three different biodiversity indicators. In these two classes the priorities for conservation planning will be different, reduce threat values in the former and restrain any increase in the latter. We also identified low priority sites (low biodiversity with either high or low threats). This procedure thus allows for the integration of a spatial ranking of vulnerability into priority setting for regional conservation planning. Copyright © 2011 Elsevier Ltd. All rights reserved.

Big data privacy protection model based on multi-level trusted system

NASA Astrophysics Data System (ADS)

Zhang, Nan; Liu, Zehua; Han, Hongfeng

2018-05-01

This paper introduces and inherit the multi-level trusted system model that solves the Trojan virus by encrypting the privacy of user data, and achieve the principle: "not to read the high priority hierarchy, not to write the hierarchy with low priority". Thus ensuring that the low-priority data privacy leak does not affect the disclosure of high-priority data privacy. This paper inherits the multi-level trustworthy system model of Trojan horse and divides seven different risk levels. The priority level 1˜7 represent the low to high value of user data privacy, and realize seven kinds of encryption with different execution efficiency Algorithm, the higher the priority, the greater the value of user data privacy, at the expense of efficiency under the premise of choosing a more encrypted encryption algorithm to ensure data security. For enterprises, the price point is determined by the unit equipment users to decide the length of time. The higher the risk sub-group algorithm, the longer the encryption time. The model assumes that users prefer the lower priority encryption algorithm to ensure efficiency. This paper proposes a privacy cost model for each of the seven risk subgroups. Among them, the higher the privacy cost, the higher the priority of the risk sub-group, the higher the price the user needs to pay to ensure the privacy of the data. Furthermore, by introducing the existing pricing model of economics and the human traffic model proposed by this paper and fluctuating with the market demand, this paper improves the price of unit products when the market demand is low. On the other hand, when the market demand increases, the profit of the enterprise will be guaranteed under the guidance of the government by reducing the price per unit of product. Then, this paper introduces the dynamic factors of consumers' mood and age to optimize. At the same time, seven algorithms are selected from symmetric and asymmetric encryption algorithms to define the enterprise costs at different levels. Therefore, the proposed model solves the continuous influence caused by cascading events and ensures that the disclosure of low-level data privacy of users does not affect the high-level data privacy, thus greatly improving the safety of the private information of user.

Priorities for family building among patients and partners seeking treatment for infertility.

PubMed

Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Sandlow, Jay; Schoyer, Katherine D; Strawn, Estil; Flynn, Kathryn E

2017-04-05

Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist. Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test). Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p < 0.001), whereas more men ranked 4 factors higher than their partners: 1) that our child has [woman's] genes (p = 0.025), 2) that our child has [man's] genes (p < 0.001), 3) that I maintain a close relationship with my partner (p = 0.034), and 4) that I avoid side effects from treatment (p < 0.001). Clinicians who support patients in assessing available family-building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as well as frank discussions about each partner's priorities for building their family.

[Comprehensive sexual education in Mexico: an analysis of coverage, comprehensiveness and continuity of contents in Mexican public and private schools].

PubMed

Rojas, Rosalba; Castro, Filipa de; Villalobos, Aremis; Allen-Leigh, Betania; Romero, Martin; Braverman-Bronstein, Ariela; Uribe, Patricia

2017-01-01

To analyze coverage of comprehensive sex education (CSE) in high schools in Mexico and describe whether it is comprehensive, homogeneous and has continuity based on student reports of exposure to topics in three dimensions: reproductive and sexual health, self-efficacy and rights and relations. Within a probabilistic, cross-sectional survey with stratified, cluster sampling, a nationally representative sample of 3 824 adolescents attending 45 public and private high-schools in urban and rural areas completed questionnaires on CSE. The proportion of adolescents reporting having received sex education from school personnel varies depending on topics and grade level. Topics most frequently covered are those related to sexual and reproductive health while rights and relations are least frequently dealt with. Most sex education topics are covered during junior high school and much less frequently in elementary or high school. CSE needs to be comprehensive and homogenous in terms of content, ensure inclusion of priority topics, meet national and international recommendations, ensure continuity and adapt contents to student age through all education levels.

Identifying and prioritising systematic review topics with public health stakeholders: A protocol for a modified Delphi study in Switzerland to inform future research agendas

PubMed Central

Mütsch, Margot; Kien, Christina; Gerhardus, Ansgar; Lhachimi, Stefan K

2017-01-01

Introduction The Cochrane Collaboration aims to produce relevant and top priority evidence that responds to existing evidence gaps. Hence, research priority setting (RPS) is important to identify which potential research gaps are deemed most important. Moreover, RPS supports future health research to conform both health and health evidence needs. However, studies that are prioritising systematic review topics in public health are surprisingly rare. Therefore, to inform the research agenda of Cochrane Public Health Europe (CPHE), we introduce the protocol of a priority setting study on systematic review topics in several European countries, which is conceptualised as pilot. Methods and analysis We will conduct a two-round modified Delphi study in Switzerland, incorporating an anonymous web-based questionnaire, to assess which topics should be prioritised for systematic reviews in public health. In the first Delphi round public health stakeholders will suggest relevant assessment criteria and potential priority topics. In the second Delphi round the participants indicate their (dis)agreement to the aggregated results of the first round and rate the potential review topics with the predetermined criteria on a four-point Likert scale. As we invite a wide variety of stakeholders we will compare the results between the different stakeholder groups. Ethics and dissemination We have received ethical approval from the ethical board of the University of Bremen, Germany (principal investigation is conducted at the University of Bremen) and a certificate of non-objection from the Canton of Zurich, Switzerland (fieldwork will be conducted in Switzerland). The results of this study will be further disseminated through peer reviewed publication and will support systematic review author groups (i.a. CPHE) to improve the relevance of the groups´ future review work. Finally, the proposed priority setting study can be used as a framework by other systematic review groups when conducting a priority setting study in a different context. PMID:28780546

A time-motion study of ambulance-to-emergency department radio communications.

PubMed

Penner, Mark S; Cone, David C; MacMillan, Don

2003-01-01

A prospective time-motion study of radio communication between inbound ambulances and emergency department (ED) triage personnel was conducted to assess hospital triage staff time utilized, and how often radio reports result in actions taken in the ED to prepare for patient arrival. The study hypothesis was that reports for "priority 2" (P2, nonemergent) patients rarely provide information that is acted upon in the ED prior to the patient's arrival. The study was conducted at an academic adult ED receiving 22,000 ambulances per year. An observer in the ED monitored and timed (to the second) all radio reports as well as the activities of triage nurses and arriving emergency medical services (EMS) personnel. A convenience sample of 437 reports was collected: 83 priority 1 (P1, emergent) and 354 P2. Average report times (minutes:seconds) with ranges were 0:53 (0:07-1:57) for P1, and 0:44 (0:04-3:50) for P2. Only 16% of the P2 reports resulted in any preparatory action, and 55% of these were requests to have hospital police officers available to receive intoxicated patients, as per local protocol. An in-person report was given in the ED for 61% of the P2 cases, and in 48% of these, the in-person report was longer than the radio report. In the system studied, P2 reports rarely provide information that is acted on prior to the patient's arrival. The time spent giving a radio report is frequently duplicated in the ED. Radio reports for low-priority patients may not be an efficient or productive use of providers' or nurses' time.

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

Reproductive management of dairy herds in New Zealand: attitudes, priorities and constraints perceived by farmers managing seasonal-calving, pasture-based herds in four regions.

PubMed

Brownlie, T S; Weir, A M; Tarbotton, I; Morton, J M; Heuer, C; McDougall, S

2011-01-01

To examine attitudes, priorities, and constraints pertaining to herd reproductive management perceived by farmers managing seasonal-calving, pasture-based dairy herds in four regions of New Zealand, and to explore how these varied with demographic and biophysical factors. Key decision makers (KDM) on 133 dairy herds in four dairy regions (Waikato, Taranaki, and north and south Canterbury) were interviewed between May and July 2009. They were asked to provide demographic and biophysical data about the farm, and to rate their attitude in relation to their own personality traits, management issues and priorities, and likely constraints affecting reproductive performance in their herds. Associations between demographic factors and attitudes, priorities and constraints were analysed using univariable and multivariable proportional-odds regression models. Farms in the regions studied in the South Island were larger, had larger herds and more staff than farms in the regions studied in the North Island. The farms in the South Island were more likely to be owned by a corporation, managed by younger people or people who had more education, and the herds were more likely to be fed a higher percentage of supplementary feed. The majority of KDM rated the current genetics, milksolids performance and reproductive performance of their herds as high or very high, and >70% believed that the reproductive performance had remained the same or improved over the preceding 3 years. Despite this, improving reproductive performance was the most highly rated priority for the next 3 years. The constraints considered most likely to have affected reproductive performance in the last 2 years were anoestrous cows, protracted calving periods, and low body condition scores; those considered least likely were artificial breeding and heat detection. Of the variables examined related to attitudes, priorities and likely constraints, there were significant differences between region for 10/40, and with age and occupation of the KDM for 24/40 and 5/40, respectively (p<0.05). The majority of KDM reported the current reproductive performance of their herds to be high or very high, yet rated improving reproductive performance as a very high priority for the next 3 years. Mismatch between perceived and actual performance may result in reduced uptake of extension programmes designed to improve performance, and accurate benchmarking may help increase uptake and engagement. Further work is needed to determine whether the attitudes and perceptions about performance of farmers affect the likelihood of changes in their management behaviour which translate to measurable change in the actual reproductive performance of their herds. The variation in attitude, priorities and perceived constraints among age groups and region indicates that design of extension programmes may need to vary with these demographics.

Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

PubMed Central

van der Fels-Klerx, H.J. (Ine); Adamse, Paulien; Punt, Ans; van Asselt, Esther D.

2018-01-01

Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products) and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products); all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials. PMID:29373559

Do different stakeholder groups share mental health research priorities? A four-arm Delphi study.

PubMed

Owens, Christabel; Ley, Ann; Aitken, Peter

2008-12-01

Despite considerable investment in research priority setting within diverse fields of healthcare, little is known about the extent to which different stakeholder groups share research priorities. Conflicting priorities may jeopardize stakeholder engagement in research. To identify the research priorities of different stakeholder groups within mental health care and examine the extent and nature of agreement between them. Using a Delphi technique, we conducted parallel consultation processes within four different stakeholder groups. Each group process consisted of three rounds. The study was carried out within a mental health and learning disabilities trust in southern England. Participants were recruited from the following groups: mental health service users (34), informal carers (26), mental health practitioners (35) and service managers (23). There were striking differences between the four groups in respect of their ability and willingness to make priority decisions. These differences notwithstanding, there was considerable overlap in respect of their research interests. All groups identified and attached high importance to issues relating to the promotion of independence, self-esteem and recovery. The quality of in-patient care, the place of psychological therapies and the relationship between physical and mental health also emerged across the board. The confluence of four different stakeholder groups around a number of clear themes is highly encouraging, providing a framework within which to construct a research agenda and suggesting that mental health research can be built on solid partnerships.

Integrating Economic Costs and Biological Traits into Global Conservation Priorities for Carnivores

PubMed Central

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-01-01

Background Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. Methodology/Principal Findings We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Conclusions/Significance Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy. PMID:19710911

Parent and Youth Priorities during the Transition to Adulthood for Youth with Special Health Care Needs and Developmental Disability

PubMed Central

Rehm, Roberta S.; Fuentes-Afflick, Elena; Fisher, Lucille T.; Chesla, Catherine A.

2014-01-01

Families undertake extensive planning during transition to adulthood so youth with concomitant special health care needs and developmental disabilities will have a long-term high quality of life. Findings from an interpretive field study involving 64 youth and their parents indicated that the meaning of adulthood was functioning as independently as possible with appropriate supports. Parental priorities included protecting health, assuring safety and security in multiple realms, finding meaningful activities after high school, and establishing supportive social relationships. These priorities demonstrated the need to broaden usual health care transition goals that focus on finding adult providers and optimizing self-management. PMID:22869218

Helping your patients want to pay you.

PubMed

Boden, Timothy W

2010-01-01

Back in the day when deductibles and copayments represented a relatively small share of your accounts receivable, you might have been able to get away with relegating patient-balance collections to your secondary list of practice management priorities. But in today's world of flat or declining medical revenue--coupled with burgeoning consumer-driven health plans--collecting those patient dollars has become a significant part of revenue cycle management.

Worldwide Emerging Environmental Issues Affecting the U.S. Military. January 2009

DTIC Science & Technology

2009-01-01

islands as a consequence of climate change effects. Coastal residents of Fiji were instructed to move to higher ground to avoid storms and flooding...environmental matters from energy security to international cooperation for addressing climate change . [See Appendix for more detail]. Military...military environmental programs could receive higher profiles. Since climate change is a new top priority, the military should identify all its resources

STEM: How a Poorly Defined Acronym Is Shaping Education and Workforce Development Policy in the United States. WCER Working Paper No. 2014-2

ERIC Educational Resources Information Center

Oleson, Amanda K.; Hora, Matthew T.; Benbow, Ross J.

2014-01-01

The fields of science, technology, engineering, and mathematics, more ubiquitously known by the acronym "STEM," have received a substantial amount of attention in recent years. As part of a research study investigating the alignment (or lack thereof) between the goals and priorities of educators and employers, we found it difficult to…

Simulator sickness research program at NASA-Ames Research Center

NASA Technical Reports Server (NTRS)

Mccauley, Michael E.; Cook, Anthony M.

1987-01-01

The simulator sickness syndrome is receiving increased attention in the simulation community. NASA-Ames Research Center has initiated a program to facilitate the exchange of information on this topic among the tri-services and other interested government organizations. The program objectives are to identify priority research issues, promote efficient research strategies, serve as a repository of information, and disseminate information to simulator users.

Assessment of shrimp farming impact on groundwater quality using analytical hierarchy process

NASA Astrophysics Data System (ADS)

Anggie, Bernadietta; Subiyanto, Arief, Ulfah Mediaty; Djuniadi

2018-03-01

Improved shrimp farming affects the groundwater quality conditions. Assessment of shrimp farming impact on groundwater quality conventionally has less accuracy. This paper presents the implementation of Analytical Hierarchy Process (AHP) method for assessing shrimp farming impact on groundwater quality. The data used is the impact data of shrimp farming in one of the regions in Indonesia from 2006-2016. Criteria used in this study were 8 criteria and divided into 49 sub-criteria. The weighting by AHP performed to determine the importance level of criteria and sub-criteria. Final priority class of shrimp farming impact were obtained from the calculation of criteria's and sub-criteria's weights. The validation was done by comparing priority class of shrimp farming impact and water quality conditions. The result show that 50% of the total area was moderate priority class, 37% was low priority class and 13% was high priority class. From the validation result impact assessment for shrimp farming has been high accuracy to the groundwater quality conditions. This study shows that assessment based on AHP has a higher accuracy to shrimp farming impact and can be used as the basic fisheries planning to deal with impacts that have been generated.

Trends and priorities in occupational health research and knowledge transfer in Italy.

PubMed

Rondinone, Bruna Maria; Boccuni, Fabio; Iavicoli, Sergio

2010-06-01

In 2000-2001, the Italian National Institute for Occupational Safety and Prevention (ISPESL) carried out a survey to identify the research priorities in the field of occupational safety and health (OSH). The present study, carried out in 2007-2008, was a follow-up designed to (i) review the themes identified earlier, (ii) detect emerging issues linked to new risks and forms of work, and (iii) look for any shifts in focus. The survey was extended to cover not only research but also the concept of knowledge transfer. In the first round, ISPESL distributed questionnaires to the heads of both university occupational medicine departments and prevention departments in local national health units (known as ASL in Italy) asking respondents to identify OSH priority themes. In the latest survey covering both research and the need for knowledge transfer, the same experts were asked to rank the importance of the earlier-identified topics and list any emerging issues in the OSH field. The two most important themes identified were "work accidents" and "occupational carcinogenesis". In the overall sample and among ASL experts, they received the 1st and 2nd highest mean scores. The university respondents also prioritized them but in reverse order. Some of the new priority topics included: risks associated with nanotechnologies; assessment of psychosocial and organizational risks; migration and work; and cost-benefit analysis of prevention. In light of the findings, efforts are urgently needed to identify research and knowledge transfer priorities related to workers' health and safety on an international scale using a standardized method in order to obtain comparable results, avoid wasteful duplication of resources, and reduce occupational accidents and illness.

Optical/IR from ground

NASA Technical Reports Server (NTRS)

Strom, Stephen; Sargent, Wallace L. W.; Wolff, Sidney; Ahearn, Michael F.; Angel, J. Roger; Beckwith, Steven V. W.; Carney, Bruce W.; Conti, Peter S.; Edwards, Suzan; Grasdalen, Gary

1991-01-01

Optical/infrared (O/IR) astronomy in the 1990's is reviewed. The following subject areas are included: research environment; science opportunities; technical development of the 1980's and opportunities for the 1990's; and ground-based O/IR astronomy outside the U.S. Recommendations are presented for: (1) large scale programs (Priority 1: a coordinated program for large O/IR telescopes); (2) medium scale programs (Priority 1: a coordinated program for high angular resolution; Priority 2: a new generation of 4-m class telescopes); (3) small scale programs (Priority 1: near-IR and optical all-sky surveys; Priority 2: a National Astrometric Facility); and (4) infrastructure issues (develop, purchase, and distribute optical CCDs and infrared arrays; a program to support large optics technology; a new generation of large filled aperture telescopes; a program to archive and disseminate astronomical databases; and a program for training new instrumentalists)

49 CFR 350.329 - How may a State or local agency qualify for High Priority Funds?

Code of Federal Regulations, 2014 CFR

2014-10-01

... ensure the proposal is consistent with State and national CMV safety program priorities. (3) Certify that... sanctions for violations of CMV and driver laws and regulations that are consistent with those of the State...

49 CFR 350.329 - How may a State or local agency qualify for High Priority Funds?

Code of Federal Regulations, 2013 CFR

2013-10-01

... ensure the proposal is consistent with State and national CMV safety program priorities. (3) Certify that... sanctions for violations of CMV and driver laws and regulations that are consistent with those of the State...

49 CFR 350.329 - How may a State or local agency qualify for High Priority Funds?

Code of Federal Regulations, 2012 CFR

2012-10-01

... ensure the proposal is consistent with State and national CMV safety program priorities. (3) Certify that... sanctions for violations of CMV and driver laws and regulations that are consistent with those of the State...

Policy Implications and Suggestions on Administrative Measures of Urban Flood

NASA Astrophysics Data System (ADS)

Lee, S. V.; Lee, M. J.; Lee, C.; Yoon, J. H.; Chae, S. H.

2017-12-01

The frequency and intensity of floods are increasing worldwide as recent climate change progresses gradually. Flood management should be policy-oriented in urban municipalities due to the characteristics of urban areas with a lot of damage. Therefore, the purpose of this study is to prepare a flood susceptibility map by using data mining model and make a policy suggestion on administrative measures of urban flood. Therefore, we constructed a spatial database by collecting relevant factors including the topography, geology, soil and land use data of the representative city, Seoul, the capital city of Korea. Flood susceptibility map was constructed by applying the data mining models of random forest and boosted tree model to input data and existing flooded area data in 2010. The susceptibility map has been validated using the 2011 flood area data which was not used for training. The predictor importance value of each factor to the results was calculated in this process. The distance from the water, DEM and geology showed a high predictor importance value which means to be a high priority for flood preparation policy. As a result of receiver operating characteristic (ROC), random forest model showed 78.78% and 79.18% accuracy of regression and classification and boosted tree model showed 77.55% and 77.26% accuracy of regression and classification, respectively. The results show that the flood susceptibility maps can be applied to flood prevention and management, and it also can help determine the priority areas for flood mitigation policy by providing useful information to policy makers.

Priority-setting in public health research funding organisations: an exploratory qualitative study among five high-profile funders.

PubMed

Cartier, Yuri; Creatore, Maria I; Hoffman, Steven J; Potvin, Louise

2018-06-22

Priority-driven funding streams for population and public health are an important part of the health research landscape and contribute to orienting future scholarship in the field. While research priorities are often made public through targeted calls for research, less is known about how research funding organisations arrive at said priorities. Our objective was to explore how public health research funding organisations develop priorities for strategic extramural research funding programmes. Content analysis of published academic and grey literature and key informant interviews for five public and private funders of public health research in the United Kingdom, Australia, the United States and France were performed. We found important distinctions in how funding organisations processed potential research priorities through four non-sequential phases, namely idea generation, idea analysis, idea socialisation and idea selection. Funders generally involved the public health research community and public health decision-makers in idea generation and socialisation, but other groups of stakeholders (e.g. the public, advocacy organisations) were not as frequently included. Priority-setting for strategic funding programmes in public health research involves consultation mainly with researchers in the early phase of the process. There is an opportunity for greater breadth of participation and more transparency in priority-setting mechanisms for strategic funding programmes in population and public health research.

Noradrenergic Mechanisms of Arousal’s Bidirectional Effects on Episodic Memory

PubMed Central

Clewett, David; Sakaki, Michiko; Nielsen, Shawn; Petzinger, Giselle; Mather, Mara

2016-01-01

Arousal’s selective effects on cognition go beyond the simple enhancement of emotional stimuli, sometimes enhancing and other times impairing processing of proximal neutral information. Past work shows that arousal impairs encoding of subsequent neutral stimuli regardless of their top-down priority via the engagement of β-adrenoreceptors. In contrast, retrograde amnesia induced by emotional arousal can flip to enhancement when preceding neutral items are prioritized in top-down attention. Whether β-adrenoreceptors also contribute to this retrograde memory enhancement of goal-relevant neutral stimuli is unclear. In this pharmacological study, we administered 40mg of propranolol or 40mg of placebo to healthy young adults to examine whether emotional arousal’s bidirectional effects on declarative memory relies on β-adrenoreceptor activation. Following pill intake, participants completed an emotional oddball task in which they were asked to prioritize a neutral object appearing just before an emotional or neutral oddball image within a sequence of 7 neutral objects. Under placebo, emotional oddballs impaired memory for lower priority oddball+1 objects but had no effect on memory for high priority oddball−1 objects. Propranolol blocked this anterograde amnesic effect of arousal. Emotional oddballs also enhanced selective memory trade-offs significantly more in the placebo than drug condition, such that high priority oddball−1 objects were more likely to be remembered at the cost of their corresponding lower priority oddball+1 objects under arousal. Lastly, those who recalled more high priority oddball−1 objects preceding an emotional versus neutral oddball image showed greater increases in salivary alpha-amylase, a biomarker of noradrenergic system activation, across the task. Together these findings suggest that different noradrenergic mechanisms contribute to the anterograde and retrograde mnemonic effects of arousal on proximal neutral memoranda. PMID:27815214

Noradrenergic mechanisms of arousal's bidirectional effects on episodic memory.

PubMed

Clewett, David; Sakaki, Michiko; Nielsen, Shawn; Petzinger, Giselle; Mather, Mara

2017-01-01

Arousal's selective effects on cognition go beyond the simple enhancement of emotional stimuli, sometimes enhancing and other times impairing processing of proximal neutral information. Past work shows that arousal impairs encoding of subsequent neutral stimuli regardless of their top-down priority via the engagement of β-adrenoreceptors. In contrast, retrograde amnesia induced by emotional arousal can flip to enhancement when preceding neutral items are prioritized in top-down attention. Whether β-adrenoreceptors also contribute to this retrograde memory enhancement of goal-relevant neutral stimuli is unclear. In this pharmacological study, we administered 40mg of propranolol or 40mg of placebo to healthy young adults to examine whether emotional arousal's bidirectional effects on declarative memory relies on β-adrenoreceptor activation. Following pill intake, participants completed an emotional oddball task in which they were asked to prioritize a neutral object appearing just before an emotional or neutral oddball image within a sequence of 7 neutral objects. Under placebo, emotional oddballs impaired memory for lower priority oddball+1 objects but had no effect on memory for high priority oddball-1 objects. Propranolol blocked this anterograde amnesic effect of arousal. Emotional oddballs also enhanced selective memory trade-offs significantly more in the placebo than drug condition, such that high priority oddball-1 objects were more likely to be remembered at the cost of their corresponding lower priority oddball+1 objects under arousal. Lastly, those who recalled more high priority oddball-1 objects preceding an emotional versus neutral oddball image showed greater increases in salivary alpha-amylase, a biomarker of noradrenergic system activation, across the task. Together these findings suggest that different noradrenergic mechanisms contribute to the anterograde and retrograde mnemonic effects of arousal on proximal neutral memoranda. Copyright © 2016 Elsevier Inc. All rights reserved.

Occupational health research priorities in Malaysia: a Delphi study

PubMed Central

Sadhra, S; Beach, J; Aw, T; Sheikh-Ahmed, K

2001-01-01

OBJECTIVES—As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia.
METHODS—Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations.
RESULTS—The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority.
CONCLUSIONS—The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions.


Keywords: occupational health; research priorities; Malaysia PMID:11404445

OCCURRENCE OF A NEW GENERATION OF DISINFECTION BY-PRODUCTS

EPA Science Inventory

A survey of disinfection by-product (DBP) occurrence in the United States was conducted at 12 drinking water treatment plants. In addition to currently regulated DBPs, more than 50 DBPs that rated a high priority for potential toxicity were studied. These priority DBPs included...

Exclusion of agricultural lands in spatial conservation prioritization strategies: consequences for biodiversity and ecosystem service representation

PubMed Central

Durán, América P.; Duffy, James P.; Gaston, Kevin J.

2014-01-01

Agroecosystems have traditionally been considered incompatible with biological conservation goals, and often been excluded from spatial conservation prioritization strategies. The consequences for the representativeness of identified priority areas have been little explored. Here, we evaluate these for biodiversity and carbon storage representation when agricultural land areas are excluded from a spatial prioritization strategy for South America. Comparing different prioritization approaches, we also assess how the spatial overlap of priority areas changes. The exclusion of agricultural lands was detrimental to biodiversity representation, indicating that priority areas for agricultural production overlap with areas of relatively high occurrence of species. By contrast, exclusion of agricultural lands benefits representation of carbon storage within priority areas, as lands of high value for agriculture and carbon storage overlap little. When agricultural lands were included and equally weighted with biodiversity and carbon storage, a balanced representation resulted. Our findings suggest that with appropriate management, South American agroecosystems can significantly contribute to biodiversity conservation. PMID:25143040

Stakeholders' perspectives on access-to-medicines policy and research priorities in Latin America and the Caribbean: face-to-face and web-based interviews.

PubMed

Azeredo, Thiago Botelho; Luiza, Vera Lucia; Oliveira, Maria Auxiliadora; Emmerick, Isabel Cristina Martins; Bigdeli, Maryam

2014-06-25

This study aims to rank policy concerns and policy-related research issues in order to identify policy and research gaps on access to medicines (ATM) in low- and middle-income countries in Latin America and the Caribbean (LAC), as perceived by policy makers, researchers, NGO and international organization representatives, as part of a global prioritization exercise. Data collection, conducted between January and May 2011, involved face-to-face interviews in El Salvador, Colombia, Dominican Republic, and Suriname, and an e-mail survey with key-stakeholders. Respondents were asked to choose the five most relevant criteria for research prioritization and to score policy/research items according to the degree to which they represented current policies, desired policies, current research topics, and/or desired research topics. Mean scores and summary rankings were obtained. Linear regressions were performed to contrast rankings concerning current and desired policies (policy gaps), and current and desired research (research gaps). Relevance, feasibility, and research utilization were the top ranked criteria for prioritizing research. Technical capacity, research and development for new drugs, and responsiveness, were the main policy gaps. Quality assurance, staff technical capacity, price regulation, out-of-pocket payments, and cost containment policies, were the main research gaps. There was high level of coherence between current and desired policies: coefficients of determination (R2) varied from 0.46 (Health system structure; r = 0.68, P <0.01) to 0.86 (Sustainable financing; r = 0.93, P <0.01). There was also high coherence between current and desired research on Rational selection and use of medicines (r = 0.71, P <0.05, R2 = 0.51), Pricing/affordability (r = 0.82, P <0.01, R2 = 0.67), and Sustainable financing (r = 0.76, P <0.01, R2 = 0.58). Coherence was less for Health system structure (r = 0.61, P <0.01, R2 = 0.38). This study combines metrics approaches, contributing to priority setting methodology development, with country and regional level stakeholder participation. Stakeholders received feedback with the results, and we hope to have contributed to the discussion and implementation of ATM research and policy priorities in LAC.

Occupational health research priorities in Malaysia: a Delphi study.

PubMed

Sadhra, S; Beach, J R; Aw, T C; Sheikh-Ahmed, K

2001-07-01

As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia. Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations. The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority. The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions.

Verifying Safety Messages Using Relative-Time and Zone Priority in Vehicular Ad Hoc Networks.

PubMed

Banani, Sam; Gordon, Steven; Thiemjarus, Surapa; Kittipiyakul, Somsak

2018-04-13

In high-density road networks, with each vehicle broadcasting multiple messages per second, the arrival rate of safety messages can easily exceed the rate at which digital signatures can be verified. Since not all messages can be verified, algorithms for selecting which messages to verify are required to ensure that each vehicle receives appropriate awareness about neighbouring vehicles. This paper presents a novel scheme to select important safety messages for verification in vehicular ad hoc networks (VANETs). The proposed scheme uses location and direction of the sender, as well as proximity and relative-time between vehicles, to reduce the number of irrelevant messages verified (i.e., messages from vehicles that are unlikely to cause an accident). Compared with other existing schemes, the analysis results show that the proposed scheme can verify messages from nearby vehicles with lower inter-message delay and reduced packet loss and thus provides high level of awareness of the nearby vehicles.

OAST Space Theme Workshop. Volume 3: Working group summary. 3: Sensors (E-3). A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2). D. Additional assessment

NASA Technical Reports Server (NTRS)

1976-01-01

Developments required to support the space power, SETI, solar system exploration and global services programs are identified. Instrumentation and calibration sensors (rather than scientific) are needed for the space power system. Highly sophisticated receivers for narrowband detection of microwave sensors and sensors for automated stellar cataloging to provide a mapping data base for SETI are needed. Various phases of solar system exploration require large area solid state imaging arrays from UV to IR; a long focal plane telescope; high energy particle detectors; advanced spectrometers; a gravitometer; and atmospheric distanalyzer; sensors for penetrometers; in-situ sensors for surface chemical analysis, life detection, spectroscopic and microscopic analyses of surface soils, and for meteorological measurements. Active and passive multiapplication sensors, advanced multispectral scanners with improved resolution in the UV and IR ranges, and laser techniques for advanced probing and oceanographic characterization will enhance for global services.

Verifying Safety Messages Using Relative-Time and Zone Priority in Vehicular Ad Hoc Networks

PubMed Central

Banani, Sam; Thiemjarus, Surapa; Kittipiyakul, Somsak

2018-01-01

In high-density road networks, with each vehicle broadcasting multiple messages per second, the arrival rate of safety messages can easily exceed the rate at which digital signatures can be verified. Since not all messages can be verified, algorithms for selecting which messages to verify are required to ensure that each vehicle receives appropriate awareness about neighbouring vehicles. This paper presents a novel scheme to select important safety messages for verification in vehicular ad hoc networks (VANETs). The proposed scheme uses location and direction of the sender, as well as proximity and relative-time between vehicles, to reduce the number of irrelevant messages verified (i.e., messages from vehicles that are unlikely to cause an accident). Compared with other existing schemes, the analysis results show that the proposed scheme can verify messages from nearby vehicles with lower inter-message delay and reduced packet loss and thus provides high level of awareness of the nearby vehicles. PMID:29652840

The effects of socioeconomic status on stroke risk and outcomes.

PubMed

Marshall, Iain J; Wang, Yanzhong; Crichton, Siobhan; McKevitt, Christopher; Rudd, Anthony G; Wolfe, Charles D A

2015-12-01

The latest evidence on socioeconomic status and stroke shows that stroke not only disproportionately affects low-income and middle-income countries, but also socioeconomically deprived populations within high-income countries. These disparities are reflected not only in risk of stroke but also in short-term and long-term outcomes after stroke. Increased average levels of conventional risk factors (eg, hypertension, hyperlipidaemia, excessive alcohol intake, smoking, obesity, and sedentary lifestyle) in populations with low socioeconomic status account for about half of these effects. In many countries, evidence shows that people with lower socioeconomic status are less likely to receive good-quality acute hospital and rehabilitation care than people with higher socioeconomic status. For clinical practice, better implementation of well established treatments, effective management of risk factors, and equity of access to high-quality acute stroke care and rehabilitation will probably reduce inequality substantially. Overcoming barriers and adapting evidence-based interventions to different countries and health-care settings remains a research priority. Copyright © 2015 Elsevier Ltd. All rights reserved.

The role the Great Barrier Reef plays in resident wellbeing and implications for its management.

PubMed

Larson, Silva; Stoeckl, Natalie; Farr, Marina; Esparon, Michelle

2015-04-01

Improvements in human wellbeing are dependent on improving ecosystems. Such considerations are particularly pertinent for regions of high ecological, but also social and cultural importance that are facing rapid change. One such region is the Great Barrier Reef (GBR). Although the GBR has world heritage status for its 'outstanding universal value', little is known about resident perceptions of its values. We surveyed 1545 residents, finding that absence of visible rubbish; healthy reef fish, coral cover, and mangroves; and iconic marine species, are considered to be more important to quality of life than the jobs and incomes associated with industry (most respondents were dissatisfied with the benefits they received from industry). Highly educated females placed more importance on environmental non-use values than other respondents; less educated males and those employed in mining found non-market use-values relatively more important. Environmental non-use values emerged as the most important management priority for all.

Vaccination Week in the Americas, 2011: an opportunity to assess the routine vaccination program in the Bolivarian Republic of Venezuela.

PubMed

Sánchez, Daniel; Sodha, Samir V; Kurtis, Hannah J; Ghisays, Gladys; Wannemuehler, Kathleen A; Danovaro-Holliday, M Carolina; Ropero-Álvarez, Alba María

2015-04-17

Vaccination Week in the Americas (VWA) is an annual initiative in countries and territories of the Americas every April to highlight the work of national expanded programs on immunization (EPI) and increase access to vaccination services for high-risk population groups. In 2011, as part of VWA, Venezuela targeted children aged less than 6 years in 25 priority border municipalities using social mobilization to increase institution-based vaccination. Implementation of social communication activities was decentralized to the local level. We conducted a survey in one border municipality of Venezuela to evaluate the outcome of VWA 2011 and provide a snapshot of the overall performance of the routine EPI at that level. We conducted a coverage survey, using stratified cluster sampling, in the Venezuelan municipality of Bolivar (bordering Colombia) in August 2011. We collected information for children aged <6 years through caregiver interviews and transcription of vaccination card data. We estimated each child's eligibility to receive a specific vaccine dose during VWA 2011 and whether or not they were actually vaccinated during VWA activities. We also estimated baseline vaccination coverage, timeliness and 95% confidence intervals (CI), and used chi-square tests to compare coverage across age cohorts, taking into account the sampling design. We surveyed 839 children from 698 households; 93% of children had a vaccination card. Among households surveyed, 216 (31%) caregivers reported having heard about a vaccination activity during April or May 2011. Of the 528 children eligible to receive a vaccine during VWA, 24% received at least one dose, while 13% received all doses due. Overall, baseline coverage with routine vaccines, as measured by the survey, was >85%, with a few exceptions. Low levels of VWA awareness among caregivers probably contributed to the limited vaccination of eligible children during the VWA activities in Bolivar in 2011. However, vaccine coverage for most EPI vaccines was high. Additionally, high vaccination card availability and high participation in VWA among those caregivers aware of it in 2011 suggest public trust in the EPI program in the municipality. Health authorities have used survey findings to inform changes to the routine EPI and better VWA implementation in subsequent years.

Preliminary Findings: Issues in Surface Movement

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Denning, Rebecca; Obradovich, Jodi; Billings, Charles; Woods, David

1999-01-01

The final report for the grant is presented. The recent goals for this project have been: (1) To identify common surface movement challenges which affect the airlines and Air Traffic Control; (2) To map out possible solutions to these challenges; (3) To start generalizing about the information we are receiving so that major, abstract categories of challenges and potential solutions will begin to emerge. In particular, there are several areas of opportunity which are beginning to emerge from the data, dealing with the need for: (1) Tools to support information exchange regarding priorities (both within an individual airline and between the ATC tower and airlines). Such priorities include both concerns affecting departure throughput as well as the ordering of departures to accommodate other airline considerations; (2) Planning tools to help ATC and airline Ramp staff deal with information about priorities; (3) Implementation of strategies to enable greater flexibility in queueing flights for departures; (4) Tools to provide better coordination and situation awareness during taxiing (within an airline as well as between airlines and between the airlines); (5) Tools to support planning and to deal with the interactions between departures and arrivals. Thus far, the initial interviews and observations at three airlines and two ATC facilities have been completed.

Prioritizing registered donors in organ allocation: an ethical appraisal of the Israeli organ transplant law.

PubMed

Lavee, Jacob; Brock, Dan W

2012-12-01

A new organ transplant law in Israel, which gives priority in organ allocation to candidates who in various ways support organ donation, has resulted in a significant increase in organ donation in 2011. We provide an ethical analysis of the new law. We note that by continuing to require opt-in consent, the Israeli law has an ethical advantage over opt-out laws, which may result in some use of organs from donors who have not consented. We discuss the fair response to 'free-riding' candidates who, usually for religious reasons, are opposed to donation, but nevertheless seek a transplant, who will not receive any priority over candidates who have been registered donors for at least 3 years before listing. We spell out several reasons why it is potentially unfair to prioritize patients whose first-degree relatives are registered donors, whereas it is fair to prioritize candidates who have been living directed or nondirected donors. Finally, we note the difficulty of ensuring public awareness of the priority system, which is necessary for its fairness. Athough needing some modifications, the new Israeli law is based on sound ethical approach that seems to begin already to bear fruits.

A quality function deployment framework for the service quality of health information websites.

PubMed

Chang, Hyejung; Kim, Dohoon

2010-03-01

This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results.

Governance factors in the identification of global conservation priorities for mammals

PubMed Central

Eklund, Johanna; Arponen, Anni; Visconti, Piero; Cabeza, Mar

2011-01-01

Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development. PMID:21844045

Identifying appropriate protected areas for endangered fern species under climate change.

PubMed

Wang, Chun-Jing; Wan, Ji-Zhong; Zhang, Zhi-Xiang; Zhang, Gang-Min

2016-01-01

The management of protected areas (PAs) is widely used in the conservation of endangered plant species under climate change. However, studies that have identified appropriate PAs for endangered fern species are rare. To address this gap, we must develop a workflow to plan appropriate PAs for endangered fern species that will be further impacted by climate change. Here, we used endangered fern species in China as a case study, and we applied conservation planning software coupled with endangered fern species distribution data and distribution modeling to plan conservation areas with high priority protection needs under climate change. We identified appropriate PAs for endangered fern species under climate change based on the IUCN protected area categories (from Ia to VI) and planned additional PAs for endangered fern species. The high priority regions for protecting the endangered fern species were distributed throughout southern China. With decreasing temperature seasonality, the priority ranking of all endangered fern species is projected to increase in existing PAs. Accordingly, we need to establish conservation areas with low climate vulnerability in existing PAs and expand the conservation areas for endangered fern species in the high priority conservation regions.

Governance factors in the identification of global conservation priorities for mammals.

PubMed

Eklund, Johanna; Arponen, Anni; Visconti, Piero; Cabeza, Mar

2011-09-27

Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development.

Essential hypertension--is erroneous receptor output to blame?

PubMed

Ufnal, Marcin

2012-04-01

Hypertension is a chronic medical condition in which systemic arterial blood pressure is elevated. About 80-90% of diagnosed hypertension is considered essential (idiopathic), which means there is no obvious cause of the increase in blood pressure. My hypothesis states that part of idiopathic hypertension results from erroneous information that the brain receives from receptors involved in the regulation of arterial blood pressure, i.e. if, despite high systemic blood pressure, the brain receives false "low-arterial pressure input" from cardiovascular receptors. As a result the brain centres which control blood pressure reset and produce an inappropriate output to the effectors (heart, blood vessels, kidneys and glands). The information errors may result from: (i) structural and/or functional impairment of cardiovascular receptors, (ii) changes in cardiovascular receptors activity, which are caused by other factors than changes in blood pressure, and (iii) impaired transmission in afferent fibres. I assume that in contrast to the lack of input from damaged or denervated cardiovascular receptors, an erroneous input will impair the control of arterial blood pressure. This will apply especially to false input which imitates "low-arterial pressure input". Higher priority of "low-arterial pressure input" over "high-arterial pressure input" or none input may be explained by the evolutionary adaptation, i.e. low blood pressure, mostly due to haemorrhage, used to be a more common condition than high blood pressure and constitute a major threat to humans. Copyright © 2012 Elsevier Ltd. All rights reserved.

Respecting the autonomy of cancer patients when talking with their families: qualitative analysis of semistructured interviews with patients.

PubMed Central

Benson, J.; Britten, N.

1996-01-01

OBJECTIVE: To discover cancer patients' views about disclosure of information to their family, their family's influence over the information given them, and their preferences for doctors' behaviour if they and their family disagree, as a complement to applied ethical theory. DESIGN: Semistructured interviews followed by qualitative content analysis. SETTING: Mainly urban British general practice. SUBJECTS: 30 patients in whom cancer, excluding basal and squamous cell skin carcinomas, was diagnosed 1-7 years earlier. RESULTS: All subjects wished doctors to respect their views rather than those of their family, should they differ. With their consent, subjects favoured close family receiving information about their illness, all but one mentioning advantage to their family. Without such consent, six unconditionally favoured disclosure of information to their family while seven unconditionally opposed disclosure. Seventeen participants restricted their approval for such disclosure to specific circumstances. Only two participants approved of their family influencing the information that they received about their illness; all but seven wished to receive full information, the exceptions relating to information about bad prognosis. CONCLUSIONS: Subjects favoured openness with their family but most rejected unconditional disclosure of information without their consent and their family influencing what information they would be given. They valued respect for their autonomy more highly than beneficence and considered that their own needs took priority over those of their family. PMID:8819445

DRD4 long allele carriers show heightened attention to high-priority items relative to low-priority items.

PubMed

Gorlick, Marissa A; Worthy, Darrell A; Knopik, Valerie S; McGeary, John E; Beevers, Christopher G; Maddox, W Todd

2015-03-01

Humans with seven or more repeats in exon III of the DRD4 gene (long DRD4 carriers) sometimes demonstrate impaired attention, as seen in attention-deficit hyperactivity disorder, and at other times demonstrate heightened attention, as seen in addictive behavior. Although the clinical effects of DRD4 are the focus of much work, this gene may not necessarily serve as a "risk" gene for attentional deficits, but as a plasticity gene where attention is heightened for priority items in the environment and impaired for minor items. Here we examine the role of DRD4 in two tasks that benefit from selective attention to high-priority information. We examine a category learning task where performance is supported by focusing on features and updating verbal rules. Here, selective attention to the most salient features is associated with good performance. In addition, we examine the Operation Span (OSPAN) task, a working memory capacity task that relies on selective attention to update and maintain items in memory while also performing a secondary task. Long DRD4 carriers show superior performance relative to short DRD4 homozygotes (six or less tandem repeats) in both the category learning and OSPAN tasks. These results suggest that DRD4 may serve as a "plasticity" gene where individuals with the long allele show heightened selective attention to high-priority items in the environment, which can be beneficial in the appropriate context.

DRD4 Long Allele Carriers Show Heightened Attention to High-Priority Items Relative to Low-Priority Items

PubMed Central

Gorlick, Marissa A.; Worthy, Darrell A.; Knopik, Valerie S.; McGeary, John E.; Beevers, Christopher G.; Maddox, W. Todd

2014-01-01

Humans with 7 or more repeats in exon III of the DRD4 gene (long DRD4 carriers) sometimes demonstrate impaired attention, as seen in ADHD, and at other times demonstrate heightened attention, as seen in addictive behavior. Though the clinical effects of DRD4 are the focus of much work, this gene may not necessarily serve as a ‘risk’ gene for attentional deficits, but as a plasticity gene where attention is heightened for priority items in the environment and impaired for minor items. Here we examine the role of DRD4 in two tasks that benefit from selective attention to high-priority information. We examine a category learning task where performance is supported by focusing on features and updating verbal rules. Here selective attention to the most salient features is associated with good performance. In addition, we examine the Operation Span Task (OSPAN), a working memory capacity task that relies on selective attention to update and maintain items in memory while also performing a secondary task. Long DRD4 carriers show superior performance relative to short DRD4 homozygotes (six or less tandem repeats) in both the category learning and OSPAN tasks. These results suggest that DRD4 may serve as a ‘plasticity’ gene where individuals with the long allele show heightened selective attention to high-priority items in the environment, which can be beneficial in the appropriate context. PMID:25244120

Typology of end-of-life priorities in Saudi females: averaging analysis and Q-methodology.

PubMed

Hammami, Muhammad M; Hammami, Safa; Amer, Hala A; Khodr, Nesrine A

2016-01-01

Understanding culture-and sex-related end-of-life preferences is essential to provide quality end-of-life care. We have previously explored end-of-life choices in Saudi males and found important culture-related differences and that Q-methodology is useful in identifying intraculture, opinion-based groups. Here, we explore Saudi females' end-of-life choices. A volunteer sample of 68 females rank-ordered 47 opinion statements on end-of-life issues into a nine-category symmetrical distribution. The ranking scores of the statements were analyzed by averaging analysis and Q-methodology. The mean age of the females in the sample was 30.3 years (range, 19-55 years). Among them, 51% reported average religiosity, 78% reported very good health, 79% reported very good life quality, and 100% reported high-school education or more. The extreme five overall priorities were to be able to say the statement of faith, be at peace with God, die without having the body exposed, maintain dignity, and resolve all conflicts. The extreme five overall dis-priorities were to die in the hospital, die well dressed, be informed about impending death by family/friends rather than doctor, die at peak of life, and not know if one has a fatal illness. Q-methodology identified five opinion-based groups with qualitatively different characteristics: "physical and emotional privacy concerned, family caring" (younger, lower religiosity), "whole person" (higher religiosity), "pain and informational privacy concerned" (lower life quality), "decisional privacy concerned" (older, higher life quality), and "life quantity concerned, family dependent" (high life quality, low life satisfaction). Out of the extreme 14 priorities/dis-priorities for each group, 21%-50% were not represented among the extreme 20 priorities/dis-priorities for the entire sample. Consistent with the previously reported findings in Saudi males, transcendence and dying in the hospital were the extreme end-of-life priority and dis-priority, respectively, in Saudi females. Body modesty was a major overall concern; however, concerns about pain, various types of privacy, and life quantity were variably emphasized by the five opinion-based groups but masked by averaging analysis.

Typology of end-of-life priorities in Saudi females: averaging analysis and Q-methodology

PubMed Central

Hammami, Muhammad M; Hammami, Safa; Amer, Hala A; Khodr, Nesrine A

2016-01-01

Background Understanding culture-and sex-related end-of-life preferences is essential to provide quality end-of-life care. We have previously explored end-of-life choices in Saudi males and found important culture-related differences and that Q-methodology is useful in identifying intraculture, opinion-based groups. Here, we explore Saudi females’ end-of-life choices. Methods A volunteer sample of 68 females rank-ordered 47 opinion statements on end-of-life issues into a nine-category symmetrical distribution. The ranking scores of the statements were analyzed by averaging analysis and Q-methodology. Results The mean age of the females in the sample was 30.3 years (range, 19–55 years). Among them, 51% reported average religiosity, 78% reported very good health, 79% reported very good life quality, and 100% reported high-school education or more. The extreme five overall priorities were to be able to say the statement of faith, be at peace with God, die without having the body exposed, maintain dignity, and resolve all conflicts. The extreme five overall dis-priorities were to die in the hospital, die well dressed, be informed about impending death by family/friends rather than doctor, die at peak of life, and not know if one has a fatal illness. Q-methodology identified five opinion-based groups with qualitatively different characteristics: “physical and emotional privacy concerned, family caring” (younger, lower religiosity), “whole person” (higher religiosity), “pain and informational privacy concerned” (lower life quality), “decisional privacy concerned” (older, higher life quality), and “life quantity concerned, family dependent” (high life quality, low life satisfaction). Out of the extreme 14 priorities/dis-priorities for each group, 21%–50% were not represented among the extreme 20 priorities/dis-priorities for the entire sample. Conclusion Consistent with the previously reported findings in Saudi males, transcendence and dying in the hospital were the extreme end-of-life priority and dis-priority, respectively, in Saudi females. Body modesty was a major overall concern; however, concerns about pain, various types of privacy, and life quantity were variably emphasized by the five opinion-based groups but masked by averaging analysis. PMID:27274205

Mexican Industrial Development Plans: Implications for United States Policy.

DTIC Science & Technology

1981-04-01

of strate- gies involving investments, credit, subsidies, insur- ance, commercialization, and a mass media approach to improving nutritional habits... nutrition to the poor, rural sectors. The instruments for seeking this re- sult are: 1. Preferential rates of credit for the production of corn and...storehouses and distribution centers in priority rural areas. SAM identifies 782 townships as "critical nutrition zones" which will receive the brunt of

FAFSA Filing among First-Year College Students: Who Files on Time, Who Doesn't, and Why Does It Matter?

ERIC Educational Resources Information Center

McKinney, Lyle; Novak, Heather

2015-01-01

Students who do not file the free application for federal student aid (FAFSA), or who file after the priority application deadline, are at risk of not receiving grant aid that could help them persist and graduate from college. This study used data from the beginning postsecondary student study (BPS:04/06) to examine FAFSA filing behavior (i.e.…

Task Force to Improve Timeliness of Senior Official Administrative Investigations

DTIC Science & Technology

2014-11-04

from FY 2013. Prior to FY 2014, the Director, ISO, read and reviewed every senior official complaint received through the DoD Hotline. Beginning...files all documentary evidence into D-CATS for seamless transition to the ISO investigator. ODIG-AI Investigative Process ODIG-AI conducts...availability of potential witnesses, and the volume of documentary evidence. Key investigative milestones for a lower priority case of typical complexity

Battlefield Trauma Care Research, Development, Test and Evaluation Priorities

DTIC Science & Technology

2011-06-14

approved them by unanimous vote on March 8, 2011. FINDINGS Non-Compressible Hemorrhage Control-Follow-Up Tranexamic Acid Studies 5. Hemorrhagic shock...received tranexamic acid demonstrated a significant decrease in mortality without any increase in venous occlusive events either accompanied by or at...occlusive events. 8. Tranexarnic acid is a low-cost, FDA-approved agent. 9. The potential benefit and optimal use of tranexamic acid are not yet

Impact of new medical technologies on health expenditures in Israel 2000-07.

PubMed

Rabinovich, Mordechai; Wood, Francis; Shemer, Joshua

2007-01-01

The aim of this study was to estimate the impact of new medical technologies on public healthcare expenditures in Israel over the period 2000-07. For each year, government estimates for the costs of new technologies recommended as high-priority for public funding were summarized. The ratio of projected costs of these technologies to total public healthcare expenditures was calculated and compared with actual governmental budget allocations for new technologies. Funding all new high-priority medical technologies would have increased healthcare expenditures by 2.1 percent per year. Government allocations for new technologies raised expenditures by 1.0 percent per year. New medical technologies significantly increase healthcare expenditures in Israel. Budgetary constraints have reduced their actual impact by 52 percent. This study indicates the need for an annual addition of 2 percent to public healthcare budget for funding new high-priority technologies.

Braille use among Norwegian children from 1967 to 2007: trends in the underlying causes.

PubMed

Augestad, Liv Berit; Klingenberg, Oliv; Fosse, Per

2012-08-01

The aim of the study was to estimate the occurrence, diagnoses and time trends among Norwegian children that have received education in braille from 1967 to 2007. We used a retrospective population-based study design. The health care system is free for all inhabitants in Norway. We included all children that had received braille education the last four decades. From each student's record, we abstracted year born, country of birth, gender, year diagnosed, diagnosis, classification of visual impairment and type of reading media. We identified 287 children (137 girls and 150 boys) that had received braille education over the last 40 years. Of these, 262 (91.3%) children were born in Norway, 145 (53.7%) were diagnosed within the first year of life and 59 (20.6%) from age of one to five. The most frequent diagnoses were Retinopathy of Prematurity (ROP), Juvenile Ceroid Lipofuscinoses (JNCL), Lebers Congenital Amaurosis (LCA) and Retinitis Pigmentosa (RP). Among the children, 63% (N = 170) used braille only, 9% (N = 25) braille and print, but priority braille, and 27% (N = 73) braille and print, priority print. The number of children with ROP using braille had a peak in 1977, then the number declined. The number diagnosed with LCA increased from 1987 to 1992. The number of braille users among children diagnosed with JNCL tended to increase substantially after 1992. Braille education seemed to be dependent of trends in diagnoses as well as trends in recommendations from professional educators. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

Development of an international research agenda for adult congenital heart disease nursing.

PubMed

Goossens, Eva; Fleck, Desiree; Canobbio, Mary M; Harrison, Jeanine L; Moons, Philip

2013-02-01

Since the population of adults with congenital heart disease (CHD) is growing, the role of nurse specialists is expanding. In order to advance ACHD nursing, the establishment of an international nursing research agenda is recommended. We aimed to investigate research priorities as perceived by nurse specialists and researchers in ACHD. We applied a sequential quan-qual design. In the quantitative phase, a two-round Delphi study was conducted, in which 37 nurse specialists and nurse researchers in ACHD care participated. Respondents assessed the level of priority of 21 research topics using a 9-point rating scale (1 = no priority at all; 9 = very high priority). In the qualitative phase, semi-structured interviews were performed with six selected Delphi panelists, to scrutinize pending research questions. This study revealed that priority should be given to studies investigating knowledge and education of patients, outcomes of Advanced Practice Nursing, quality of life, transfer and transition, and illness experiences and psychosocial issues in adults with CHD. A low priority was given to post-operative pain, sexual functioning, transplantation in ACHD, and health care costs and utilization. Agreement about the level of priority was obtained for 14 out of 21 research topics. Based on this study, we could develop an international research agenda for ACHD. Researchers ought to focus on these areas of highest priority, in order to expand and strengthen the body of knowledge in ACHD nursing.

MsFLASH participants' priorities for alleviating menopausal symptoms.

PubMed

Carpenter, J S; Woods, N F; Otte, J L; Guthrie, K A; Hohensee, C; Newton, K M; Joffe, H; Cohen, L; Sternfeld, B; Lau, R J; Reed, S D; LaCroix, A Z

2015-01-01

To describe self-reported menopausal symptom priorities and their association with demographics and other symptoms among participants in an intervention trial for vasomotor symptoms (VMS). Cross-sectional study embedded in the MsFLASH 02 trial, a three-by-two factorial design of yoga vs. exercise vs. usual activity and omega-3-fatty acid vs. placebo. At baseline, women (n = 354) completed hot flush diaries, a card sort task to prioritize symptoms they would most like to alleviate, and standardized questionnaires. The most common symptom priorities were: VMS (n = 322), sleep (n = 191), concentration (n = 140), and fatigue (n = 116). In multivariate models, women who chose VMS as their top priority symptom (n = 210) reported significantly greater VMS severity (p = 0.004) and never smoking (p = 0.012), and women who chose sleep as their top priority symptom (n = 100) were more educated (p ≤ 0.001) and had worse sleep quality (p < 0.001). ROC curves identified sleep scale scores that were highly predictive of ranking sleep as a top priority symptom. Among women entering an intervention trial for VMS and with relatively low prevalence of depression and anxiety, VMS was the priority symptom for treatment. A card sort may be a valid tool for quickly assessing symptom priorities in clinical practice and research.

Key Problems in Science and Technology in Thailand.

ERIC Educational Resources Information Center

Yuthavong, Yongyuth; And Others

1985-01-01

Cites the need for promoting science/technology management and policy formation in Thailand, viewing contributions of science/technology to the socioeconomic development of the country as high priorities. Criteria for selecting priority areas and key problems are noted; they include relevance to development, availability of human resources, and…

78 FR 31359 - Applications for New Awards; Ehanced Assessment Instruments Grants Program-Enhanced Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... measure for high-stakes decisions. (b) Design. The KEA must-- (1) Be a component of a State's student... States for measuring the academic achievement of elementary and secondary school students. In 2013, the... assessment. Priorities: This competition includes five absolute priorities and one competitive preference...

Department of Defense Curricula: Information Concerning Conversion for Civilian Use.

ERIC Educational Resources Information Center

Forgione, Pascal D., Jr.; Orth, Mollie N.

Designed to assist in the selection of national priorities for the conversion of military curricula to civilian use, a study selected curricula pertinent to occupations with high growth potential and evaluated them against criteria important for curriculum conversion decisions. Procedures consisted of identification of priority occupational areas…

75 FR 8854 - Teacher Incentive Fund Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

...The Secretary of Education (Secretary) proposes priorities, requirements, definitions, and selection criteria under the Teacher Incentive Fund (TIF) program. These proposed priorities, requirements, definitions, and selection criteria are designed to be used in two separate and distinct TIF grant competitions: The Main TIF competition, which will provide TIF funding to eligible entities to support their implementation of performance-based compensation systems (PBCSs) in accordance with the priorities, the Main TIF requirements, the definitions, and the selection criteria proposed in this document, and the TIF Evaluation competition, which will provide, in accordance with the priorities, the Main TIF requirements, the definitions, and the selection criteria as well as the Evaluation requirements proposed in this document, TIF funding to help pay for the costs of implementing these eligible entities' PBCS in exchange for an agreement to participate in the national evaluation. The Secretary may use these proposed TIF priorities, requirements, definitions, and selection criteria in fiscal year (FY) 2010 and subsequent years. We intend the proposed priorities, requirements, definitions, and selection criteria to improve student achievement in high-need schools by creating incentives for effective teachers and principals in these schools.

[National and regional prioritisation in Swedish health care: experiences from cardiology].

PubMed

Carlsson, Jörg

2012-01-01

Prioritisation of medical services in Sweden takes place on two different levels. On the national level, the Swedish priority guidelines ascribe priority values ranging from 1 (high priority) to 10 (low priority) to measures (in terms of condition-treatment pairs) of prevention, diagnosis, treatment and rehabilitation of cardiovascular diseases. In addition, this list contains interventions that should be avoided and those that should only be provided as part of clinical research projects. The government then commissions a multi-professional team under the supervision of the National Board of Health and Welfare "Socialstyelsen" with the development of corresponding guidelines. In addition to the scientific evidence, the priority lists incorporate ethical and economical aspects and are based on the so-called ethics platform consisting of human dignity, needs, solidarity and cost-effectiveness. At the other level of prioritisation there are regional projects aiming at the in- and exclusion of medical measures. The Swedish prioritisation process will be described using the example of priority lists in cardiology. (As supplied by publisher). Copyright © 2012. Published by Elsevier GmbH.

[The contribution of oncology nursing to the Swiss Research Agenda for Nursing - SRAN].

PubMed

Shaha, Maya; Schmid-Büchi, Silvia; Abt, Judith; Mathis-Jäggi, Franziska; Holdener, Eveline; Riederer, Evelyn; Stoll, Hans Ruedi; Fliedner, Monica; Imhof, Lorenz

2008-12-01

Worldwide, cancer remains the second most frequent cause of death in adults and children. A cancer diagnosis often marks the beginning of therapies that may continue over months and years. These therapies frequently consist in surgical interventions in combination with chemotherapy and radiotherapy. For all healthcare professionals involved, cancer also signifies a very complex illness with high demands. It is therefore important to identify research priorities in order to successfully and comprehensively address these demands and to provide high quality patient care. In order to identify research priorities in oncology care in Switzerland, a systematic review of literature was conducted. A total of 30 research priorities emerged from the literature. In accordance with SRAN guidelines, 25 were passed on to the SRAN. The systematic identification of research priorities in oncology nursing has, for the first time, resulted in a list of topics in need of investigation in Switzerland. Completing the list of research priorities for oncology nursing with an updated systematic review of literature and presenting it to a larger and more representative group of oncology nurses, experts, and nurse scientists with oncology nursing experience for assessment and valuation, will be crucial for any future revision of the SRAN. In the future, it will be indispensable to include patients and their families in the process.

Spatial analysis on school environment characteristics in mangrove management based on local wisdom (Case study at Lhokseumawe, Aceh)

NASA Astrophysics Data System (ADS)

Susiloningtyas, Dewi; Handayani, Tuty; Amalia, Naila; Nadhira, Arum Ira

2017-01-01

After 2004 tsunami, lots of efforts have been made, such as building school and distributing mangrove forests. This study examines the perception of teachers and students about mangrove management which spread in the administrative area of Lhokseumawe to become a reference then applied as local education regarding mangrove after tsunami disaster. This paper was based on primary data taken using questionnaire with a predetermined analysis unit to interview teachers and students in the study area. The result presented with quantitative and descriptive analysis. The result is of the total number of junior high schools in the city of Lhokseumawe as many as 41 Public Schools, Private and Religious School, there are 31 schools with priority for local wisdom education implemented mangrove. The result is classified with 3 class. The school’s first priority is schools with a melee, with mangroves mangrove poor condition. Educational priority 2 is schools with close proximity to the mangrove and mangrove condition with moderate levels of damage. Schools with third priority are school with a close range, and mangrove good condition. Priority I as many as 18 schools, 10 schools priority II and 3 school for priority with learning competency standards that differ from each other.

Transfer of skill engendered by complex task training under conditions of variable priority.

PubMed

Boot, Walter R; Basak, Chandramallika; Erickson, Kirk I; Neider, Mark; Simons, Daniel J; Fabiani, Monica; Gratton, Gabriele; Voss, Michelle W; Prakash, Ruchika; Lee, HyunKyu; Low, Kathy A; Kramer, Arthur F

2010-11-01

We explored the theoretical underpinnings of a commonly used training strategy by examining issues of training and transfer of skill in the context of a complex video game (Space Fortress, Donchin, 1989). Participants trained using one of two training regimens: Full Emphasis Training (FET) or Variable Priority Training (VPT). Transfer of training was assessed with a large battery of cognitive and psychomotor tasks ranging from basic laboratory paradigms measuring reasoning, memory, and attention to complex real-world simulations. Consistent with previous studies, VPT accelerated learning and maximized task mastery. However, the hypothesis that VPT would result in broader transfer of training received limited support. Rather, transfer was most evident in tasks that were most similar to the Space Fortress game itself. Results are discussed in terms of potential limitations of the VPT approach. Copyright © 2010 Elsevier B.V. All rights reserved.

Planning attitudes, lay philosophies, and water allocation: A preliminary analysis and research agenda

NASA Astrophysics Data System (ADS)

Syme, Geoffrey J.; Nancarrow, Blair E.

Despite the important societal consequences of water policy, community attitudes toward planning, ethics, and equity for allocation of water have received little research attention. This preliminary research was conducted to assess the range and structure of planning attitudes and equity and ethical considerations which might be relevant to the general public's evaluation of water allocation systems. The relationship of these to priorities for water allocation were also examined. The results showed a complex structure for planning attitudes. There were also generalized but clearly defined community approaches to water allocation. A number of significant relationships between planning attitudes and philosophies of allocation were shown. Planning attitudes also related to priorities for water allocation. In practical terms the research provides some preliminary, ethically based evaluative criteria which could be applied to allocation decision-making systems. Theoretical research possibilities are also outlined.

Health assessment for Harvey and Knott Drum National Priorities List (NPL) Site, New Castle County, Delaware, Region 3. CERCLIS No. DED980713093. Final report

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

Not Available

The Harvey Knott Drum National Priorities List site, located near Kirkwood in New Castle County, Delaware, is an inactive landfill that had received sanitary, municipal and industrial wastes. Contaminants released from the site include heavy metals and organic compounds and have entered groundwater, soils, sediments, and surface waters. The principal concern is that contaminated groundwater may migrate to off-site domestic, public, and agricultural water supply wells. Also, contaminants in off-site surface water and sediments pose some concern for recreational use and consumption of fish. Off-site contaminated soils near the west property line may be a threat to persons that trespassmore » into that area. The site is of potential health concern because of the risk to human health resulting from possible exposure to hazardous substances at concentrations that may result in adverse health effects.« less

Prioritizing conservation investments for mammal species globally

PubMed Central

Wilson, Kerrie A.; Evans, Megan C.; Di Marco, Moreno; Green, David C.; Boitani, Luigi; Possingham, Hugh P.; Chiozza, Federica; Rondinini, Carlo

2011-01-01

We need to set priorities for conservation because we cannot do everything, everywhere, at the same time. We determined priority areas for investment in threat abatement actions, in both a cost-effective and spatially and temporally explicit way, for the threatened mammals of the world. Our analysis presents the first fine-resolution prioritization analysis for mammals at a global scale that accounts for the risk of habitat loss, the actions required to abate this risk, the costs of these actions and the likelihood of investment success. We evaluated the likelihood of success of investments using information on the past frequency and duration of legislative effectiveness at a country scale. The establishment of new protected areas was the action receiving the greatest investment, while restoration was never chosen. The resolution of the analysis and the incorporation of likelihood of success made little difference to this result, but affected the spatial location of these investments. PMID:21844046

Setting priorities for safe motherhood programme evaluation: a participatory process in three developing countries.

PubMed

Madi, Banyana Cecilia; Hussein, Julia; Hounton, Sennen; D'Ambruoso, Lucia; Achadi, Endang; Arhinful, Daniel Kojo

2007-09-01

A participatory approach to priority setting in programme evaluation may help improve the allocation and more efficient use of scarce resources especially in low-income countries. Research agendas that are the result of collaboration between researchers, programme managers, policy makers and other stakeholders have the potential to ensure rigorous studies are conducted on matters of local priority, based on local, expert knowledge. This paper describes a process involving key stakeholders to elicit and prioritise evaluation needs for safe motherhood in three developing countries. A series of reiterative consultations with safe motherhood stakeholders from each country was conducted over a period of 36 months. In each country, the consultation process consisted of a series of participatory workshops; firstly, stakeholder's views on evaluation were elicited with parallel descriptive work on the contexts. Secondly, priorities for evaluation were identified from stakeholders; thirdly, the evaluation-priorities were refined; and finally, the evaluation research questions, reflecting the identified priorities, were agreed and finalised. Three evaluation-questions were identified in each country, and one selected, on which a full scale evaluation was undertaken. While there is a great deal written about the importance of transparent and participatory priority setting in evaluation; few examples of how such processes could be implemented exist, particularly for maternal health programmes. Our experience demonstrates that the investment in a participatory priority-setting effort is high but the process undertaken resulted in both globally and contextually-relevant priorities for evaluation. This experience provides useful lessons for public health practitioners committed to bridging the research-policy interface.

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China

PubMed Central

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups (p-values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development. PMID:29682412

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China.

PubMed

Qu, Yi; Lu, Ming

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km 2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups ( p -values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development.

What do District Health Planners in Tanzania think about improving priority setting using 'Accountability for Reasonableness'?

PubMed Central

Mshana, Simon; Shemilu, Haji; Ndawi, Benedict; Momburi, Roman; Olsen, Oystein Evjen; Byskov, Jens; Martin, Douglas K

2007-01-01

Background Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD) and cost-effectiveness analysis (CEA), which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for reasonableness' be helpful for improving priority setting in less wealthy countries? Methods In 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI) conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach. Results The approach to improving priority setting using 'accountability for reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach. Conclusion Both Tanzanian district and governmental health planners viewed the 'accountability for reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns. PMID:17997824

Health Care Priorities: Opinions of One State's Citizens and Legislators.

ERIC Educational Resources Information Center

Jankel, Charlotte A.; And Others

1994-01-01

Reports a study that examined the attitudes of Georgia citizens and legislators toward funding for specific health care services and national health insurance. Legislators were less in favor of national health insurance than were citizens. Both groups set a high priority on providing a wide range of health care services to everyone. (SM)

School Discipline Inequities Become a Federal Priority

ERIC Educational Resources Information Center

Zehr, Mary Ann

2010-01-01

Federal officials are getting the word out that addressing racial disparities in school discipline is a high priority, and they plan to use "disparate-impact analysis" in enforcing school discipline cases--a legal course of action that some civil rights lawyers contend was neglected under the administration of President George W. Bush. In…

A Guide to Addressing Multiple Priorities in Core Content Instruction for Students with Severe Disabilities

ERIC Educational Resources Information Center

Root, Jenny R.; Knight, Victoria F.; Mims, Pamela J.

2017-01-01

Instruction in academic core content provides students with moderate to severe disabilities a full educational opportunity that promotes current and future options in the community and can complement acquisition of daily living skills. However, high school teachers face many challenges in balancing instructional priorities given the mission to…

The Influence of Nursing Faculty Workloads on Faculty Retention: A Case Study

ERIC Educational Resources Information Center

Wood, Jennifer J.

2013-01-01

Nursing faculty workloads have come to the forefront of discussion in nursing education. The National League of Nursing (NLN) has made nursing faculty workloads a high priority in nursing education. Included in the priorities are areas of creating reform through innovations in nursing education, evaluating reform through evaluation research, and…

The Priority of the Question: Focus Questions for Sustained Reasoning in Science

ERIC Educational Resources Information Center

Lustick, David

2010-01-01

Science education standards place a high priority on promoting the skills and dispositions associated with inquiry at all levels of learning. Yet, the questions teachers employ to foster sustained reasoning are most likely borrowed from a textbook, lab manual, or worksheet. Such generic questions generated for a mass audience, lack authenticity…

SERDP and ESTCP Technical Exchange Meeting on DoD Operational Range Assessment and Management Approaches

DTIC Science & Technology

2007-10-01

Development of Phytostabilization/ Phytoremediation Growing Guides for Varying Geographic and Range Use Conditions...Demonstration Needs Critical Priority High Priority Development of Phytostabilization/ Phytoremediation Growing Guides for Varying Geographic and...several additional management and mitigation methods are in varying stages of research and development: surface soil amendments, phytoremediation , and

Exclusion of agricultural lands in spatial conservation prioritization strategies: consequences for biodiversity and ecosystem service representation.

PubMed

Durán, América P; Duffy, James P; Gaston, Kevin J

2014-10-07

Agroecosystems have traditionally been considered incompatible with biological conservation goals, and often been excluded from spatial conservation prioritization strategies. The consequences for the representativeness of identified priority areas have been little explored. Here, we evaluate these for biodiversity and carbon storage representation when agricultural land areas are excluded from a spatial prioritization strategy for South America. Comparing different prioritization approaches, we also assess how the spatial overlap of priority areas changes. The exclusion of agricultural lands was detrimental to biodiversity representation, indicating that priority areas for agricultural production overlap with areas of relatively high occurrence of species. By contrast, exclusion of agricultural lands benefits representation of carbon storage within priority areas, as lands of high value for agriculture and carbon storage overlap little. When agricultural lands were included and equally weighted with biodiversity and carbon storage, a balanced representation resulted. Our findings suggest that with appropriate management, South American agroecosystems can significantly contribute to biodiversity conservation. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Jovian system science issues and implications for a Mariner Jupiter Orbiter mission

NASA Technical Reports Server (NTRS)

Beckman, J. C.; Miner, E. D.

1975-01-01

Science goals for missions to Jupiter in the early 1980's are reviewed and a case is made for the science community to play the key role in assigning relative priorities for these goals. A reference set of measurement requirements and their priorities is established and those high priority goals that are most demanding on spacecraft and mission design are used to develop a reference mission concept. An orbiter mission is required to satisfy a majority of the measurements, and a spacecraft data handling capability as least equivalent to the Mariner Jupiter/Saturn spacecraft is the major system design driver. This reference Mission Concept is called Mariner Jupiter Orbiter. The remaining measurement requirements are reviewed in light of the potential science return of this mission, and certain options are developed to augment this science return. Two attractive options fulfill high priority objectives not achieved by the reference Mariner Jupiter Orbiter mission alone: an atmospheric entry probe, released prior to orbit insertion; and a daughter satellite dedicated to particle and fields measurements, ejected into an independent orbit about Jupiter.

Translations on Eastern Europe Scientific Affairs No. 559

DTIC Science & Technology

1977-09-19

from 1977 and will continue to work on until 1980. These research activities are covered by all institutes in the research...been or are about to be put on the market since this research received priority status in 1972. These include such products as "Grandaxin," a ...17-19 [Article by Skender Malja, radiochemist in the Institute of Nuclear Physics] [Text] From year to year, as a result of the party’s

Military Justice: Oversight and Better Collaboration Needed for Sexual Assault Investigations and Adjudications

DTIC Science & Technology

2011-06-01

Coast Guard Academies Have Taken Steps to Address Incidents of Sexual Harassment and Assault, but Greater Federal Oversight Is Needed, GAO-08-296...provided through multiple sources and vary annually relative to other programmatic priorities. According to the Army Sexual Harassment /Assault...2.1 million it received from the Army’s Sexual Harassment /Assault Response and Prevention program in fiscal year 2010 for the improvement of sexual

Consensus and contention in the priority setting process: examining the health sector in Uganda.

PubMed

Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

2015-06-01

Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Norepinephrine ignites local hot spots of neuronal excitation: How arousal amplifies selectivity in perception and memory

PubMed Central

Mather, Mara; Clewett, David; Sakaki, Michiko; Harley, Carolyn W.

2018-01-01

Long Abstract Existing brain-based emotion-cognition theories fail to explain arousal’s ability to both enhance and impair cognitive processing. In the Glutamate Amplifies Noradrenergic Effects (GANE) model outlined in this paper, we propose that arousal-induced norepinephrine (NE) released from the locus coeruleus (LC) biases perception and memory in favor of salient, high priority representations at the expense of lower priority representations. This increase in gain under phasic arousal occurs via synaptic self-regulation of NE based on glutamate levels. When the LC is phasically active, elevated levels of glutamate at the site of prioritized representations increase local NE release, creating “NE hot spots.” At these local hot spots, glutamate and NE release are mutually enhancing and amplify activation of prioritized representations. This excitatory effect contrasts with widespread NE suppression of weaker representations via lateral and auto-inhibitory processes. On a broader scale, hot spots increase oscillatory synchronization across neural ensembles transmitting high priority information. Furthermore, key brain structures that detect or pre-determine stimulus priority interact with phasic NE release to preferentially route such information through large-scale functional brain networks. A surge of NE before, during or after encoding enhances synaptic plasticity at sites of high glutamate activity, triggering local protein synthesis processes that enhance selective memory consolidation. Together, these noradrenergic mechanisms increase perceptual and memory selectivity under arousal. Beyond explaining discrepancies in the emotion-cognition literature, GANE reconciles and extends previous influential theories of LC neuromodulation by highlighting how NE can produce such different outcomes in processing based on priority. PMID:26126507

Identifying and prioritising systematic review topics with public health stakeholders: A protocol for a modified Delphi study in Switzerland to inform future research agendas.

PubMed

Hoekstra, Dyon; Mütsch, Margot; Kien, Christina; Gerhardus, Ansgar; Lhachimi, Stefan K

2017-08-04

The Cochrane Collaboration aims to produce relevant and top priority evidence that responds to existing evidence gaps. Hence, research priority setting (RPS) is important to identify which potential research gaps are deemed most important. Moreover, RPS supports future health research to conform both health and health evidence needs. However, studies that are prioritising systematic review topics in public health are surprisingly rare. Therefore, to inform the research agenda of Cochrane Public Health Europe (CPHE), we introduce the protocol of a priority setting study on systematic review topics in several European countries, which is conceptualised as pilot. We will conduct a two-round modified Delphi study in Switzerland, incorporating an anonymous web-based questionnaire, to assess which topics should be prioritised for systematic reviews in public health. In the first Delphi round public health stakeholders will suggest relevant assessment criteria and potential priority topics. In the second Delphi round the participants indicate their (dis)agreement to the aggregated results of the first round and rate the potential review topics with the predetermined criteria on a four-point Likert scale. As we invite a wide variety of stakeholders we will compare the results between the different stakeholder groups. We have received ethical approval from the ethical board of the University of Bremen, Germany (principal investigation is conducted at the University of Bremen) and a certificate of non-objection from the Canton of Zurich, Switzerland (fieldwork will be conducted in Switzerland). The results of this study will be further disseminated through peer reviewed publication and will support systematic review author groups (i.a. CPHE) to improve the relevance of the groups´ future review work. Finally, the proposed priority setting study can be used as a framework by other systematic review groups when conducting a priority setting study in a different context. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership

PubMed Central

Boney, Oliver; Bell, Madeline; Bell, Natalie; Conquest, Ann; Cumbers, Marion; Drake, Sharon; Galsworthy, Mike; Gath, Jacqui; Grocott, Michael P W; Harris, Emma; Howell, Simon; Ingold, Anthony; Nathanson, Michael H; Pinkney, Thomas; Metcalf, Leanne

2015-01-01

Objective To identify research priorities for Anaesthesia and Perioperative Medicine. Design Prospective surveys and consensus meetings guided by an independent adviser. Setting UK. Participants 45 stakeholder organisations (25 professional, 20 patient/carer) affiliated as James Lind Alliance partners. Outcomes First ‘ideas-gathering’ survey: Free text research ideas and suggestions. Second ‘prioritisation’ survey: Shortlist of ‘summary’ research questions (derived from the first survey) ranked by respondents in order of priority. Final ‘top ten’: Agreed by consensus at a final prioritisation workshop. Results First survey: 1420 suggestions received from 623 respondents (49% patients/public) were refined into a shortlist of 92 ‘summary’ questions. Second survey: 1718 respondents each nominated up to 10 questions as research priorities. Top ten: The 25 highest-ranked questions advanced to the final workshop, where 23 stakeholders (13 professional, 10 patient/carer) agreed the 10 most important questions: ▸ What can we do to stop patients developing chronic pain after surgery? ▸ How can patient care around the time of emergency surgery be improved? ▸ What long-term harm may result from anaesthesia, particularly following repeated anaesthetics? ▸ What outcomes should we use to measure the ‘success’ of anaesthesia and perioperative care? ▸ How can we improve recovery from surgery for elderly patients? ▸ For which patients does regional anaesthesia give better outcomes than general anaesthesia? ▸ What are the effects of anaesthesia on the developing brain? ▸ Do enhanced recovery programmes improve short and long-term outcomes? ▸ How can preoperative exercise or fitness training, including physiotherapy, improve outcomes after surgery? ▸ How can we improve communication between the teams looking after patients throughout their surgical journey? Conclusions Almost 2000 stakeholders contributed their views regarding anaesthetic and perioperative research priorities. This is the largest example of patient and public involvement in shaping anaesthetic and perioperative research to date. PMID:26674506

Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership.

PubMed

Boney, Oliver; Bell, Madeline; Bell, Natalie; Conquest, Ann; Cumbers, Marion; Drake, Sharon; Galsworthy, Mike; Gath, Jacqui; Grocott, Michael P W; Harris, Emma; Howell, Simon; Ingold, Anthony; Nathanson, Michael H; Pinkney, Thomas; Metcalf, Leanne

2015-12-16

To identify research priorities for Anaesthesia and Perioperative Medicine. Prospective surveys and consensus meetings guided by an independent adviser. UK. 45 stakeholder organisations (25 professional, 20 patient/carer) affiliated as James Lind Alliance partners. First 'ideas-gathering' survey: Free text research ideas and suggestions. Second 'prioritisation' survey: Shortlist of 'summary' research questions (derived from the first survey) ranked by respondents in order of priority. Final 'top ten': Agreed by consensus at a final prioritisation workshop. First survey: 1420 suggestions received from 623 respondents (49% patients/public) were refined into a shortlist of 92 'summary' questions. Second survey: 1718 respondents each nominated up to 10 questions as research priorities. Top ten: The 25 highest-ranked questions advanced to the final workshop, where 23 stakeholders (13 professional, 10 patient/carer) agreed the 10 most important questions: ▸ What can we do to stop patients developing chronic pain after surgery? ▸ How can patient care around the time of emergency surgery be improved? ▸ What long-term harm may result from anaesthesia, particularly following repeated anaesthetics?▸ What outcomes should we use to measure the 'success' of anaesthesia and perioperative care? ▸ How can we improve recovery from surgery for elderly patients? ▸ For which patients does regional anaesthesia give better outcomes than general anaesthesia? ▸ What are the effects of anaesthesia on the developing brain? ▸ Do enhanced recovery programmes improve short and long-term outcomes? ▸ How can preoperative exercise or fitness training, including physiotherapy, improve outcomes after surgery? ▸ How can we improve communication between the teams looking after patients throughout their surgical journey? Almost 2000 stakeholders contributed their views regarding anaesthetic and perioperative research priorities. This is the largest example of patient and public involvement in shaping anaesthetic and perioperative research to date. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden

PubMed Central

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Åke

2014-01-01

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit. PMID:25396208

Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments.

PubMed

Luyckx, Valerie A; Miljeteig, Ingrid; Ejigu, Addisu M; Moosa, M Rafique

2017-05-01

The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis. The health system's obligation to provide financial risk protection is an important component of global and national strategies to achieve universal health coverage. An ethical imperative therefore exists to develop transparent dialysis priority-setting guidelines to facilitate public understanding and acceptance of the realistic limits within the health system, and facilitate fair allocation of scarce resources. In this article, we present ethical challenges faced by patients, families, clinicians, and policy makers where dialysis is not universally accessible and discuss the potential ethical consequences of various dialysis allocation strategies. Finally, we suggest an ethical framework for use in policy development for priority setting of dialysis care. The accountability for reasonableness framework is proposed as a procedurally fair decision-making, priority-setting process. Copyright © 2017 Elsevier Inc. All rights reserved.

Glecaprevir/Pibrentasvir Treatment in Liver or Kidney Transplant Patients With Hepatitis C Virus Infection.

PubMed

Reau, Nancy; Kwo, Paul Y; Rhee, Susan; Brown, Robert S; Agarwal, Kosh; Angus, Peter; Gane, Edward; Kao, Jia-Horng; Mantry, Parvez S; Mutimer, David; Reddy, K Rajender; Tran, Tram T; Hu, Yiran B; Gulati, Abhishek; Krishnan, Preethi; Dumas, Emily O; Porcalla, Ariel; Shulman, Nancy S; Liu, Wei; Samanta, Suvajit; Trinh, Roger; Forns, Xavier

2018-04-19

Well-tolerated, ribavirin-free, pangenotypic hepatitis C virus (HCV) treatments for transplant recipients remain a high priority. Once-daily glecaprevir/pibrentasvir demonstrates high rates of sustained virologic response for 12 weeks post-treatment (SVR12) across all major HCV genotypes (GT). This trial evaluated the safety and efficacy of glecaprevir/pibrentasvir for patients with chronic HCV GT1-6 infection who had received a liver or kidney transplant. MAGELLAN-2 was a phase 3, open-label trial conducted in patients who were ≥3 months post-transplant. Patients without cirrhosis who were HCV treatment-naïve (GT1-6) or treatment-experienced (GT1, 2, 4-6; with interferon-based therapy with or without sofosbuvir, or sofosbuvir plus ribavirin) received glecaprevir/pibrentasvir (300/120 mg) once daily for 12 weeks. The primary endpoint compared the percentage of patients receiving glecaprevir/pibrentasvir with SVR12 to a historic SVR12 rate based on the standard of care. Safety of glecaprevir/pibrentasvir was assessed. In total, 80 liver and 20 kidney transplant patients participated in the trial. Most patients had no or minimal fibrosis (80% had fibrosis scores F0-F1) and were infected with HCV GT1 (57%) or GT3 (24%). The overall SVR12 was 98% (n/N=98/100; 95% confidence interval, 95.3%-100%), which exceeded the pre-specified historic standard of care SVR12 threshold of 94%. One patient experienced virologic failure. One patient discontinued because of an adverse event considered to be unrelated to treatment; this patient achieved SVR12. Adverse events were mostly mild in severity and laboratory abnormalities were infrequent. Once-daily glecaprevir/pibrentasvir for 12 weeks is a well-tolerated and efficacious, ribavirin-free treatment for patients with chronic HCV GT1-6 infection who had received a liver or kidney transplant. ClinicalTrials.gov NCT02692703. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

Evaluation of the acceptability of improved supplementary foods for the treatment of moderate acute malnutrition in Burkina Faso using a mixed method approach.

PubMed

Iuel-Brockdorf, Ann-Sophie; Draebel, Tania Aase; Ritz, Christian; Fabiansen, Christian; Cichon, Bernardette; Brix Christensen, Vibeke; Yameogo, Charles; Oummani, Rouafi; Briend, André; Michaelsen, Kim F; Ashorn, Per; Filteau, Suzanne; Friis, Henrik

2016-04-01

The objective of this study was to evaluate, within the context of a randomized controlled trial of product effectiveness, the acceptability of new formulations of six corn-soy blended flours (CSB) and six lipid-based nutrient supplements (LNS) with different quantities of milk and qualities of soy for the treatment of children with moderate acute malnutrition (MAM). Our study included 1546 children aged 6-23 months and involved questionnaires after one month of supplementation home visits and interviews with a sub-sample of 20 trial participants and their caretakers, and nine focus group discussion. All 12 products were well accepted in terms of organoleptic qualities and received good ratings. However, LNS were more appreciated by caretakers and children. Additionally, an effect of soy isolate was detected on child appreciation where products with high milk content also received better ratings. CSB were not consumed as readily; 33.9% (n = 257) of children receiving CSB were reported to have leftovers compared to 17.3% (n = 134) of children receiving LNS (p=<0.001). Both CSB and LNS were referred to as foods with medicinal properties and perceived as beneficial to child health. They were both reported to have high priority in the daily feeding of the child. In conclusion, there were minimal differences in acceptability of the various CSB and LNS formulations, although CSB were less readily consumed and required smaller meal volumes. Since all products were well-accepted, decisions regarding whether the more expensive products should be used for the treatment of MAM will need to be based on their effect on child nutrition, growth and health. Future supplementary feeding programs in similar contexts could furthermore consider introducing supplementary foods as a medical treatment, as this may increase adherence and decrease sharing. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prevalence Study of Yaws in the Democratic Republic of Congo Using the Lot Quality Assurance Sampling Method

PubMed Central

Gerstl, Sibylle; Kiwila, Gédeon; Dhorda, Mehul; Lonlas, Sylvaine; Myatt, Mark; Ilunga, Benoît Kebela; Lemasson, Denis; Szumilin, Elisabeth; Guerin, Philippe J.; Ferradini, Laurent

2009-01-01

Background Until the 1970s the prevalence of non-venereal trepanomatosis, including yaws, was greatly reduced after worldwide mass treatment. In 2005, cases were again reported in the Democratic Republic of the Congo. We carried out a survey to estimate the village-level prevalence of yaws in the region of Equator in the north of the country in order to define appropriate strategies to effectively treat the affected population. Methodology/Principal Findings We designed a community-based survey using the Lot Quality Assurance Sampling method to classify the prevalence of active yaws in 14 groups of villages (lots). The classification into high, moderate, or low yaws prevalence corresponded to World Health Organization prevalence thresholds for identifying appropriate operational treatment strategies. Active yaws cases were defined by suggestive clinical signs and positive rapid plasma reagin and Treponema pallidum hemagglutination serological tests. The overall prevalence in the study area was 4.7% (95% confidence interval: 3.4–6.0). Two of 14 lots had high prevalence (>10%), three moderate prevalence (5–10%) and nine low prevalence (<5%.). Conclusions/Significance Although yaws is no longer a World Health Organization priority disease, the presence of yaws in a region where it was supposed to be eradicated demonstrates the importance of continued surveillance and control efforts. Yaws should remain a public health priority in countries where previously it was known to be endemic. The integration of sensitive surveillance systems together with free access to effective treatment is recommended. As a consequence of our study results, more than 16,000 people received free treatment against yaws. PMID:19623266

Analysis of conservation priorities of Iberoamerican cattle based on autosomal microsatellite markers

PubMed Central

2013-01-01

Background Determining the value of livestock breeds is essential to define conservation priorities, manage genetic diversity and allocate funds. Within- and between-breed genetic diversity need to be assessed to preserve the highest intra-specific variability. Information on genetic diversity and risk status is still lacking for many Creole cattle breeds from the Americas, despite their distinct evolutionary trajectories and adaptation to extreme environmental conditions. Methods A comprehensive genetic analysis of 67 Iberoamerican cattle breeds was carried out with 19 FAO-recommended microsatellites to assess conservation priorities. Contributions to global diversity were investigated using alternative methods, with different weights given to the within- and between-breed components of genetic diversity. Information on Iberoamerican plus 15 worldwide cattle breeds was used to investigate the contribution of geographical breed groups to global genetic diversity. Results Overall, Creole cattle breeds showed a high level of genetic diversity with the highest level found in breeds admixed with zebu cattle, which were clearly differentiated from all other breeds. Within-breed kinships revealed seven highly inbred Creole breeds for which measures are needed to avoid further genetic erosion. However, if contribution to heterozygosity was the only criterion considered, some of these breeds had the lowest priority for conservation decisions. The Weitzman approach prioritized highly differentiated breeds, such as Guabalá, Romosinuano, Cr. Patagonico, Siboney and Caracú, while kinship-based methods prioritized mainly zebu-related breeds. With the combined approaches, breed ranking depended on the weights given to the within- and between-breed components of diversity. Overall, the Creole groups of breeds were generally assigned a higher priority for conservation than the European groups of breeds. Conclusions Conservation priorities differed significantly according to the weight given to within- and between-breed genetic diversity. Thus, when establishing conservation programs, it is necessary to also take into account other features. Creole cattle and local isolated breeds retain a high level of genetic diversity. The development of sustainable breeding and crossbreeding programs for Creole breeds, and the added value resulting from their products should be taken into consideration to ensure their long-term survival. PMID:24079454

Setting Priorities for Diabetic Retinopathy Clinical Research and Identifying Evidence Gaps.

PubMed

Le, Jimmy T; Hutfless, Susan; Li, Tianjing; Bressler, Neil M; Heyward, James; Bittner, Ava K; Glassman, Adam; Dickersin, Kay

2017-01-01

Prioritizing comparative effectiveness research may contribute to obtaining answers that clinicians perceive they need and may minimize research that could be considered wasteful. Our objective was to identify evidence gaps and set priorities for new systematic reviews and randomized controlled trials for managing diabetic retinopathy (DR), including diabetic macular edema (DME). Cross-sectional study. Diabetic Retinopathy Clinical Research Network (DRCR.net) investigators. We provided recommendations from the American Academy of Ophthalmology's 2012 Preferred Practice Patterns for Diabetic Retinopathy as 91 answerable clinical research questions about intervention effectiveness to 410 DRCR.net investigators to rate each question's importance from 0 (not important) to 10 (very important) using a 2-round Delphi survey and to suggest additional questions. We considered questions as high priority if at least 75% of respondents to both rounds assigned an importance rating of 5 or more in round 2. We also extracted outcome measures relevant to DR and asked respondents to identify those that must be measured in all studies. We mapped Cochrane reviews published up to March 2016 to high-priority clinical research questions. Ranking of importance of each clinical question. Thirty-two individuals completed rounds 1 and 2 and suggested 15 questions. Among the final list of 106 clinical research questions, 22 questions met our definition of high priority: 9 of 22 concerned the effectiveness of anti-VEGF therapy, and 13 of 22 focused on how often patients should be followed up (re-examination) and treatment effectiveness in patients with specific characteristics (e.g., DME). Outcomes that 75% or more of respondents marked as "must be measured in all studies" included visual acuity and visual loss, death of participants, and intraocular pressure. Only 1 prioritized question was associated with conclusive evidence from a Cochrane systematic review. A limited response rate among DRCR.net members identified 22 comparative effectiveness research questions as high priority for the management of DR, including DME, but few were associated with Cochrane reviews. These results support the need of systematic reviews and randomized controlled trials to address evidence gaps.

Establishing health systems financing research priorities in developing countries using a participatory methodology.

PubMed

Ranson, Kent; Law, Tyler J; Bennett, Sara

2010-06-01

Donor funding for health systems financing (HSF) research is inadequate and often poorly aligned with national priorities. This study aimed to generate consensus about a core set of research issues that urgently require attention in order to facilitate policy development. There were three key inputs into the priority setting process: key-informant interviews with health policy makers, researchers, community and civil society representatives across twenty-four low- and middle-income countries in four regions; an overview of relevant reviews to identify research completed to date; and inputs from 12 key informants (largely researchers) at a consultative workshop. Nineteen priority research questions emerged from key-informant interviews. The overview of reviews was instructive in showing which health financing topics have had comparatively little written about them, despite being identified as important by key informants. The questions ranked as most important at the consultative workshop were: It is hoped that this work on HSF research priorities will complement calls for increased health systems research and evaluation by providing specific suggestions as to where new and existing research resources can best be invested. The list of high priority HSF research questions is being communicated to research funders and researchers in order to seek to influence global patterns of HSF research funding and activity. A "bottom up" approach to setting global research priorities such as that employed here should ensure that priorities are more sensitive to user needs. Copyright 2010 Elsevier Ltd. All rights reserved.

Spatial analysis of ecosystem service relationships to improve targeting of payments for hydrological services

PubMed Central

Manson, Robert H.; Ricketts, Taylor H.; Geissert, Daniel

2018-01-01

Payment for hydrological services (PHS) are popular tools for conserving ecosystems and their water-related services. However, improving the spatial targeting and impacts of PHS, as well as their ability to foster synergies with other ecosystem services (ES), remain challenging. We aimed at using spatial analyses to evaluate the targeting performance of México’s National PHS program in central Veracruz. We quantified the effectiveness of areas targeted for PHS in actually covering areas of high HS provision and social priority during 2003–2013. First, we quantified provisioning and spatial distributions of two target (water yield and soil retention), and one non-target ES (carbon storage) using InVEST. Subsequently, pairwise relationships among ES were quantified by using spatial correlation and overlap analyses. Finally, we evaluated targeting by: (i) prioritizing areas of individual and overlapping ES; (ii) quantifying spatial co-occurrences of these priority areas with those targeted by PHS; (iii) evaluating the extent to which PHS directly contribute to HS delivery; and (iv), testing if PHS targeted areas disproportionately covered areas with high ecological and social priority. We found that modelled priority areas exhibited non-random distributions and distinct spatial patterns. Our results show significant pairwise correlations between all ES suggesting synergistic relationships. However, our analysis showed a significantly lower overlap than expected and thus significant mismatches between PHS targeted areas and all types of priority areas. These findings suggest that the targeting of areas with high HS provisioning and social priority by Mexico’s PHS program could be improved significantly. This study underscores: (1) the importance of using maps of HS provisioning as main targeting criteria in PHS design to channel payments towards areas that require future conservation, and (2) the need for future research that helps balance ecological and socioeconomic targeting criteria. PMID:29462205

Phylogenetically-informed priorities for amphibian conservation.

PubMed

Isaac, Nick J B; Redding, David W; Meredith, Helen M; Safi, Kamran

2012-01-01

The amphibian decline and extinction crisis demands urgent action to prevent further large numbers of species extinctions. Lists of priority species for conservation, based on a combination of species' threat status and unique contribution to phylogenetic diversity, are one tool for the direction and catalyzation of conservation action. We describe the construction of a near-complete species-level phylogeny of 5713 amphibian species, which we use to create a list of evolutionarily distinct and globally endangered species (EDGE list) for the entire class Amphibia. We present sensitivity analyses to test the robustness of our priority list to uncertainty in species' phylogenetic position and threat status. We find that both sources of uncertainty have only minor impacts on our 'top 100' list of priority species, indicating the robustness of the approach. By contrast, our analyses suggest that a large number of Data Deficient species are likely to be high priorities for conservation action from the perspective of their contribution to the evolutionary history.

Top 40 priorities for science to inform conservation and management policy in the United States

USGS Publications Warehouse

Fleishman, Erica; Blockstein, David E.; Hall, John A.; Mascia, Michael B.; Rudd, Murray A.; Scott, J. Michael; Sutherland, William J.; Bartuska, Ann M.; Brown, A. Gordon; Christen, Catherine A.; Clement, Joel P.; DellaSala, Dominick; Duke, Clifford D.; Fiske, Shirley J.; Gosnell, Hannah; Haney, J. Christopher; Hutchins, Michael; Klein, Mary L.; Marqusee, Jeffrey; Noon, Barry R.; Nordgren, John R.; Orbuch, Paul M.; Powell, Jimmie; Quarles, Steven P.; Saterson, Kathryn A.; Stein, Bruce A.; Webster, Michael S.; Vedder, Amy

2011-01-01

To maximize the utility of research to decisionmaking, especially given limited financial resources, scientists must set priorities for their efforts. We present a list of the top 40 high-priority, multidisciplinary research questions directed toward informing some of the most important current and future decisions about management of species, communities, and ecological processes in the United States. The questions were generated by an open, inclusive process that included personal interviews with decisionmakers, broad solicitation of research needs from scientists and policymakers, and an intensive workshop that included scientifically oriented individuals responsible for managing and developing policy related to natural resources. The process differed from previous efforts to set priorities for conservation research in its focus on the engagement of decisionmakers in addition to researchers. The research priorities emphasized the importance of addressing societal context and exploration of trade-offs among alternative policies and actions, as well as more traditional questions related to ecological processes and functions.

Fluvial processes in Ma'adim Vallis and the potential of Gusev crater as a high priority site

NASA Technical Reports Server (NTRS)

Cabrol, Nathalie; Landheim, Ragnild; Greeley, Ronald; Farmer, Jack

1994-01-01

According to exobiology site selection criteria for Mars, the search for potential extinct/extant water dependent life should focus on sites were water flowed and ponded. The Ma'adim Vallis/Gusev crater system is of high priority for exobiology research, because it appears to have involved long term flooding, different periods and rates of sedimentation, and probable episodic ponding. The topics covered include the following: evidence of nonuniform fluvial processes and early overflooding of the plateau and ponding.

Reconfigurable Auditory-Visual Display

NASA Technical Reports Server (NTRS)

Begault, Durand R. (Inventor); Anderson, Mark R. (Inventor); McClain, Bryan (Inventor); Miller, Joel D. (Inventor)

2008-01-01

System and method for visual and audible communication between a central operator and N mobile communicators (N greater than or equal to 2), including an operator transceiver and interface, configured to receive and display, for the operator, visually perceptible and audibly perceptible signals from each of the mobile communicators. The interface (1) presents an audible signal from each communicator as if the audible signal is received from a different location relative to the operator and (2) allows the operator to select, to assign priority to, and to display, the visual signals and the audible signals received from a specified communicator. Each communicator has an associated signal transmitter that is configured to transmit at least one of the visual signals and the audio signal associated with the communicator, where at least one of the signal transmitters includes at least one sensor that senses and transmits a sensor value representing a selected environmental or physiological parameter associated with the communicator.

The physician as a manager.

PubMed

McDonagh, T J

1982-02-01

The practice of occupational medicine has undergone considerable change over the last decade. Increased awareness of potential health hazards associated with the workplace and its products and wastes, the interest of society and workers in these subjects, and related governmental regulation have resulted in expanded occupational health programs within industry. The occupational physician has become a key company resource in the optimal management of the business impacts of health-related issues. Health-related matters often have noteworthy business implications, and the occupational physician needs to spend considerable time as a manager in the planning, resourcing, implementation, evaluation, and stewardship of programs. Thus he is experiencing greater demands and often is inadequately prepared for this nonclinical, nonscientific role. Therefore, the preparation of occupational physicians to assume such managerial responsibilities needs to receive high priority. The physician must be willing to accept this challenge both to ensure the program's success and to retain a leadership position in occupational health programs.

Effect of vitamin A supplementation on childhood morbidity and mortality.

PubMed

Chowdhury, S; Kumar, R; Ganguly, N K; Kumar, L; Walia, B N S

2002-06-01

In a double blind design, 1520 children aged < 10 years were individually randomised in vitamin A and placebo group in slums of Chandigarh. Children > 12, 6-12 and < 6 months of age received 200,000, 100,000, 500,000 I.U. of vitamin A respectively every 4 to 6 months during 15 months trial period. The prevalence of vitamin A deficiency was significantly reduced in vitamin A compared to placebo group during the follow-up period. In vitamin A group, incidence of diarrhoea and measles was significantly reduced but incidence of acute respiratory infections was not significantly different compared to control group. Risk of death was also significantly less in vitamin A group. Therefore, promotion of vitamin A rich diet or supplementation with synthetic vitamin A at 4-6 month interval should be a priority in populations where risk of vitamin A deficiency is high.

The economics of academic health sciences libraries: cost recovery in the era of big science.

PubMed Central

Williams, T L; Lemkau, H L; Burrows, S

1988-01-01

With launching of Sputnik by the Soviet Union in the late 1950s, science and technology became a high priority in the United States. During the two decades since, health sciences libraries have experienced changes in almost all aspects of their operations. Additionally, recent developments in medical care and in medical education have had major influences on the mission of health science libraries. In the unending struggle to keep up with new technologies and services, libraries have had to support increasing demands while they receive a decreasing share of the health care dollar. This paper explores the economic challenges faced by academic health sciences libraries and suggests measures for augmenting traditional sources of funding. The development of marketing efforts, institutional memberships, and fee-based services by the Louis Calder Memorial Library, University of Miami School of Medicine, is presented as a case study. PMID:3224223

Overview of pediatric oncology and hematology in Myanmar

PubMed Central

Halbert, Jay; Khaing, Aye Aye

2014-01-01

Myanmar is a country in southeast Asia in political, economic and healthcare transition. There are currently only two pediatric oncology centers serving a population of almost 19 million children. An estimated 85-92% of children with cancer are undiagnosed or not receiving treatment. Abandonment of treatment is as high as 60%. Although a number of chemotherapy agents are available, difficulties remain concerning treatment costs, quality control and the availability of supportive care. Radiotherapy services are also limited and not usually included in pediatric protocols. Healthcare professional training, improved diagnostics, strategies to tackle abandonment of treatment and the development of a parents’ support group are major priorities. Local and international partnerships including a recent partnership with world child cancer are essential in the interim to support the development of pediatric oncology and hematology in Myanmar. A unique opportunity exists to support the development of preventive, diagnostic, curative and palliative care for children's cancer in Myanmar from the outset. PMID:24665454

The economics of academic health sciences libraries: cost recovery in the era of big science.

PubMed

Williams, T L; Lemkau, H L; Burrows, S

1988-10-01

With launching of Sputnik by the Soviet Union in the late 1950s, science and technology became a high priority in the United States. During the two decades since, health sciences libraries have experienced changes in almost all aspects of their operations. Additionally, recent developments in medical care and in medical education have had major influences on the mission of health science libraries. In the unending struggle to keep up with new technologies and services, libraries have had to support increasing demands while they receive a decreasing share of the health care dollar. This paper explores the economic challenges faced by academic health sciences libraries and suggests measures for augmenting traditional sources of funding. The development of marketing efforts, institutional memberships, and fee-based services by the Louis Calder Memorial Library, University of Miami School of Medicine, is presented as a case study.

Cost-effective monolithic and hybrid integration for metro and long-haul applications

NASA Astrophysics Data System (ADS)

Clayton, Rick; Carter, Andy; Betty, Ian; Simmons, Timothy

2003-12-01

Today's telecommunication market is characterized by conservative business practices: tight management of costs, low risk investing and incremental upgrades, rather than the more freewheeling approach taken a few years ago. Optimizing optical components for the current and near term market involves substantial integration, but within particular bounds. The emphasis on evolution, in particular, has led to increased standardization of functions and so created extensive opportunities for integrated product offerings. The same standardization that enables commercially successful integrated functions also changes the competitive environment, and changes the emphasis for component development; shifting the innovation priority from raw performance to delivering the most effective integrated products. This paper will discuss, with specific examples from our transmitter, receiver and passives product families, our understanding of the issues based on extensive experience in delivering high end integrated products to the market, and the direction it drives optical components.

"Targeting to zero" in pediatric oncology: a review of central venous catheter-related bloodstream infections.

PubMed

Secola, Rita; Lewis, Mary Ann; Pike, Nancy; Needleman, Jack; Doering, Lynn

2012-01-01

Reducing or eliminating hospital acquired infections is a national quality of care priority. The majority of the 12,400 children diagnosed with cancer each year require long-term intravenous access to receive intensive and complex therapies. These children are at high risk for infection by nature of their disease and treatment, which often involves use of a central venous catheter (CVC). Throughout the nation, nurses assume frontline responsibility for safe, quality CVC care to minimize the risk of potentially life-threatening infections. Substantial financial and human costs are associated with CVC-related bloodstream infections, including prolonged hospital lengths of stay and increased care required to treat these infections. The purpose of this review of the literature is to summarize existing adult and pediatric data on CVC-related bloodstream infections and explore nursing models of CVC care that may improve pediatric oncology patient outcomes.

Overview of pediatric oncology and hematology in Myanmar.

PubMed

Halbert, Jay; Khaing, Aye Aye

2014-01-01

Myanmar is a country in southeast Asia in political, economic and healthcare transition. There are currently only two pediatric oncology centers serving a population of almost 19 million children. An estimated 85-92% of children with cancer are undiagnosed or not receiving treatment. Abandonment of treatment is as high as 60%. Although a number of chemotherapy agents are available, difficulties remain concerning treatment costs, quality control and the availability of supportive care. Radiotherapy services are also limited and not usually included in pediatric protocols. Healthcare professional training, improved diagnostics, strategies to tackle abandonment of treatment and the development of a parents' support group are major priorities. Local and international partnerships including a recent partnership with world child cancer are essential in the interim to support the development of pediatric oncology and hematology in Myanmar. A unique opportunity exists to support the development of preventive, diagnostic, curative and palliative care for children's cancer in Myanmar from the outset.

"Asthma can take over your life but having the right support makes that easier to deal with." Informing research priorities by exploring the barriers and facilitators to asthma control: a qualitative analysis of survey data.

PubMed

Normansell, Rebecca; Welsh, Emma

2015-01-01

Involving patients and the public in research prioritisation is important. Cochrane Airways works with authors to produce systematic reviews of evidence related to chronic airways disease. Cochrane Airways has undertaken activities to identify research priorities, including workshops with stakeholders and consultation with experts. We present the findings of an online survey, designed to align our work with the priorities of people affected by asthma. We promoted a survey comprising open-ended questions via social media to people affected by asthma. We compiled the free-text responses and conducted an exploratory thematic analysis to identify important barriers and facilitators to asthma control. We triangulated findings with other research prioritisation activities to produce new review questions. We received 57 survey responses. Eight main themes emerged, most encompassing both facilitators and barriers: attitudes and knowledge; financial costs; environmental factors and triggers; healthcare systems; lifestyle factors; medication; self-care; and support. Barriers were more frequently mentioned than facilitators and many related to healthcare systems. These findings offer valuable insights into the challenges faced by individuals affected by asthma in the UK, and possibly further afield. We developed a list of priority reviews based on what was said by people in this survey and at a workshop. This demonstrates the real impact that people affected by asthma have on the research agenda of Cochrane Airways. Over the next 2-3 years we will produce reviews that address some of these questions hopefully leading to health benefits.

Short-term predictive capacity of two different triage systems in patients with acute heart failure: TRICA-EAHFE study.

PubMed

Miró, Òscar; Tost, Josep; Herrero, Pablo; Jacob, Javier; Martín-Sánchez, Francisco Javier; Gil, Víctor; Fernández-Pérez, Cristina; Escoda, Rosa; Llorens, Pere

2016-12-01

To evaluate whether prioritization of patients with acute heart failure (AHF) in the Andorran Triage Model/Spanish Triage System (MAT/SET) and the Manchester Triage System (MTS) also allows the identification of different profiles of outcome and prognosis and determine whether either system has a better predictive capacity of outcomes. Patients with AHF included in the Spanish EAHFE registry from hospitals using the MAT/SET or MTS were selected and divided according to the triage system used. Outcome variables included hospital admission, length of stay, death during admission, 3, 7, and 30-day all-cause mortality, and emergency department (ED) reconsultation at 30 days. The results were compared according to the level of priority and the triage system used. We included 3837 patients (MAT/SET=2474; MTS=1363) classified as follows: 4.0% level 1; 34.7% level 2; 55.1% level 3; and 6.3% levels 4-5. Both systems associated greater priority with higher rates of admission and mortality; the MTS associated greater priority with greater ED reconsultation and the MAT/SET found greater priority to be associated with less ED reconsultation. The discriminative capacity of the two scales for adverse outcomes was statistically significant, albeit poor, for almost all the outcome events and it was of scarce clinical relevance (Area under the curve of the receiver operating characteristic between 0.458 and 0.661). The prediction of the outcome of patients with AHF determined with the MAT/SET or MTS showed scarce differences between the two systems, and their discriminative capacity does not seem to be clinically relevant.

Domestic Violence and Pregnancy: A CBPR Coalition Approach to Identifying Needs and Informing Policy.

PubMed

Bright, Candace Forbes; Bagley, Braden; Pulliam, Ivie; Newton, Amy Swetha

2018-01-01

Community engagement-the collaborative process of addressing issues that impact the well-being of a community-is a strategic effort to address community issues. The Gulf States Health Policy Center (GS-HPC) formed the Hattiesburg Area Health Coalition (HAHC) in November 2014 for the purpose of addressing policies impacting the health of Forrest and Lamar counties in Mississippi. To chronicle the community-based participatory research (CBPR) process used by HAHC's identification of infant and maternal health as a policy area, domestic violence in pregnancy as a priority area within infant and maternal health, and a community action plan (CAP) regarding this priority area. HAHC reviewed data and identified infant and maternal health as a priority area. They then conducted a policy scan of local prenatal health care to determine the policy area of domestic violence in pregnancy. HAHC developed a CAP identifying three goals with regard to domestic violence and pregnancy that together informed policy. Changes included the development of materials specific to resources available in the area. The materials and recommended changes will first be implemented by Southeast Mississippi Rural Health Initiative (SeMRHI) through a screening question for all pregnant patients, and the adoption of policies for providing information and referrals. The lack of community-level data was a challenge to HAHC in identifying focus and priority areas, but this was overcome by shared leadership and community engagement. After completion of the CAP, 100% of expecting mothers receiving prenatal care in the area will be screened for domestic violence.

Priorities for research into human resources for health in low- and middle-income countries

PubMed Central

Chopra, Mickey; Atkins, Salla; Dal Poz, Mario Roberto; Bennett, Sara

2010-01-01

Abstract Objective To identify the human resources for health (HRH) policy concerns and research priorities of key stakeholders in low- and middle-income countries; to assess the extent to which existing HRH research addresses these concerns and priorities; and to develop a prioritized list of core research questions requiring immediate attention to facilitate policy development and implementation. Methods The study involved interviews with key informants, including health policy-makers, researchers and community and civil society representatives, in 24 low- and middle-income countries in four regions, a literature search for relevant reviews of research completed to date, and the assessment of interview and literature search findings at a consultative multinational workshop, during which research questions were prioritized. Findings Twenty-one research questions emerged from the key informant interviews, many of which had received little or no attention in the reviewed literature. The questions ranked as most important at the consultative workshop were: (i) To what extent do incentives work in attracting and retaining qualified health workers in underserviced areas? (ii) What is the impact of dual practice and multiple employment? and (iii) How can incentives be used to optimize efficiency and the quality of health care? Conclusion There was a clear consensus about the type of HRH policy problems faced by different countries and the nature of evidence needed to tackle them. Coordinated action to support and implement research into the highest priority questions identified here could have a major impact on health worker policies and, ultimately, on the health of the poor. PMID:20539857

Political priority in the global fight against non-communicable diseases.

PubMed

Maher, Anthony; Sridhar, Devi

2012-12-01

The prevalence of non-communicable diseases (NCDs) - such as cancer, diabetes, cardiovascular disease, and chronic respiratory diseases - is surging globally. Yet despite the availability of cost-effective interventions, NCDs receive less than 3% of annual development assistance for health to low and middle income countries. The top donors in global health - including the Bill and Melinda Gates Foundation, the US Government, and the World Bank - together commit less than 2% of their budgets to the prevention and control of NCDs. Why is there such meagre funding on the table for the prevention and control of NCDs? Why has a global plan of action aimed at halting the spread of NCDs been so difficult to achieve? This paper aims to tackle these two interrelated questions by analysing NCDs through the lens of Jeremy Shiffman's 2009 political priority framework. We define global political priority as 'the degree to which international and national political leaders actively give attention to an issue, and back up that attention with the provision of financial, technical, and human resources that are commensurate with the severity of the issue'. Grounded in social constructionism, this framework critically examines the relationship between agenda setting and 'objective' factors in global health, such as the existence of cost-effective interventions and a high mortality burden. From a methodological perspective, this paper fits within the category of discipline configurative case study. We support Shiffman's claim that strategic communication - or ideas in the form of issue portrayals - ought to be a core activity of global health policy communities. But issue portrayals must be the products of a robust and inclusive debate. To this end, we also consider it essential to recognise that issue portrayals reach political leaders through a vast array of channels. Raising the political priority of NCDs means engaging with the diverse ways in which actors express concern for the global proliferation of these diseases. Ultimately, our political interactions amount to struggles for influence, and determining which issues to champion in the midst of these struggles - and which to disregard - is informed by subjectively held notions of the right, the good, and the just. Indeed, the very act of choosing which issues to prioritise in our daily lives forces us to evaluate our values and aspirations as individual agents against the shared values that structure the societies in which we live.

A lock-free priority queue design based on multi-dimensional linked lists

DOE PAGES

Dechev, Damian; Zhang, Deli

2015-04-03

The throughput of concurrent priority queues is pivotal to multiprocessor applications such as discrete event simulation, best-first search and task scheduling. Existing lock-free priority queues are mostly based on skiplists, which probabilistically create shortcuts in an ordered list for fast insertion of elements. The use of skiplists eliminates the need of global rebalancing in balanced search trees and ensures logarithmic sequential search time on average, but the worst-case performance is linear with respect to the input size. In this paper, we propose a quiescently consistent lock-free priority queue based on a multi-dimensional list that guarantees worst-case search time of O(logN)more » for key universe of size N. The novel multi-dimensional list (MDList) is composed of nodes that contain multiple links to child nodes arranged by their dimensionality. The insertion operation works by first injectively mapping the scalar key to a high-dimensional vector, then uniquely locating the target position by using the vector as coordinates. Nodes in MDList are ordered by their coordinate prefixes and the ordering property of the data structure is readily maintained during insertion without rebalancing nor randomization. Furthermore, in our experimental evaluation using a micro-benchmark, our priority queue achieves an average of 50% speedup over the state of the art approaches under high concurrency.« less

A lock-free priority queue design based on multi-dimensional linked lists

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

Dechev, Damian; Zhang, Deli

The throughput of concurrent priority queues is pivotal to multiprocessor applications such as discrete event simulation, best-first search and task scheduling. Existing lock-free priority queues are mostly based on skiplists, which probabilistically create shortcuts in an ordered list for fast insertion of elements. The use of skiplists eliminates the need of global rebalancing in balanced search trees and ensures logarithmic sequential search time on average, but the worst-case performance is linear with respect to the input size. In this paper, we propose a quiescently consistent lock-free priority queue based on a multi-dimensional list that guarantees worst-case search time of O(logN)more » for key universe of size N. The novel multi-dimensional list (MDList) is composed of nodes that contain multiple links to child nodes arranged by their dimensionality. The insertion operation works by first injectively mapping the scalar key to a high-dimensional vector, then uniquely locating the target position by using the vector as coordinates. Nodes in MDList are ordered by their coordinate prefixes and the ordering property of the data structure is readily maintained during insertion without rebalancing nor randomization. Furthermore, in our experimental evaluation using a micro-benchmark, our priority queue achieves an average of 50% speedup over the state of the art approaches under high concurrency.« less

Patient and public engagement in priority setting: A systematic rapid review of the literature.

PubMed

Manafò, Elizabeth; Petermann, Lisa; Vandall-Walker, Virginia; Mason-Lai, Ping

2018-01-01

Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify 'high-level' priorities in health ecosystem priority setting, and at the preparation phase for health research. The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar's Portal. i) published in English; ii) published within the timeframe of 2007-Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1-Deliberative and Tier 2-Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered.

Landscape level reforestation priorities for forest breeding landbirds in the Mississippi Alluvial Valley

USGS Publications Warehouse

Twedt, D.J.; Uihlein, W.B.; Fredrickson, L.H.; King, S.L.; Kaminski, R.M.

2005-01-01

Thousands of ha of cleared wetlands are being reforested annually in the Mississippi Alluvial Valley (MAV). Despite the expansive and long-term impacts of reforestation on the biological communities of the MAV, there is generally a lack of landscape level planning in its implementation. To address this deficiency we used raster-based digital data to assess the value of forest restoration to migratory landbirds for each ha within the MAV. Raster themes were developed that reflected distance from 3 existing forest cover parameters: (1) extant forest, (2) contiguous forest patches between 1,012 and 40,000 ha, and (3) forest cores with contiguous area 1 km from an agricultural, urban, or pastoral edge. Two additional raster themes were developed that combined information on the proportion of forest cover and average size of forest patches, respectively, within landscapes of 50,000, 100,000, 150,000, and 200,000 ha. Data from these 5 themes were amalgamated into a single raster using a weighting system that gave increased emphasis to existing forest cores, larger forest patches, and moderately forested landscapes while deemphasizing reforestation near small or isolated forest fragments and within largely agricultural landscapes. This amalgamated raster was then modified by the geographic location of historical forest cover and the current extent of public land ownership to assign a reforestation priority score to each ha in the MAV. However, because reforestation is not required on areas with extant forest cover and because restoration is unlikely on areas of open water and urban communities, these lands were not assigned a reforestation priority score. These spatially explicit reforestation priority scores were used to simulate reforestation of 368,000 ha (5%) of the highest priority lands in the MAV. Targeting restoration to these high priority areas resulted in a 54% increase in forest core - an area of forest core that exceeded the area of simulated reforestation. Bird Conservation Regions, developed within the framework of the Partners in Flight: Mississippi Alluvial Valley Bird Conservation Plan, encompassed a large proportion (circa 70%) of the area with highest priority for reforestation. Similarly, lands with high reforestation priority often were enrolled in the Wetland Reserve Program.

Otolaryngology residents' objectives in entering the workforce.

PubMed

Kay, David J; Lucente, Frank E

2002-10-01

To determine the priorities of current otolaryngologists-in-training in considering their first employment opportunities. Twenty-one-item survey measuring the importance of various first job issues, with all items scored on a five-point Likert-type ordinal scale. The resident membership of the American Academy of Otolaryngology-Head and Neck Surgery was anonymously surveyed by means of mail-in questionnaires. Results were stratified by years of training. Responses from 242 of 1174 mail-in surveys (21% response rate) exhibited a wide distribution of responses for all 21 questions. The availability of free time to spend with one's family was regarded by more than half of the respondents to have the highest overall importance. As years of training increased, priorities shifted toward geographic location, away from issues such as the on-call schedules. The availability of research time and resources received the overall lowest priority, with more than half of the respondents ranking it as only somewhat important or lower. Otolaryngologists-in-training feel strongest about the availability of free time to spend with their families as they finish formal training and consider employment opportunities. By acknowledging the concerns of graduating residents, including the ability to pursue their primary interests when they start working, we can better adapt conditions to create a more comfortable and stable entry into the workforce.

A Quality Function Deployment Framework for the Service Quality of Health Information Websites

PubMed Central

Kim, Dohoon

2010-01-01

Objectives This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Methods Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Results Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. Conclusions The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results. PMID:21818418

Patients' satisfaction with emergency care and priorities for change in a university teaching hospital in Nigeria.

PubMed

Oluwadiya, Kehinde; Olatoke, Samuel A; Ariba, Adekunle J; Omotosho, Omotola A; Olakulehin, Olakunle A

2010-10-01

Little work has been done on patients' satisfaction with hospital care in Nigeria. This prospective study was done to identify factors affecting patients' satisfaction with emergency care in a teaching hospital in Nigeria. This study was carried out among adult patients who had received care at the Accident and Emergency unit of the hospital. We used the priority index (calculated by combining the mean score on all items and correlated weight) to identify areas of emergency services in need of urgent improvement. There were 250 respondents; 147 males and 103 females. Six (6.4%) patients declined to answer the questionnaire. Time to surgical intervention was the item with the highest priority for change. This was followed by three indicators of caregiver conduct: showing genuine concern by health workers, attitude of nurses, and courtesy by health workers. Females rated all indices of satisfaction lower than males. Surgical and gynecological patients were also less satisfied with their care than their medical and trauma counterparts. The results from this study provided necessary data to guide changes needed to improve patient satisfaction in the A&E. Our findings suggest that improving speed of access to surgery and enhancing interpersonal skills of healthcare givers are areas that need to be prioritized. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Commercial Market For Priority Review Vouchers.

PubMed

Ridley, David B; Régnier, Stephane A

2016-05-01

In 2007 the US Congress created the priority review voucher program to encourage the development of drugs for neglected diseases. Under the program, the developer of a drug that treats a neglected disease receives both a faster review of the drug by the Food and Drug Administration and a voucher for a faster review of a different drug. The developer can sell the voucher. We estimated the commercial value of the voucher using US sales of new treatments approved in the period 2007-09. A third of the commercial value of a voucher comes from capturing market share from competitors, nearly half from the value of earlier sales because of the expedited review, and less than a quarter from lengthening the time between approval and the launch of a generic competitor. We estimate that if only one priority review voucher is available in a year, it will be worth more than $200 million, but if four vouchers are available, the value could fall below $100 million. Congress should be cautious about expanding the voucher program, because increasing the number of vouchers sharply decreases the expected price. Lower voucher prices could undermine the incentive to develop new medicines for neglected diseases. Project HOPE—The People-to-People Health Foundation, Inc.

Chronic airflow limitation in developing countries: burden and priorities

PubMed Central

Aït-Khaled, Nadia; Enarson, Donald A; Ottmani, Salah; Sony, Asma El; Eltigani, Mai; Sepulveda, Ricardo

2007-01-01

Respiratory disease has never received priority in relation to its impact on health. Estimated DALYs lost in 2002 were 12% globally (similar for industrialized and developing countries). Chronic airflow limitation (due mainly to asthma and COPD) alone affects more than 100 million persons in the world and the majority of them live in developing countries. International guidelines for management of asthma (GINA) and COPD (GOLD) have been adopted and their cost-effectiveness demonstrated in industrialized countries. As resources are scarce in developing countries, adaptation of these guidelines using only essential drugs is required. It remains for governments to set priorities. To make these choices, a set of criteria have been proposed. It is vital that the results of scientific investigations are presented in these terms to facilitate their use by decision-makers. To respond to this emerging public health problem in developing countries, WHO has developed 2 initiatives: “Practical Approach to Lung Health (PAL)” and the Global Alliance Against Chronic Respiratory Diseases (GARD)”, and the International Union Against Tuberculosis and Lung Diseases (The Union) has launched a new initiative to increase affordability of essential asthma drugs for patients in developing countries termed the “Asthma Drug Facility” (ADF), which could facilitate the care of patients living in these parts of the world. PMID:18044686

Chronic airflow limitation in developing countries: burden and priorities.

PubMed

Aït-Khaled, Nadia; Enarson, Donald A; Ottmani, Salah; El Sony, Asma; Eltigani, Mai; Sepulveda, Ricardo

2007-01-01

Respiratory disease has never received priority in relation to its impact on health. Estimated DALYs lost in 2002 were 12% globally (similar for industrialized and developing countries). Chronic airflow limitation (due mainly to asthma and COPD) alone affects more than 100 million persons in the world and the majority of them live in developing countries. International guidelines for management of asthma (GINA) and COPD (GOLD) have been adopted and their cost-effectiveness demonstrated in industrialized countries. As resources are scarce in developing countries, adaptation of these guidelines using only essential drugs is required. It remains for governments to set priorities. To make these choices, a set of criteria have been proposed. It is vital that the results of scientific investigations are presented in these terms to facilitate their use by decision-makers. To respond to this emerging public health problem in developing countries, WHO has developed 2 initiatives: "Practical Approach to Lung Health (PAL)" and the Global Alliance Against Chronic Respiratory Diseases (GARD)", and the International Union Against Tuberculosis and Lung Diseases (The Union) has launched a new initiative to increase affordability of essential asthma drugs for patients in developing countries termed the "Asthma Drug Facility" (ADF), which could facilitate the care of patients living in these parts of the world.

Competing priorities that rival health in adults on probation in Rhode Island: substance use recovery, employment, housing, and food intake.

PubMed

Dong, Kimberly R; Must, Aviva; Tang, Alice M; Beckwith, Curt G; Stopka, Thomas J

2018-02-27

Individuals on probation experience economic disadvantage because their criminal records often prohibit gainful employment, which compromises their ability to access the basic components of wellbeing. Unemployment and underemployment have been studied as distinct phenomenon but no research has examined multiple determinants of health in aggregate or explored how these individuals prioritize each of these factors. This study identified and ranked competing priorities in adults on probation and qualitatively explored how these priorities impact health. We conducted in-depth interviews in 2016 with 22 adults on probation in Rhode Island to determine priority rankings of basic needs. We used Maslow's hierarchy of needs theory and the literature to guide the priorities we pre-selected for probationers to rank. Within a thematic analysis framework, we used a modified ranking approach to identify the priorities chosen by participants and explored themes related to the top four ranked priorities. We found that probationers ranked substance use recovery, employment, housing, and food intake as the top four priorities. Probationers in recovery reported sobriety as the most important issue, a necessary basis to be able to address other aspects of life. Participants also articulated the interrelatedness of difficulties in securing employment, food, and housing; these represent stressors for themselves and their families, which negatively impact health. Participants ranked healthcare last and many reported underinsurance as an issue to accessing care. Adults on probation are often faced with limited economic potential and support systems that consistently place them in high-risk environments with increased risk for recidivism. These findings emphasize the need for policies that address the barriers to securing gainful employment and safe housing. Interventions that reflect probationer priorities are necessary to begin to mitigate the health disparities in this population.

A Descriptive Analysis of End-of-Life Conversations With Long-Term Glioblastoma Survivors.

PubMed

Miranda, Stephen P; Bernacki, Rachelle E; Paladino, Joanna M; Norden, Andrew D; Kavanagh, Jane E; Palmor, Marissa C; Block, Susan D

2018-05-01

Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. To describe the prevalence, timing, and quality of documented SI conversations and evaluate their focus on patient goals/priorities. Thirty-three patients with GBM enrolled in the control group of a randomized controlled trial of a communication intervention and were followed for 2 years or until death. At baseline, all patients answered a validated question about preferences for life-extending versus comfort-focused care and completed a Life Priorities Survey about their goals/priorities. In this secondary analysis, retrospective chart review was performed for 18 patients with GBM who died. Documented SI conversations were systematically identified and evaluated using a codebook reflecting 4 domains: prognosis, goals/priorities, end-of-life planning, and life-sustaining treatments. Patient goals/priorities were compared to documentation. At baseline, 16 of 24 patients preferred life-extending care. In the Life Priorities Survey, goals/priorities most frequently ranked among the top 3 were "Live as long as possible," "Be mentally aware," "Provide support for family," "Be independent," and "Be at peace." Fifteen of 18 patients had at least 1 documented SI conversation (range: 1-4). Median timing of the first documented SI conversation was 84 days before death (range: 29-231; interquartile range: 46-119). Fifteen patients had documentation about end-of-life planning, with "hospice" and "palliative care" most frequently documented. Five of 18 patients had documentation about their goals. Patients with GBM had multiple goals/priorities with potential treatment implications, but documentation showed SI conversations occurred relatively late and infrequently reflected patient goals/priorities.

Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Fotaki, Marianna; Harvey, Gillian

2013-08-01

The question of how priority setting processes work remains topical, contentious and political in every health system across the globe. It is particularly acute in the context of developing countries because of the mismatch between needs and resources, which is often compounded by an underdeveloped capacity for decision making and weak institutional infrastructures. Yet there is limited research into how the process of setting and implementing health priorities works in developing countries. This study aims to address this gap by examining how a national priority setting programme works in the centralized health system of Iran and what factors influence its implementation at the meso and micro levels. We used a qualitative case study approach, incorporating mixed methods: in-depth interviews at three levels and a textual analysis of policy documents. The data analysis showed that the process of priority setting is non-systematic, there is little transparency as to how specific priorities are decided, and the decisions made are separated from their implementation. This is due to the highly centralized system, whereby health priorities are set at the macro level without involving meso or micro local levels or any representative of the public. Furthermore, the two main benefit packages are decided by different bodies (Ministry of Health and Medical Education and Ministry of Welfare and Social Security) and there is no co-ordination between them. The process is also heavily influenced by political pressure exerted by various groups, mostly medical professionals who attempt to control priority setting in accordance with their interests. Finally, there are many weaknesses in the implementation of priorities, resulting in a growing gap between rural and urban areas in terms of access to health services.

Benchmarking and gap analysis of faculty mentorship priorities and how well they are met.

PubMed

Bruner, Deborah Watkins; Dunbar, Sandra; Higgins, Melinda; Martyn, Kristy

2016-01-01

There is little consensus among faculty mentoring programs as to best practices. While there are recommendations in the literature to base faculty development programs on gap analyses of faculty ratings of actual and preferred performance in teaching, scholarship and service, no gap analysis was found in the literature. Thus, the purpose of this study was to develop a survey tool to benchmark school of nursing (SON) faculty mentorship priorities and conduct a gap analysis of how well they were being addressed. Senior faculty who lead mentorship as part of their roles in the SON (associate and assistant deans and director of mentorship) developed a survey through (a) asking faculty members for priorities at in-person mentorship seminars, (b) a review of current nursing literature, and (c) input from the SON mentorship advisory board. The final survey included 37 items focused on general job duties, structure of the mentoring program, time management, as well as skills needed for research, teaching, practice, writing and team science. Responses (rated from 0-not important to 5-very high priority) were requested in 4 areas: the first area focused on how high a priority the respondent rated a given item and areas 2 to 4 focused on how well the need was met by one of three resources: their SON primary assigned mentor, other SON resources, or other university resources. There were 63 eligible SON faculty to whom the survey was e-mailed with a 60% (n = 38) response rate. Most of the respondents were clinical track (42.1%) followed by tenure track (39.5%) and research track (15.8%). Half were assistant professors. The percentage of respondents giving a rating of 4 to 5 were calculated and then ranked. Almost all the faculty responding, regardless of track or rank, desired formal mentorship. Among all faculty, the top five priorities were guidance on producing timely publications (70.4%), mentorship on work-life balance (68%), mentorship on putting together a promotion package (61.5%), guidance on test writing (60%), and utilizing technology in the classroom (60%). Priorities varied by faculty track. In terms of the gap between mentorship priorities and how well they were being met, the highest gaps overall were for test writing, using technology in the classroom, curriculum development, lecturing, and developing and managing a research team. As with priorities, the gaps between priorities and how well they were being met varied by track. The priorities and gap analysis were used to guide career development program activities and to develop a plan for future mentor-mentee training and activities. The survey tool demonstrated face validity, variability, and preliminary utility as one method for assessing and guiding improvements in faculty mentorship. Published by Elsevier Inc.

76 FR 40898 - Final Priorities, Requirements, and Selection Criteria; Charter Schools Program (CSP) Grants for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... schools. (3) A multi-year financial and operating model for the organization, a demonstrated commitment of... school model and to expand the number of high-quality charter schools available to students across the... percent threshold in this priority is consistent with the average percentage of students in large urban...

Basic Principles--Outdoor Living Skills Series. Instructor Manual.

ERIC Educational Resources Information Center

Deaton, Don

The priorities for sustaining life--air, shelter, water, and food--are the subjects of this module designed to give junior and senior high school students the foundation for safe, rewarding experiences in the outdoors. Five 50-minute lesson plans cover the basic need in order of priority: air (3 minutes to survive without it), shelter (3 hours, in…

The Next Linear Collider Program-News

Science.gov Websites

The Next Linear Collider at SLAC Navbar The Next Linear Collider In The Press The Secretary of Linear Collider is a high-priority goal of this plan. http://www.sc.doe.gov/Sub/Facilities_for_future/20 -term projects in conceputal stages (the Linear Collider is the highest priority project in this

Major Facilities for Materials Research and Related Disciplines.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Commission on Physical Sciences, Mathematics, and Resources.

This report presents priorities for new facilities and new capabilities at existing facilities with initial costs of at least $5 million. The new facilities in order of priority are: (1) a 6 GeV synchrotron radiation facility; (2) an advanced steady state neutron facility; (3) a 1 to 2 GeV synchrotron radiation facility; and (4) a high intensity…

Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea, Uganda, and Sierra Leone

PubMed Central

Dare, Anna J.; Lee, Katherine C.; Bleicher, Josh; Elobu, Alex E.; Kamara, Thaim B.; Liko, Osborne; Luboga, Samuel; Danlop, Akule; Kune, Gabriel; Hagander, Lars; Leather, Andrew J. M.; Yamey, Gavin

2016-01-01

Background Little is known about the social and political factors that influence priority setting for different health services in low- and middle-income countries (LMICs), yet these factors are integral to understanding how national health agendas are established. We investigated factors that facilitate or prevent surgical care from being prioritized in LMICs. Methods and Findings We undertook country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. We conducted 74 semi-structured interviews with stakeholders involved in health agenda setting and surgical care in these countries. Interviews were triangulated with published academic literature, country reports, national health plans, and policies. Data were analyzed using a conceptual framework based on four components (actor power, ideas, political contexts, issue characteristics) to assess national factors influencing priority for surgery. Political priority for surgical care in the three countries varies. Priority was highest in Papua New Guinea, where surgical care is firmly embedded within national health plans and receives significant domestic and international resources, and much lower in Uganda and Sierra Leone. Factors influencing whether surgical care was prioritized were the degree of sustained and effective domestic advocacy by the local surgical community, the national political and economic environment in which health policy setting occurs, and the influence of international actors, particularly donors, on national agenda setting. The results from Papua New Guinea show that a strong surgical community can generate priority from the ground up, even where other factors are unfavorable. Conclusions National health agenda setting is a complex social and political process. To embed surgical care within national health policy, sustained advocacy efforts, effective framing of the problem and solutions, and country-specific data are required. Political, technical, and financial support from regional and international partners is also important. PMID:27186645

Water safety in the bush: strategies for addressing training needs in remote areas.

PubMed

Beattie, N; Shaw, P; Larson, A

2008-01-01

This article describes a unique, remote, water safety-training program delivered to 11 remote Australian communities during 2006-2007. The program, known as 'Water Safety in the Bush', was developed by Combined Universities Centre for Rural Health in Geraldton Western Australia in consultation with the Commonwealth Government Department of Health and Ageing, and the Royal Life Saving Society of Australia. Drowning and near drowning are major causes of childhood death and injury in rural and remote Australia, making improved water safety awareness and skills a public health priority. Water Safety in the Bush employed a flexible, community development model to meet the special requirements of remote and isolated communities. The model had three elements: coordination by a local organisation; a water safety instruction program based on a Royal Life Saving Society of Australia curriculum adapted to meet local priorities; and strategies for sustainability. In the delivery of the program a total of 873 children and 219 adults received swimming and water safety instruction; 47 adults and older children received first-aid training; and 38 community members became AUSTAWIM (the Australian Council for the Teaching of Swimming and Water Safety) accredited instructors. Project evaluation showed parents and community organisations were very satisfied with the program which met a real need. Parents and instructors gave evidence of children's increased skills in water safety, swimming ability, life-saving and water confidence. Training programs with greater contact hours showed greater skill gains. Sustainability strategies included accreditation of local AUSTSWIM instructors, the erection of water safety signs, sourcing of continuing funding, and the introduction of water safety theory into the school curriculum. Flexibility was the major success factor. Within the parameters of minimum guidelines, communities were encouraged to choose the timing, venue and delivery mode of the training to ensure the program was best suited to the local community. Community ownership was achieved by requiring that local organisations design and implement the projects. Designing programs that addressed local constraints ensured high participation rates. A number of challenges were also identified. Not all community organisations had the capacity to take on the coordinating role, and struggled to effectively deliver a sustainable program. Other models may be needed for these communities. Accessing appropriately qualified water safety instructors in local areas also proved difficult at several of the sites. Further, designing standardised outcome evaluation strategies that could be implemented across all participating sites was problematic. Remote and isolated communities have a pressing need to gain the knowledge and skills necessary for water safety and survival. Standard training programs, which in the case of swimming and water safety instruction are generally run in two-week blocks, are often not feasible. Models for delivering training, which give resources and power to local organisations to find innovative ways to meet their priorities, build capacity and ensure high participation rates.

A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings: a focus on front-line health workers and health-system organizations.

PubMed

Wallis, Lee; Hasselberg, Marie; Barkman, Catharina; Bogoch, Isaac; Broomhead, Sean; Dumont, Guy; Groenewald, Johann; Lundin, Johan; Norell Bergendahl, Johan; Nyasulu, Peter; Olofsson, Maud; Weinehall, Lars; Laflamme, Lucie

2017-06-01

Diagnostic support for clinicians is a domain of application of mHealth technologies with a slow uptake despite promising opportunities, such as image-based clinical support. The absence of a roadmap for the adoption and implementation of these types of applications is a further obstacle. This article provides the groundwork for a roadmap to implement image-based support for clinicians, focusing on how to overcome potential barriers affecting front-line users, the health-care organization and the technical system. A consensual approach was used during a two-day roundtable meeting gathering a convenience sample of stakeholders (n = 50) from clinical, research, policymaking and business fields and from different countries. A series of sessions was held including small group discussions followed by reports to the plenary. Session moderators synthesized the reports in a number of theme-specific strategies that were presented to the participants again at the end of the meeting for them to determine their individual priority. There were four to seven strategies derived from the thematic sessions. Once reviewed and prioritized by the participants some received greater priorities than others. As an example, of the seven strategies related to the front-line users, three received greater priority: the need for any system to significantly add value to the users; the usability of mHealth apps; and the goodness-of-fit into the work flow. Further, three aspects cut across the themes: ease of integration of the mHealth applications; solid ICT infrastructure and support network; and interoperability. Research and development in image-based diagnostic pave the way to making health care more accessible and more equitable. The successful implementation of those solutions will necessitate a seamless introduction into routines, adequate technical support and significant added value.

Avian Conservation Areas as a Proxy for Contaminated Soil Remediation

PubMed Central

Lin, Wei-Chih; Lin, Yu-Pin; Anthony, Johnathen; Ding, Tsun-Su

2015-01-01

Remediation prioritization frequently falls short of systematically evaluating the underlying ecological value of different sites. This study presents a novel approach to delineating sites that are both contaminated by any of eight heavy metals and have high habitat value to high-priority species. The conservation priority of each planning site herein was based on the projected distributions of eight protected bird species, simulated using 900 outputs of species distribution models (SDMs) and the subsequent application of a systematic conservation tool. The distributions of heavy metal concentrations were generated using a geostatistical joint-simulation approach. The uncertainties in the heavy metal distributions were quantified in terms of variability among 1000 realization sets. Finally, a novel remediation decision-making approach was presented for delineating contaminated sites in need of remediation based on the spatial uncertainties of multiple realizations and the priorities of conservation areas. The results thus obtained demonstrate that up to 42% of areas of high conservation priority are also contaminated by one or more of the heavy metal contaminants of interest. Moreover, as the proportion of the land for proposed remediated increased, the projected area of the pollution-free habitat also increased. Overall uncertainty, in terms of the false positive contamination rate, also increased. These results indicate that the proposed decision-making approach successfully accounted for the intrinsic trade-offs among a high number of pollution-free habitats, low false positive rates and robustness of expected decision outcomes. PMID:26193297

The burden of acute respiratory infections in crisis-affected populations: a systematic review

PubMed Central

2010-01-01

Crises due to armed conflict, forced displacement and natural disasters result in excess morbidity and mortality due to infectious diseases. Historically, acute respiratory infections (ARIs) have received relatively little attention in the humanitarian sector. We performed a systematic review to generate evidence on the burden of ARI in crises, and inform prioritisation of relief interventions. We identified 36 studies published since 1980 reporting data on the burden (incidence, prevalence, proportional morbidity or mortality, case-fatality, attributable mortality rate) of ARI, as defined by the International Classification of Diseases, version 10 and as diagnosed by a clinician, in populations who at the time of the study were affected by natural disasters, armed conflict, forced displacement, and nutritional emergencies. We described studies and stratified data by age group, but did not do pooled analyses due to heterogeneity in case definitions. The published evidence, mainly from refugee camps and surveillance or patient record review studies, suggests very high excess morbidity and mortality (20-35% proportional mortality) and case-fatality (up to 30-35%) due to ARI. However, ARI disease burden comparisons with non-crisis settings are difficult because of non-comparability of data. Better epidemiological studies with clearer case definitions are needed to provide the evidence base for priority setting and programme impact assessments. Humanitarian agencies should include ARI prevention and control among infants, children and adults as priority activities in crises. Improved data collection, case management and vaccine strategies will help to reduce disease burden. PMID:20181220

Factory approach can streamline patient accounting.

PubMed

Rands, J; Muench, M

1991-08-01

Although they may seem fundamentally different, similarities exist between operations of factories and healthcare organizations' business offices. As a result, a patient accounting approach based on manufacturing firms' management techniques may help smooth healthcare business processes. Receivables performance management incorporates the Japanese techniques of "just-in-time" and total quality management to reduce unbilled accounts and information backlog and accelerate payment. A preliminary diagnostic assessment of a patient accounting process helps identify bottlenecks and set priorities for work flow.

America’s Conditional Advantage: Airpower, Counterinsurgency, and the Theory of John Warden

DTIC Science & Technology

2009-06-01

regenerate and fight on. These properties make the insurgent less like a military machine than a virus .30 But while this is a useful way of...VC ambush of a convoy near Ben Cat that same year compelled Diem to order that all priority convoys receive air cover. Together, these factors set...Progress Report: Project CORONA HARVEST (Washington, DC: Headquarters US Air Force, Operations Analysis, June 1966), 2. 57 Lieutenant Colonel Jack G

A randomized comparative trial of two decision tools for pregnant women with prior cesareans.

PubMed

Eden, Karen B; Perrin, Nancy A; Vesco, Kimberly K; Guise, Jeanne-Marie

2014-01-01

Evaluate tools to help pregnant women with prior cesareans make informed decisions about having trials of labor. Randomized comparative trial. A research assistant with a laptop met the women in quiet locations at clinics and at health fairs. Pregnant women (N = 131) who had one prior cesarean and were eligible for vaginal birth after cesarean (VBAC) participated one time between 2005 and 2007. Women were randomized to receive either an evidence-based, interactive decision aid or two evidence-based educational brochures about cesarean delivery and VBAC. Effect on the decision-making process was assessed before and after the interventions. Compared to baseline, women in both groups felt more informed (F = 23.8, p < .001), were more clear about their birth priorities (F = 9.7, p = .002), felt more supported (F = 9.8, p = .002, and overall reported less conflict (F = 18.1, p < 0.001) after receiving either intervention. Women in their third trimesters reported greater clarity around birth priorities after using the interactive decision aid than women given brochures (F = 9.8, p = .003). Although both decision tools significantly reduced conflict around the birth decision compared to baseline, more work is needed to understand which format, the interactive decision aid or paper brochures, are more effective early and late in pregnancy. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Emotion strengthens high priority memory traces but weakens low priority memory traces

PubMed Central

Sakaki, Michiko; Fryer, Kellie; Mather, Mara

2014-01-01

When encountering emotional events, memory for those events is typically enhanced. But it has been unclear how emotionally arousing events influence memory for preceding information. Does emotional arousal induce retrograde amnesia or retrograde enhancement? The current study revealed that this depends on the top-down goal relevance of the preceding information. Across three studies, we found that emotional arousal induced by one image facilitated memory for the preceding neutral item when people prioritized that neutral item. In contrast, an emotional image impaired memory for the preceding neutral item when people did not prioritize that neutral item. Emotional arousal elicited by negative and positive pictures both showed this pattern of enhancing or impairing memory for the preceding stimulus depending on its priority. These results indicate that emotional arousal amplifies the effects of top-down priority in memory formation. PMID:24311478

Strengthening expertise for health technology assessment and priority-setting in Africa

PubMed Central

Doherty, Jane E; Wilkinson, Thomas; Edoka, Ijeoma; Hofman, Karen

2017-01-01

ABSTRACT Background: Achieving sustainable universal health coverage depends partly on fair priority-setting processes that ensure countries spend scarce resources wisely. While general health economics capacity-strengthening initiatives exist in Africa, less attention has been paid to developing the capacity of individuals, institutions and networks to apply economic evaluation in support of health technology assessment and effective priority-setting. Objective: On the basis of international  lessons, to identify how research organisations and partnerships could contribute to capacity strengthening for health technology assessment and priority-setting in Africa. Methods: A rapid scan was conducted of international formal and grey literature and lessons extracted from the deliberations of two international and regional workshops relating to capacity-building for health technology assessment. ‘Capacity’ was defined in broad terms, including a conducive political environment, strong public institutional capacity to drive priority-setting, effective networking between experts, strong research organisations and skilled researchers. Results: Effective priority-setting requires more than high quality economic research. Researchers have to engage with an array of stakeholders, network closely other research organisations, build partnerships with different levels of government and train the future generation of researchers and policy-makers. In low- and middle-income countries where there are seldom government units or agencies dedicated to health technology assessment, they also have to support the development of an effective priority-setting process that is sensitive to societal and government needs and priorities. Conclusions: Research organisations have an important role to play in contributing to the development of health technology assessment and priority-setting capacity. In Africa, where there are resource and capacity challenges, effective partnerships between local and international researchers, and with key government stakeholders, can leverage existing skills and knowledge to generate a critical mass of individuals and institutions. These would help to meet the priority-setting needs of African countries and contribute to sustainable universal health coverage. PMID:29035166

Regional scale prioritisation for key ecosystem services, renewable energy production and urban development.

PubMed

Casalegno, Stefano; Bennie, Jonathan J; Inger, Richard; Gaston, Kevin J

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services.

Regional Scale Prioritisation for Key Ecosystem Services, Renewable Energy Production and Urban Development

PubMed Central

Casalegno, Stefano; Bennie, Jonathan J.; Inger, Richard; Gaston, Kevin J.

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services. PMID:25250775

Summary of Martian Dust Filtering Challenges and Current Filter Development

NASA Technical Reports Server (NTRS)

O'Hara, William J., IV

2017-01-01

Traditional air particulate filtering in manned spaceflight (Apollo, Shuttle, ISS, etc.) has used cleanable or replaceable catch filters such as screens and High-Efficiency Particulate Arrestance (HEPA) filters. However, the human mission to Mars architecture will require a new approach. It is Martian dust that is the particulate of concern but the need also applies to particulates generated by crew. The Mars Exploration Program Analysis Group (MEPAG) high-lighted this concern in its Mars Science, Goals, Objectives, Investigations and Priorities document [7], by saying specifically that one high priority investigation will be to "Test ISRU atmospheric processing systems to measure resilience with respect to dust and other environmental challenge performance parameters that are critical to the design of a full-scale system." By stating this as high priority the MEPAG is acknowledging that developing and adequately verifying this capability is critical to success of a human mission to Mars. This architecture will require filtering capabilities that are highly reliable, will not restrict the flow path with clogging, and require little to no maintenance. This paper will summarize why this is the case, the general requirements for developing the technology, and the status of the progress made in this area.

Open wide: looking into the safety culture of dental school clinics.

PubMed

Ramoni, Rachel; Walji, Muhammad F; Tavares, Anamaria; White, Joel; Tokede, Oluwabunmi; Vaderhobli, Ram; Kalenderian, Elsbeth

2014-05-01

Although dentists perform highly technical procedures in complex environments, patient safety has not received the same focus in dentistry as in medicine. Cultivating a robust patient safety culture is foundational to minimizing patient harm, but little is known about how dental teams view patient safety or the patient safety culture within their practice. As a step toward rectifying that omission, the goals of this study were to benchmark the patient safety culture in three U.S. dental schools, identifying areas for improvement. The extensively validated Medical Office Survey on Patient Safety Culture (MOSOPS), developed by the Agency for Healthcare Research and Quality, was administered to dental faculty, dental hygienists, dental students, and staff at the three schools. Forty-seven percent of the 328 invited individuals completed the survey. The "Teamwork" category received the highest marks and "Patient Care Tracking and Follow-Up" and "Leadership Support for Patient Safety" the lowest. Only 48 percent of the respondents rated systems and processes in place to prevent/catch patient problems as good/excellent. All patient safety dimensions received lower marks than in medical practices. These findings and the inherent risk associated with dental procedures lead to the conclusion that dentistry in general, and academic dental clinics in particular, stands to benefit from an increased focus on patient safety. This first published use of the MOSOPS in a dental clinic setting highlights both clinical and educational priorities for improving the safety of care in dental school clinics.

1988 Delphi survey of nursing research priorities for New York State.

PubMed

Shortridge, L; Doswell, W; Evans, M E; Levin, R F; Millor, G K; Carter, E

1989-09-01

In order to inform decisions about nursing research and health care policy, the Council on Nursing Research of the New York State Nurses Association (NYSNA) conducted a Delphi survey to identify the priorities for nursing research in New York state. The Delphi technique is a method of eliciting judgements from experts for the purpose of short-term forecasting and planning. The survey was conducted by mail in three rounds during 1988. Round I required participants to identify three primary research priorities for the nursing profession. In Round II participants ranked the 37 most frequently identified categories from Round I. The highest 16 categories from Round II were ranked by participants in Round III to provide the final 10 nursing research priority categories for New York state. All members of the New York State Nurses Association holding a minimum of a master's degree in nursing were invited to participate. The response rates were: Round I, 34% (N = 872); Round II, 38% (N = 985); Round III 37% (N = 974). Of the 10 nursing research priority categories identified in the final round, 5 relate to nurses, 2 relate to nursing, and 3 relate to clients. None of the high-risk conditions or populations with whom nurses work appear in the top 10, and only 2 of these are ranked in the top 15 priority categories. These priority categories will be used by the NYSNA Council on Nursing Research to influence its future agenda and activities. They can be used by the nursing profession and others for planning, policy making, and establishing nursing research funding priorities.(ABSTRACT TRUNCATED AT 250 WORDS)

Impact Analysis of Flow Shaping in Ethernet-AVB/TSN and AFDX from Network Calculus and Simulation Perspective

PubMed Central

He, Feng; Zhao, Lin; Li, Ershuai

2017-01-01

Ethernet-AVB/TSN (Audio Video Bridging/Time-Sensitive Networking) and AFDX (Avionics Full DupleX switched Ethernet) are switched Ethernet technologies, which are both candidates for real-time communication in the context of transportation systems. AFDX implements a fixed priority scheduling strategy with two priority levels. Ethernet-AVB/TSN supports a similar fixed priority scheduling with an additional Credit-Based Shaper (CBS) mechanism. Besides, TSN can support time-triggered scheduling strategy. One direct effect of CBS mechanism is to increase the delay of its flows while decreasing the delay of other priority ones. The former effect can be seen as the shaping restriction and the latter effect can be seen as the shaping benefit from CBS. The goal of this paper is to investigate the impact of CBS on different priority flows, especially on the intermediate priority ones, as well as the effect of CBS bandwidth allocation. It is based on a performance comparison of AVB/TSN and AFDX by simulation in an automotive case study. Furthermore, the shaping benefit is modeled based on integral operation from network calculus perspective. Combing with the analysis of shaping restriction and shaping benefit, some configuration suggestions on the setting of CBS bandwidth are given. Results show that the effect of CBS depends on flow loads and CBS configurations. A larger load of high priority flows in AVB tends to a better performance for the intermediate priority flows when compared with AFDX. Shaping benefit can be explained and calculated according to the changing from the permitted maximum burst. PMID:28531158

Prioritizing conservation areas for coastal plant diversity under increasing urbanization.

PubMed

Doxa, Aggeliki; Albert, Cécile Hélène; Leriche, Agathe; Saatkamp, Arne

2017-10-01

Coastal urban expansion will continue to drive further biodiversity losses, if conservation targets for coastal ecosystems are not defined and met. Prioritizing areas for future protected area networks is thus an urgent task in such urbanization-threatened ecosystems. Our aim is to quantify past and future losses of coastal vegetation priority areas due to urbanization and assess the effectiveness of the existing protected area network for conservation. We conduct a prioritization analysis, based on 82 coastal plants, including common and IUCN red list species, in a highly-urbanized but biotically diverse region, in South-Eastern France. We evaluate the role of protected areas, by taking into account both strict and multi-use areas. We assess the impact of past and future urbanization on high priority areas, by combining prioritization analyses and urbanization models. We show that half of the highly diverse areas have already been lost due to urbanization. Remaining top priority areas are also among the most exposed to future urban expansion. The effectiveness of the existing protected area (PA) network is only partial. While strict PAs coincide well with top priority areas, they only represent less than one third of priority areas. The effectiveness of multi-use PAs, such as the Natura 2000 network, also remains limited. Our approach highlights the impact of urbanization on plant conservation targets. By modelling urbanization, we manage to identify those areas where protection could be more efficient to limit further losses. We suggest to use our approach in the future to expand the PA network in order to achieve the 2020 Aichi biodiversity targets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Monitoring Natural World Heritage Sites: optimization of the monitoring system in Bogda with GIS-based multi-criteria decision analysis.

PubMed

Wang, Zhaoguo; Du, Xishihui

2016-07-01

Natural World Heritage Sites (NWHSs) are invaluable treasure due to the uniqueness of each site. Proper monitoring and management can guarantee their protection from multiple threats. In this study, geographic information system (GIS)-based multi-criteria decision analysis (GIS-MCDA) was used to assess criteria layers acquired from the data available in the literature. A conceptual model for determining the priority area for monitoring in Bogda, China, was created based on outstanding universal values (OUV) and expert knowledge. Weights were assigned to each layer using the analytic hierarchy process (AHP) based on group decisions, encompassing three experts: one being a heritage site expert, another a forest ranger, and the other a heritage site manager. Subsequently, evaluation layers and constraint layers were used to generate a priority map and to determine the feasibility of monitoring in Bogda. Finally, a monitoring suitability map of Bogda was obtained by referencing priority and feasibility maps.The high-priority monitoring area is located in the montane forest belt, which exhibits high biodiversity and is the main tourist area of Bogda. The northern buffer zone of Bogda comprises the concentrated feasible monitoring areas, and the area closest to roads and monitoring facilities is highly feasible for NWHS monitoring. The suitability of an area in terms of monitoring is largely determined by the monitoring priority in that particular area. The majority of planned monitoring facilities are well distributed in both suitable and less suitable areas. Analysis results indicate that the protection of Bogda will be more scientifically based due to its effective and all-around planned monitoring system proposed by the declaration text of Xinjiang Tianshan, which is the essential file submitted to World Heritage Centre to inscribe as a NWHS.

Tropical montane cloud forests: current threats and opportunities for their conservation and sustainable management in Mexico.

PubMed

Toledo-Aceves, Tarin; Meave, Jorge A; González-Espinosa, Mario; Ramírez-Marcial, Neptalí

2011-03-01

Tropical montane cloud forests (TMCF) are among the most threatened ecosystems globally in spite of their high strategic value for sustainable development due to the key role played by these forests in hydrological cycle maintenance and as reservoirs of endemic biodiversity. Resources for effective conservation and management programs are rarely sufficient, and criteria must be applied to prioritize TMCF for conservation action. This paper reports a priority analysis of the 13 main regions of TMCF distribution in Mexico, based on four criteria: (1) forest quality, (2) threats to forest permanence, (3) threats to forest integrity, and (4) opportunities for conservation. Due to the diverse socio-environmental conditions of the local communities living in Mexican TMCF regions, their associated social characteristics were also evaluated to provide a background for the planning of conservation actions. A set of indicators was defined for the measurement of each criterion. To assign priority values for subregions within each main region, an international team of 40 participants evaluated all the indicators using multicriteria decision-making analysis. This procedure enabled the identification of 15 subregions of critical priority, 17 of high priority, and 10 of medium priority; three more were not analysed due to lack of information. The evaluation revealed a number of subjects that had hitherto been undetected and that may prove useful for prioritization efforts in other regions where TMCF is similarly documented and faces equally severe threats. Based on this analysis, key recommendations are outlined to advance conservation objectives in those TMCF areas that are subjected to high pressure on forest resources. Copyright © 2010 Elsevier Ltd. All rights reserved.

Task Force Report 5. Report of the Task Force on Family Medicine’s Role in Shaping the Future Health Care Delivery System

PubMed Central

Roberts, Richard G.; Snape, Pam S.; Burke, Kevin

2004-01-01

BACKGROUND Recognizing that the implementation of needed changes within family medicine will be enhanced through a concurrent effort to transform the broader health care system, this Future of Family Medicine task force was charged with determining family medicine’s leadership role in shaping the future health care delivery system. METHODS After reviewing the changes taking place within family medicine and the broader health care system, this task force identified 6 priorities for fostering necessary modifications in the health care system. In addressing the leadership challenge facing the discipline, the task force presents a 3-dimensional matrix that provides a useful framework for describing the audiences that should be targeted, the strategic priorities that should be pursued, and the specific recommendations that should be addressed. Noting that leadership is part of the heritage of family medicine, the task force reviewed past successes by the discipline as important lessons that can be instructive as family physicians begin advocating for needed changes. MAJOR FINDINGS Effective leadership is an essential ingredient that will determine, to a large extent, the success of family medicine in advocating for needed change in the health care system overall and in the specialty. It is vitally important to groom leaders within family medicine and to create venues where policy makers and influence leaders can look beyond their usual constituencies and horizons to a comprehensive view of health care. A central concept being proposed is that of a relationship-centered personal medical home. This medical home serves as the focal point through which all individuals—regardless of age, gender, race, ethnicity, or socioeconomic status—receive a basket of acute, chronic, and preventive medical care services that are accessible, accountable, comprehensive, integrated, patient-centered, safe, scientifically valid, and satisfying to both patients and their physicians. CONCLUSION Family medicine has and will continue to have an important leadership role in health system change. It has been most successful when it has been able to identify a high-priority goal through consensus within the discipline, to focus and coordinate local and national resources, and to use a multipronged approach in addressing the priority. Although the Future of Family Medicine project has provided an important impetus for the identification of key priorities across the discipline, for the FFM project ultimately to be a success, implementation steps will need to be identified and prioritized. The leadership matrix presented in this report can provide a useful structuring tool to identify, understand, and coordinate change efforts more effectively. Strategic alliances with primary care groups and others also will be critical to the success of change initiatives.

Evaluation of a promotional strategy to increase bicycle helmet use by children.

PubMed

Parkin, P C; Spence, L J; Hu, X; Kranz, K E; Shortt, L G; Wesson, D E

1993-04-01

Bicycle-related head injuries are an important cause of death and disability, despite the availability of helmets. The objective of this study was to evaluate the effectiveness of a school-based bicycle helmet promotion program in increasing helmet use by children while controlling for secular trends. Two high-income and two low-income schools in an urban Canadian community were selected to receive a bicycle helmet promotion intervention, with the remaining 18 schools serving as controls. Approximately 1800 observations of bicycling children were made at randomly selected observational sites 2 to 5 months after the intervention to assess changes in behavior. Helmet use at all observation sites tripled from 3.4% (1990, preintervention) to 16% (1991, postintervention). In the high-income intervention area, observed helmet use rose dramatically from 4% to 36% in contrast to the more modest increase in the high-income control area from 4% to 15%. In the low-income intervention area, there was a modest increase from 1% to 7%, but it did not differ from the increase in the low-income control area from 3% to 13%. The program was highly successful in children of high-income families but not in children of low-income families. Developing strategies for low-income families remains a priority.