Integrated vehicle-based safety systems (IVBSS) : heavy truck extended pilot test summary report.

DOT National Transportation Integrated Search

2009-05-01

This report describes the findings and recommendations from the heavy-truck (HT) extended pilot test (EPT) conducted by University of Michigan Transportation Research Institute (UMTRI) and its partners under the Integrated Vehicle-Based Safety System...

1991 NASA Life Support Systems Analysis workshop

NASA Technical Reports Server (NTRS)

Evanich, Peggy L.; Crabb, Thomas M.; Gartrell, Charles F.

1992-01-01

The 1991 Life Support Systems Analysis Workshop was sponsored by NASA Headquarters' Office of Aeronautics and Space Technology (OAST) to foster communication among NASA, industrial, and academic specialists, and to integrate their inputs and disseminate information to them. The overall objective of systems analysis within the Life Support Technology Program of OAST is to identify, guide the development of, and verify designs which will increase the performance of the life support systems on component, subsystem, and system levels for future human space missions. The specific goals of this workshop were to report on the status of systems analysis capabilities, to integrate the chemical processing industry technologies, and to integrate recommendations for future technology developments related to systems analysis for life support systems. The workshop included technical presentations, discussions, and interactive planning, with time allocated for discussion of both technology status and time-phased technology development recommendations. Key personnel from NASA, industry, and academia delivered inputs and presentations on the status and priorities of current and future systems analysis methods and requirements.

Formation of integrated structural units using the systematic and integrated method when implementing high-rise construction projects

NASA Astrophysics Data System (ADS)

Abramov, Ivan

2018-03-01

Development of design documentation for a future construction project gives rise to a number of issues with the main one being selection of manpower for structural units of the project's overall implementation system. Well planned and competently staffed integrated structural construction units will help achieve a high level of reliability and labor productivity and avoid negative (extraordinary) situations during the construction period eventually ensuring improved project performance. Research priorities include the development of theoretical recommendations for enhancing reliability of a structural unit staffed as an integrated construction crew. The author focuses on identification of destabilizing factors affecting formation of an integrated construction crew; assessment of these destabilizing factors; based on the developed mathematical model, highlighting the impact of these factors on the integration criterion with subsequent identification of an efficiency and reliability criterion for the structural unit in general. The purpose of this article is to develop theoretical recommendations and scientific and methodological provisions of an organizational and technological nature in order to identify a reliability criterion for a structural unit based on manpower integration and productivity criteria. With this purpose in mind, complex scientific tasks have been defined requiring special research, development of corresponding provisions and recommendations based on the system analysis findings presented herein.

Risk Quantification of Systems Engineering Documents Improves Probability of DOD Project Success

DTIC Science & Technology

2009-09-01

comprehensive risk model for DoD milestone review documentation as well as recommended changes to the Capability Maturity Model Integration ( CMMI ) Project...Milestone Documentation, Project Planning, Rational Frame, Political Frame, CMMI Project Planning Process Area, CMMI Risk Management Process Area...well as recommended changes to the Capability Maturity Model Integration ( CMMI ) Project Planning and Risk Management process areas. The intent is to

Automated recommendation for cervical cancer screening and surveillance.

PubMed

Wagholikar, Kavishwar B; MacLaughlin, Kathy L; Casey, Petra M; Kastner, Thomas M; Henry, Michael R; Hankey, Ronald A; Peters, Steve G; Greenes, Robert A; Chute, Christopher G; Liu, Hongfang; Chaudhry, Rajeev

2014-01-01

Because of the complexity of cervical cancer prevention guidelines, clinicians often fail to follow best-practice recommendations. Moreover, existing clinical decision support (CDS) systems generally recommend a cervical cytology every three years for all female patients, which is inappropriate for patients with abnormal findings that require surveillance at shorter intervals. To address this problem, we developed a decision tree-based CDS system that integrates national guidelines to provide comprehensive guidance to clinicians. Validation was performed in several iterations by comparing recommendations generated by the system with those of clinicians for 333 patients. The CDS system extracted relevant patient information from the electronic health record and applied the guideline model with an overall accuracy of 87%. Providers without CDS assistance needed an average of 1 minute 39 seconds to decide on recommendations for management of abnormal findings. Overall, our work demonstrates the feasibility and potential utility of automated recommendation system for cervical cancer screening and surveillance.

Integrating complex business processes for knowledge-driven clinical decision support systems.

PubMed

Kamaleswaran, Rishikesan; McGregor, Carolyn

2012-01-01

This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

Making the Case for New Research to Support the Integration of Small Unmanned Aircraft Systems into the National Airspace System

NASA Technical Reports Server (NTRS)

McAdaragh, Raymon M.; Comstock, James R., Jr.; Ghatas, Rania W.; Burdette, Daniel W.; Trujillo, Anna C.

2014-01-01

This paper describes the current state of sUAS regulation, their technical capabilities and the latest technologies that will allow for sUAS NAS integration. The research that is needed to demonstrate sUAS NAS integration capability is identified, and recommendations for conducting this necessary research are suggested.

Energy Integrated Design of Lighting, Heating, and Cooling Systems, and Its Effect on Building Energy Requirements.

ERIC Educational Resources Information Center

Meckler, Gershon

Comments on the need for integrated design of lighting, heating, and cooling systems. In order to eliminate the penalty of refrigerating the lighting heat, minimize the building non-usable space, and optimize the total energy input, a "systems approach" is recommended. This system would employ heat-recovery techniques based on the ability of the…

Expert Recommender: Designing for a Network Organization

NASA Astrophysics Data System (ADS)

Reichling, Tim; Veith, Michael; Wulf, Volker

Recent knowledge management initiatives focus on expertise sharing within formal organizational units and informal communities of practice. Expert recommender systems seem to be a promising tool in support of these initiatives. This paper presents experiences in designing an expert recommender system for a knowledge- intensive organization, namely the National Industry Association (NIA). Field study results provide a set of specific design requirements. Based on these requirements, we have designed an expert recommender system which is integrated into the specific software infrastructure of the organizational setting. The organizational setting is, as we will show, specific for historical, political, and economic reasons. These particularities influence the employees’ organizational and (inter-)personal needs within this setting. The paper connects empirical findings of a long-term case study with design experiences of an expertise recommender system.

Diffusion-based recommendation with trust relations on tripartite graphs

NASA Astrophysics Data System (ADS)

Wang, Ximeng; Liu, Yun; Zhang, Guangquan; Xiong, Fei; Lu, Jie

2017-08-01

The diffusion-based recommendation approach is a vital branch in recommender systems, which successfully applies physical dynamics to make recommendations for users on bipartite or tripartite graphs. Trust links indicate users’ social relations and can provide the benefit of reducing data sparsity. However, traditional diffusion-based algorithms only consider rating links when making recommendations. In this paper, the complementarity of users’ implicit and explicit trust is exploited, and a novel resource-allocation strategy is proposed, which integrates these two kinds of trust relations on tripartite graphs. Through empirical studies on three benchmark datasets, our proposed method obtains better performance than most of the benchmark algorithms in terms of accuracy, diversity and novelty. According to the experimental results, our method is an effective and reasonable way to integrate additional features into the diffusion-based recommendation approach.

Review of quality measures of the most integrated health care settings for children and the need for improved measures: recommendations for initial core measurement set for CHIPRA.

PubMed

Sternberg, Scot B; Co, John Patrick T; Homer, Charles J

2011-01-01

To identify, assess, and make recommendations for inclusion of measures that assess the domain of "most integrated health care setting," with a specific focus on measures of the medical home, one particular mechanism for integrating care, to identify gaps in measurement; and to make recommendations for new measure development. We developed a conceptual framework for care integration and reviewed literature on measures assessing the presence and quality of the medical home to determine their validity, reliability, and feasibility as a proxy for care integration. We identified 2 broad approaches to assessing the extent to which patients receive care that fulfills the aims of the medical home: 1) organizational assessment of practice systems and processes thought associated with achieving these desired aims (viz, the National Committee for Quality Assurance Physician Practice Connections-Patient Centered Medical Home measure and the Medical Home Index, and 2) direct assessment by patients/families of their experience of care in targeted dimensions. Based on concerns about the absence of reliability data and the feasibility of applying the practice audit/self-assessment approach on a population level for the purpose of state reporting, as well as the limited data linking performance on the specific measures with important child outcomes, we did not recommend any of the measures of organizational assessments of practice systems for inclusion in the core set as an indicator of care integration. In contrast, measures of the medical home based on items from the National Survey of Child Health on a population level of or the Consumer Assessment of Healthcare Providers and Systems for practice- and state-level assessment are more feasible, have known reliability and performance characteristics, and more closely reflect the aims of the medical home, including care integration. Measures of health care integration as captured by the experience of care in a medical home can best be assessed for state-level performance through patient/family experience surveys. Better measures of care integration, care coordination, and integration of mental, developmental, and physical health into a comprehensive care system are high-priority topics for measure development. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Improved system integration for integrated gasification combined cycle (IGCC) systems.

PubMed

Frey, H Christopher; Zhu, Yunhua

2006-03-01

Integrated gasification combined cycle (IGCC) systems are a promising technology for power generation. They include an air separation unit (ASU), a gasification system, and a gas turbine combined cycle power block, and feature competitive efficiency and lower emissions compared to conventional power generation technology. IGCC systems are not yet in widespread commercial use and opportunities remain to improve system feasibility via improved process integration. A process simulation model was developed for IGCC systems with alternative types of ASU and gas turbine integration. The model is applied to evaluate integration schemes involving nitrogen injection, air extraction, and combinations of both, as well as different ASU pressure levels. The optimal nitrogen injection only case in combination with an elevated pressure ASU had the highest efficiency and power output and approximately the lowest emissions per unit output of all cases considered, and thus is a recommended design option. The optimal combination of air extraction coupled with nitrogen injection had slightly worse efficiency, power output, and emissions than the optimal nitrogen injection only case. Air extraction alone typically produced lower efficiency, lower power output, and higher emissions than all other cases. The recommended nitrogen injection only case is estimated to provide annualized cost savings compared to a nonintegrated design. Process simulation modeling is shown to be a useful tool for evaluation and screening of technology options.

Human Systems Integration in Practice: Constellation Lessons Learned

NASA Technical Reports Server (NTRS)

Zumbado, Jennifer Rochlis

2012-01-01

NASA's Constellation program provided a unique testbed for Human Systems Integration (HSI) as a fundamental element of the Systems Engineering process. Constellation was the first major program to have HSI mandated by NASA's Human Rating document. Proper HSI is critical to the success of any project that relies on humans to function as operators, maintainers, or controllers of a system. HSI improves mission, system and human performance, significantly reduces lifecycle costs, lowers risk and minimizes re-design. Successful HSI begins with sufficient project schedule dedicated to the generation of human systems requirements, but is by no means solely a requirements management process. A top-down systems engineering process that recognizes throughout the organization, human factors as a technical discipline equal to traditional engineering disciplines with authority for the overall system. This partners with a bottoms-up mechanism for human-centered design and technical issue resolution. The Constellation Human Systems Integration Group (HSIG) was a part of the Systems Engineering and Integration (SE&I) organization within the program office, and existed alongside similar groups such as Flight Performance, Environments & Constraints, and Integrated Loads, Structures and Mechanisms. While the HSIG successfully managed, via influence leadership, a down-and-in Community of Practice to facilitate technical integration and issue resolution, it lacked parallel top-down authority to drive integrated design. This presentation will discuss how HSI was applied to Constellation, the lessons learned and best practices it revealed, and recommendations to future NASA program and project managers. This presentation will discuss how Human Systems Integration (HSI) was applied to NASA's Constellation program, the lessons learned and best practices it revealed, and recommendations to future NASA program and project managers on how to accomplish this critical function.

Treatment Integrity Assessment of a Daily Report Card Intervention: A Preliminary Evaluation of Two Methods and Frequencies

ERIC Educational Resources Information Center

Sanetti, Lisa M. Hagermoser; Chafouleas, Sandra M.; O'Keeffe, Breda V.; Kilgus, Stephen P.

2013-01-01

Although intuitively appealing, teacher self-report of treatment integrity is not currently recommended as a method for collecting treatment integrity data. Education researchers have not, however, evaluated features of a treatment integrity self-reporting system that may facilitate accurate self-report. In this preliminary investigation, four…

Implementation of Recommendations from the One System Comparative Evaluation of the Hanford Tank Farms and Waste Treatment Plant Safety Bases

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

Garrett, Richard L.; Niemi, Belinda J.; Paik, Ingle K.

2013-11-07

A Comparative Evaluation was conducted for One System Integrated Project Team to compare the safety bases for the Hanford Waste Treatment and Immobilization Plant Project (WTP) and Tank Operations Contract (TOC) (i.e., Tank Farms) by an Expert Review Team. The evaluation had an overarching purpose to facilitate effective integration between WTP and TOC safety bases. It was to provide One System management with an objective evaluation of identified differences in safety basis process requirements, guidance, direction, procedures, and products (including safety controls, key safety basis inputs and assumptions, and consequence calculation methodologies) between WTP and TOC. The evaluation identified 25more » recommendations (Opportunities for Integration). The resolution of these recommendations resulted in 16 implementation plans. The completion of these implementation plans will help ensure consistent safety bases for WTP and TOC along with consistent safety basis processes. procedures, and analyses. and should increase the likelihood of a successful startup of the WTP. This early integration will result in long-term cost savings and significant operational improvements. In addition, the implementation plans lead to the development of eight new safety analysis methodologies that can be used at other U.S. Department of Energy (US DOE) complex sites where URS Corporation is involved.« less

Program Manager: Journal of the Defense Systems Management College. Volume 19, Number 1, January-February 1990

DTIC Science & Technology

1990-02-01

proposal to the HQ USAF than optimum communication be- While the report indicated that this recommended a long-range, integrated tween the user and the...SRA), conduct of The three functional Working Integrated logistics program plan- tradeoff studies, and development of Groups are separated into the...as well * INTEGRATION as a rapid retargeting capability. V. SYSTEM REQUIREMENTS Working Conditions At the same time, SAC realized that VI. SYSTEM

Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward.

PubMed

Schildkrout, Barbara; Benjamin, Sheldon; Lauterbach, Margo D

2016-05-01

Increasing the integration of neuroscience knowledge and neuropsychiatric skills into general psychiatric practice would facilitate expanded approaches to diagnosis, formulation, and treatment while positioning practitioners to utilize findings from emerging brain research. There is growing consensus that the field of psychiatry would benefit from more familiarity with neuroscience and neuropsychiatry. Yet there remain numerous factors impeding the integration of these domains of knowledge into general psychiatry.The authors make recommendations to move the field forward, focusing on the need for advocacy by psychiatry and medical organizations and changes in psychiatry education at all levels. For individual psychiatrists, the recommendations target obstacles to attaining expanded neuroscience and neuropsychiatry education and barriers stemming from widely held, often unspoken beliefs. For the system of psychiatric care, recommendations address the conceptual and physical separation of psychiatry from medicine, overemphasis on the Diagnostic and Statistical Manual of Mental Disorders and on psychopharmacology, and different systems in medicine and psychiatry for handling reimbursement and patient records. For psychiatry residency training, recommendations focus on expanding neuroscience/neuropsychiatry faculty and integrating neuroscience education throughout the curriculum.Psychiatry traditionally concerns itself with helping individuals construct meaningful life narratives. Brain function is one of the fundamental determinants of individuality. It is now possible for psychiatrists to integrate knowledge of neuroscience into understanding the whole person by asking, What person has this brain? How does this brain make this person unique? How does this brain make this disorder unique? What treatment will help this disorder in this person with this brain?

Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

PubMed

Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan M V

2006-01-01

Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies. Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted. A total of twenty-eight semistructured interviews were done with physicians from fifteen hospitals and other stakeholders in Catalonia. Interview content was analyzed iteratively and classified according to theoretical dimensions and contextual factors. At the sociopolitical level, factors related to the organization and financing of the health system were found to affect the utilization of HTA recommendations. At the healthcare organization level, existing collaborations between the hospital and the HTA agency favored the integration of recommendations into practices. Formalism in the organization also influenced the utilization of HTA recommendations. At the professional level, the high degree of autonomy of specialists, the importance of peers and collegial control, and the definition of professional roles and responsibilities influenced physicians' willingness to integrate HTA recommendations into their practice. This study offers a comprehensive framework to understand the complex dynamics that affect adoption of health technologies in organizational and professional practices. The findings suggest some avenues to promote the integration of HTA recommendations into practices and, thus, increase the utilization of scientific evidence to support decision making in health care.

Human factors in the Naval Air Systems Command: Computer based training

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

Seamster, T.L.; Snyder, C.E.; Terranova, M.

1988-01-01

Military standards applied to the private sector contracts have a substantial effect on the quality of Computer Based Training (CBT) systems procured for the Naval Air Systems Command. This study evaluated standards regulating the following areas in CBT development and procurement: interactive training systems, cognitive task analysis, and CBT hardware. The objective was to develop some high-level recommendations for evolving standards that will govern the next generation of CBT systems. One of the key recommendations is that there be an integration of the instructional systems development, the human factors engineering, and the software development standards. Recommendations were also made formore » task analysis and CBT hardware standards. (9 refs., 3 figs.)« less

A technical evaluation of the Nucletron FIRST system: conformance of a remote afterloading brachytherapy seed implantation system to manufacturer specifications and AAPM Task Group report recommendations.

PubMed

Rivard, Mark J; Evans, Dee-Ann Radford; Kay, Ian

2005-01-01

The Fully Integrated Real-time Seed Treatment (FIRST) system by Nucletron has been available in Europe since November 2001 and is being used more and more in Canada and the United States. Like the conventional transrectal ultrasound implant procedure, the FIRST system utilizes an ultrasound probe, needles, and brachytherapy seeds. However, this system is unique in that it (1) utilizes a low-dose-rate brachytherapy seed remote afterloader (the seedSelectron), (2) utilizes 3D image reconstruction acquired from electromechanically controlled, nonstepping rotation of the ultrasound probe, (3) integrates the control of a remote afterloader with electromechanical control of the ultrasound probe for integrating the clinical procedure into a single system, and (4) automates the transfer of planning information and seed delivery to improve quality assurance and radiation safety. This automated delivery system is specifically intended to address reproducibility and accuracy of seed positioning during implantation. The FIRST computer system includes two software environments: SPOT PRO and seedSelectron; both are used to facilitate treatment planning and brachytherapy seed implantation from beginning to completion of the entire procedure. In addition to these features, the system is reported to meet certain product specifications for seed delivery positioning accuracy and reproducibility, seed calibration accuracy and reliability, and brachytherapy dosimetry calculations. Consequently, a technical evaluation of the FIRST system was performed to determine adherence to manufacturer specifications and to the American Association of Physicists in Medicine (AAPM) Task Group Reports 43, 53, 56, 59, and 64 and recommendations of the American Brachytherapy Society (ABS). The United States Nuclear Regulatory Commission (NRC) has recently added Licensing Guidance for the seedSelectron system under 10 CFR 35.1000. Adherence to licensing guidance is made by referencing applicable AAPM Task Group recommendations. In general, results of this evaluation indicated that the system met its claimed specifications as well as the applicable recommendations outlined in the AAPM and ABS reports.

Towards an integrated EU data system within AtlantOS project

NASA Astrophysics Data System (ADS)

Pouliquen, Sylvie; Harscoat, Valerie; Waldmann, Christoph; Koop-Jakobsen, ketill

2017-04-01

The H2020 AtlantOS project started in June 2015 and aims to optimise and enhance the Integrated Atlantic Ocean Observing Systems (IAOOS). One goal is to ensure that data from different and diverse in-situ observing networks are readily accessible and useable to the wider community, international ocean science community and other stakeholders in this field. To achieve that, the strategy is to move towards an integrated data system within AtlantOS that harmonises work flows, data processing and distribution across the in-situ observing network systems, and integrates in-situ observations in existing European and international data infrastructures (Copernicus marine service, SeaDataNet NODCs, EMODnet, OBIS, GEOSS) so called Integrators. The targeted integrated system will deal with data management challenges for efficient and reliable data service to users: • Quality control commons for heterogeneous and nearly real time data • Standardisation of mandatory metadata for efficient data exchange • Interoperability of network and integrator data management systems Presently the situation is that the data acquired by the different in situ observing networks contributing to the AtlantOS project are processed and distributed using different methodologies and means. Depending on the network data management organization, the data are either processed following recommendations elaborated y the network teams and accessible through a unique portal (FTP or Web), or are processed by individual scientific researchers and made available through National Data Centres or directly at institution level. Some datasets are available through Integrators, such as Copernicus or EMODnet, but connected through ad-hoc links. To facilitate the access to the Atlantic observations and avoid "mixing pears with apples", it has been necessary to agree on (1) the EOVs list and definition across the Networks, (2) a minimum set of common vocabularies for metadata and data description to be used by all the Networks, and (3) a minimum level of Near Real Time Quality Control Procedures for selected EOVs. Then a data exchange backbone has been defined and is being setting up to facilitate discovery, viewing and downloading by the users. Some tools will be recommended to help Network plugging their data on this backbone and facilitate integration in the Integrators. Finally, existing services to the users for data discovery, viewing and downloading will be enhanced to ease access to existing observations. An initial working phase relying on existing international standards and protocols, involving data providers, both Networks and Integrators, and dealing with data harmonisation and integration objectives, has led to agreements and recommendations .The setup phase has started, both on Networks and Integrators sides, to adapt the existing systems in order to move toward this integrated EU data system within AtlantOS as well as collaboration with international partners arpound the ATlantic Ocean.

Integrated Utility Systems Feasibility Study and Conceptual Design at the University of Florida. Executive Summary.

ERIC Educational Resources Information Center

Kirmse, Dale W.; Manyimo, Steve B.

This executive summary presents a brief analysis of findings and recommendations. The concept of the Integrated Utility System (IUS) is to consider the interaction and mutual support of five utility subsystems needed by a campus complex of buildings. The subsystems are: (1) Electric power service; (2) Heating - ventilating - air conditioning and…

Integration of New Technology in Army Libraries. Appendices.

ERIC Educational Resources Information Center

DAMANS and Associates, Rockville, MD.

Eight appendices provide information related to a study which was conducted to determine the feasibility of introducing new automatic techniques to Army library technical processing activities; to examine and recommend appropriate systems and configurations for library automation; and to determine costs of implementing the recommendations. The…

Assessment of range planting as a conservation practice [Chapter 4

Treesearch

Stuart P. Hardegree; Thomas A. Jones; Bruce A. Roundy; Nancy L. Shaw; Thomas A. Monaco

2011-01-01

The Range Planting Conservation Practice Standard is used to inform development of Natural Resource Conservation Service (NRCS) management recommendations for improving vegetation composition and productivity of grazed plant communities. Range planting recommendations are generally implemented within an integrated conservation management system in conjunction with...

Advanced technology for America's future in space

NASA Technical Reports Server (NTRS)

1990-01-01

In response to Recommendation 8 of the Augustine Committee Report, NASA's Office of Aeronautics, Exploration and Technology (OAET) developed a proposed 'Integrated Technology Plan for the Civil Space Program' that entails substantial changes in the processes, structure and the content of NASA's space research and technology program. The Space Systems and Technology Advisory Committee (SSTAC, a subcommittee of the NASA Advisory Committee) and several other senior, expert, informed advisory groups conducted a review of NASA's proposed Integrated Technology Plan (ITP). This review was in response to the specific request in Recommendation 8 that 'NASA utilize an expert, outside review process, managed from headquarters, to assist in the allocation of technology funds'. This document, the final report from that review, addresses: (1) summary recommendations; (2) mission needs; (3) the integrated technology plan; (4) summary reports of the technical panels; and (5) conclusions and observations.

75 FR 56491 - Technical Amendments for Marine Spark-Ignition Engines and Vessels

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... spillage, incorporating safe recommended practices will result in a net benefit to the environment and lead... spillage, incorporating safe recommended practices will result in a net benefit to the environment and lead... portable fuel tanks to these new requirements, manufacturers working together on systems integration...

DRIS Analysis Identifies a Common Potassium Imbalance in Sweetgum Plantations

Treesearch

Mark D. Coleman; S.X. Chang; D.J. Robison

2003-01-01

DRIS (Diagnosis and Recommendation Integrated System) analysis was applied to fast-growing sweetgum (Liquidambar styraciflua L.) plantations in the southeast United States as a tool for nutrient diagnosis and fertilizer recommendations. First, standard foliar nutrient ratios for nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), and...

Systems Analysis Of Advanced Coal-Based Power Plants

NASA Technical Reports Server (NTRS)

Ferrall, Joseph F.; Jennings, Charles N.; Pappano, Alfred W.

1988-01-01

Report presents appraisal of integrated coal-gasification/fuel-cell power plants. Based on study comparing fuel-cell technologies with each other and with coal-based alternatives and recommends most promising ones for research and development. Evaluates capital cost, cost of electricity, fuel consumption, and conformance with environmental standards. Analyzes sensitivity of cost of electricity to changes in fuel cost, to economic assumptions, and to level of technology. Recommends further evaluation of integrated coal-gasification/fuel-cell integrated coal-gasification/combined-cycle, and pulverized-coal-fired plants. Concludes with appendixes detailing plant-performance models, subsystem-performance parameters, performance goals, cost bases, plant-cost data sheets, and plant sensitivity to fuel-cell performance.

Use of a remote clinical decision support service for a multicenter trial to implement prediction rules for children with minor blunt head trauma.

PubMed

Goldberg, Howard S; Paterno, Marilyn D; Grundmeier, Robert W; Rocha, Beatriz H; Hoffman, Jeffrey M; Tham, Eric; Swietlik, Marguerite; Schaeffer, Molly H; Pabbathi, Deepika; Deakyne, Sara J; Kuppermann, Nathan; Dayan, Peter S

2016-03-01

To evaluate the architecture, integration requirements, and execution characteristics of a remote clinical decision support (CDS) service used in a multicenter clinical trial. The trial tested the efficacy of implementing brain injury prediction rules for children with minor blunt head trauma. We integrated the Epic(®) electronic health record (EHR) with the Enterprise Clinical Rules Service (ECRS), a web-based CDS service, at two emergency departments. Patterns of CDS review included either a delayed, near-real-time review, where the physician viewed CDS recommendations generated by the nursing assessment, or a real-time review, where the physician viewed recommendations generated by their own documentation. A backstopping, vendor-based CDS triggered with zero delay when no recommendation was available in the EHR from the web-service. We assessed the execution characteristics of the integrated system and the source of the generated recommendations viewed by physicians. The ECRS mean execution time was 0.74 ±0.72 s. Overall execution time was substantially different at the two sites, with mean total transaction times of 19.67 and 3.99 s. Of 1930 analyzed transactions from the two sites, 60% (310/521) of all physician documentation-initiated recommendations and 99% (1390/1409) of all nurse documentation-initiated recommendations originated from the remote web service. The remote CDS system was the source of recommendations in more than half of the real-time cases and virtually all the near-real-time cases. Comparisons are limited by allowable variation in user workflow and resolution of the EHR clock. With maturation and adoption of standards for CDS services, remote CDS shows promise to decrease time-to-trial for multicenter evaluations of candidate decision support interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

RAND Arroyo Center Annual Report 2009

DTIC Science & Technology

2010-01-01

forces to transfer responsibility and authority to other entities outside the U.S. Department of Defense (DoD) at the tactical level. It recommended...SoSE principles and recommended how to use them to efficiently implement and integrate SoSE capability into the Army acquisition framework . Sponsored...exploring how the Department of Defense acquisition system can more rapidly develop, procure, and field effective C2 systems within the framework of

Distributed Deliberative Recommender Systems

NASA Astrophysics Data System (ADS)

Recio-García, Juan A.; Díaz-Agudo, Belén; González-Sanz, Sergio; Sanchez, Lara Quijano

Case-Based Reasoning (CBR) is one of most successful applied AI technologies of recent years. Although many CBR systems reason locally on a previous experience base to solve new problems, in this paper we focus on distributed retrieval processes working on a network of collaborating CBR systems. In such systems, each node in a network of CBR agents collaborates, arguments and counterarguments its local results with other nodes to improve the performance of the system's global response. We describe D2ISCO: a framework to design and implement deliberative and collaborative CBR systems that is integrated as a part of jcolibritwo an established framework in the CBR community. We apply D2ISCO to one particular simplified type of CBR systems: recommender systems. We perform a first case study for a collaborative music recommender system and present the results of an experiment of the accuracy of the system results using a fuzzy version of the argumentation system AMAL and a network topology based on a social network. Besides individual recommendation we also discuss how D2ISCO can be used to improve recommendations to groups and we present a second case of study based on the movie recommendation domain with heterogeneous groups according to the group personality composition and a group topology based on a social network.

Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation.

PubMed

Shiffman, Richard N; Michel, George; Essaihi, Abdelwaheb; Thornquist, Elizabeth

2004-01-01

A gap exists between the information contained in published clinical practice guidelines and the knowledge and information that are necessary to implement them. This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems. This approach uses the Guideline Elements Model (GEM) to represent the guideline knowledge. Implementation requires a number of steps to translate the knowledge contained in guideline text into a computable format and to integrate the information into clinical workflow. The steps include: (1) selection of a guideline and specific recommendations for implementation, (2) markup of the guideline text, (3) atomization, (4) deabstraction and (5) disambiguation of recommendation concepts, (6) verification of rule set completeness, (7) addition of explanations, (8) building executable statements, (9) specification of origins of decision variables and insertions of recommended actions, (10) definition of action types and selection of associated beneficial services, (11) choice of interface components, and (12) creation of requirement specification. The authors illustrate these component processes using examples drawn from recent experience translating recommendations from the National Heart, Lung, and Blood Institute's guideline on management of chronic asthma into a workflow-integrated decision support system that operates within the Logician electronic health record system. Using the guideline document as a knowledge source promotes authentic translation of domain knowledge and reduces the overall complexity of the implementation task. From this framework, we believe that a better understanding of activities involved in guideline implementation will emerge.

Proceedings of the Sixth Integrated Communications, Navigation and Surveillance (ICNS) Conference & Workshop 2006

NASA Technical Reports Server (NTRS)

Ponchak, Denise (Compiler)

2006-01-01

The Integrated Communications, Navigation and Surveillance (ICNS) Technologies Conference and Workshop provides a forum for government, industry, and academic communities performing research and technology development for advanced digital communications, navigation, and surveillance security systems and associated applications supporting the national and global air transportation systems. The event s goals are to understand current efforts and recent results in near- and far-term research and technology demonstration; identify integrated digital communications, navigation and surveillance research requirements necessary for a safe, high-capacity, advanced air transportation system; foster collaboration and coordination among all stakeholders; and discuss critical issues and develop recommendations to achieve the future integrated CNS vision for the national and global air transportation system.

Proceedings of the Fourth Integrated Communications, Navigation, and Surveillance (ICNS) Conference and Workshop

NASA Technical Reports Server (NTRS)

Fujikawa, Gene (Compiler)

2004-01-01

The Integrated Communications, Navigational and Surveillance (ICNS) Technologies Conference and Workshop provides a forum for Government, industry, and academic communities performing research and technology development for advanced digital communications, navigation, and surveillance security systems and associated applications supporting the national and global air transportation systems. The event's goals are to understand current efforts and recent results in near-and far-term research and technology demonstration; identify integrated digital communications, navigation and surveillance research requirements necessary for a safe, high-capacity, advanced air transportation system; foster collaboration and coordination among all stakeholders; and discuss critical issues and develop recommendations to achieve the future integrated CNS vision for the national and global air transportation system.

RIPE integrity primitives, part 2 (RACE Integrity Primitives Evaluation)

NASA Astrophysics Data System (ADS)

Denboer, B.; Boly, J. P.; Bosselaers, A.; Brandt, J.; Chaum, D.; Damgaard, I.; Dichtl, M.; Fumy, W.; Vanderham, M.; Jansen, C. J. A.

1993-04-01

A manual intended for those seeking to secure information systems by applying modern cryptography is presented. It represents the successful attainment of goals by RIPE (RACE (Research and development of Advanced Communications technology in Europe) Integrity Primitives Evaluation). The recommended portfolio of integrity primitives, which is the main product of the project, forms the heart of the manual. By integrity, is meant the kinds of security that can be achieved through cryptography, apart from keeping messages secret. Thus included are ways to ensure that stored or communicated data is not illicitly modified, that parties exchanging messages are actually present, and that 'signed' electronic messages can be recognized as authentic by anyone. Of particular concern to the project were the high speed requirements of broadband communication. The project also aimed for completeness in its recommendations. As a result, the portfolio contains primitives, that is building blocks, that can meet most of today's perceived needs for integrity.

RIPE integrity primitives, part 1 (RACE Integrity Primitives Evaluation)

NASA Astrophysics Data System (ADS)

Denboer, B.; Boly, J. P.; Bosselaers, A.; Brandt, J.; Chaum, D.; Damgaard, I.; Dichtl, M.; Fumy, W.; Vanderham, M.; Jansen, C. J. A.

1993-04-01

A manual intended for those seeking to secure information systems by applying modern cryptography is presented. It represents the successful attainment of goals by RIPE (RACE (Research and development of Advanced Communication technology in Europe) Integrity Primitives Evaluation). The recommended portfolio of integrity primitives, which is the main product of the project, forms the heart of the manual. By integrity, is meant the kinds of security that can be achieved through cryptography, apart from keeping messages secret. Thus included are ways to ensure that stored or communicated data is not illicitly modified, that parties exchanging messages are actually present, and that 'signed' electronic messages can be recognized as authentic by anyone. Of particular concern to the project were the high speed requirements of broadband communication. The project also aimed for completeness in its recommendations. As a result, the portfolio contains primitives, that is building blocks, that can meet most of today's perceived needs for integrity.

The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China.

PubMed

Wang, Xin; Birch, Stephen; Ma, Huifen; Zhu, Weiming; Meng, Qingyue

2016-08-12

Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhong having implemented health system integration. Questionnaires, interviews, and health insurance records were sources of data. Social network analysis was employed to analyze integration, through structure measurement and effectiveness evaluation. Health system integration in Huangzhong is higher than in Hualong, so is system effectiveness. The patient referral network in Hualong has more "leapfrog" referrals. The information sharing networks in both counties are larger than the other types of networks. The average distance in the joint training network of Huangzhong is less than in Hualong. Meanwhile, there are deficiencies common to both systems. Both county health systems have strengths and limitations regarding system integration. The use of medical consortia in Huangzhong has contributed to system effectiveness. Future research might consider alternative more context specific models of health system integration.

Intrarater and interrater reliability and validity in the assessment of the mechanism of injury and integrity of the posterior ligamentous complex: a novel injury severity scoring system for thoracolumbar injuries. Invited submission from the Joint Section Meeting On Disorders of the Spine and Peripheral Nerves, March 2005.

PubMed

Harrop, James S; Vaccaro, Alexander R; Hurlbert, R John; Wilsey, Jared T; Baron, Eli M; Shaffrey, Christopher I; Fisher, Charles G; Dvorak, Marcel F; Oner, F C; Wood, Kirkham B; Anand, Neel; Anderson, D Greg; Lim, Moe R; Lee, Joon Y; Bono, Christopher M; Arnold, Paul M; Rampersaud, Y Raja; Fehlings, Michael G

2006-02-01

A new classification and treatment algorithm for thoracolumbar injuries was recently introduced by Vaccaro and colleagues in 2005. A thoracolumbar injury severity scale (TLISS) was proposed for grading and guiding treatment for these injuries. The scale is based on the following: 1) the mechanism of injury; 2) the integrity of the posterior ligamentous complex (PLC); and 3) the patient's neurological status. The reliability and validity of assessing injury mechanism and the integrity of the PLC was assessed. Forty-eight spine surgeons, consisting of neurosurgeons and orthopedic surgeons, reviewed 56 clinical thoracolumbar injury case histories. Each was classified and scored to determine treatment recommendations according to a novel classification system. After 3 months the case histories were reordered and the physicians repeated the exercise. Validity of this classification was good among reviewers; the vast majority (> 90%) agreed with the system's treatment recommendations. Surgeons were unclear as to a cogent description of PLC disruption and fracture mechanism. The TLISS demonstrated acceptable reliability in terms of intra- and interobserver agreement on the algorithm's treatment recommendations. Replacing injury mechanism with a description of injury morphology and better definition of PLC injury will improve inter- and intraobserver reliability of this injury classification system.

Integrated intelligent systems in advanced reactor control rooms

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

Beckmeyer, R.R.

1989-01-01

An intelligent, reactor control room, information system is designed to be an integral part of an advanced control room and will assist the reactor operator's decision making process by continuously monitoring the current plant state and providing recommended operator actions to improve that state. This intelligent system is an integral part of, as well as an extension to, the plant protection and control systems. This paper describes the interaction of several functional components (intelligent information data display, technical specifications monitoring, and dynamic procedures) of the overall system and the artificial intelligence laboratory environment assembled for testing the prototype. 10 refs.,more » 5 figs.« less

Design techniques for modular integrated utility systems. [energy production and conversion efficiency

NASA Technical Reports Server (NTRS)

Wolfer, B. M.

1977-01-01

Features basic to the integrated utility system, such as solid waste incineration, heat recovery and usage, and water recycling/treatment, are compared in terms of cost, fuel conservation, and efficiency to conventional utility systems in the same mean-climatic area of Washington, D. C. The larger of the two apartment complexes selected for the test showed the more favorable results in the three areas of comparison. Restrictions concerning the sole use of currently available technology are hypothetically removed to consider the introduction and possible advantages of certain advanced techniques in an integrated utility system; recommendations are made and costs are estimated for each type of system.

75 FR 9205 - Science Advisory Board Staff Office Notification of a Public Meeting of a Workgroup of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-01

... on the Integrated Risk Information System (IRIS)'' (EPA/ 635/R-10/001). The SAB workgroup will assess the adequacy of EPA's implementation of the SAB previous recommendations regarding the cancer risk... previous recommendations for the revision of EPA's cancer risk assessment of inorganic arsenic. Background...

Earth Observing System, Conclusions and Recommendations

NASA Technical Reports Server (NTRS)

1984-01-01

The following Earth Observing Systems (E.O.S.) recommendations were suggested: (1) a program must be initiated to ensure that present time series of Earth science data are maintained and continued. (2) A data system that provides easy, integrated, and complete access to past, present, and future data must be developed as soon as possible. (3) A long term research effort must be sustained to study and understand these time series of Earth observations. (4) The E.O.S. should be established as an information system to carry out those aspects of the above recommendations which go beyond existing and currently planned activities. (5) The scientific direction of the E.O.S. should be established and continued through an international scientific steering committee.

Predesign study for a modern 4-bladed rotor for the NASA rotor systems research aircraft

NASA Technical Reports Server (NTRS)

Bishop, H. E.; Burkam, J. E.; Heminway, R. C.; Keys, C. N.; Smith, K. E.; Smith, J. H.; Staley, J. A.

1981-01-01

Trade-off study results and the rationale for the final selection of an existing modern four-bladed rotor system that can be adapted for installation on the Rotor Systems Research Aircraft (RSRA) are reported. The results of the detailed integration studies, parameter change studies, and instrumentation studies and the recommended plan for development and qualification of the rotor system is also given. Its parameter variants, integration on the RSRA, and support of ground and flight test programs are also discussed.

Career Directions--Renewable Energy Systems Integrator

ERIC Educational Resources Information Center

Fleeman, Stephen R.

2012-01-01

Renewable energy systems are beginning to appear everywhere. Solar modules are creating "blue roofs" that convert the energy from the sun into household electricity. Solar thermal systems on roofs can generate hot water. Wind turbines catch breezes to provide even more electricity. Recommendations for saving energy, specifying systems for…

Use of the adult attachment projective picture system in psychodynamic psychotherapy with a severely traumatized patient

PubMed Central

George, Carol; Buchheim, Anna

2014-01-01

The following case study is presented to facilitate an understanding of how the attachment information evident from Adult Attachment Projective Picture System (AAP) assessment can be integrated into a psychodynamic perspective in making therapeutic recommendations that integrate an attachment perspective. The Adult Attachment Projective Picture System (AAP) is a valid representational measure of internal representations of attachment based on the analysis of a set of free response picture stimuli designed to systematically activate the attachment system (George and West, 2012). The AAP provides a fruitful diagnostic tool for psychodynamic-oriented clinicians to identify attachment-based deficits and resources for an individual patient in therapy. This paper considers the use of the AAP with a traumatized patient in an inpatient setting and uses a case study to illustrate the components of the AAP that are particularly relevant to a psychodynamic conceptualization. The paper discusses also attachment-based recommendations for intervention. PMID:25140164

Enhancement of NRC station blackout requirements for nuclear power plants

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

McConnell, M. W.

2012-07-01

The U.S. Nuclear Regulatory Commission (NRC) established a Near-Term Task Force (NTTF) in response to Commission direction to conduct a systematic and methodical review of NRC processes and regulations to determine whether the agency should make additional improvements to its regulatory system and to make recommendations to the Commission for its policy direction, in light of the accident at the Fukushima Dai-ichi Nuclear Power Plant. The NTTF's review resulted in a set of recommendations that took a balanced approach to defense-in-depth as applied to low-likelihood, high-consequence events such as prolonged station blackout (SBO) resulting from severe natural phenomena. Part 50,more » Section 63, of Title 10 of the Code of Federal Regulations (CFR), 'Loss of All Alternating Current Power,' currently requires that each nuclear power plant must be able to cool the reactor core and maintain containment integrity for a specified duration of an SBO. The SBO duration and mitigation strategy for each nuclear power plant is site specific and is based on the robustness of the local transmission system and the transmission system operator's capability to restore offsite power to the nuclear power plant. With regard to SBO, the NTTF recommended that the NRC strengthen SBO mitigation capability at all operating and new reactors for design-basis and beyond-design-basis external events. The NTTF also recommended strengthening emergency preparedness for prolonged SBO and multi-unit events. These recommendations, taken together, are intended to clarify and strengthen US nuclear reactor safety regarding protection against and mitigation of the consequences of natural disasters and emergency preparedness during SBO. The focus of this paper is on the existing SBO requirements and NRC initiatives to strengthen SBO capability at all operating and new reactors to address prolonged SBO stemming from design-basis and beyond-design-basis external events. The NRC initiatives are intended to enhance core and spent fuel pool cooling, reactor coolant system integrity, and containment integrity. (authors)« less

Feasibility of Integrated Menu Recommendation and Self-Order System for Small-Scale Restaurants

NASA Astrophysics Data System (ADS)

Kashima, Tomoko; Matsumoto, Shimpei; Ishii, Hiroaki

2010-10-01

In recent years, point of sales (POS) systems with order function have been developed for restaurants. Since expensive apparatus and system are required for installing POS systems, usually only large-scale restaurant chains can afford to introduce them. In this research, we consider the POS management in a restaurant, which cooperates with an automatic order function by using a personal digital device aiming at the safety of the food, pursuit of service, and further operational efficiency improvements, such as foods management, accounting treatment, and ordering work. In traditional POS systems, information recommendation technology is not taken into consideration. We realize the recommendation of a menu according to the user's preference using rough sets and menu planning based on stock status by applying information recommendation technology. Therefore, we believe that this system can be used in comfort with regard to freshness of foods, allergy, diabetes, etc. Furthermore, due to the reduction of the personnel expenses by an operational efficiency improvement such technology becomes even feasible for small-scale stores.

Towards a Participatory Strategy for Integrated Rural Development.

ERIC Educational Resources Information Center

Lowdermilk, Max; Laitos, W. Robert

1981-01-01

Details essential elements of any rural development program, describes a seven-stage project development strategy which has proved successful in water management projects in Pakistan and Egypt, delineates the key concepts in each of the seven stages, and recommends integration of the client system into rural development programs. (Author)

Digital case-based learning system in school.

PubMed

Gu, Peipei; Guo, Jiayang

2017-01-01

With the continuing growth of multi-media learning resources, it is important to offer methods helping learners to explore and acquire relevant learning information effectively. As services that organize multi-media learning materials together to support programming learning, the digital case-based learning system is needed. In order to create a case-oriented e-learning system, this paper concentrates on the digital case study of multi-media resources and learning processes with an integrated framework. An integration of multi-media resources, testing and learning strategies recommendation as the learning unit is proposed in the digital case-based learning framework. The learning mechanism of learning guidance, multi-media materials learning and testing feedback is supported in our project. An improved personalized genetic algorithm which incorporates preference information and usage degree into the crossover and mutation process is proposed to assemble the personalized test sheet for each learner. A learning strategies recommendation solution is proposed to recommend learning strategies for learners to help them to learn. The experiments are conducted to prove that the proposed approaches are capable of constructing personalized sheets and the effectiveness of the framework.

Digital case-based learning system in school

PubMed Central

Gu, Peipei

2017-01-01

With the continuing growth of multi-media learning resources, it is important to offer methods helping learners to explore and acquire relevant learning information effectively. As services that organize multi-media learning materials together to support programming learning, the digital case-based learning system is needed. In order to create a case-oriented e-learning system, this paper concentrates on the digital case study of multi-media resources and learning processes with an integrated framework. An integration of multi-media resources, testing and learning strategies recommendation as the learning unit is proposed in the digital case-based learning framework. The learning mechanism of learning guidance, multi-media materials learning and testing feedback is supported in our project. An improved personalized genetic algorithm which incorporates preference information and usage degree into the crossover and mutation process is proposed to assemble the personalized test sheet for each learner. A learning strategies recommendation solution is proposed to recommend learning strategies for learners to help them to learn. The experiments are conducted to prove that the proposed approaches are capable of constructing personalized sheets and the effectiveness of the framework. PMID:29107965

System Engineering and Integration Contract for Implementation of the National Airspace System Plan. Volume 1. Sections 1.0-4.0, 6.0.

DTIC Science & Technology

1984-08-01

recommendations in the report with Martin Marietta over the next few months. Appropriate followup actions will be deter- mined, and any program changes...Technical Feasibility and Validity ...... . . .. 1-6 1.3.2 Program Schedule . . . . . . ......... . .. 1-7 1.3.3 NAS Plan Cost...343.1.1 Overview 3-1 3.1.2 Findings, Risks, and Recommendations . . . . . . . . . 3-3 3.2 Program Schedule . . . . . . . . . . * . . * . *. . 3-6

Systems biology of personalized nutrition

PubMed Central

van Ommen, Ben; van den Broek, Tim; de Hoogh, Iris; van Erk, Marjan; van Someren, Eugene; Rouhani-Rankouhi, Tanja; Anthony, Joshua C; Hogenelst, Koen; Pasman, Wilrike; Boorsma, André; Wopereis, Suzan

2017-01-01

Abstract Personalized nutrition is fast becoming a reality due to a number of technological, scientific, and societal developments that complement and extend current public health nutrition recommendations. Personalized nutrition tailors dietary recommendations to specific biological requirements on the basis of a person’s health status and goals. The biology underpinning these recommendations is complex, and thus any recommendations must account for multiple biological processes and subprocesses occurring in various tissues and must be formed with an appreciation for how these processes interact with dietary nutrients and environmental factors. Therefore, a systems biology–based approach that considers the most relevant interacting biological mechanisms is necessary to formulate the best recommendations to help people meet their wellness goals. Here, the concept of “systems flexibility” is introduced to personalized nutrition biology. Systems flexibility allows the real-time evaluation of metabolism and other processes that maintain homeostasis following an environmental challenge, thereby enabling the formulation of personalized recommendations. Examples in the area of macro- and micronutrients are reviewed. Genetic variations and performance goals are integrated into this systems approach to provide a strategy for a balanced evaluation and an introduction to personalized nutrition. Finally, modeling approaches that combine personalized diagnosis and nutritional intervention into practice are reviewed. PMID:28969366

Bridging the Guideline Implementation Gap: A Systematic, Document-Centered Approach to Guideline Implementation

PubMed Central

Shiffman, Richard N.; Michel, George; Essaihi, Abdelwaheb; Thornquist, Elizabeth

2004-01-01

Objective: A gap exists between the information contained in published clinical practice guidelines and the knowledge and information that are necessary to implement them. This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems. Design: This approach uses the Guideline Elements Model (GEM) to represent the guideline knowledge. Implementation requires a number of steps to translate the knowledge contained in guideline text into a computable format and to integrate the information into clinical workflow. The steps include: (1) selection of a guideline and specific recommendations for implementation, (2) markup of the guideline text, (3) atomization, (4) deabstraction and (5) disambiguation of recommendation concepts, (6) verification of rule set completeness, (7) addition of explanations, (8) building executable statements, (9) specification of origins of decision variables and insertions of recommended actions, (10) definition of action types and selection of associated beneficial services, (11) choice of interface components, and (12) creation of requirement specification. Results: The authors illustrate these component processes using examples drawn from recent experience translating recommendations from the National Heart, Lung, and Blood Institute's guideline on management of chronic asthma into a workflow-integrated decision support system that operates within the Logician electronic health record system. Conclusion: Using the guideline document as a knowledge source promotes authentic translation of domain knowledge and reduces the overall complexity of the implementation task. From this framework, we believe that a better understanding of activities involved in guideline implementation will emerge. PMID:15187061

Recommendations Service for Chronic Disease Patient in Multimodel Sensors Home Environment

PubMed Central

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Latif, Khalid

2015-01-01

Abstract With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC3). SC3 services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC3 platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms. PMID:25559934

Recommendations service for chronic disease patient in multimodel sensors home environment.

PubMed

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Lee, Sungyoung; Latif, Khalid

2015-03-01

With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC(3)). SC(3) services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC(3) platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms.

A study of an orbital radar mapping mission to Venus. Volume 2: Configuration comparisons and systems evaluation

NASA Technical Reports Server (NTRS)

1973-01-01

Configuration comparisons and systems evaluation for the orbital radar mapping mission of the planet Venus are discussed. Designs are recommended which best satisfy the science objectives of the Venus radar mapping concept. Attention is given to the interaction and integration of those specific mission-systems recommendations with one another, and the final proposed designs are presented. The feasibility, cost, and scheduling of these configurations are evaluated against assumptions of reasonable state-of-the-art growth and space funding expectations.

Health issues for adolescents in the justice system.

PubMed

Soler, Mark

2002-12-01

Three major health issues for adolescents in the justice system are discussed: the lack of mental health resources and services for youth in the system, increased prosecution of juveniles as adults (and consequent incarceration of youth in adult jails and prisons), and the epidemic of gun violence in this country. For each issue, the paper describes the scope of the problem, analyzes the components of the problem, and makes recommendations for future research and reform efforts. The analysis and recommendations are based on criminal justice, legal, service integration, and public health research.

Study report recommendations for the next generation Range Safety System (RSS) Integrated Receiver/Decoder (IRD)

NASA Technical Reports Server (NTRS)

Crosby, Robert H.

1992-01-01

The Integrated Receiver/Decoder (IRD) currently used on the Space Shuttle was designed in the 1980 and prior time frame. Over the past 12 years, several parts have become obsolete or difficult to obtain. As directed by the Marshall Space Flight Center, a primary objective is to investigate updating the IRD design using the latest technology subsystems. To take advantage of experience with the current designs, an analysis of failures and a review of discrepancy reports, material review board actions, scrap, etc. are given. A recommended new design designated as the Advanced Receiver/Decoder (ARD) is presented. This design uses the latest technology components to simplify circuits, improve performance, reduce size and cost, and improve reliability. A self-test command is recommended that can improve and simplify operational procedures. Here, the new design is contrasted with the old. Possible simplification of the total Range Safety System is discussed, as is a single-step crypto technique that can improve and simplify operational procedures.

Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

PubMed

Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

2015-01-01

An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

PubMed Central

Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

2015-01-01

Background An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations − usually companies − are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. Purpose The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. Methods A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in “mergers,” which could be used to build an integrative medicine department or integrative medicine service. Results Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). Conclusion The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation. PMID:25632226

Impact Assessment of GNSS Spoofing Attacks on INS/GNSS Integrated Navigation System.

PubMed

Liu, Yang; Li, Sihai; Fu, Qiangwen; Liu, Zhenbo

2018-05-04

In the face of emerging Global Navigation Satellite System (GNSS) spoofing attacks, there is a need to give a comprehensive analysis on how the inertial navigation system (INS)/GNSS integrated navigation system responds to different kinds of spoofing attacks. A better understanding of the integrated navigation system’s behavior with spoofed GNSS measurements gives us valuable clues to develop effective spoofing defenses. This paper focuses on an impact assessment of GNSS spoofing attacks on the integrated navigation system Kalman filter’s error covariance, innovation sequence and inertial sensor bias estimation. A simple and straightforward measurement-level trajectory spoofing simulation framework is presented, serving as the basis for an impact assessment of both unsynchronized and synchronized spoofing attacks. Recommendations are given for spoofing detection and mitigation based on our findings in the impact assessment process.

Full Life Cycle of Data Analysis with Climate Model Diagnostic Analyzer (CMDA)

NASA Astrophysics Data System (ADS)

Lee, S.; Zhai, C.; Pan, L.; Tang, B.; Zhang, J.; Bao, Q.; Malarout, N.

2017-12-01

We have developed a system that supports the full life cycle of a data analysis process, from data discovery, to data customization, to analysis, to reanalysis, to publication, and to reproduction. The system called Climate Model Diagnostic Analyzer (CMDA) is designed to demonstrate that the full life cycle of data analysis can be supported within one integrated system for climate model diagnostic evaluation with global observational and reanalysis datasets. CMDA has four subsystems that are highly integrated to support the analysis life cycle. Data System manages datasets used by CMDA analysis tools, Analysis System manages CMDA analysis tools which are all web services, Provenance System manages the meta data of CMDA datasets and the provenance of CMDA analysis history, and Recommendation System extracts knowledge from CMDA usage history and recommends datasets/analysis tools to users. These four subsystems are not only highly integrated but also easily expandable. New datasets can be easily added to Data System and scanned to be visible to the other subsystems. New analysis tools can be easily registered to be available in the Analysis System and Provenance System. With CMDA, a user can start a data analysis process by discovering datasets of relevance to their research topic using the Recommendation System. Next, the user can customize the discovered datasets for their scientific use (e.g. anomaly calculation, regridding, etc) with tools in the Analysis System. Next, the user can do their analysis with the tools (e.g. conditional sampling, time averaging, spatial averaging) in the Analysis System. Next, the user can reanalyze the datasets based on the previously stored analysis provenance in the Provenance System. Further, they can publish their analysis process and result to the Provenance System to share with other users. Finally, any user can reproduce the published analysis process and results. By supporting the full life cycle of climate data analysis, CMDA improves the research productivity and collaboration level of its user.

Gear Damage Detection Integrating Oil Debris and Vibration Measurement Technologies Developed

NASA Technical Reports Server (NTRS)

Gyekeyeski, Andrew L.; Sawicki, Jerzy T.

2001-01-01

The development of highly reliable health-monitoring systems is one technology area recommended for reducing the number of helicopter accidents. Helicopter transmission diagnostics are an important part of a helicopter health-monitoring system because helicopters depend on the power train for propulsion, lift, and flight maneuvering. One technique currently being tested for increasing the reliability and decreasing the false alarm rate of current transmission diagnostic tools is the replacement of simple single-sensor limits with multisensor systems integrating different measurement technologies.

Improving Driver Alertness through Music Selection Using a Mobile EEG to Detect Brainwaves

PubMed Central

Liu, Ning-Han; Chiang, Cheng-Yu; Hsu, Hsiang-Ming

2013-01-01

Driving safety has become a global topic of discussion with the recent development of the Smart Car concept. Many of the current car safety monitoring systems are based on image discrimination techniques, such as sensing the vehicle drifting from the main road, or changes in the driver's facial expressions. However, these techniques are either too simplistic or have a low success rate as image processing is easily affected by external factors, such as weather and illumination. We developed a drowsiness detection mechanism based on an electroencephalogram (EEG) reading collected from the driver with an off-the-shelf mobile sensor. This sensor employs wireless transmission technology and is suitable for wear by the driver of a vehicle. The following classification techniques were incorporated: Artificial Neural Networks, Support Vector Machine, and k Nearest Neighbor. These classifiers were integrated with integration functions after a genetic algorithm was first used to adjust the weighting for each classifier in the integration function. In addition, since past studies have shown effects of music on a person's state-of-mind, we propose a personalized music recommendation mechanism as a part of our system. Through the in-car stereo system, this music recommendation mechanism can help prevent a driver from becoming drowsy due to monotonous road conditions. Experimental results demonstrate the effectiveness of our proposed drowsiness detection method to determine a driver's state of mind, and the music recommendation system is therefore able to reduce drowsiness. PMID:23803789

Perioperative and ICU Healthcare Analytics within a Veterans Integrated System Network: a Qualitative Gap Analysis.

PubMed

Mudumbai, Seshadri; Ayer, Ferenc; Stefanko, Jerry

2017-08-01

Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development. Methods consisted of semi-structured interviews in 2 phases with a diverse set (n = 9) of support personnel and end users from five facilities across a Veterans Integrated Service Network. Phase 1 identified underlying needs and previous experiences with the analytics platform across various roles and operational responsibilities. Phase 2 validated preliminary feedback, lessons learned, and recommendations for improvement. Emerging themes suggested that the existing system met a small pool of national reporting requirements. However, pain points were identified with accessing data in several information system silos and performing multiple manual validation steps of data content. Notable recommendations included enhancing systems integration to create "one-stop shopping" for data, and developing a capability to perform trends analysis. Our gap analysis suggests that analytics platforms designed for surgical and ICU patients should employ approaches similar to those being used for primary care patients.

Systems Perspective of Amazon Mechanical Turk for Organizational Research: Review and Recommendations

PubMed Central

Keith, Melissa G.; Tay, Louis; Harms, Peter D.

2017-01-01

Amazon Mechanical Turk (MTurk) is becoming a prevalent source of quick and cost effective data for organizational research, but there are questions about the appropriateness of the platform for organizational research. To answer these questions, we conducted an integrative review based on 75 papers evaluating the MTurk platform and 250 MTurk samples used in organizational research. This integrative review provides four contributions: (1) we analyze the trends associated with the use of MTurk samples in organizational research; (2) we develop a systems perspective (recruitment system, selection system, and work management system) to synthesize and organize the key factors influencing data collected on MTurk that may affect generalizability and data quality; (3) within each factor, we also use available MTurk samples from the organizational literature to analyze key issues (e.g., sample characteristics, use of attention checks, payment); and (4) based on our review, we provide specific recommendations and a checklist for data reporting in order to improve data transparency and enable further research on this issue. PMID:28848474

An Overview of Integrated Logistic Support in Medical Material Programs.

DTIC Science & Technology

1980-12-01

OF MEDICAL INTEGRATED LOGISTIC SUPPORT ----------------- 7 B. PROBLEM DEFINITION AND OBJECTIVE ------------ 9 C. GENERAL APPROACH AND METHODOLOGY...SYSTEM ---------------------- 61 C. GENERAL CONCLUSIONS ------------------------- 63 D. RECOMMENDATIONS ----------------------------- 73 E. CONCLUSION...21 Technological advancement has caused major changes in medicine and dentistry in the last several decades. Inten- sive care units, computerized axial

Redefining Security. A Report by the Joint Security Commission

DTIC Science & Technology

1994-02-28

security policies. This report offers recommendations on developing new strategies for achieving security within our infor-mation systems, including...better, and we outline methods of improving government and industry personnel security poli- cies. We offer recommendations on developing new strategies ... strategies , sufficient funding, and management attention if our comput- ers and networks are to protect the confidentiality, integrity, and availability of

Making intelligent systems team players: Case studies and design issues. Volume 1: Human-computer interaction design

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Woods, David D.; Potter, Scott S.; Johannesen, Leila; Holloway, Matthew; Forbus, Kenneth D.

1991-01-01

Initial results are reported from a multi-year, interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. The objective is to achieve more effective human-computer interaction (HCI) for systems with real time fault management capabilities. Intelligent fault management systems within the NASA were evaluated for insight into the design of systems with complex HCI. Preliminary results include: (1) a description of real time fault management in aerospace domains; (2) recommendations and examples for improving intelligent systems design and user interface design; (3) identification of issues requiring further research; and (4) recommendations for a development methodology integrating HCI design into intelligent system design.

Web-Based Learning Information System for Web 3.0

NASA Astrophysics Data System (ADS)

Rego, Hugo; Moreira, Tiago; García-Peñalvo, Francisco Jose

With the emergence of Web/eLearning 3.0 we have been developing/adjusting AHKME in order to face this great challenge. One of our goals is to allow the instructional designer and teacher to access standardized resources and evaluate the possibility of integration and reuse in eLearning systems, not only content but also the learning strategy. We have also integrated some collaborative tools for the adaptation of resources, as well as the collection of feedback from users to provide feedback to the system. We also provide tools for the instructional designer to create/customize specifications/ontologies to give structure and meaning to resources, manual and automatic search with recommendation of resources and instructional design based on the context, as well as recommendation of adaptations in learning resources. We also consider the concept of mobility and mobile technology applied to eLearning, allowing access by teachers and students to learning resources, regardless of time and space.

VisIRR: A Visual Analytics System for Information Retrieval and Recommendation for Large-Scale Document Data

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

Choo, Jaegul; Kim, Hannah; Clarkson, Edward

In this paper, we present an interactive visual information retrieval and recommendation system, called VisIRR, for large-scale document discovery. VisIRR effectively combines the paradigms of (1) a passive pull through query processes for retrieval and (2) an active push that recommends items of potential interest to users based on their preferences. Equipped with an efficient dynamic query interface against a large-scale corpus, VisIRR organizes the retrieved documents into high-level topics and visualizes them in a 2D space, representing the relationships among the topics along with their keyword summary. In addition, based on interactive personalized preference feedback with regard to documents,more » VisIRR provides document recommendations from the entire corpus, which are beyond the retrieved sets. Such recommended documents are visualized in the same space as the retrieved documents, so that users can seamlessly analyze both existing and newly recommended ones. This article presents novel computational methods, which make these integrated representations and fast interactions possible for a large-scale document corpus. We illustrate how the system works by providing detailed usage scenarios. Finally, we present preliminary user study results for evaluating the effectiveness of the system.« less

VisIRR: A Visual Analytics System for Information Retrieval and Recommendation for Large-Scale Document Data

DOE PAGES

Choo, Jaegul; Kim, Hannah; Clarkson, Edward; ...

2018-01-31

In this paper, we present an interactive visual information retrieval and recommendation system, called VisIRR, for large-scale document discovery. VisIRR effectively combines the paradigms of (1) a passive pull through query processes for retrieval and (2) an active push that recommends items of potential interest to users based on their preferences. Equipped with an efficient dynamic query interface against a large-scale corpus, VisIRR organizes the retrieved documents into high-level topics and visualizes them in a 2D space, representing the relationships among the topics along with their keyword summary. In addition, based on interactive personalized preference feedback with regard to documents,more » VisIRR provides document recommendations from the entire corpus, which are beyond the retrieved sets. Such recommended documents are visualized in the same space as the retrieved documents, so that users can seamlessly analyze both existing and newly recommended ones. This article presents novel computational methods, which make these integrated representations and fast interactions possible for a large-scale document corpus. We illustrate how the system works by providing detailed usage scenarios. Finally, we present preliminary user study results for evaluating the effectiveness of the system.« less

The opportunities for and challenges of common integrated electronics

NASA Astrophysics Data System (ADS)

Nelson, J. R.; Retterer, Bernard L.; Cloud, Harley A.

1994-02-01

This document summarizes a portion of IDA's work concerning common integrated electronics and the potential cost savings of using common electronic hardware and software. It addresses trends in avionics costs and recent experiences in applying common electronic standards to weapon programs as a way to reduce costs. The following essential elements of a program to acquire common integrated electronics are explored: (1) integrated system architecture; (2) advanced technology programs; (3) open system standards; (4) standard common modules; and (5) associated management and policies. The principal recommendation is that OSD support and coordinate such a-program by taking a strong leadership role and setting standards policy.

Development of the engineering design integration (EDIN) system: A computer aided design development

NASA Technical Reports Server (NTRS)

Glatt, C. R.; Hirsch, G. N.

1977-01-01

The EDIN (Engineering Design Integration) System which provides a collection of hardware and software, enabling the engineer to perform man-in-the-loop interactive evaluation of aerospace vehicle concepts, was considered. Study efforts were concentrated in the following areas: (1) integration of hardware with the Univac Exec 8 System; (2) development of interactive software for the EDIN System; (3) upgrading of the EDIN technology module library to an interactive status; (4) verification of the soundness of the developing EDIN System; (5) support of NASA in design analysis studies using the EDIN System; (6) provide training and documentation in the use of the EDIN System; and (7) provide an implementation plan for the next phase of development and recommendations for meeting long range objectives.

Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer

PubMed Central

Balneaves, Lynda G.; Carlson, Linda E.; Cohen, Misha; Deng, Gary; Hershman, Dawn; Mumber, Matthew; Perlmutter, Jane; Seely, Dugald; Sen, Ananda; Zick, Suzanna M.; Tripathy, Debu

2014-01-01

Background The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies. Methods Following the Institute of Medicine’s guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system. Results The search (January 1, 1990–December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (n = 32) had weaker evidence of benefit (Grade C). Some interventions (n = 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (n = 138) did not have sufficient evidence to form specific recommendations (Grade I). Conclusions Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes. PMID:25749602

The application of integrated knowledge-based systems for the Biomedical Risk Assessment Intelligent Network (BRAIN)

NASA Technical Reports Server (NTRS)

Loftin, Karin C.; Ly, Bebe; Webster, Laurie; Verlander, James; Taylor, Gerald R.; Riley, Gary; Culbert, Chris

1992-01-01

One of NASA's goals for long duration space flight is to maintain acceptable levels of crew health, safety, and performance. One way of meeting this goal is through BRAIN, an integrated network of both human and computer elements. BRAIN will function as an advisor to mission managers by assessing the risk of inflight biomedical problems and recommending appropriate countermeasures. Described here is a joint effort among various NASA elements to develop BRAIN and the Infectious Disease Risk Assessment (IDRA) prototype. The implementation of this effort addresses the technological aspects of knowledge acquisition, integration of IDRA components, the use of expert systems to automate the biomedical prediction process, development of a user friendly interface, and integration of IDRA and ExerCISys systems. Because C language, CLIPS and the X-Window System are portable and easily integrated, they were chosen ss the tools for the initial IDRA prototype.

Integrating qualitative research methods into care improvement efforts within a learning health system: addressing antibiotic overuse.

PubMed

Munoz-Plaza, Corrine E; Parry, Carla; Hahn, Erin E; Tang, Tania; Nguyen, Huong Q; Gould, Michael K; Kanter, Michael H; Sharp, Adam L

2016-08-15

Despite reports advocating for integration of research into healthcare delivery, scant literature exists describing how this can be accomplished. Examples highlighting application of qualitative research methods embedded into a healthcare system are particularly needed. This article describes the process and value of embedding qualitative research as the second phase of an explanatory, sequential, mixed methods study to improve antibiotic stewardship for acute sinusitis. Purposive sampling of providers for in-depth interviews improved understanding of unwarranted antibiotic prescribing and elicited stakeholder recommendations for improvement. Qualitative data collection, transcription and constant comparative analyses occurred iteratively. Emerging themes and sub-themes identified primary drivers of unwarranted antibiotic prescribing patterns and recommendations for improving practice. These findings informed the design of a health system intervention to improve antibiotic stewardship for acute sinusitis. Core components of the intervention are also described. Qualitative research can be effectively applied in learning healthcare systems to elucidate quantitative results and inform improvement efforts.

Analysis and Preliminary Design of an Advanced Technology Transport Flight Control System

NASA Technical Reports Server (NTRS)

Frazzini, R.; Vaughn, D.

1975-01-01

The analysis and preliminary design of an advanced technology transport aircraft flight control system using avionics and flight control concepts appropriate to the 1980-1985 time period are discussed. Specifically, the techniques and requirements of the flight control system were established, a number of candidate configurations were defined, and an evaluation of these configurations was performed to establish a recommended approach. Candidate configurations based on redundant integration of various sensor types, computational methods, servo actuator arrangements and data-transfer techniques were defined to the functional module and piece-part level. Life-cycle costs, for the flight control configurations, as determined in an operational environment model for 200 aircraft over a 15-year service life, were the basis of the optimum configuration selection tradeoff. The recommended system concept is a quad digital computer configuration utilizing a small microprocessor for input/output control, a hexad skewed set of conventional sensors for body rate and body acceleration, and triple integrated actuators.

A Network and Visual Quality Aware N-Screen Content Recommender System Using Joint Matrix Factorization

PubMed Central

Ullah, Farman; Sarwar, Ghulam; Lee, Sungchang

2014-01-01

We propose a network and visual quality aware N-Screen content recommender system. N-Screen provides more ways than ever before to access multimedia content through multiple devices and heterogeneous access networks. The heterogeneity of devices and access networks present new questions of QoS (quality of service) in the realm of user experience with content. We propose, a recommender system that ensures a better visual quality on user's N-screen devices and the efficient utilization of available access network bandwidth with user preferences. The proposed system estimates the available bandwidth and visual quality on users N-Screen devices and integrates it with users preferences and contents genre information to personalize his N-Screen content. The objective is to recommend content that the user's N-Screen device and access network are capable of displaying and streaming with the user preferences that have not been supported in existing systems. Furthermore, we suggest a joint matrix factorization approach to jointly factorize the users rating matrix with the users N-Screen device similarity and program genres similarity. Finally, the experimental results show that we also enhance the prediction and recommendation accuracy, sparsity, and cold start issues. PMID:24982999

Applying Web Usage Mining for Personalizing Hyperlinks in Web-Based Adaptive Educational Systems

ERIC Educational Resources Information Center

Romero, Cristobal; Ventura, Sebastian; Zafra, Amelia; de Bra, Paul

2009-01-01

Nowadays, the application of Web mining techniques in e-learning and Web-based adaptive educational systems is increasing exponentially. In this paper, we propose an advanced architecture for a personalization system to facilitate Web mining. A specific Web mining tool is developed and a recommender engine is integrated into the AHA! system in…

Mobile Clinical Decision Support System for Acid-base Balance Diagnosis and Treatment Recommendation.

PubMed

Mandzuka, Mensur; Begic, Edin; Boskovic, Dusanka; Begic, Zijo; Masic, Izet

2017-06-01

This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment. The application is a tool in the hands of the user, which provides assistance during acid-base disorders treatment. The application will assist the physician in clinical practice and is focused on the treatment in intensive care.

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project. ACT/Control/Guidance System study. Volume 2: Appendices

NASA Technical Reports Server (NTRS)

1982-01-01

The integrated application of active controls (IAAC) technology to an advanced subsonic transport is reported. Supplementary technical data on the following topics are included: (1) 1990's avionics technology assessment; (2) function criticality assessment; (3) flight deck system for total control and functional features list; (4) criticality and reliability assessment of units; (5) crew procedural function task analysis; and (6) recommendations for simulation mechanization.

Making Technology Ready: Integrated Systems Health Management

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Oliver, Patrick J.

2007-01-01

This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

PubMed

Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

2010-09-01

Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the Division of Cancer Prevention and Control (DCPC). Its project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resource s and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedicate funding and human resources for technical assistance, (4) provide opportunities for capacity-building across programs and jurisdictions, (5) consider ways to more directly link program reporting with technical assistance. This project provided a unique opportunity for CDC and USAPI stakeholders to share diverse perspectives on challenges to public health programs in the USAPI. Despite diverse experiences, the final set of recommendations reflected a high level of concordance between USAPI and CDC stakeholders on ways to improve coordination and integration of CDC processes and activities in the three core areas. Recommendations have informed some actions already initiated by the DCPC, including the dedication of funds for leadership institutes aimed at enhancing USAPI capacity for sustainable, integrated regional and jurisdictional cancer control infrastructure. Such efforts are an important beginning, but more remains to be done. Indicated is the need for continuous dialogue and collaboration. While this project focused on the USAPI, our results may be relevant to those interested in inter-organizational collaborations, medically underserved areas, public health services programs, and community-based participatory approaches.

The Global Positioning System and Its Integration into College Geography Curricula.

ERIC Educational Resources Information Center

Wikle, Thomas A.; Lambert, Dean P.

1996-01-01

Introduces global positioning system (GPS) technology to nonspecialist geographers and recommends a framework for implementing GPS instructional modules in college geography courses. GPS was developed as a worldwide satellite-based system by the U.S. Department of Defense to simplify and improve military and civilian navigation and positioning.…

Cohesive ARMD Full UAS Integration Strategy

NASA Technical Reports Server (NTRS)

Hackenberg, Davis

2017-01-01

Introduction / Background; Current Landscape and Future Vision; UAS (Unmanned Aircraft System) Demand and Key Challenges; UAS Airspace Access Pillars and Enablers; Overarching UAS Community Strategy; Long Term Vision Considerations; Recommendations and Next Steps.

Integrated information management and hospital libraries.

PubMed Central

Buchanan, H S; Fazzone, N

1985-01-01

It is demonstrated that hospitals are information-dependent and that there is need for integration of information generated and gathered through their subsystems. This paper discusses recommendations of the Matheson Report for an integrated information management system which would link these subsystems. The library's statement of mission, means for self-assessment, and analysis of information needs and uses are explored. Future directions with examples of new roles for the library are outlined. PMID:3978295

Towards accessible integrated palliative care: Perspectives of leaders from seven European countries on facilitators, barriers and recommendations for improvement.

PubMed

den Herder-van der Eerden, Marlieke; Ewert, Benjamin; Hodiamont, Farina; Hesse, Michaela; Hasselaar, Jeroen; Radbruch, Lukas

2017-01-01

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice. A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis. IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems. Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

Electronic Systems for Spacecraft Vehicles: Required EDA Tools

NASA Technical Reports Server (NTRS)

Bachnak, Rafic

1999-01-01

The continuous increase in complexity of electronic systems is making the design and manufacturing of such systems more challenging than ever before. As a result, designers are finding it impossible to design efficient systems without the use of sophisticated Electronic Design Automation (EDA) tools. These tools offer integrated simulation of the electrical, mechanical, and manufacturing functions and lead to a correct by design methodology. This report identifies the EDA tools that would be needed to design, analyze, simulate, and evaluate electronic systems for spacecraft vehicles. In addition, the report presents recommendations to enhance the current JSC electronic design capabilities. This includes cost information and a discussion as to the impact, both positive and negative, of implementing the recommendations.

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project. ACT/Control/Guidance System study, volume 1

NASA Technical Reports Server (NTRS)

1982-01-01

The active control technology (ACT) control/guidance system task of the integrated application of active controls (IAAC) technology project within the NASA energy efficient transport program was documented. The air traffic environment of navigation and air traffic control systems and procedures were extrapolated. An approach to listing flight functions which will be performed by systems and crew of an ACT configured airplane of the 1990s, and a determination of function criticalities to safety of flight, are the basis of candidate integrated ACT/Control/Guidance System architecture. The system mechanizes five active control functions: pitch augmented stability, angle of attack limiting, lateral/directional augmented stability, gust load alleviation, and maneuver load control. The scope and requirements of a program for simulating the integrated ACT avionics and flight deck system, with pilot in the loop, are defined, system and crew interface elements are simulated, and mechanization is recommended. Relationships between system design and crew roles and procedures are evaluated.

Vocational Education in Algeria, Egypt, and Morocco: The Crisis and its Lessons.

ERIC Educational Resources Information Center

Salmi, Jamil

1990-01-01

Examines developments in vocational and technical education systems in Algeria, Egypt, and Morocco. Argues each system faces critical problems resulting from demographic pressures, educational demand, lack of funding, and job placement difficulties. Recommends programs should reflect industry's needs, urging integration between general and…

Integrated energy system for a high performance building

NASA Astrophysics Data System (ADS)

Jaczko, Kristen

Integrated energy systems have the potential to reduce of the energy consumption of residential buildings in Canada. These systems incorporate components to meet the building heating, cooling and domestic hot water load into a single system in order to reduce energy losses. An integrated energy system, consisting of a variable speed heat pump, cold and hot thermal storage tanks, a photovoltaic/thermal (PV/T) collector array and a battery bank, was designed for the Queen's Solar Design Team's (QSDT) test house. The system uses a radiant floor to provide space- heating and sensible cooling and a dedicated outdoor air system provides ventilation and dehumidifies the incoming fresh air. The test house, the Queen's Solar Education Centre (QSEC), and the integrated energy system were both modelled in TRNSYS. Additionally, a new TRNSYS Type was developed to model the PV/T collectors, enabling the modeling of the collection of energy from the ambient air. A parametric study was carried out in TRNSYS to investigate the effect of various parameters on the overall energy performance of the system. These parameters included the PV/T array size and the slope of the collectors, the heat pump source and load-side inlet temperature setpoints, the compressor speed control and the size of the thermal storage tanks and the battery bank. The controls of the heat pump were found to have a large impact on the performance of the integrated energy system. For example, a low evaporator setpoint improved the overall free energy ratio (FER) of the system but the heat pump performance was lowered. Reducing the heat loss of the PV/T panels was not found to have a large effect on the system performance however, as the heat pump is able to lower the inlet collector fluid temperature, thus reducing thermal losses. From the results of the sensitivity study, a recommended system model was created and this system had a predicted FER of 77.9% in Kingston, Ontario, neglecting the energy consumption of circulation pumps and fans. Simulations of the recommended integrated energy system were also performed in several other Canadian cities and the predicted FER was above 60% in all except for the most northern city investigated, Yellowknife. Thus, the integrated energy system has the potential of reducing the energy consumption of residential buildings in Canada.

Integrator Windup Protection-Techniques and a STOVL Aircraft Engine Controller Application

NASA Technical Reports Server (NTRS)

KrishnaKumar, K.; Narayanaswamy, S.

1997-01-01

Integrators are included in the feedback loop of a control system to eliminate the steady state errors in the commanded variables. The integrator windup problem arises if the control actuators encounter operational limits before the steady state errors are driven to zero by the integrator. The typical effects of windup are large system oscillations, high steady state error, and a delayed system response following the windup. In this study, methods to prevent the integrator windup are examined to provide Integrator Windup Protection (IW) for an engine controller of a Short Take-Off and Vertical Landing (STOVL) aircraft. An unified performance index is defined to optimize the performance of the Conventional Anti-Windup (CAW) and the Modified Anti-Windup (MAW) methods. A modified Genetic Algorithm search procedure with stochastic parameter encoding is implemented to obtain the optimal parameters of the CAW scheme. The advantages and drawbacks of the CAW and MAW techniques are discussed and recommendations are made for the choice of the IWP scheme, given some characteristics of the system.

Fourth Integrated Communications, Navigation, and Surveillance (ICNS) Conference and Workshop 2004: Conclusions and Recommendations

NASA Technical Reports Server (NTRS)

Phillips, Brent; Swanda, Ronald L.; Lewis, Michael S.; Kenagy, Randy; Donahue, George; Homans, Al; Kerczewski, Robert; Pozesky, Marty

2004-01-01

The NASA Glenn Research Center organized and hosted the Fourth Integrated Communications, Navigation, and Surveillance (ICNS) Technologies Conference and Workshop, which took place April 26-30, 2004 at the Hyatt Fair Lakes Hotel in Fairfax, Virginia. This fourth conference of the annual series followed the very successful first ICNS Conference (May 1-3, 2001 in Cleveland, Ohio), second ICNS conference (April 29-May 2, 2002 in Vienna, Virginia), and third ICNS conference (May 19-22, 2003 in Annapolis, Maryland). The purpose of the Fourth ICNS Conference was to assemble government, industry and academic communities performing research and development for advanced digital communications, surveillance and navigation systems and associated applications supporting the national and global air transportation systems to: 1) Understand current efforts and recent results in near- and far-term R&D and technology demonstration; 2) Identify integrated digital communications, navigation and surveillance R&D requirements necessary for a safe, secure and reliable, high-capacity, advanced air transportation system; 3) Provide a forum for fostering collaboration and coordination; and 4) Discuss critical issues and develop recommendations to achieve the future integrated CNS vision for national and global air transportation. The workshop attracted 316 attendees from government, industry and academia to address these purposes through technical presentations, breakout sessions, and individual and group discussions during the workshop and after-hours events, and included 16 international attendees. An Executive Committee consisting of representatives of several key segments of the aviation community concerned with CNS issues met on the day following the workshop to consider the primary outcomes and recommendations of the workshop. This report presents an overview of the conference, workshop breakout session results, and the findings of the Executive Committee.

An integrative approach to space-flight physiology using systems analysis and mathematical simulation

NASA Technical Reports Server (NTRS)

Leonard, J. I.; White, R. J.; Rummel, J. A.

1980-01-01

An approach was developed to aid in the integration of many of the biomedical findings of space flight, using systems analysis. The mathematical tools used in accomplishing this task include an automated data base, a biostatistical and data analysis system, and a wide variety of mathematical simulation models of physiological systems. A keystone of this effort was the evaluation of physiological hypotheses using the simulation models and the prediction of the consequences of these hypotheses on many physiological quantities, some of which were not amenable to direct measurement. This approach led to improvements in the model, refinements of the hypotheses, a tentative integrated hypothesis for adaptation to weightlessness, and specific recommendations for new flight experiments.

NCCN Guidelines® Insights Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines

PubMed Central

Clark, Peter E.; Spiess, Philippe E.; Agarwal, Neeraj; Bangs, Rick; Boorjian, Stephen A.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Flaig, Thomas W.; Friedlander, Terence; Greenberg, Richard E.; Guru, Khurshid A.; Hahn, Noah; Herr, Harry W.; Hoimes, Christopher; Inman, Brant A.; Kader, A. Karim; Kibel, Adam S.; Kuzel, Timothy M.; Lele, Subodh M.; Meeks, Joshua J.; Michalski, Jeff; Montgomery, Jeffrey S.; Pagliaro, Lance C.; Pal, Sumanta K.; Patterson, Anthony; Petrylak, Daniel; Plimack, Elizabeth R.; Pohar, Kamal S.; Porter, Michael P.; Sexton, Wade J.; Siefker-Radtke, Arlene O.; Sonpavde, Guru; Tward, Jonathan; Wile, Geoffrey; Dwyer, Mary A.; Smith, Courtney

2017-01-01

These NCCN Guidelines Insights discuss the major recent updates to the NCCN Guidelines for Bladder Cancer based on the review of the evidence in conjunction with the expert opinion of the panel. Recent updates include (1) refining the recommendation of intravesical bacillus Calmette-Guérin, (2) strengthening the recommendations for perioperative systemic chemotherapy, and (3) incorporating immunotherapy into second-line therapy for locally advanced or metastatic disease. These NCCN Guidelines Insights further discuss factors that affect integration of these recommendations into clinical practice. PMID:27697976

NCCN Guidelines Insights: Bladder Cancer, Version 2.2016.

PubMed

Clark, Peter E; Spiess, Philippe E; Agarwal, Neeraj; Bangs, Rick; Boorjian, Stephen A; Buyyounouski, Mark K; Efstathiou, Jason A; Flaig, Thomas W; Friedlander, Terence; Greenberg, Richard E; Guru, Khurshid A; Hahn, Noah; Herr, Harry W; Hoimes, Christopher; Inman, Brant A; Kader, A Karim; Kibel, Adam S; Kuzel, Timothy M; Lele, Subodh M; Meeks, Joshua J; Michalski, Jeff; Montgomery, Jeffrey S; Pagliaro, Lance C; Pal, Sumanta K; Patterson, Anthony; Petrylak, Daniel; Plimack, Elizabeth R; Pohar, Kamal S; Porter, Michael P; Sexton, Wade J; Siefker-Radtke, Arlene O; Sonpavde, Guru; Tward, Jonathan; Wile, Geoffrey; Dwyer, Mary A; Smith, Courtney

2016-10-01

These NCCN Guidelines Insights discuss the major recent updates to the NCCN Guidelines for Bladder Cancer based on the review of the evidence in conjunction with the expert opinion of the panel. Recent updates include (1) refining the recommendation of intravesical bacillus Calmette-Guérin, (2) strengthening the recommendations for perioperative systemic chemotherapy, and (3) incorporating immunotherapy into second-line therapy for locally advanced or metastatic disease. These NCCN Guidelines Insights further discuss factors that affect integration of these recommendations into clinical practice. Copyright © 2016 by the National Comprehensive Cancer Network.

Valuing the scholarship of integration and the scholarship of application in the academy for health sciences scholars: recommended methods

PubMed Central

Hofmeyer, Anne; Newton, Mandi; Scott, Cathie

2007-01-01

In the landmark 1990 publication Scholarship Reconsidered, Boyer challenged the 'teaching verses research debates' by advocating for the scholarship of discovery, teaching, integration, and application. The scholarship of discovery considers publications and research as the yardstick in the merit, promotion and tenure system the world over. But this narrow view of scholarship does not fully support the obligations of universities to serve global societies and to improve health and health equity. Mechanisms to report the scholarship of teaching have been developed and adopted by some universities. In this article, we contribute to the less developed areas of scholarship, i.e. integration and application. We firstly situate the scholarship of discovery, teaching, integration and application within the interprofessional and knowledge exchange debates. Second, we propose a means for health science scholars to report the process and outcomes of the scholarship of integration and application with other disciplines, decision-makers and communities. We conclude with recommendations for structural and process change in faculty merit, tenure, and promotion systems so that health science scholars with varied academic portfolios are valued and many forms of academic scholarship are sustained. It is vital academic institutions remain relevant in an era when the production of knowledge is increasingly recognized as a social collaborative activity. PMID:17535436

Child maltreatment: the collaboration of child welfare, mental health, and judicial system.

PubMed

Butler, S; Atkinson, L; Magnatta, M; Hood, E

1995-03-01

The alliance of child welfare, mental health, and legal systems has received little empirical attention, despite the magnitude of its impact on children and families. We examined the congruence of child protection agencies legal positions, court clinic recommendations, and judicial dispositions in a sample of 59 contested child maltreatment cases. Placement recommendations/decisions among all three systems were highly correlated, although the relationship was not so strong as to undermine the independence of any one system. Where there was disagreement between successive evaluations, it was in the direction of enhancing family integrity and parental access rights. We advanced three hypotheses to account for our findings: (a) changes in successive recommendations reflect the increasing sophistication of the assessment process; (b) changes reflect increasing distance from the family's ecology and are therefore increasingly ill informed; and (c) the changes are purely probabilistic, reflecting a drift toward the societal status quo.

Results of Absolute Cavity Pyrgeometer (ACP), InfraRed Integrating Sphere (IRIS), and Atmospheric Emitted Radiance Interferometer (AERI) Comparisons and CIMO Recommendations

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

Reda, Ibrahim M; Dooraghi, Michael R; Sengupta, Manajit

Presenting results of five comparisons between ACPs and IRISs and the difference between the longwave irradiance measured by the ACPs and IRISs versus the average irradiance measured by the WISG. The process of CIMO recommendation to establish the world reference for measuring the atmospheric longwave irradiance with traceability to the International System of Units (SI) is also presented.

OSTA data systems planning workshop recommendations

NASA Technical Reports Server (NTRS)

Desjardins, R.

1981-01-01

The Integrated Discipline Requirements are presented, including the following needs: (1) quality data sets, (2) a systematic treatment of problems with present data, (3) a single integrated catalog or master directory, (4) continuity of data formats, (5) a standard geographic and time basis, (6) data delivery in terms of easy rather than immediate accessibility, (7) data archives, and (8) cooperation with user agencies.

Does Artificial Tutoring Foster Inquiry Based Learning?

ERIC Educational Resources Information Center

Schmoelz, Alexander; Swertz, Christian; Forstner, Alexandra; Barberi, Alessandro

2014-01-01

This contribution looks at the Intelligent Tutoring Interface for Technology Enhanced Learning, which integrates multistage-learning and inquiry-based learning in an adaptive e-learning system. Based on a common pedagogical ontology, adaptive e-learning systems can be enabled to recommend learning objects and activities, which follow inquiry-based…

Apollo experience report: Lunar module instrumentation subsystem

NASA Technical Reports Server (NTRS)

Obrien, D. E., III; Woodfill, J. R., IV

1972-01-01

The design concepts and philosophies of the lunar module instrumentation subsystem are discussed along with manufacturing and systems integration. The experience gained from the program is discussed, and recommendations are made for making the subsystem more compatible and flexible in system usage. Characteristics of lunar module caution and warning circuits are presented.

Silvicultural options for neotropical migratory birds

Treesearch

Frank R. Thompson; John R. Probst; Martin G. Raphael

1993-01-01

We review: factors that affect forest bird populations; basic concepts of silvicultural systems; potential impacts of these systems on neotropical migratory birds (NTMBs); and conclude with management recommendations for integrating NTMB conservation with forest management. We approach this topic from a regional-landscape scale to a forest stand-habitat scale, rather...

Lack of integration governance in ERP development: a case study on causes and effects

NASA Astrophysics Data System (ADS)

Kähkönen, Tommi; Smolander, Kari; Maglyas, Andrey

2017-09-01

The development of an enterprise resource planning (ERP) system starts actually after it has been implemented and taken into use. It is necessary to integrate ERP with other business information systems inside and outside the company. With the grounded theory, we aim to understand how integration challenges emerged in a large manufacturing enterprise when the long-term ERP system reached the beginning of its retirement. Structural changes, an information technology governance model, lack of organisational vision, having no architectural descriptions, lack of collaboration, cost cutting, and organisational culture made integration governance troublesome. As a consequence, the enterprise suffered from several undesired effects, such as complex integration scenarios between internal systems, and failing to provide its customers the needed information. The reduction of costs strengthened the organisational silos further and led to unrealised business process improvements. We provide practitioners with four recommendations. First, the organisational goals for integration should be exposed. Second, when evaluating the needs and impacts of integration, a documented architectural description about the system landscape needs to be utilised. Third, the role of IT should be emphasised in development decision-making, and fourth, collaboration is the core ingredient for successful integration governance.

Improving the Care of Individuals with Schizophrenia and Substance Use Disorders: Consensus Recommendations

PubMed Central

ZIEDONIS, DOUGLAS M.; SMELSON, DAVID; ROSENTHAL, RICHARD N.; BATKI, STEVEN L.; GREEN, ALAN I.; HENRY, RENATA J.; MONTOYA, IVAN; PARKS, JOE; D. WEISS, ROGER

2008-01-01

National attention continues to focus on the need to improve care for individuals with co-occurring mental illnesses and substance use disorders, as emphasized in the 2003 President's New Freedom Commission Report on Mental Health and recent publications from the Substance Abuse and Mental Health Services Administration (SAMHSA). These reports document the need for best practice recommendations that can be translated into routine clinical care. Although efforts are underway to synthesize literature in this area, few focused recommendations are available that include expert opinion and evidence-based findings on the management of specific co-occurring disorders, such as schizophrenia and addiction. In response to the need for user-friendly recommendations on the treatment of schizophrenia and addiction, a consensus conference of experts from academic institutions and state mental health systems was organized to 1) frame the problem from clinical and systems-level perspectives; 2) identify effective and problematic psychosocial, pharmacological, and systems practices; and 3) develop a summary publication with recommendations for improving current practice. The results of the consensus meeting served as the foundation for this publication, which presents a broad set of recommendations for clinicians who treat individuals with schizophrenia. “Integrated treatment” is the new standard for evidence-based treatment for this population and recommendations are given to help clinicians implement such integrated treatment. Specific recommendations are provided concerning screening for substance use disorders in patients with schizophrenia, assessing motivation for change, managing medical conditions that commonly occur in patients with dual diagnoses (e.g., cardiovascular disease, liver complications, lung cancer, HIV, and hepatitis B or C infections) and selecting the most appropriate medications for such patients to maximize safety and minimize drug interactions, use of evidence-based psychosocial interventions for patients with dual diagnoses (e.g., Dual Recovery Therapy, modified cognitive-behavioral therapy, modified motivational enhancement therapy, and the Substance Abuse Management Module), and key pharmacotherapy principles for treating schizophrenia, substance use disorders, and comorbid anxiety, depression, and sleep problems in this population. Finally the article reviews programmatic and systemic changes needed to overcome treatment barriers and promote the best outcomes for this patient population. An algorithm summarizing the consensus recommendations is provided in an appendix to the article. PMID:16184072

Air cargo: An Integrated Systems View. 1978 Summer Faculty Fellowship Program in Engineering Systems Design

NASA Technical Reports Server (NTRS)

Keaton, A. (Editor); Eastman, R. (Editor); Hargrove, A. (Editor); Rabiega, W. (Editor); Olsen, R. (Editor); Soberick, M. (Editor)

1978-01-01

The national air cargo system is analyzed and how it should be in 1990 is prescribed in order to operate successfully through 2015; that is through one equipment cycle. Elements of the system which are largely under control of the airlines and the aircraft manufacturers are discussed. The discussion deals with aircraft, networks, facilities, and procedures. The regulations which govern the movement of air freight are considered. The larger public policy interests which must be served by the kind of system proposed, the air cargo integrated system (ACIS), are addressed. The possible social, economical, political, and environment impacts of the system are considered. Recommendations are also given.

Mobile Clinical Decision Support System for Acid-base Balance Diagnosis and Treatment Recommendation

PubMed Central

Mandzuka, Mensur; Begic, Edin; Boskovic, Dusanka; Begic, Zijo; Masic, Izet

2017-01-01

Introduction: This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. Material and methods: The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. Results: The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment. Conclusion: The application is a tool in the hands of the user, which provides assistance during acid-base disorders treatment. The application will assist the physician in clinical practice and is focused on the treatment in intensive care. PMID:28883678

Social Integration and Domestic Violence Support in an Indigenous Community: Women's Recommendations of Formal Versus Informal Sources of Support.

PubMed

Gauthier, G Robin; Francisco, Sara C; Khan, Bilal; Dombrowski, Kirk

2018-05-01

Throughout North America, indigenous women experience higher rates of intimate partner violence and sexual violence than any other ethnic group, and so it is of particular importance to understand sources of support for Native American women. In this article, we use social network analysis to study the relationship between social integration and women's access to domestic violence support by examining the recommendations they would give to another woman in need. We ask two main questions: First, are less integrated women more likely to make no recommendation at all when compared with more socially integrated women? Second, are less integrated women more likely than more integrated women to nominate a formal source of support rather than an informal one? We use network data collected from interviews with 158 Canadian women residing in an indigenous community to measure their access to support. We find that, in general, less integrated women are less likely to make a recommendation than more integrated women. However, when they do make a recommendation, less integrated women are more likely to recommend a formal source of support than women who are more integrated. These results add to our understanding of how access to two types of domestic violence support is embedded in the larger set of social relations of an indigenous community.

Enacting the Carnegie Foundation call for reform of medical school and residency.

PubMed

O'Brien, Bridget C; Irby, David M

2013-01-01

On the 100th anniversary of the Flexner Report, the Carnegie Foundation for the Advancement of Teaching published a new study of medical education. This study, titled Educating Physicians: A Call for Reform of Medical Schools and Residency Programs, contained four primary recommendations intended to stimulate innovation and improvement in medical education. In this article, the authors examined the ways others have applied the four recommendations from Educating Physicians within and beyond medical education. In their review of 246 publications citing the Carnegie work, they found that the recommendation for integration was addressed most frequently, often through descriptions of integration of curricular content in undergraduate medical education. The recommendation to focus on professional identity formation was the second most frequently addressed, followed by standardization and individualization, then inquiry, innovation, and improvement. The publications related to these latter three recommendations tended to be conceptual rather than descriptive or empirical. Publications spanned the continuum of medical education (from medical school to residency to physicians in practice) and even into other fields, but undergraduate medical education received the most attention. The authors discuss common themes among the citing publications and highlight opportunities for further discussion and innovation. Many exciting developments have occurred in medical education and beyond since the publication of Educating Physicians in 2010. Thus far, most of the publications citing the Carnegie recommendations describe incremental changes in medical education, particularly in the area of integration. Some of the conceptual work around these recommendations, coupled with a variety of external factors such as changes in health care and accreditation systems, suggests the potential for changes that are more transformative in nature.

Systems and methods for knowledge discovery in spatial data

DOEpatents

Obradovic, Zoran; Fiez, Timothy E.; Vucetic, Slobodan; Lazarevic, Aleksandar; Pokrajac, Dragoljub; Hoskinson, Reed L.

2005-03-08

Systems and methods are provided for knowledge discovery in spatial data as well as to systems and methods for optimizing recipes used in spatial environments such as may be found in precision agriculture. A spatial data analysis and modeling module is provided which allows users to interactively and flexibly analyze and mine spatial data. The spatial data analysis and modeling module applies spatial data mining algorithms through a number of steps. The data loading and generation module obtains or generates spatial data and allows for basic partitioning. The inspection module provides basic statistical analysis. The preprocessing module smoothes and cleans the data and allows for basic manipulation of the data. The partitioning module provides for more advanced data partitioning. The prediction module applies regression and classification algorithms on the spatial data. The integration module enhances prediction methods by combining and integrating models. The recommendation module provides the user with site-specific recommendations as to how to optimize a recipe for a spatial environment such as a fertilizer recipe for an agricultural field.

Integrity and security in an Ada runtime environment

NASA Technical Reports Server (NTRS)

Bown, Rodney L.

1991-01-01

A review is provided of the Formal Methods group discussions. It was stated that integrity is not a pure mathematical dual of security. The input data is part of the integrity domain. The group provided a roadmap for research. One item of the roadmap and the final position statement are closely related to the space shuttle and space station. The group's position is to use a safe subset of Ada. Examples of safe sets include the Army Secure Operating System and the Penelope Ada verification tool. It is recommended that a conservative attitude is required when writing Ada code for life and property critical systems.

Planning for New Primary Airports in the United States: A Survey of Metropolitan Planning Organizations

NASA Technical Reports Server (NTRS)

NewMyer, David A.

1999-01-01

Airport congestion at primary airports in major metropolitan areas was analyzed in a report prepared by the Transportation Research Board (TRB) in 1990. Taking the top twenty-three most congested airports from this study, a questionnaire was prepared and sent to the metropolitan planning organizations (MPOs) for twenty of the twenty-three metropolitan areas represented in the TRB study, The questionnaire focused on the role of the MPOs in planning for new primary airports in the United States, including questions about the status of the most recent MPO airport system plan, whether or not the latest plan recommends a new primary airport, and whether or not any other entities in the MPO areas are recommending new primary airports. The results indicated that 44.4 percent of the eighteen respondent MPOs have airport system plans that are five years old or older. Also, only two of the respondent MPOs have recommended a new primary airport in their latest regional airport system plan and only one of these two is a common recommendation in the Federal Aviation Administration's National Plan of Integrated Airport System.

Planning for New Primary Airports in the United States: A Survey of Metropolitan Planning Organizations

NASA Technical Reports Server (NTRS)

NewMeyer, David A.

1999-01-01

Airport congestion at primary airports in major metropolitan areas was analyzed in a report prepared by the Transportation Research Board (TRB) in 1990. Taking the top twenty-three most congested airports from this study, a questionnaire was prepared and sent to the metropolitan planning organizations (MPOS) for twenty of the twenty-three metropolitan areas represented in the TRB study. The questionnaire focused on the role of the MPOs in planning for new primary airports in the United States, including questions about the status of the most recent MPO airport system plan, whether or not the latest plan recommends a new primary airport, and whether or not any other entities in the MPO areas are recommending new primary airports. The results indicated that 44.4 percent of the eighteen respondent MPOs have airport system plans that are five years old or older. Also, only two of the respondent MPOs have recommended a new primary airport in their latest regional airport system plan and only one of these two is a common recommendation in the Federal Aviation Administration's National Plan of Integrated Airport System.

A Simplified Integrated Fish Culture Hydroponics System.

ERIC Educational Resources Information Center

Emberger, Gary

1991-01-01

Investigations that facilitate experimental design, the concept of replication, data analysis, and other aspects of scientific study are described. A list of materials, the recommended plants, and the directions for building the hydroponics unit are included. (KR)

Sunshine Skyway Bridge monitoring phase I : system assessment and integration recommendations.

DOT National Transportation Integrated Search

2016-10-01

The Sunshine Skyway Bridge has several different types of monitoring instruments in place maintained by Florida : Department of Transportation (FDOT) offices, divisions, and partners. The current decentralized approach to data collection : and monito...

Great Lakes O shore Wind Project: Utility and Regional Integration Study

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

Sajadi, Amirhossein; Loparo, Kenneth A.; D'Aquila, Robert

This project aims to identify transmission system upgrades needed to facilitate offshore wind projects as well as operational impacts of offshore generation on operation of the regional transmission system in the Great Lakes region. A simulation model of the US Eastern Interconnection was used as the test system as a case study for investigating the impact of the integration of a 1000MW offshore wind farm operating in Lake Erie into FirstEnergy/PJM service territory. The findings of this research provide recommendations on offshore wind integration scenarios, the locations of points of interconnection, wind profile modeling and simulation, and computational methods tomore » quantify performance, along with operating changes and equipment upgrades needed to mitigate system performance issues introduced by an offshore wind project.« less

Guidelines for testing and release procedures

NASA Technical Reports Server (NTRS)

Molari, R.; Conway, M.

1984-01-01

Guidelines and procedures are recommended for the testing and release of the types of computer software efforts commonly performed at NASA/Ames Research Center. All recommendations are based on the premise that testing and release activities must be specifically selected for the environment, size, and purpose of each individual software project. Guidelines are presented for building a Test Plan and using formal Test Plan and Test Care Inspections on it. Frequent references are made to NASA/Ames Guidelines for Software Inspections. Guidelines are presented for selecting an Overall Test Approach and for each of the four main phases of testing: (1) Unit Testing of Components, (2) Integration Testing of Components, (3) System Integration Testing, and (4) Acceptance Testing. Tools used for testing are listed, including those available from operating systems used at Ames, specialized tools which can be developed, unit test drivers, stub module generators, and the use of format test reporting schemes.

A comparison of teaching strategies for integrating information technology into clinical nursing education.

PubMed

Elfrink, V L; Davis, L S; Fitzwater, E; Castleman, J; Burley, J; Gorney-Moreno, M J; Sullivan, J; Nichols, B; Hall, D; Queen, K; Johnson, S; Martin, A

2000-01-01

As health care becomes more information-intensive and diverse, there is a need to integrate information technology (IT) into clinical education. Little is known, however, about how to design instructional strategies for integrating information technology into clinical nursing education. This article outlines the instructional strategies used by faculty in five nursing programs who taught students to use a point-of-care information technology system. The article also reports students' computer acceptance and summarizes IT clinical teaching recommendations.

The Defense Science Board Task Force on Tactical Battlefield Communications

DTIC Science & Technology

1999-12-01

impact of the system is clearly under appreciated. It could be the foundation for a common- user , QoS, Internet and could integrate legacy systems...into a common- user framework as is occurring in the private sector. Unfortunately, the networking aspects of the system are being lost; the focus...system-centric framework to a common- user , internetwork framework . Recommendation V—Information Security

Design and specification of a centralized manufacturing data management and scheduling system

NASA Technical Reports Server (NTRS)

Farrington, Phillip A.

1993-01-01

As was revealed in a previous study, the Materials and Processes Laboratory's Productivity Enhancement Complex (PEC) has a number of automated production areas/cells that are not effectively integrated, limiting the ability of users to readily share data. The recent decision to utilize the PEC for the fabrication of flight hardware has focused new attention on the problem and brought to light the need for an integrated data management and scheduling system. This report addresses this need by developing preliminary designs specifications for a centralized manufacturing data management and scheduling system for managing flight hardware fabrication in the PEC. This prototype system will be developed under the auspices of the Integrated Engineering Environment (IEE) Oversight team and the IEE Committee. At their recommendation the system specifications were based on the fabrication requirements of the AXAF-S Optical Bench.

Making the Cut in Gifted Selection: Score Combination Rules and Their Impact on Program Diversity

ERIC Educational Resources Information Center

Lakin, Joni M.

2018-01-01

The recommendation of using "multiple measures" is common in policy guidelines for gifted and talented assessment systems. However, the integration of multiple test scores in a system that uses cut-scores requires choosing between different methods of combining quantitative scores. Past research has indicated that OR combination rules…

An Instructional and Collaborative Learning System with Content Recommendation

ERIC Educational Resources Information Center

Zheng, Xiang-wei; Ma, Hong-wei; Li, Yan

2013-01-01

With the rapid development of Internet, e-learning has become a new teaching and learning mode. However, lots of e-learning systems deployed on Internet are just electronic learning materials with very limited interactivity and diagnostic capability. This paper presents an integrated e-learning environment named iCLSR. Firstly, iCLSR provides an…

Integration of an Intelligent Tutoring System in a Course of Computer Network Design

ERIC Educational Resources Information Center

Verdú, Elena; Regueras, Luisa M.; Gal, Eran; de Castro, Juan P.; Verdú, María J.; Kohen-Vacs, Dan

2017-01-01

INTUITEL is a research project aiming to offer a personalized learning environment. The INTUITEL approach includes an Intelligent Tutoring System that gives students recommendations and feedback about what the best learning path is for them according to their profile, learning progress, context and environmental influences. INTUITEL combines…

Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

PubMed

Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

2011-03-01

Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the CDC Division of Cancer Prevention and Control (DCPC). The project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resources and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedication of funding and human resources for technical assistance, (4) provision of opportunities for capacity-building across programs and jurisdictions, (5) consideration of ways to more directly link program reporting with technical assistance. This project provided a unique opportunity for CDC and USAPI stakeholders to share diverse perspectives on challenges to public health programs in the USAPI. Despite diverse experiences, the final set of recommendations reflected a high level of concordance between USAPI and CDC stakeholders. Recommendations have informed or reinforced actions initiated by the DCPC, including the dedication of funds for leadership institutes aimed at enhancing USAPI capacity for sustainable, integrated regional and jurisdictional cancer control infrastructure. Such efforts are an important beginning, but more remains to be done. Indicated is the need for continuous dialogue and collaboration. While this project focused on the USAPI, our results may be relevant to those interested in inter-organizational collaborations, medically underserved areas, public health services programs, and community-based participatory approaches.

Multimodal hybrid reasoning methodology for personalized wellbeing services.

PubMed

Ali, Rahman; Afzal, Muhammad; Hussain, Maqbool; Ali, Maqbool; Siddiqi, Muhammad Hameed; Lee, Sungyoung; Ho Kang, Byeong

2016-02-01

A wellness system provides wellbeing recommendations to support experts in promoting a healthier lifestyle and inducing individuals to adopt healthy habits. Adopting physical activity effectively promotes a healthier lifestyle. A physical activity recommendation system assists users to adopt daily routines to form a best practice of life by involving themselves in healthy physical activities. Traditional physical activity recommendation systems focus on general recommendations applicable to a community of users rather than specific individuals. These recommendations are general in nature and are fit for the community at a certain level, but they are not relevant to every individual based on specific requirements and personal interests. To cover this aspect, we propose a multimodal hybrid reasoning methodology (HRM) that generates personalized physical activity recommendations according to the user׳s specific needs and personal interests. The methodology integrates the rule-based reasoning (RBR), case-based reasoning (CBR), and preference-based reasoning (PBR) approaches in a linear combination that enables personalization of recommendations. RBR uses explicit knowledge rules from physical activity guidelines, CBR uses implicit knowledge from experts׳ past experiences, and PBR uses users׳ personal interests and preferences. To validate the methodology, a weight management scenario is considered and experimented with. The RBR part of the methodology generates goal, weight status, and plan recommendations, the CBR part suggests the top three relevant physical activities for executing the recommended plan, and the PBR part filters out irrelevant recommendations from the suggested ones using the user׳s personal preferences and interests. To evaluate the methodology, a baseline-RBR system is developed, which is improved first using ranged rules and ultimately using a hybrid-CBR. A comparison of the results of these systems shows that hybrid-CBR outperforms the modified-RBR and baseline-RBR systems. Hybrid-CBR yields a 0.94% recall, a 0.97% precision, a 0.95% f-score, and low Type I and Type II errors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Apollo experience report: Crew station integration. Volume 2: Crew station displays and controls

NASA Technical Reports Server (NTRS)

Langdoc, W. A.; Nassman, D. A.

1975-01-01

The functional requirements for the Apollo displays and controls system are presented. The configuration of the displays, controls, and panels for both the command module and the lunar module are described, and the design development and operational experience of the displays and controls system are discussed. Pertinent recommendations for future displays and controls system design efforts are made.

Scientific Integrity: The Need for Government Standards

NASA Astrophysics Data System (ADS)

McPhaden, Michael J.

2010-11-01

The U.S. government makes substantial investments in scientific research that address the nation’s need for accurate and authoritative information to guide federal policy decisions. Therefore, there is a lot at stake in having a consistent and explicit federal policy on scientific integrity to increase transparency and build trust in government science. Scientific integrity is an issue that applies not only to individual scientists working within the federal system but also to government agencies in how they use scientific information to formulate policy. The White House issued a memorandum on scientific integrity in March 2009, and it is regrettable that it has taken so much longer than the 120 days stipulated in the president's memo for the release of recommendations by the Office of Science and Technology Policy (OSTP) (see related news item in this issue). While it is also understandable given the welter of different agencies and organizations that make up the executive branch of the government, AGU urges that these recommendations be finalized and published as soon as possible.

Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer.

PubMed

Greenlee, Heather; Balneaves, Lynda G; Carlson, Linda E; Cohen, Misha; Deng, Gary; Hershman, Dawn; Mumber, Matthew; Perlmutter, Jane; Seely, Dugald; Sen, Ananda; Zick, Suzanna M; Tripathy, Debu

2014-11-01

The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies. Following the Institute of Medicine's guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system. The search (January 1, 1990-December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (n = 32) had weaker evidence of benefit (Grade C). Some interventions (n = 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (n = 138) did not have sufficient evidence to form specific recommendations (Grade I). Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The world after SA : benefits to GPS integrity.

DOT National Transportation Integrated Search

2000-03-01

The Presidential Decision Directive (PDD) on the Global Positioning System (GPS) recommends that selective availability (SA) be removed by 2006. The question remains: if SA were to be turned off, how significant are the benefits to the GPS community?...

A Geospatial Data Recommender System based on Metadata and User Behaviour

NASA Astrophysics Data System (ADS)

Li, Y.; Jiang, Y.; Yang, C. P.; Armstrong, E. M.; Huang, T.; Moroni, D. F.; Finch, C. J.; McGibbney, L. J.

2017-12-01

Earth observations are produced in a fast velocity through real time sensors, reaching tera- to peta- bytes of geospatial data daily. Discovering and accessing the right data from the massive geospatial data is like finding needle in the haystack. To help researchers find the right data for study and decision support, quite a lot of research focusing on improving search performance have been proposed including recommendation algorithm. However, few papers have discussed the way to implement a recommendation algorithm in geospatial data retrieval system. In order to address this problem, we propose a recommendation engine to improve discovering relevant geospatial data by mining and utilizing metadata and user behavior data: 1) metadata based recommendation considers the correlation of each attribute (i.e., spatiotemporal, categorical, and ordinal) to data to be found. In particular, phrase extraction method is used to improve the accuracy of the description similarity; 2) user behavior data are utilized to predict the interest of a user through collaborative filtering; 3) an integration method is designed to combine the results of the above two methods to achieve better recommendation Experiments show that in the hybrid recommendation list, the all the precisions are larger than 0.8 from position 1 to 10.

Technology advancement of an oxygen generation subsystem

NASA Technical Reports Server (NTRS)

Lee, M. K.; Burke, K. A.; Schubert, F. H.; Wynveen, R. A.

1979-01-01

An oxygen generation subsystem based on water electrolysis was developed and tested to further advance the concept and technology of the spacecraft air revitalization system. Emphasis was placed on demonstrating the subsystem integration concept and hardware maturity at a subsystem level. The integration concept of the air revitalization system was found to be feasible. Hardware and technology of the oxygen generation subsystem was demonstrated to be close to the preprototype level. Continued development of the oxygen generation technology is recommended to further reduce the total weight penalties of the oxygen generation subsystem through optimization.

Integrative dimensions of psychotherapy training.

PubMed

Greben, Daniel H

2004-04-01

This paper investigates the influence of integrative factors on psychotherapy education. The broad relevance of integrative psychotherapy to residency training and continuing mental health education is discussed. Following a review of the existing literature on the education of integrative psychotherapists, the article systematically examines the integrative and pedagogic issues to be considered in planning psychotherapy training informed by integrative principles. The integrative issues are organized into 5 categories: attitudinal set, knowledge base, clinical techniques and skills, developmental tasks and challenges, and systemic institutional factors. The educational issues can be divided into 4 categories: content, format and process, sequence, and faculty development. Brief descriptions of actual educational interventions illustrate the implementation of such ideas. Specific recommendations are made regarding the development of integrative educational initiatives and future study of unresolved questions.

Improving the Spiritual Dimension of Whole Person Care: Reaching National and International Consensus

PubMed Central

Vitillo, Robert; Hull, Sharon K.; Reller, Nancy

2014-01-01

Abstract Two conferences, Creating More Compassionate Systems of Care (November 2012) and On Improving the Spiritual Dimension of Whole Person Care: The Transformational Role of Compassion, Love and Forgiveness in Health Care (January 2013), were convened with the goals of reaching consensus on approaches to the integration of spirituality into health care structures at all levels and development of strategies to create more compassionate systems of care. The conferences built on the work of a 2009 consensus conference, Improving the Quality of Spiritual Care as a Dimension of Palliative Care. Conference organizers in 2012 and 2013 aimed to identify consensus-derived care standards and recommendations for implementing them by building and expanding on the 2009 conference model of interprofessional spiritual care and its recommendations for palliative care. The 2013 conference built on the 2012 conference to produce a set of standards and recommended strategies for integrating spiritual care across the entire health care continuum, not just palliative care. Deliberations were based on evidence that spiritual care is a fundamental component of high-quality compassionate health care and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers. PMID:24842136

Integrated orbital servicing study for low-cost payload programs. Volume 2: Technical and cost analysis

NASA Technical Reports Server (NTRS)

Cody, E. R.; Deats, C. L.; Derocher, W. L., Jr.; Kyrias, G. M.; Snodgrass, M. R.; Sosnay, R. D.; Spencer, R. A.; Wudell, A. E.

1975-01-01

Orbital maintenance concepts were examined in an effort to determine a cost effective orbital maintenance system compatible with the space transportation system. An on-orbit servicer maintenance system is recommended as the most cost effective system. A pivoting arm on-orbit servicer was selected and a preliminary design was prepared. It is indicated that orbital maintenance does not have any significant impact on the space transportation system.

Innovation in transformative nursing leadership: nursing informatics competencies and roles.

PubMed

Remus, Sally; Kennedy, Margaret Ann

2012-12-01

In a recent brief to the Canadian Nurses Association's National Expert Commission on the Health of Our Nation, the Academy of Canadian Executive Nurses (ACEN) discussed leadership needs in the Canadian healthcare system, and promoted the pivotal role of nursing executives in transforming Canada's healthcare system into an integrated patient-centric system. Included among several recommendations was the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. This paper focuses on an emerging "avant-garde executive leadership competency" recommended for today's health leaders to guide health system transformation. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive. The authors of this paper propose that distinct nursing informatics competencies are required to augment traditional executive skills to support transformational outcomes of safe, integrated, high-quality care delivery through knowledge-driven care. International trends involving nursing informatics competencies and the evolution of new corporate informatics roles, such as chief nursing informatics officers (CNIOs), are demonstrating value and advanced transformational leadership as nursing executive roles that are informed by clinical data. Copyright © 2013 Longwoods Publishing.

Analysis of Advanced Respiratory Support Onboard ISS and CCV

NASA Technical Reports Server (NTRS)

Shah, Ronak V.; Kertsman, Eric L.; Alexander, David J.; Duchesne, Ted; Law, Jennifer; Roden, Sean K.

2014-01-01

NASA is collaborating with private entities for the development of commercial space vehicles. The Space and Clinical Operations Division was tasked to review the oxygen and respiratory support system and recommend what capabilities, if any, the vehicle should have to support the return of an ill or injured crewmember. The Integrated Medical Model (IMM) was utilized as a data source for the development of these recommendations. The Integrated Medical Model (IMM) was used to simulate a six month, six crew, International Space Station (ISS) mission. Three medical system scenarios were considered based on the availability of (1) oxygen only, (2) oxygen and a ventilator, or (3) neither oxygen nor ventilator. The IMM analysis provided probability estimates of medical events that would require either oxygen or ventilator support. It also provided estimates of crew health, the probability of evacuation, and the probability of loss of crew life secondary to medical events for each of the three medical system scenarios. These IMM outputs were used as objective data to enable evidence-based decisions regarding oxygen and respiratory support system requirements for commercial crew vehicles. The IMM provides data that may be utilized to support informed decisions regarding the development of medical systems for commercial crew vehicles.

Development the conceptual design of Knowledge Based System for Integrated Maintenance Strategy and Operation

NASA Astrophysics Data System (ADS)

Milana; Khan, M. K.; Munive, J. E.

2014-07-01

The importance of maintenance has escalated significantly by the increasing of automation in manufacturing process. This condition switches traditional maintenance perspective of inevitable cost into the business competitive driver. Consequently, maintenance strategy and operation decision needs to be synchronized to business and manufacturing concerns. This paper shows the development of conceptual design of Knowledge Based System for Integrated Maintenance Strategy and Operation (KBIMSO). The framework of KBIMSO is elaborated to show the process of how the KBIMSO works to reach the maintenance decision. By considering the multi-criteria of maintenance decision making, the KB system embedded with GAP and AHP to support integrated maintenance strategy and operation which is novel in this area. The KBIMSO is useful to review the existing maintenance system and give reasonable recommendation of maintenance decisions in respect to business and manufacturing perspective.

GPS Availability for Aviation Applications : How Good Does it Need to Be?

DOT National Transportation Integrated Search

2000-09-19

The availability of GPS for airborne applications is driven by the accuracy, integrity, and continuity of the system. The International Civil Aviation Organization (ICAO) Standards and Recommended Practices (SARPS) for GNSS spells out all of these re...

IRIS Toxicological Review of Formaldehyde (Inhalation) (External Review Draft 2010)

EPA Science Inventory

UPDATE EPA is currently revising its Integrated Risk Information System (IRIS) assessment of formaldehyde to address the 2011 NAS peer review recommendations. This assessment addresses both noncancer and cancer human health effects that are relevant to assessing ...

Workshop proceedings: Information Systems for Space Astrophysics in the 21st Century, volume 1

NASA Technical Reports Server (NTRS)

Cutts, James (Editor); Ng, Edward (Editor)

1991-01-01

The Astrophysical Information Systems Workshop was one of the three Integrated Technology Planning workshops. Its objectives were to develop an understanding of future mission requirements for information systems, the potential role of technology in meeting these requirements, and the areas in which NASA investment might have the greatest impact. Workshop participants were briefed on the astrophysical mission set with an emphasis on those missions that drive information systems technology, the existing NASA space-science operations infrastructure, and the ongoing and planned NASA information systems technology programs. Program plans and recommendations were prepared in five technical areas: Mission Planning and Operations; Space-Borne Data Processing; Space-to-Earth Communications; Science Data Systems; and Data Analysis, Integration, and Visualization.

Analysis methods for wind turbine control and electrical system dynamics

NASA Technical Reports Server (NTRS)

Hinrichsen, E. N.

1995-01-01

The integration of new energy technologies into electric power systems requires methods which recognize the full range of dynamic events in both the new generating unit and the power system. Since new energy technologies are initially perceived as small contributors to large systems, little attention is generally paid to system integration, i.e. dynamic events in the power system are ignored. As a result, most new energy sources are only capable of base-load operation, i.e. they have no load following or cycling capability. Wind turbines are no exception. Greater awareness of this implicit (and often unnecessary) limitation is needed. Analysis methods are recommended which include very low penetration (infinite bus) as well as very high penetration (stand-alone) scenarios.

Accident/Mishap Investigation System

NASA Technical Reports Server (NTRS)

Keller, Richard; Wolfe, Shawn; Gawdiak, Yuri; Carvalho, Robert; Panontin, Tina; Williams, James; Sturken, Ian

2007-01-01

InvestigationOrganizer (IO) is a Web-based collaborative information system that integrates the generic functionality of a database, a document repository, a semantic hypermedia browser, and a rule-based inference system with specialized modeling and visualization functionality to support accident/mishap investigation teams. This accessible, online structure is designed to support investigators by allowing them to make explicit, shared, and meaningful links among evidence, causal models, findings, and recommendations.

Which Doctor to Trust: A Recommender System for Identifying the Right Doctors.

PubMed

Guo, Li; Jin, Bo; Yao, Cuili; Yang, Haoyu; Huang, Degen; Wang, Fei

2016-07-07

Key opinion leaders (KOLs) are people who can influence public opinion on a certain subject matter. In the field of medical and health informatics, it is critical to identify KOLs on various disease conditions. However, there have been very few studies on this topic. We aimed to develop a recommender system for identifying KOLs for any specific disease with health care data mining. We exploited an unsupervised aggregation approach for integrating various ranking features to identify doctors who have the potential to be KOLs on a range of diseases. We introduce the design, implementation, and deployment details of the recommender system. This system collects the professional footprints of doctors, such as papers in scientific journals, presentation activities, patient advocacy, and media exposure, and uses them as ranking features to identify KOLs. We collected the information of 2,381,750 doctors in China from 3,657,797 medical journal papers they published, together with their profiles, academic publications, and funding. The empirical results demonstrated that our system outperformed several benchmark systems by a significant margin. Moreover, we conducted a case study in a real-world system to verify the applicability of our proposed method. Our results show that doctors' profiles and their academic publications are key data sources for identifying KOLs in the field of medical and health informatics. Moreover, we deployed the recommender system and applied the data service to a recommender system of the China-based Internet technology company NetEase. Patients can obtain authority ranking lists of doctors with this system on any given disease.

Which Doctor to Trust: A Recommender System for Identifying the Right Doctors

PubMed Central

Yao, Cuili; Yang, Haoyu; Huang, Degen; Wang, Fei

2016-01-01

Background Key opinion leaders (KOLs) are people who can influence public opinion on a certain subject matter. In the field of medical and health informatics, it is critical to identify KOLs on various disease conditions. However, there have been very few studies on this topic. Objective We aimed to develop a recommender system for identifying KOLs for any specific disease with health care data mining. Methods We exploited an unsupervised aggregation approach for integrating various ranking features to identify doctors who have the potential to be KOLs on a range of diseases. We introduce the design, implementation, and deployment details of the recommender system. This system collects the professional footprints of doctors, such as papers in scientific journals, presentation activities, patient advocacy, and media exposure, and uses them as ranking features to identify KOLs. Results We collected the information of 2,381,750 doctors in China from 3,657,797 medical journal papers they published, together with their profiles, academic publications, and funding. The empirical results demonstrated that our system outperformed several benchmark systems by a significant margin. Moreover, we conducted a case study in a real-world system to verify the applicability of our proposed method. Conclusions Our results show that doctors’ profiles and their academic publications are key data sources for identifying KOLs in the field of medical and health informatics. Moreover, we deployed the recommender system and applied the data service to a recommender system of the China-based Internet technology company NetEase. Patients can obtain authority ranking lists of doctors with this system on any given disease. PMID:27390219

The French Vocational Education and Training System: Like an Unrecognised Prototype?

ERIC Educational Resources Information Center

Bouder, Annie; Kirsch, Jean-Louis

2007-01-01

The genesis of this article is based on the observation by the authors that the French training system has witnessed an evolution since the 1970s that corresponds to the one that was later recommended by the European authorities, i.e.: --the creation of a national qualifications framework that integrates general and vocational training and initial…

The Domestic Telecommunications Carrier Industry. Part I. President's Task Force on Communications Policy. Staff Paper Five.

ERIC Educational Resources Information Center

Rostow, Eugene V.

A staff paper submitted to the President's Task Force on Communications Policy recommends that public policy ensure an integrated structure in the telecommunications industry, while fostering limited competition to keep the system responsive to new technology and to consumer demands. The present system of regulated monopoly for companies supplying…

Primary prevention of type 2 diabetes: integrative public health and primary care opportunities, challenges and strategies

PubMed Central

Green, Lawrence W; Brancati, Frederick L; Albright, Ann

2012-01-01

Type 2 diabetes imposes a large and growing burden on the public’s health. This burden, combined with the growing evidence for primary prevention from randomized controlled trials of structured lifestyle programs leads to recommendations to include caloric reduction, increased physical activity and specific assistance to patients in problem solving to achieve modest weight loss as well as pharmacotherapy. These recommendations demand exploration of new ways to implement such primary prevention strategies through more integrated community organization, medical practice and policy. The US experience with control of tobacco use and high blood pressure offers valuable lessons for policy, such as taxation on products, and for practice in a variety of settings, such as coordination of referrals for lifestyle supports. We acknowledge also some notable exceptions to their generalizability. This paper presents possible actions proposed by an expert panel, summarized in Table 1 as recommendations for immediate action, strategic action and research. The collaboration of primary care and public health systems will be required to make many of these recommendations a reality. This paper also provides information on the progress made in recent years by the Division of Diabetes Translation at the US Centers for Disease Control and Prevention (CDC) to implement or facilitate such integration of primary care and public health for primary prevention. PMID:22399542

An overview of the model integration process: From pre ...

EPA Pesticide Factsheets

Integration of models requires linking models which can be developed using different tools, methodologies, and assumptions. We performed a literature review with the aim of improving our understanding of model integration process, and also presenting better strategies for building integrated modeling systems. We identified five different phases to characterize integration process: pre-integration assessment, preparation of models for integration, orchestration of models during simulation, data interoperability, and testing. Commonly, there is little reuse of existing frameworks beyond the development teams and not much sharing of science components across frameworks. We believe this must change to enable researchers and assessors to form complex workflows that leverage the current environmental science available. In this paper, we characterize the model integration process and compare integration practices of different groups. We highlight key strategies, features, standards, and practices that can be employed by developers to increase reuse and interoperability of science software components and systems. The paper provides a review of the literature regarding techniques and methods employed by various modeling system developers to facilitate science software interoperability. The intent of the paper is to illustrate the wide variation in methods and the limiting effect the variation has on inter-framework reuse and interoperability. A series of recommendation

Integration of Neuropsychology in Primary Care.

PubMed

Lanca, Margaret

2018-05-01

The field of neuropsychology is making inroads in primary care as the importance of cognition in physical health is increasingly acknowledged. With neuropsychology primary care integration, patients receive a range of cognitive assessments (e.g., screens, brief neuropsychological assessments, treatment recommendations through provider-to-neuropsychologist consultations) based on a stepped model of care which can more efficiently diagnose cognitive disorders/problems and assist with treatment. Two case studies are described to illuminate this process. Information is provided to illustrate how neuropsychology integration was introduced in two primary care clinics at a community-based hospital system.

Identifying Challenges to the Integration of Computer-Based Surveillance Information Systems in a Large City Health Department: A Case Study.

PubMed

Jennings, Jacky M; Stover, Jeffrey A; Bair-Merritt, Megan H; Fichtenberg, Caroline; Munoz, Mary Grace; Maziad, Rafiq; Ketemepi, Sherry Johnson; Zenilman, Jonathan

2009-01-01

Integrated infectious disease surveillance information systems have the potential to provide important new surveillance capacities and business efficiencies for local health departments. We conducted a case study at a large city health department of the primary computer-based infectious disease surveillance information systems during a 10-year period to identify the major challenges for information integration across the systems. The assessment included key informant interviews and evaluations of the computer-based surveillance information systems used for acute communicable diseases, human immunodeficiency virus/acquired immunodeficiency syndrome, sexually transmitted diseases, and tuberculosis. Assessments were conducted in 1998 with a follow-up in 2008. Assessments specifically identified and described the primary computer-based surveillance information system, any duplicative information systems, and selected variables collected. Persistent challenges to information integration across the information systems included the existence of duplicative data systems, differences in the variables used to collect similar information, and differences in basic architecture. The assessments identified a number of challenges for information integration across the infectious disease surveillance information systems at this city health department. The results suggest that local disease control programs use computer-based surveillance information systems that were not designed for data integration. To the extent that integration provides important new surveillance capacities and business efficiencies, we recommend that patient-centric information systems be designed that provide all the epidemiologic, clinical, and research needs in one system. In addition, the systems should include a standard system of elements and fields across similar surveillance systems.

The Texas Children's Hospital immunization forecaster: conceptualization to implementation.

PubMed

Cunningham, Rachel M; Sahni, Leila C; Kerr, G Brady; King, Laura L; Bunker, Nathan A; Boom, Julie A

2014-12-01

Immunization forecasting systems evaluate patient vaccination histories and recommend the dates and vaccines that should be administered. We described the conceptualization, development, implementation, and distribution of a novel immunization forecaster, the Texas Children's Hospital (TCH) Forecaster. In 2007, TCH convened an internal expert team that included a pediatrician, immunization nurse, software engineer, and immunization subject matter experts to develop the TCH Forecaster. Our team developed the design of the model, wrote the software, populated the Excel tables, integrated the software, and tested the Forecaster. We created a table of rules that contained each vaccine's recommendations, minimum ages and intervals, and contraindications, which served as the basis for the TCH Forecaster. We created 15 vaccine tables that incorporated 79 unique dose states and 84 vaccine types to operationalize the entire United States recommended immunization schedule. The TCH Forecaster was implemented throughout the TCH system, the Indian Health Service, and the Virginia Department of Health. The TCH Forecast Tester is currently being used nationally. Immunization forecasting systems might positively affect adherence to vaccine recommendations. Efforts to support health care provider utilization of immunization forecasting systems and to evaluate their impact on patient care are needed.

Neuropsychological Functioning in Survivors of Childhood Leukemia.

ERIC Educational Resources Information Center

Reeb, Roger N.; Regan, Judith M.

1998-01-01

Examined neuropsychological functioning of survivors of acute lymphoblastic leukemia who underwent central-nervous-system prophylactic treatment. Findings replicated past research in showing survivors perform poorly on visual-motor integration tasks and develop a Nonverbal Learning Disability. Findings offer recommendations for future research and…

Recommendation Techniques for Drug-Target Interaction Prediction and Drug Repositioning.

PubMed

Alaimo, Salvatore; Giugno, Rosalba; Pulvirenti, Alfredo

2016-01-01

The usage of computational methods in drug discovery is a common practice. More recently, by exploiting the wealth of biological knowledge bases, a novel approach called drug repositioning has raised. Several computational methods are available, and these try to make a high-level integration of all the knowledge in order to discover unknown mechanisms. In this chapter, we review drug-target interaction prediction methods based on a recommendation system. We also give some extensions which go beyond the bipartite network case.

Crew Exploration Vehicle (CEV) Avionics Integration Laboratory (CAIL) Independent Analysis

NASA Technical Reports Server (NTRS)

Davis, Mitchell L.; Aguilar, Michael L.; Mora, Victor D.; Regenie, Victoria A.; Ritz, William F.

2009-01-01

Two approaches were compared to the Crew Exploration Vehicle (CEV) Avionics Integration Laboratory (CAIL) approach: the Flat-Sat and Shuttle Avionics Integration Laboratory (SAIL). The Flat-Sat and CAIL/SAIL approaches are two different tools designed to mitigate different risks. Flat-Sat approach is designed to develop a mission concept into a flight avionics system and associated ground controller. The SAIL approach is designed to aid in the flight readiness verification of the flight avionics system. The approaches are complimentary in addressing both the system development risks and mission verification risks. The following NESC team findings were identified: The CAIL assumption is that the flight subsystems will be matured for the system level verification; The Flat-Sat and SAIL approaches are two different tools designed to mitigate different risks. The following NESC team recommendation was provided: Define, document, and manage a detailed interface between the design and development (EDL and other integration labs) to the verification laboratory (CAIL).

A Filing System for Medical Literature

PubMed Central

Cumming, Millie

1988-01-01

The author reviews the types of systems available for personal literature files and makes specific recommendations for filing systems for family physicians. A personal filing system can be an integral part of family practice, and need not require time out of proportion to the worth of the system. Because it is a personal system, different types will suit different users; some systems, however, are more reliable than others for use in family practice. (Can Fam Physician 1988; 34:425-433.) PMID:21253062

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

A systemic view of higher education and professional psychology: implications of the Combined-Integrated model of doctoral training.

PubMed

Brown, Douglas T; Benson, A Jerry; Walker, N William; Sternberger, Lee G; Lung, Deborah S; Kassinove, Howard

2004-10-01

This article was developed in response to the proceedings of the Consensus Conference on Combined and Integrated Doctoral Training in Psychology held at James Madison University in Harrisonburg, VA, May 2 to 4, 2003. The authors approach the recommendations of the conference from the perspective of their experiences in higher education administration at the national, regional, and state levels. The authors conclude that the Consensus Conference represents an exemplar of best practice in program planning. They suggest that a major reconceptualization of higher education is under way that emphasizes broad collaboration among various professional groups as a means of providing appropriate mental health and health care services. Consequently, professional psychology will need to reconceptualize its role in the broader context of other professions within the university setting. Recommendations for the education of psychologists and the development of future training programs are provided. Suggestions for implementation of various recommendations flowing from the Consensus Conference are delineated. Copyright 2004 Wiley Periodicals, Inc.

Leveraging tagging and rating for recommendation: RMF meets weighted diffusion on tripartite graphs

NASA Astrophysics Data System (ADS)

Li, Jianguo; Tang, Yong; Chen, Jiemin

2017-10-01

Recommender systems (RSs) have been a widely exploited approach to solving the information overload problem. However, the performance is still limited due to the extreme sparsity of the rating data. With the popularity of Web 2.0, the social tagging system provides more external information to improve recommendation accuracy. Although some existing approaches combine the matrix factorization models with the tag co-occurrence and context of tags, they neglect the issue of tag sparsity that would also result in inaccurate recommendations. Consequently, in this paper, we propose a novel hybrid collaborative filtering model named WUDiff_RMF, which improves regularized matrix factorization (RMF) model by integrating Weighted User-Diffusion-based CF algorithm(WUDiff) that obtains the information of similar users from the weighted tripartite user-item-tag graph. This model aims to capture the degree correlation of the user-item-tag tripartite network to enhance the performance of recommendation. Experiments conducted on four real-world datasets demonstrate that our approach significantly performs better than already widely used methods in the accuracy of recommendation. Moreover, results show that WUDiff_RMF can alleviate the data sparsity, especially in the circumstance that users have made few ratings and few tags.

The Application of Integrated Knowledge-based Systems for the Biomedical Risk Assessment Intelligent Network (BRAIN)

NASA Technical Reports Server (NTRS)

Loftin, Karin C.; Ly, Bebe; Webster, Laurie; Verlander, James; Taylor, Gerald R.; Riley, Gary; Culbert, Chris; Holden, Tina; Rudisill, Marianne

1993-01-01

One of NASA's goals for long duration space flight is to maintain acceptable levels of crew health, safety, and performance. One way of meeting this goal is through the Biomedical Risk Assessment Intelligent Network (BRAIN), an integrated network of both human and computer elements. The BRAIN will function as an advisor to flight surgeons by assessing the risk of in-flight biomedical problems and recommending appropriate countermeasures. This paper describes the joint effort among various NASA elements to develop BRAIN and an Infectious Disease Risk Assessment (IDRA) prototype. The implementation of this effort addresses the technological aspects of the following: (1) knowledge acquisition; (2) integration of IDRA components; (3) use of expert systems to automate the biomedical prediction process; (4) development of a user-friendly interface; and (5) integration of the IDRA prototype and Exercise Countermeasures Intelligent System (ExerCISys). Because the C Language, CLIPS (the C Language Integrated Production System), and the X-Window System were portable and easily integrated, they were chosen as the tools for the initial IDRA prototype. The feasibility was tested by developing an IDRA prototype that predicts the individual risk of influenza. The application of knowledge-based systems to risk assessment is of great market value to the medical technology industry.

A development of logistics management models for the Space Transportation System

NASA Technical Reports Server (NTRS)

Carrillo, M. J.; Jacobsen, S. E.; Abell, J. B.; Lippiatt, T. F.

1983-01-01

A new analytic queueing approach was described which relates stockage levels, repair level decisions, and the project network schedule of prelaunch operations directly to the probability distribution of the space transportation system launch delay. Finite source population and limited repair capability were additional factors included in this logistics management model developed specifically for STS maintenance requirements. Data presently available to support logistics decisions were based on a comparability study of heavy aircraft components. A two-phase program is recommended by which NASA would implement an integrated data collection system, assemble logistics data from previous STS flights, revise extant logistics planning and resource requirement parameters using Bayes-Lin techniques, and adjust for uncertainty surrounding logistics systems performance parameters. The implementation of these recommendations can be expected to deliver more cost-effective logistics support.

MIUS wastewater technology evaluation

NASA Technical Reports Server (NTRS)

Poradek, J. C.

1976-01-01

A modular integrated utility system wastewater-treatment process is described. Research in the field of wastewater treatment is reviewed, treatment processes are specified and evaluated, and recommendations for system use are made. The treatment processes evaluated are in the broad categories of preparatory, primary, secondary, and tertiary treatment, physical-chemical processing, dissolved-solids removal, disinfection, sludge processing, and separate systems. Capital, operating, and maintenance costs are estimated, and extensive references are given.

A Primer on Autonomous Aerial Vehicle Design

PubMed Central

Coppejans, Hugo H. G.; Myburgh, Herman C.

2015-01-01

There is a large amount of research currently being done on autonomous micro-aerial vehicles (MAV), such as quadrotor helicopters or quadcopters. The ability to create a working autonomous MAV depends mainly on integrating a simultaneous localization and mapping (SLAM) solution with the rest of the system. This paper provides an introduction for creating an autonomous MAV for enclosed environments, aimed at students and professionals alike. The standard autonomous system and MAV automation are discussed, while we focus on the core concepts of SLAM systems and trajectory planning algorithms. The advantages and disadvantages of using remote processing are evaluated, and recommendations are made regarding the viability of on-board processing. Recommendations are made regarding best practices to serve as a guideline for aspirant MAV designers. PMID:26633410

A Primer on Autonomous Aerial Vehicle Design.

PubMed

Coppejans, Hugo H G; Myburgh, Herman C

2015-12-02

There is a large amount of research currently being done on autonomous micro-aerial vehicles (MAV), such as quadrotor helicopters or quadcopters. The ability to create a working autonomous MAV depends mainly on integrating a simultaneous localization and mapping (SLAM) solution with the rest of the system. This paper provides an introduction for creating an autonomous MAV for enclosed environments, aimed at students and professionals alike. The standard autonomous system and MAV automation are discussed, while we focus on the core concepts of SLAM systems and trajectory planning algorithms. The advantages and disadvantages of using remote processing are evaluated, and recommendations are made regarding the viability of on-board processing. Recommendations are made regarding best practices to serve as a guideline for aspirant MAV designers.

Comparison of solar photovoltaic and nuclear reactor power systems for a human-tended lunar observatory

NASA Technical Reports Server (NTRS)

Hickman, J. M.; Bloomfield, H. S.

1989-01-01

Photovoltaic and nuclear surface power systems were examined at the 20 to 100 kW power level range for use at a human-tended lunar astronomical observatory, and estimates of the power system masses were made. One system, consisting of an SP-100 thermoelectric nuclear power supply integrated with a lunar lander, is recommended for further study due to its low system mass, potential for modular growth, and applicability to other surface power missions, particularly in the Martian system.

Comparison of solar photovoltaic and nuclear reactor power systems for a human-tended lunar observatory

NASA Technical Reports Server (NTRS)

Hickman, J. M.; Bloomfield, H. S.

1989-01-01

Photovoltaic and nuclear surface power systems were examined at the 20 to 100 kW power level range for use at a human-tended lunar astronomical observatory, andestimates of the power system masses were made. One system, consisting of an SP-100 thermoelectric nuclear power supply integrated with a lunar lander, is recommended for further study due to its low system mass, potential for modular growth, and applicability to other surface power missions, particularly in the Martian system.

A CLIPS expert system for maximizing alfalfa (Medicago Sativa L.) production

NASA Technical Reports Server (NTRS)

Engel, B. A.; Jones, D. D.; Rhykerd, R. L.; Rhykerd, L. M.; Rhykerd, C. L., Jr.; Rhykerd, C. L.

1990-01-01

An alfalfa management expert system originally developed by Purdue University agricultural scientists on the PC Plus expert system shell from Texas Instrument has been updated and successfully converted to CLIPS (C Language Integrated Production System). This reduces the cost and legal restrictions associated with making the expert system available to agribusiness industries, extension personnel and farm managers and operators. The expert system includes recommendations concerning soil drainage, liming, P and K fertilization, weed control, variety selection and seeding rate including pure live seeds.

Finnish perspectives of wireless in healthcare.

PubMed

Alasaarela, Esko

2009-01-01

Wireless solutions are a good choice for healthcare development in Finland. A survey of 135 experts in Finland show that (1) the competences needed for developing wireless solutions exist (2) the Finnish healthcare system is integrated enough and (3) the technology industry in this area is too weak for global marketing. The following recommendations can be concluded: (1) Cooperate internationally (2) Develop integrated solutions and health managing concepts for the important health problems (such as diabetes), (3) Harness the healthcare system to act as a test bed for new solutions and (4) Help companies to grow and take global roles.

Woody tissue analysis using an element ratio technique (DRIS)

Treesearch

Kurt H. Riitters; L.F. Ohmann; D.F. Grigal

1991-01-01

The diagnosis and recommendation integrated system (DRIS) was used to describe the variation of 12 elements in woody tree tissue and balsam fir (Abies balsamae (L.) Mill.), sugar maple (Acer saccharum Marsh.), jack pine (Pinus banksiana Lamb.), red pine (Pinus resinosa alt.), and aspen (

Towards a Net Zero Building Cluster Energy Systems Analysis for US Army Installations

DTIC Science & Technology

2011-05-01

depending on the alternative chosen. Since the proposed energy efficiency work includes the implementation of DOAS and high efficiency dehumidification ...cluster Net Zero fossil fuel energy. The recommended, integrated energy solution demonstrates that vastly improved energy efficiency and greenhouse gas

Adaptive Signal Processing Testbed: VME-based DSP board market survey

NASA Astrophysics Data System (ADS)

Ingram, Rick E.

1992-04-01

The Adaptive Signal Processing Testbed (ASPT) is a real-time multiprocessor system utilizing digital signal processor technology on VMEbus based printed circuit boards installed on a Sun workstation. The ASPT has specific requirements, particularly as regards to the signal excision application, with respect to interfacing with current and planned data generation equipment, processing of the data, storage to disk of final and intermediate results, and the development tools for applications development and integration into the overall EW/COM computing environment. A prototype ASPT was implemented using three VME-C-30 boards from Applied Silicon. Experience gained during the prototype development led to the conclusions that interprocessor communications capability is the most significant contributor to overall ASPT performance. In addition, the host involvement should be minimized. Boards using different processors were evaluated with respect to the ASPT system requirements, pricing, and availability. Specific recommendations based on various priorities are made as well as recommendations concerning the integration and interaction of various tools developed during the prototype implementation.

Integrative medicine and patient-centered care.

PubMed

Maizes, Victoria; Rakel, David; Niemiec, Catherine

2009-01-01

Integrative medicine has emerged as a potential solution to the American healthcare crisis. It provides care that is patient centered, healing oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine. Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy. This paper defines integrative medicine and its principles, describes the history of complementary and alternative medicine (CAM) in American healthcare, and discusses the current state and desired future of integrative medical practice. The importance of patient-centered care, patient empowerment, behavior change, continuity of care, outcomes research, and the challenges to successful integration are discussed. The authors suggest a model for an integrative healthcare system grounded in team-based care. A primary health partner who knows the patient well, is able to addresses mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece. Collectively, the team can meet all the health needs of the particular patient and forms the patient-centered medical home. The paper culminates with 10 recommendations directed to key actors to facilitate the systemic changes needed for a functional healthcare delivery system. Recommendations include creating financial incentives aligned with health promotion and prevention. Insurers are requested to consider the total costs of care, the potential cost effectiveness of lifestyle approaches and CAM modalities, and the value of longer office visits to develop a therapeutic relationship and stimulate behavioral change. Outcomes research to track the effectiveness of integrative models must be funded, as well as feedback and dissemination strategies. Additional competencies for primary health partners, including CAM and conventional medical providers, will need to be developed to foster successful integrative practices. Skills include learning to develop appropriate healthcare teams that function well in a medical home, developing an understanding of the diverse healing traditions, and enhancing communication skills. For integrative medicine to flourish in the United States, new providers, new provider models, and a realignment of incentives and a commitment to health promotion and disease management will be required.

Galileo spacecraft integration - International cooperation on a planetary mission in the Shuttle era

NASA Technical Reports Server (NTRS)

Spehalski, R. J.

1983-01-01

The Galileo mission is designed to greatly expand scientific knowledge of Jupiter and its system. The retropropulsion module (RPM) as a major functional element of the Galileo spacecraft is described. The major mission and spacecraft requirements on the RPM are presented. Complexities of the integration process due to the international interface are identified. Challenges associated with integration with new launch vehicles, the Shuttle and upper stage, and their relationships to the RPM are discussed. The results of the integration process involving mission and propulsion performance, reliability, mechanical and thermal interfaces, and safety are described. Finally, considerations and recommendations for future missions involving international cooperation are given.

Conceptual design study: Forest Fire Advanced System Technology (FFAST)

NASA Technical Reports Server (NTRS)

Nichols, J. D.; Warren, J. R.

1986-01-01

An integrated forest fire detection and mapping system that will be based upon technology available in the 1990s was defined. Uncertainties in emerging and advanced technologies related to the conceptual design were identified and recommended for inclusion as preferred system components. System component technologies identified for an end-to-end system include thermal infrared, linear array detectors, automatic georeferencing and signal processing, geosynchronous satellite communication links, and advanced data integration and display. Potential system configuration options were developed and examined for possible inclusion in the preferred system configuration. The preferred system configuration will provide increased performance and be cost effective over the system currently in use. Forest fire management user requirements and the system component emerging technologies were the basis for the system configuration design. A preferred system configuration was defined that warrants continued refinement and development, examined economic aspects of the current and preferred system, and provided preliminary cost estimates for follow-on system prototype development.

An end-users oriented methodology for enhancing the integration of knowledge on soil-water-sediment systems in River Basin Management: an illustration from the AquaTerra project.

PubMed

Merly, Corinne; Chapman, Antony; Mouvet, Christophe

2012-01-01

Research results in environmental and socio-economic sciences are often under-used by stakeholders involved in the management of natural resources. To minimise this gap, the FP6 EU interdisciplinary project AquaTerra (AT) developed an end-users' integration methodology in order to ensure that the data, knowledge and tools related to the soil-water-sediment system that were generated by the project were delivered in a meaningful way for end-users, thus improving their uptake. The methodology and examples of its application are presented in this paper. From the 408 project deliverables, 96 key findings were identified, 53 related to data and knowledge, and 43 describing advanced tools. River Basin Management (RBM) stakeholders workshops identified 8 main RBM issues and 25 specific stakeholders' questions related to RBM which were classified into seven groups of cross-cutting issues, namely scale, climate change, non-climatic change, the need for systemic approaches, communication and participation, international and inter-basin coordination and collaboration, and the implementation of the Water Framework Directive. The integration methodology enabled an assessment of how AT key findings meet stakeholders' demands, and for each main RBM issue and for each specific question, described the added-value of the AT project in terms of knowledge and tools generated, key parameters to consider, and recommendations that can be made to stakeholders and the wider scientific community. Added value and limitations of the integration methodology and its outcomes are discussed and recommendations are provided to further improve integration methodology and bridge the gaps between scientific research data and their potential uptake by end-users.

Architecture and Integration Requirements for an ULCE (Unified Life Cycle Engineering) Design Environment.

DTIC Science & Technology

1988-04-01

Locate brake lines on rear side of the gear structure to prevent damage. * Provide emergency brake system , independent of the normal system , and capable of...stopping the aircraft in the same distance as the normal system . -.. * Consider brake temperature in calculating brake energy capability. * Install a...and takeoff. In addition, assume a brake nearing the end of its recommended life. - Antiskid systems shall be as reliable as the rest of the braking

Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

PubMed

Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

2011-06-01

Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

Integrated Information Support System (IISS). Volume 4. IISS System. Part 1. System Requirements Document

DTIC Science & Technology

1990-09-30

audit trail for unauthorized entries. B.6.3.3 Manage CDM Resources B.6.3.3.1 Measure CDM Performance 1. Keep running log of CDM accesses by user types...SYSTEM SPPCIFIA OMA8MSTRTO Figure B-12. System Administrator Role B-3 1 SRD620340000 30 September 1990 4. Audit IISS hardware performance (LAN...SRD620340000 30 September 1990 7. Assist IISS service specifier and application specifier in implementing standards recommendation. 8. Perform audit of IISS

Systems study for an Integrated Digital-Electric Aircraft (IDEA)

NASA Technical Reports Server (NTRS)

Tagge, G. E.; Irish, L. A.; Bailey, A. R.

1985-01-01

The results of the Integrated Digital/Electric Aircraft (IDEA) Study are presented. Airplanes with advanced systems were, defined and evaluated, as a means of identifying potential high payoff research tasks. A baseline airplane was defined for comparison, typical of a 1990's airplane with advanced active controls, propulsion, aerodynamics, and structures technology. Trade studies led to definition of an IDEA airplane, with extensive digital systems and electric secondary power distribution. This airplane showed an improvement of 3% in fuel use and 1.8% in DOC relative to the baseline configuration. An alternate configuration, an advanced technology turboprop, was also evaluated, with greater improvement supported by digital electric systems. Recommended research programs were defined for high risk, high payoff areas appropriate for implementation under NASA leadership.

MSFC Skylab program engineering and integration

NASA Technical Reports Server (NTRS)

1974-01-01

A technical history and managerial critique of the MSFC role in the Skylab program is presented. The George C. Marshall Space Flight Center had primary hardware development responsibility for the Saturn Workshop Modules and many of the designated experiments in addition to the system integration responsibility for the entire Skylab Orbital Cluster. The report also includes recommendations and conclusions applicable to hardware design, test program philosophy and performance, and program management techniques with potential application to future programs.

Selection of an Online Public Access Catalog: A Checklist Approach.

ERIC Educational Resources Information Center

O'Rourke, Victoria

1987-01-01

The development, field testing, and evaluation of a checklist approach to selecting an integrated library automation system are described, and recommendations for using this approach are outlined. The checklist, which is divided into five main sections of catalog features and functions, is appended. (Author/CLB)

Sunshine Skyway Bridge monitoring phase I : system assessment and integration recommendations [summary].

DOT National Transportation Integrated Search

2016-10-01

At over five miles long, the Sunshine Skyway Bridge, crossing Tampa Bay where it meets the Gulf of Mexico, is one of the worlds longest cable-stayed bridges. The pier-supported approaches rise to meet the center section where cables radiating from...

Report: EPA Has Adequate Controls to Manage Advice From Science and Research Federal Advisory Committees, but Transparency Could Be Improved

EPA Pesticide Factsheets

Report #17-P-0124, March 13, 2017. Science plays an integral role in the EPA's mission. The EPA has an adequate system of controls to manage recommendations from its science and research federal advisory committees.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Astrophysics Data System (ADS)

Drake, Bret G.

2007-07-01

During the summer of 2002 the NASA Deputy Administrator charted an internal NASA planning group to develop the rationale for exploration beyond low-Earth orbit. This team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond Low-Earth Orbit through the human exploration of Mars. The previous NASA Exploration Team (NEXT) activities laid the foundation and framework for development of NASA s Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the Stepping Stone approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low- Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars. Following the results of the Exploration Blueprint study, the NASA Administrator has asked for a recommendation by June, 2003 on the next steps in human and robotic exploration in order to put into context an updated Integrated Space Transportation Plan (post- Columbia) and guide Agency planning. NASA was on the verge of committing significant funding in programs that would be better served if longer term goals were better known including the Orbital Space Plane, research on the ISS, National Aerospace Initiative, Shuttle Life Extension Program, Project Prometheus, as well as a wide range of technology development throughout the Agency. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary viewgraph presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the Moon, can help reduce the risk for Mars missions.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Technical Reports Server (NTRS)

Drake, Bret G.

2007-01-01

During the summer of 2002 the NASA Deputy Administrator charted an internal NASA planning group to develop the rationale for exploration beyond low-Earth orbit. This team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond Low-Earth Orbit through the human exploration of Mars. The previous NASA Exploration Team (NEXT) activities laid the foundation and framework for development of NASA s Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the Stepping Stone approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low- Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars. Following the results of the Exploration Blueprint study, the NASA Administrator has asked for a recommendation by June, 2003 on the next steps in human and robotic exploration in order to put into context an updated Integrated Space Transportation Plan (post- Columbia) and guide Agency planning. NASA was on the verge of committing significant funding in programs that would be better served if longer term goals were better known including the Orbital Space Plane, research on the ISS, National Aerospace Initiative, Shuttle Life Extension Program, Project Prometheus, as well as a wide range of technology development throughout the Agency. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary viewgraph presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the Moon, can help reduce the risk for Mars missions.

Data Economics in Army Information Systems

DTIC Science & Technology

1989-03-01

CONTACTED: LtCol Robert DiBona Chief, Policy Plans and Integration Division (703) 664-3986 DATE: 17 January 1989 DISCUSSION: 1. The MITRE study group called...LtCol Robert DiBona on the recommendation of Mr. James Glymph of Data Management Directorate (DMD), Information Systems Engineering Command (ISEC...LtCol DiBona is in charge of the ISEC Standard Army Management Information System (STAMIS) Modernization (STAMOD) program. 2. LtCol DiBona did not know

Techniques for capturing expert knowledge - An expert systems/hypertext approach

NASA Technical Reports Server (NTRS)

Lafferty, Larry; Taylor, Greg; Schumann, Robin; Evans, Randy; Koller, Albert M., Jr.

1990-01-01

The knowledge-acquisition strategy developed for the Explosive Hazards Classification (EHC) Expert System is described in which expert systems and hypertext are combined, and broad applications are proposed. The EHC expert system is based on rapid prototyping in which primary knowledge acquisition from experts is not emphasized; the explosive hazards technical bulletin, technical guidance, and minimal interviewing are used to develop the knowledge-based system. Hypertext is used to capture the technical information with respect to four issues including procedural, materials, test, and classification issues. The hypertext display allows the integration of multiple knowlege representations such as clarifications or opinions, and thereby allows the performance of a broad range of tasks on a single machine. Among other recommendations, it is suggested that the integration of hypertext and expert systems makes the resulting synergistic system highly efficient.

Finnish care integrated?

PubMed Central

Niskanen, J. Jouni

2002-01-01

Abstract The public Finnish social and health care system has been challenged by the economic crisis, administrative reforms and increased demands. Better integration as a solution includes many examples, which have been taken to use. The most important are the rewritten national and municipals strategies and quality recommendations, where the different sectors and the levels of care are seen as one entity. Many reorganisations have taken place, both nationally and locally, and welfare clusters have been established. The best examples of integrated care are the forms of teamwork, care management, emphasis on non-institutional care and the information technology. PMID:16896395

Economic evaluation: Concepts, selected studies, system costs, and a proposed program

NASA Technical Reports Server (NTRS)

Osterhoudt, F. H. (Principal Investigator)

1979-01-01

The more usual approaches to valuing crop information are reviewed and an integrated approach is recommended. Problems associated with implementation are examined. What has already been accomplished in the economic evaluation of LACIE-type information is reported including various studies of benefits. The costs of the existing and proposed systems are considered. A method and approach is proposed for further studies.

Defense Message System Way Ahead: Conclusions and Recommendations from the Industry Advisory Panel

DTIC Science & Technology

2000-03-01

access terminals • Increasing requirement for authentication and data security for conducting business • Mergers and acquisitions in Internet space...market, used to carry PKI certificates for all types of security services including access control, confidentiality, integrity, and non-repudiation...Wireless access widespread § Unified messaging pervasive § Security /privacy dependent on service provider Long-term § Highly reliable systems

Power conditioning for space nuclear reactor systems

NASA Technical Reports Server (NTRS)

Berman, Baruch

1987-01-01

This paper addresses the power conditioning subsystem for both Stirling and Brayton conversion of space nuclear reactor systems. Included are the requirements summary, trade results related to subsystem implementation, subsystem description, voltage level versus weight, efficiency and operational integrity, components selection, and shielding considerations. The discussion is supported by pertinent circuit and block diagrams. Summary conclusions and recommendations derived from the above studies are included.

Functional Analysis and Preliminary Specifications for a Single Integrated Central Computer System for Secondary Schools and Junior Colleges. Interim Report.

ERIC Educational Resources Information Center

1968

The present report proposes a central computing facility and presents the preliminary specifications for such a system. It is based, in part, on the results of earlier studies by two previous contractors on behalf of the U.S. Office of Education. The recommendations are based upon the present contractors considered evaluation of the earlier…

Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

PubMed

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

Social Collaborative Filtering by Trust.

PubMed

Yang, Bo; Lei, Yu; Liu, Jiming; Li, Wenjie

2017-08-01

Recommender systems are used to accurately and actively provide users with potentially interesting information or services. Collaborative filtering is a widely adopted approach to recommendation, but sparse data and cold-start users are often barriers to providing high quality recommendations. To address such issues, we propose a novel method that works to improve the performance of collaborative filtering recommendations by integrating sparse rating data given by users and sparse social trust network among these same users. This is a model-based method that adopts matrix factorization technique that maps users into low-dimensional latent feature spaces in terms of their trust relationship, and aims to more accurately reflect the users reciprocal influence on the formation of their own opinions and to learn better preferential patterns of users for high-quality recommendations. We use four large-scale datasets to show that the proposed method performs much better, especially for cold start users, than state-of-the-art recommendation algorithms for social collaborative filtering based on trust.

Progress of the Enhanced Hanford Single Shell Tank (SST) Integrity Project

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

Venetz, Theodore J.; Washenfelder, Dennis J.; Boomer, Kayle D.

2015-01-07

To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project (SSTIP) in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration. In late 2010, seventeen of these recommendations were used to develop the basis for the M-45-10-1 Changemore » Package for the Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement.« less

78 FR 12037 - Announcement of the American Petroleum Institute's Standards Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... Execution, 1st Edition Standard 2CCU, Offshore Cargo Container Design, Manufacturing and Inspection, 1st... Integrity Management of Fixed Offshore Structures, 1st Edition Recommended Practice 2SM, Design, Manufacture... Offshore Production Platforms, 8th Edition Specification 14F, Design and Installation of Electrical Systems...

75 FR 56477 - Technical Amendments for Marine Spark-Ignition Engines and Vessels

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... spillage, incorporating safe recommended practices will result in a net benefit to the environment and lead... portable fuel tanks to these new requirements, manufacturers working together on systems integration.... We have engaged the industry to identify a simple, safe, and emissions neutral solution to this...

Integrated, Kerberized Login on MacOS X

NASA Technical Reports Server (NTRS)

Hotz, Henry B.

2006-01-01

Context for this information. MacOS X login process and available hooks. Authorization Services configuration. Authorization Services plug-in s. Kerberos plug-in s. Other bugs and recommendations. Authorization Services Called by loginwindow, screen saver and fast user switching. It calls Directory Services, Login Hook, and Login Items (System Preferences).

Purposefully Poetic

ERIC Educational Resources Information Center

Kelin, Daniel A., II.

2017-01-01

Arts education has no firm place in Hawaii's public school system. Even the Board of Education plan and the State Department of Education's plans differ in how they refer to and make recommendations about the place or purpose of arts education. This article reviews examples of competing policy to suggest how arts-integrated style teaching could…

Selecting a Laboratory Information Management System for Biorepositories in Low- and Middle-Income Countries: The H3Africa Experience and Lessons Learned

PubMed Central

Musinguzi, Henry; Lwanga, Newton; Kezimbira, Dafala; Kigozi, Edgar; Katabazi, Fred Ashaba; Wayengera, Misaki; Joloba, Moses Lutaakome; Abayomi, Emmanuel Akin; Swanepoel, Carmen; Croxton, Talishiea; Ozumba, Petronilla; Thankgod, Anazodo; van Zyl, Lizelle; Mayne, Elizabeth Sarah; Kader, Mukthar; Swartz, Garth

2017-01-01

Biorepositories in Africa need significant infrastructural support to meet International Society for Biological and Environmental Repositories (ISBER) Best Practices to support population-based genomics research. ISBER recommends a biorepository information management system which can manage workflows from biospecimen receipt to distribution. The H3Africa Initiative set out to develop regional African biorepositories where Uganda, Nigeria, and South Africa were successfully awarded grants to develop the state-of-the-art biorepositories. The biorepositories carried out an elaborate process to evaluate and choose a laboratory information management system (LIMS) with the aim of integrating the three geographically distinct sites. In this article, we review the processes, African experience, lessons learned, and make recommendations for choosing a biorepository LIMS in the African context.

A novel personal health system with integrated decision support and guidance for the management of chronic liver disease.

PubMed

Kiefer, Stephan; Schäfer, Michael; Bransch, Marco; Brimmers, Peter; Bartolomé, Diego; Baños, Janie; Orr, James; Jones, Dave; Jara, Maximilian; Stockmann, Martin

2014-01-01

A personal health system platform for the management of patients with chronic liver disease that incorporates a novel approach to integrate decision support and guidance through care pathways for patients and their doctors is presented in this paper. The personal health system incorporates an integrated decision support engine that guides patients and doctors through the management of the disease by issuing tasks and providing recommendations to both the care team and the patient and by controlling the execution of a Care Flow Plan based on the results of tasks and the monitored health status of the patient. This Care Flow Plan represents a formal, business process based model of disease management designed off-line by domain experts on the basis of clinical guidelines, knowledge of care pathways and an organisational model for integrated, patient-centred care. In this way, remote monitoring and treatment are dynamically adapted to the patient's actual condition and clinical symptoms and allow flexible delivery of care with close integration of specialists, therapists and care-givers.

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

Nephew, E.A.; Abbatiello, L.A.; Ballou, M.L.

The basic concept of the Annual Cycle Energy System (ACES) - an integrated system for supplying space heating, hot water, and air conditioning to a building - and the theory underlying its design and operation are described. Practical procedures for designing an ACES for a single-family residence, together with recommended guidelines for the construction and installation of system components, are presented. Methods are discussed for estimating the life-cycle cost, component sizes, and annual energy consumption of the system for residential applications in different climatic regions of the US.

Shuttle cryogenic supply system optimization study. Volume 4: Cryogenic cooling in environmental control systems

NASA Technical Reports Server (NTRS)

1973-01-01

An analysis of cryogenic fluid cooling in the environmental control system of the space shuttle was conducted. The technique for treating the cryogenic fluid storage and supply tanks and subsystems as integrated systems was developed. It was concluded that a basic incompatibility exists between the heat generated and the cryogen usage rate and cryogens cannot be used to absorb the generated heat. The use of radiators and accumulators to provide additional cooling capability is recommended.

An Assessment of Integrated Flywheel System Technology

NASA Technical Reports Server (NTRS)

Keckler, C. R. (Editor); Bechtel, R. T. (Editor); Groom, N. J. (Editor)

1984-01-01

The current state of the technology in flywheel storage systems and ancillary components, the technology in light of future requirements, and technology development needs to rectify these shortfalls were identified. Technology efforts conducted in Europe and in the United States were reviewed. Results of developments in composite material rotors, magnetic suspension systems, motor/generators and electronics, and system dynamics and control were presented. The technology issues for the various disciplines and technology enhancement scenarios are discussed. A summary of the workshop, and conclusions and recommendations are presented.

Space Transportation Avionics Technology Symposium. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1990-01-01

The focus of the symposium was to examine existing and planned avionics technology processes and products and to recommend necessary changes for strengthening priorities and program emphases. Innovative changes in avionics technology development and design processes, identified during the symposium, are needed to support the increasingly complex, multi-vehicle, integrated, autonomous space-based systems. Key technology advances make such a major initiative viable at this time: digital processing capabilities, integrated on-board test/checkout methods, easily reconfigurable laboratories, and software design and production techniques.

Space Transportation Avionics Technology Symposium. Volume 2: Conference Proceedings

NASA Technical Reports Server (NTRS)

1990-01-01

The focus of the symposium was to examine existing and planned avionics technology processes and products and to recommend necessary changes for strengthening priorities and program emphases. Innovative changes in avionics technology development and design processes are needed to support the increasingly complex, multi-vehicle, integrated, autonomous space-based systems. Key technology advances make such a major initiative viable at this time: digital processing capabilities, integrated on-board test/checkout methods, easily reconfigurable laboratories, and software design and production techniques.

Integrating Palliative Care Into Comprehensive Cancer Centers: Consensus-Based Development of Best Practice Recommendations

PubMed Central

Stiel, Stephanie; Simon, Steffen T.; Schmitz, Andrea; van Oorschot, Birgitt; Stachura, Peter; Ostgathe, Christoph

2016-01-01

Background. International associations admit that specialized palliative care (SPC) is an obvious component of excellent cancer care. Nevertheless, gaps in integration at the international level have been identified. Recommendations for integrating SPC in clinical care, research, and education are needed, which are subject of the present study. Materials and Methods. A Delphi study, with three written Delphi rounds, including a face-to-face-meeting with a multiprofessional expert panel (n = 52) working in SPC in 15 German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid was initiated. Initial recommendations are built on evidence-based literature. Consensus was defined in advance with ≥80% agreement based on the question of whether each recommendation was unambiguously formulated, relevant, and realizable for a CCC. Results. A total of 38 experts (73.1%) from 15 CCCs performed all three Delphi rounds. Consensus was achieved for 29 of 30 recommendations. High agreement related to having an organizationally and spatially independent palliative care unit (≥6 beds), a mobile multiprofessional SPC team, and cooperation with community-based SPC. Until round 3, an ongoing discussion was registered on hospice volunteers, a chair of palliative care, education in SPC among staff in emergency departments, and integration of SPC in decision-making processes such as tumor boards or consultation hours. Integration of SPC in decision-making processes was not consented by a low-rated feasibility (76.3%) due to staff shortage. Conclusion. Recommendations should be considered when developing standards for cancer center of excellence in Germany. Definition and implementation of indicators of integration of SPC in CCCs and evaluation of its effectiveness are current and future challenges. Implications for Practice: General and specialized palliative care (SPC) is an integral part of comprehensive cancer care. However, significant diversity concerning the design of SPC in the German Comprehensive Cancer Center (CCC) Network led to the establishment of consensual best practice recommendations for integration of SPC into the clinical structures, processes, research, and education throughout the CCC network. The recommendations contribute to a greater awareness relating to the strategic direction and development of SPC in CCCs. The access to information about SPC and access to offers regarding SPC shall be facilitated by implementing the recommendations in the course of treatment of patients with cancer. PMID:27440065

A stochastic regulator for integrated communication and control systems. I - Formulation of control law. II - Numerical analysis and simulation

NASA Technical Reports Server (NTRS)

Liou, Luen-Woei; Ray, Asok

1991-01-01

A state feedback control law for integrated communication and control systems (ICCS) is formulated by using the dynamic programming and optimality principle on a finite-time horizon. The control law is derived on the basis of a stochastic model of the plant which is augmented in state space to allow for the effects of randomly varying delays in the feedback loop. A numerical procedure for synthesizing the control parameters is then presented, and the performance of the control law is evaluated by simulating the flight dynamics model of an advanced aircraft. Finally, recommendations for future work are made.

Liquid rocket booster integration study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is the executive summary of the five volume series.

Liquid rocket booster integration study. Volume 5, part 1: Appendices

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is the appendices of the five volume series.

Liquid Rocket Booster Integration Study. Volume 2: Study synopsis

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is the study summary of the five volume series.

Integration of midwives into the Quebec health care system. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes.

PubMed

Collin, J; Blais, R; White, D; Demers, A; Desbiens, F

2000-01-01

This paper reports on one aspect of the evaluation of the midwifery pilot projects in Quebec: the identification of the professional and organizational factors, as well as the mode of integrating midwives into the maternity care system, that would promote the best outcomes and the autonomy of midwives. The research strategy involved a multiple-case study, in which each midwifery pilot project represented a case. Based on a qualitative approach, the study employed various sources of data: individual interviews and focus groups with key informants, site observations and analyses of written documents. Results show that midwives were poorly integrated into the health care system during the evaluation. Four main reasons were identified: lack of knowledge about the practice of midwifery on the part of other health care providers; deficiencies in the legal and organizational structure of the pilot projects; competition over professional territories; and gaps between the midwives' and other providers' professional cultures. Recommendations are provided to facilitate the integration of midwives into the health care system.

Supporting the need for an integrated system of care for youth with co-occurring traumatic stress and substance abuse problems.

PubMed

Suarez, Liza M; Belcher, Harolyn M E; Briggs, Ernestine C; Titus, Janet C

2012-06-01

Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.

Clinical practice guidelines on the evidence-based use of integrative therapies during and following breast cancer treatment

PubMed Central

Greenlee, Heather; DuPont-Reyes, Melissa J.; Balneaves, Lynda G.; Carlson, Linda E.; Cohen, Misha R.; Deng, Gary; Johnson, Jillian A.; Mumber, Matthew; Seely, Dugald; Zick, Suzanna; Boyce, Lindsay; Tripathy, Debu

2018-01-01

Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. PMID:28436999

Long-Term Preservation and Advanced Access Services to Archived Data: The Approach of a System Integrator

NASA Astrophysics Data System (ADS)

Petitjean, Gilles; de Hauteclocque, Bertrand

2004-06-01

EADS Defence and Security Systems (EADS DS SA) have developed an expertise as integrator of archive management systems for both their commercial and defence customers (ESA, CNES, EC, EUMETSAT, French MOD, US DOD, etc.), especially in Earth Observation and in Meteorology fields.The concern of valuable data owners is both their long-term preservation but also the integration of the archive in their information system with in particular an efficient access to archived data for their user community. The system integrator answers to this requirement by a methodology combining understanding of user needs, exhaustive knowledge of the existing solutions both for hardware and software elements and development and integration ability. The system integrator completes the facility development by support activities.The long-term preservation of archived data obviously involves a pertinent selection of storage media and archive library. This selection relies on storage technology survey but the selection criteria depend on the analysis of the user needs. The system integrator will recommend the best compromise for implementing an archive management facility, thanks to its knowledge and its independence of storage market and through the analysis of the user requirements. He will provide a solution, which is able to evolve to take advantage of the storage technology progress.But preserving the data for long-term is not only a question of storage technology. Some functions are required to secure the archive management system against contingency situation: multiple data set copies using operational procedures, active quality control of the archived data, migration policy optimising the cost of ownership.

Usability evaluation of Laboratory and Radiology Information Systems integrated into a hospital information system.

PubMed

Nabovati, Ehsan; Vakili-Arki, Hasan; Eslami, Saeid; Khajouei, Reza

2014-04-01

This study was conducted to evaluate the usability of widely used laboratory and radiology information systems. Three usability experts independently evaluated the user interfaces of Laboratory and Radiology Information Systems using heuristic evaluation method. They applied Nielsen's heuristics to identify and classify usability problems and Nielsen's severity rating to judge their severity. Overall, 116 unique heuristic violations were identified as usability problems. In terms of severity, 67 % of problems were rated as major and catastrophic. Among 10 heuristics, "consistency and standards" was violated most frequently. Moreover, mean severity of problems concerning "error prevention" and "help and documentation" heuristics was higher than of the others. Despite widespread use of specific healthcare information systems, they suffer from usability problems. Improving the usability of systems by following existing design standards and principles from the early phased of system development life cycle is recommended. Especially, it is recommended that the designers design systems that inhibit the initiation of erroneous actions and provide sufficient guidance to users.

Assessment of the Study of Army Logistics 1981. Volume II. Analysis of Recommendations.

DTIC Science & Technology

1983-02-01

conceived. This third generation equipment, because of its size, cost and processing characteristics, demands large scale integrated processing with a... generated by DS4. Three systems changes to SAILS ABX have been implemented which reduce the volume of supply status provided to the DS4 system. 15... generated by the wholesale system by 50 percent or nearly 1,000,000 transactions per month. Additional reductions will be generated by selected status

Guide to Flow Measurement for Electric Propulsion Systems

NASA Technical Reports Server (NTRS)

Frieman, Jason D.; Walker, Mitchell L. R.; Snyder, Steve

2013-01-01

In electric propulsion (EP) systems, accurate measurement of the propellant mass flow rate of gas or liquid to the thruster and external cathode is a key input in the calculation of thruster efficiency and specific impulse. Although such measurements are often achieved with commercial mass flow controllers and meters integrated into propellant feed systems, the variability in potential propellant options and flow requirements amongst the spectrum of EP power regimes and devices complicates meter selection, integration, and operation. At the direction of the Committee on Standards for Electric Propulsion Testing, a guide was jointly developed by members of the electric propulsion community to establish a unified document that contains the working principles, methods of implementation and analysis, and calibration techniques and recommendations on the use of mass flow meters in laboratory and spacecraft electric propulsion systems. The guide is applicable to EP devices of all types and power levels ranging from microthrusters to high-power ion engines and Hall effect thrusters. The establishment of a community standard on mass flow metering will help ensure the selection of the proper meter for each application. It will also improve the quality of system performance estimates by providing comprehensive information on the physical phenomena and systematic errors that must be accounted for during the analysis of flow measurement data. This paper will outline the standard methods and recommended practices described in the guide titled "Flow Measurement for Electric Propulsion Systems."

Merging long range transportation planning with public health: a case study from Utah's Wasatch Front.

PubMed

Burbidge, Shaunna K

2010-01-01

US transportation systems have been identified as a problem for public health, as they often encourage automobile transportation and discourage physical activity. This paper provides a case study examination of the Public Health Component of the Wasatch Front Regional Council's Regional Transportation Plan. This plan provides an example of what transportation planners at Utah's largest metropolitan planning organization (MPO) are doing to encourage physical activity through transportation. Existing active living research was used to guide recommendations using a process that included a comprehensive literature review and a review of existing state programs, advisory group and stakeholder meetings, and policy recommendations based on existing local conditions. Stakeholders from a diversity of background and interests came together with one common goal: to improve public health. Based on this collaborative process, nine policy approaches were specifically recommended for approval and integration in the Wasatch Front Regional Transportation Plan. By using current research as a guide and integrating a variety of interests, the Wasatch Front Regional Council is setting a new standard for a collaborative multi-modal focus in transportation planning, which can be replicated nationwide.

An evaluation of the documented requirements of the SSP UIL and a review of commercial software packages for the development and testing of UIL prototypes

NASA Technical Reports Server (NTRS)

Gill, Esther Naomi

1986-01-01

A review was conducted of software packages currently on the market which might be integrated with the interface language and aid in reaching the objectives of customization, standardization, transparency, reliability, maintainability, language substitutions, expandability, portability, and flexibility. Recommendations are given for best choices in hardware and software acquisition for inhouse testing of these possible integrations. Software acquisition in the line of tools to aid expert-system development and/or novice program development, artificial intelligent voice technology and touch screen or joystick or mouse utilization as well as networking were recommended. Other recommendations concerned using the language Ada for the user interface language shell because of its high level of standardization, structure, and ability to accept and execute programs written in other programming languages, its DOD ownership and control, and keeping the user interface language simple so that multiples of users will find the commercialization of space within their realm of possibility which is, after all, the purpose of the Space Station.

Enhancing S4 with Guidance from the Features of Other Behavior Modeling Systems

DTIC Science & Technology

2010-11-01

recommendations for updating S4 into a more realistic system for modeling human cognition. We focus on three areas of cognition: perception , memory, and...Research Integration Tool (IMPRINT) .........................6  4.  Improving the Cognitive Mechanisms of S4 7  4.1  Perception , Memory and Decision...Making in S4 ...........................................................7  4.2  Possible Improvements for Perception in S4

Recommendation of a More Effective Alternative to the NASA Launch Services Program Mission Integration Reporting System (MIRS) and Implementation of Updates to the Mission Plan

NASA Technical Reports Server (NTRS)

Dunn, Michael R.

2014-01-01

Over the course of my internship in the Flight Projects Office of NASA's Launch Services Program (LSP), I worked on two major projects, both of which dealt with updating current systems to make them more accurate and to allow them to operate more efficiently. The first project dealt with the Mission Integration Reporting System (MIRS), a web-accessible database application used to manage and provide mission status reporting for the LSP portfolio of awarded missions. MIRS had not gone through any major updates since its implementation in 2005, and it was my job to formulate a recommendation for the improvement of the system. The second project I worked on dealt with the Mission Plan, a document that contains an overview of the general life cycle that is followed by every LSP mission. My job on this project was to update the information currently in the mission plan and to add certain features in order to increase the accuracy and thoroughness of the document. The outcomes of these projects have implications in the orderly and efficient operation of the Flight Projects Office, and the process of Mission Management in the Launch Services Program as a whole.

Adaptive and Adaptable Automation Design: A Critical Review of the Literature and Recommendations for Future Research

NASA Technical Reports Server (NTRS)

Prinzel, Lawrence J., III; Kaber, David B.

2006-01-01

This report presents a review of literature on approaches to adaptive and adaptable task/function allocation and adaptive interface technologies for effective human management of complex systems that are likely to be issues for the Next Generation Air Transportation System, and a focus of research under the Aviation Safety Program, Integrated Intelligent Flight Deck Project. Contemporary literature retrieved from an online database search is summarized and integrated. The major topics include the effects of delegation-type, adaptable automation on human performance, workload and situation awareness, the effectiveness of various automation invocation philosophies and strategies to function allocation in adaptive systems, and the role of user modeling in adaptive interface design and the performance implications of adaptive interface technology.

Endangered Mangroves in Segara Anakan, Indonesia: Effective and Failed Problem-Solving Policy Advice.

PubMed

Dharmawan, Budi; Böcher, Michael; Krott, Max

2017-09-01

The success of scientific knowledge transfer depends on if the decision maker can transform the scientific advice into a policy that can be accepted by all involved actors. We use a science-policy interactions model called research-integration-utilization to observe the process of scientific knowledge transfer in the case of endangered mangroves in Segara Anakan, Indonesia. Scientific knowledge is produced within the scientific system (research), science-based solutions to problems are practically utilized by political actors (utilization), and important links between research and utilization must be made (integration). We looked for empirical evidence to test hypotheses about the research-integration-utilization model based on document analysis and expert interviews. Our study finds that the failures in knowledge transfer are caused by the inappropriate use of scientific findings. The district government is expected by presidential decree to only used scientifically sound recommendations as a prerequisite for designing the regulation. However, the district government prefers to implement their own solutions because they believe that they understand the solutions better than the researcher. In the process of integration, the researcher cannot be involved, since the selection of scientific recommendations here fully depends on the interests of the district government as the powerful ally.

Endangered Mangroves in Segara Anakan, Indonesia: Effective and Failed Problem-Solving Policy Advice

NASA Astrophysics Data System (ADS)

Dharmawan, Budi; Böcher, Michael; Krott, Max

2017-09-01

The success of scientific knowledge transfer depends on if the decision maker can transform the scientific advice into a policy that can be accepted by all involved actors. We use a science-policy interactions model called research-integration-utilization to observe the process of scientific knowledge transfer in the case of endangered mangroves in Segara Anakan, Indonesia. Scientific knowledge is produced within the scientific system (research), science-based solutions to problems are practically utilized by political actors (utilization), and important links between research and utilization must be made (integration). We looked for empirical evidence to test hypotheses about the research-integration-utilization model based on document analysis and expert interviews. Our study finds that the failures in knowledge transfer are caused by the inappropriate use of scientific findings. The district government is expected by presidential decree to only used scientifically sound recommendations as a prerequisite for designing the regulation. However, the district government prefers to implement their own solutions because they believe that they understand the solutions better than the researcher. In the process of integration, the researcher cannot be involved, since the selection of scientific recommendations here fully depends on the interests of the district government as the powerful ally.

Study of liquid oxygen/liquid hydrogen auxiliary propulsion systems for the space tug

NASA Technical Reports Server (NTRS)

Nichols, J. F.

1975-01-01

Design concepts are considered that permit use of a liquid-liquid (as opposed to gas-gas) oxygen/hydrogen thrust chamber for attitude control and auxiliary propulsion thrusters on the space tug. The best of the auxiliary propulsion system concepts are defined and their principal characteristics, including cost as well as operational capabilities, are established. Design requirements for each of the major components of the systems, including thrusters, are developed at the conceptual level. The competitive concepts considered use both dedicated (separate tanks) and integrated (propellant from main propulsion tanks) propellant supply. The integrated concept is selected as best for the space tug after comparative evaluation against both cryogenic and storable propellant dedicated systems. A preliminary design of the selected system is established and recommendations for supporting research and technology to further the concept are presented.

Embedded expert system for space shuttle main engine maintenance

NASA Technical Reports Server (NTRS)

Pooley, J.; Thompson, W.; Homsley, T.; Teoh, W.; Jones, J.; Lewallen, P.

1987-01-01

The SPARTA Embedded Expert System (SEES) is an intelligent health monitoring system that directs analysis by placing confidence factors on possible engine status and then recommends a course of action to an engineer or engine controller. The technique can prevent catastropic failures or costly rocket engine down time because of false alarms. Further, the SEES has potential as an on-board flight monitor for reusable rocket engine systems. The SEES methodology synergistically integrates vibration analysis, pattern recognition and communications theory techniques with an artificial intelligence technique - the Embedded Expert System (EES).

Integrated Vehicle Health Management (IVHM) for Aerospace Systems

NASA Technical Reports Server (NTRS)

Baroth, Edmund C.; Pallix, Joan

2006-01-01

To achieve NASA's ambitious Integrated Space Transportation Program objectives, aerospace systems will implement a variety of new concept in health management. System level integration of IVHM technologies for real-time control and system maintenance will have significant impact on system safety and lifecycle costs. IVHM technologies will enhance the safety and success of complex missions despite component failures, degraded performance, operator errors, and environment uncertainty. IVHM also has the potential to reduce, or even eliminate many of the costly inspections and operations activities required by current and future aerospace systems. This presentation will describe the array of NASA programs participating in the development of IVHM technologies for NASA missions. Future vehicle systems will use models of the system, its environment, and other intelligent agents with which they may interact. IVHM will be incorporated into future mission planners, reasoning engines, and adaptive control systems that can recommend or execute commands enabling the system to respond intelligently in real time. In the past, software errors and/or faulty sensors have been identified as significant contributors to mission failures. This presentation will also address the development and utilization of highly dependable sohare and sensor technologies, which are key components to ensure the reliability of IVHM systems.

Breath Alcohol Ignition Interlock Devices : Policy and Implementing Implications [Mobile .MP4 (480x320/29.97fps/13.9MB)

DOT National Transportation Integrated Search

2011-01-01

The goal of this project is to perform a systematic review of breath alcohol ignition interlock devices (BAIID or IID) to understand how other states have integrated such systems into administrative and judicial practice and to make recommendations f...

A Study of Learner-Oriented Negative Emotion Compensation in E-Learning

ERIC Educational Resources Information Center

Qin, Jiwei; Zheng, Qinghua; Li, Haifei

2014-01-01

E-learning provides an unprecedented flexibility and convenience for e-learners by breaking the limitations of space and time. However, the role of emotion is neglected in current e-learning systems. We focus strictly on negative emotions of e-learners, integrating emotion regulation theories with recommender technique, and present the study of…

Breath Alcohol Ignition Interlock Devices : Policy and Implementing Implications [SD .MP4 (640x424/29.97fps/22.6MB)

DOT National Transportation Integrated Search

2011-01-01

The goal of this project is to perform a systematic review of breath alcohol ignition interlock devices (BAIID or IID) to understand how other states have integrated such systems into administrative and judicial practice and to make recommendations f...

77 FR 29033 - Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... organizational structure, whereby multi- hospital systems have integrated their governing body functions to... based on nationally recognized and evidence-based guidelines and recommendations. Verbal Orders: We have..., Outpatient services ($300 million). Our estimates were based on input from stakeholders as well as on our own...

Crisis Management's New Role in Educational Settings

ERIC Educational Resources Information Center

Gainey, Barbara S.

2009-01-01

From natural disasters to the financial debacle, it is clear to the educational community that crises know no boundaries. Far from a passing fad, crisis planning must be an integrated part of effective school district leadership. Two studies explore the status of crisis management in selected public school systems and offer recommendations for…

An Intelligent Mobile Location-Aware Book Recommendation System that Enhances Problem-Based Learning in Libraries

ERIC Educational Resources Information Center

Chen, Chih-Ming

2013-01-01

Despite rapid and continued adoption of mobile devices, few learning modes integrate with mobile technologies and libraries' environments as innovative learning modes that emphasize the key roles of libraries in facilitating learning. In addition, some education experts have claimed that transmitting knowledge to learners is not the only…

78 FR 64929 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... process for institutions of higher education under Title IV, of the HEA, together with recommendations for... Federal Register and the Code of Federal Regulations is available via the Federal Digital System at: www... of the Department published in the Federal Register by using the article search feature at: www...

78 FR 19695 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... of higher education under Title IV, of the HEA, together with recommendations for improvement in such... available via the Federal Digital System at: www.gpo.gov/fdsys . At this site you can view this document, as... the article search feature at: www.federalregister.gov . Specifically, through the advanced search...

77 FR 64493 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... process for institutions of higher education under Title IV, of the HEA, together with recommendations for... available via the Federal Digital System at: www.gpo.gov/fdsys . At this site you can view this document, as... the article search feature at: www.federalregister.gov . Specifically, through the advanced search...

Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment.

PubMed

Greenlee, Heather; DuPont-Reyes, Melissa J; Balneaves, Lynda G; Carlson, Linda E; Cohen, Misha R; Deng, Gary; Johnson, Jillian A; Mumber, Matthew; Seely, Dugald; Zick, Suzanna M; Boyce, Lindsay M; Tripathy, Debu

2017-05-06

Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society. © 2017 American Cancer Society.

Increasing the Delivery of Preventive Health Services in Public Education.

PubMed

Cruden, Gracelyn; Kelleher, Kelly; Kellam, Sheppard; Brown, C Hendricks

2016-10-01

The delivery of prevention services to children and adolescents through traditional healthcare settings is challenging for a variety of reasons. Parent- and community-focused services are typically not reimbursable in traditional medical settings, and personal healthcare services are often designed for acute and chronic medical treatment rather than prevention. To provide preventive services in a setting that reaches the widest population, those interested in public health and prevention often turn to school settings. This paper proposes that an equitable, efficient manner in which to promote health across the life course is to integrate efforts from public health, primary care, and public education through the delivery of preventive healthcare services, in particular, in the education system. Such an integration of systems will require a concerted effort on the part of various stakeholders, as well as a shared vision to promote child health via community and institutional stakeholder partnerships. This paper includes (1) examination of some key system features necessary for delivery of preventive services that improve child outcomes; (2) a review of the features of some common models of school health services for their relevance to prevention services; and (3) policy and implementation strategy recommendations to further the delivery of preventive services in schools. These recommendations include the development of common metrics for health outcomes reporting, facilitated data sharing of these metrics, shared organization incentives for integration, and improved reimbursement and funding opportunities. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Physicians', Nurses', and Medical Assistants' Perceptions of the Human Papillomavirus Vaccine in a Large Integrated Health Care System.

PubMed

Mills, Jordan; Van Winkle, Patrick; Shen, Macy; Hong, Christina; Hudson, Sharon

2016-01-01

Vaccination against the human papillomavirus (HPV) decreases risks of cancer and genital warts and the need for gynecologic procedures, yet nationwide vaccination rates are low. Previous surveys exploring this phenomenon have not included input from nurses and medical assistants, who play integral roles in HPV vaccine delivery. To understand perceptions of HPV vaccine delivery among physicians, nurses, and medical assistants in a large integrated health care system in Southern California. Online surveys were sent to 13 nurse administrators and 75 physicians. Physicians were instructed to forward the survey to nurses and medical assistants with whom they work. A total of 76 surveys were completed, consisting of 52 physicians, 16 clinical nurses and medical assistants, and 8 nurse administrators. Physicians' perceptions of vaccine safety or strength of recommendation did not differ by specialty department. Physicians reportedly perceived the HPV vaccine as safer than did clinical nurses and medical assistants (p < 0.001), who indicated they wanted more education on the safety and efficacy of the vaccine before being comfortable strongly recommending it. Respondents advised that all clinicians could improve in their roles as HPV vaccine advocates through patient counseling and providing informational literature and that workflow standardization was needed to minimize missed vaccination opportunities. Physicians reportedly perceive the HPV vaccine as safer compared with nurses and medical assistants. Both groups think that more education of nonphysician staff is needed. Having proper systems in place is also vital to improving vaccination compliance.

Integrated Information Support System (IISS). Volume 4. IISS System. Part 1. System Requirement Document.

DTIC Science & Technology

1985-11-01

access audit trail. 2. Screen audit trail for unauthorized entries. B.6.3.3 Manage CDX Resources B.6.3.3.1 Measure CDX Performance 1. Keep running...response time B-32 SRD620140000 1 November 1985 -ii I B -3 / I 0 / . ".3 SRD620140000 1 November 1985 4. Audit 1ISS hardware performance (LAN, HOSTS...standards on-line. 7. Assist IISS service specifier and application specifier in implementing standards recommendation. 8. Perform audit of IISS

Client-Side Data Processing and Training for Multispectral Imagery Applications in the GOES-R Era

NASA Technical Reports Server (NTRS)

Fuell, Kevin; Gravelle, Chad; Burks, Jason; Berndt, Emily; Schultz, Lori; Molthan, Andrew; Leroy, Anita

2016-01-01

RGB imagery can be created locally (i.e. client-side) from single band imagery already on the system with little impact given recommended change to texture cache in AWIPS II. Training/Reference material accessible to forecasters within their operational display system improves RGB interpretation and application as demonstrated at OPG. Application examples from experienced forecasters are needed to support the larger community use of RGB imagery and these can be integrated into the user's display system.

Developing a semantic web model for medical differential diagnosis recommendation.

PubMed

Mohammed, Osama; Benlamri, Rachid

2014-10-01

In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results.

System-on-Chip Considerations for Heterogeneous Integration of CMOS and Fluidic Bio-Interfaces.

PubMed

Datta-Chaudhuri, Timir; Smela, Elisabeth; Abshire, Pamela A

2016-12-01

CMOS chips are increasingly used for direct sensing and interfacing with fluidic and biological systems. While many biosensing systems have successfully combined CMOS chips for readout and signal processing with passive sensing arrays, systems that co-locate sensing with active circuits on a single chip offer significant advantages in size and performance but increase the complexity of multi-domain design and heterogeneous integration. This emerging class of lab-on-CMOS systems also poses distinct and vexing technical challenges that arise from the disparate requirements of biosensors and integrated circuits (ICs). Modeling these systems must address not only circuit design, but also the behavior of biological components on the surface of the IC and any physical structures. Existing tools do not support the cross-domain simulation of heterogeneous lab-on-CMOS systems, so we recommend a two-step modeling approach: using circuit simulation to inform physics-based simulation, and vice versa. We review the primary lab-on-CMOS implementation challenges and discuss practical approaches to overcome them. Issues include new versions of classical challenges in system-on-chip integration, such as thermal effects, floor-planning, and signal coupling, as well as new challenges that are specifically attributable to biological and fluidic domains, such as electrochemical effects, non-standard packaging, surface treatments, sterilization, microfabrication of surface structures, and microfluidic integration. We describe these concerns as they arise in lab-on-CMOS systems and discuss solutions that have been experimentally demonstrated.

Management of environmental health issues for the 2004 Athens Olympic Games: is enhanced integrated environmental health surveillance needed in every day routine operation?

PubMed Central

Hadjichristodoulou, Christos; Mouchtouri, Varvara; Vaitsi, Vasiliki; Kapoula, Christina; Vousoureli, Anastasia; Kalivitis, Isidiros; Chervoni, Julia; Papastergiou, Panagiotis; Vasilogiannakopoulos, Antonios; Daniilidis, Vasilis D; Kremastinou, Jenny

2006-01-01

Background Management of environmental health issues is an integral part of public health systems. An active integrated environmental health surveillance and response system was developed for the Athens Olympics to monitor and prevent exposure to environmental hazards. The potential for permanent implementation of the program was examined. Methods The environmental health surveillance and response system included standardization, computerization and electronic transmission of data concerning environmental inspections of 17 site categories (restaurants, swimming pools etc) of public health interest, drinking and recreational water examinations and suggested corrective actions. The Olympic Planning Unit integrated and centrally managed data from 13 public health agencies, recommended, supervised and coordinated prompt corrective actions. Methods used to test the effectiveness of the program were the assessment of water quality test and inspection results trends over time using linear regression and epidemiological surveillance findings. Results Between January 2003 and September the 30th, 2004, 196 inspectors conducted 8562 inspections, collected 5024 water samples and recommended 17 027 corrective actions. In 10 cruise ships used as floating hotels inspectors conducted 10 full inspections, 2 re-inspections, and 27 follow-up inspections. Unsatisfactory inspection results (r = 0.44, p < 0.0001) and positive water quality tests (r = 0.39, p < 0.001) presented an overall decrease trend over time. In August, 2003, an outbreak of salmonellosis was linked to a hotel restaurant which accommodated athletes during a test event. Conclusion Lessons learned for future events include timely implementation and installation of communication processes, and rapid and coordinated response to unsatisfactory inspection results. Routine national programs need to adopt enhanced environmental health surveillance aimed at public health decision-making, but with a different perspective. PMID:17176469

Management of environmental health issues for the 2004 Athens Olympic Games: is enhanced integrated environmental health surveillance needed in every day routine operation?

PubMed

Hadjichristodoulou, Christos; Mouchtouri, Varvara; Vaitsi, Vasiliki; Kapoula, Christina; Vousoureli, Anastasia; Kalivitis, Isidiros; Chervoni, Julia; Papastergiou, Panagiotis; Vasilogiannakopoulos, Antonios; Daniilidis, Vasilis D; Kremastinou, Jenny

2006-12-18

Management of environmental health issues is an integral part of public health systems. An active integrated environmental health surveillance and response system was developed for the Athens Olympics to monitor and prevent exposure to environmental hazards. The potential for permanent implementation of the program was examined. The environmental health surveillance and response system included standardization, computerization and electronic transmission of data concerning environmental inspections of 17 site categories (restaurants, swimming pools etc) of public health interest, drinking and recreational water examinations and suggested corrective actions. The Olympic Planning Unit integrated and centrally managed data from 13 public health agencies, recommended, supervised and coordinated prompt corrective actions. Methods used to test the effectiveness of the program were the assessment of water quality test and inspection results trends over time using linear regression and epidemiological surveillance findings. Between January 2003 and September the 30th, 2004, 196 inspectors conducted 8562 inspections, collected 5024 water samples and recommended 17 027 corrective actions. In 10 cruise ships used as floating hotels inspectors conducted 10 full inspections, 2 re-inspections, and 27 follow-up inspections. Unsatisfactory inspection results (r = 0.44, p < 0.0001) and positive water quality tests (r = 0.39, p < 0.001) presented an overall decrease trend over time. In August, 2003, an outbreak of salmonellosis was linked to a hotel restaurant which accommodated athletes during a test event. Lessons learned for future events include timely implementation and installation of communication processes, and rapid and coordinated response to unsatisfactory inspection results. Routine national programs need to adopt enhanced environmental health surveillance aimed at public health decision-making, but with a different perspective.

Five key recommendations for the implementation of Hospital Electronic Prescribing and Medicines Administration systems in Scotland.

PubMed

Cresswell, Kathrin; Slee, Ann; Sheikh, Aziz

2017-01-24

NHS Scotland is about to embark on the implementation of Hospital Electronic Prescribing and Medicines Administration (HEPMA) systems. There are a number of risks associated with such ventures, thus drawing on existing experiences from other settings is crucial in informing deployment.Drawing on our previous and ongoing work in English settings as well as the international literature, we reflect on key lessons that NHS Scotland may wish to consider in going forward. These deliberations include recommendations surrounding key aspects of deployment strategy surrounding: 1) the way central coordination should be conceptualised, 2) how flexibility in can be ensured, 3) paying attention to optimising systems from the outset, 4) how expertise should be developed and centrally shared, and 5) ways in which learning from experience can be maximised.Our five recommendations will, we hope, provide a starting point for the strategic deliberations of policy makers. Throughout this journey, it is important to view the deployment of HEPMA as part of a wider strategic goal of creating integrated digital infrastructures across Scotland.

Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research

PubMed Central

Burris, Scott; Mays, Glen P; Douglas Scutchfield, F; Ibrahim, Jennifer K

2012-01-01

Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the usefulness of research in supporting practice and the long-term improvement of system performance. PMID:22709392

Space transfer vehicle concepts and requirements, volume 2, book 1

NASA Technical Reports Server (NTRS)

1991-01-01

The objective of the systems engineering task was to develop and implement an approach that would generate the required study products as defined by program directives. This product list included a set of system and subsystem requirements, a complete set of optimized trade studies and analyses resulting in a recommended system configuration, and the definition of an integrated system/technology and advanced development growth path. A primary ingredient in the approach was the TQM philosophy stressing job quality from the inception. Included throughout the Systems Engineering, Programmatics, Concepts, Flight Design, and Technology sections are data supporting the original objectives as well as supplemental information resulting from program activities. The primary result of the analyses and studies was the recommendation of a single propulsion stage Lunar Transportation System (LTS) configuration that supports several different operations scenarios with minor element changes. This concept has the potential to support two additional scenarios with complex element changes. The space based LTS concept consists of three primary configurations--Piloted, Reusable Cargo, and Expendable Cargo.

TogoDoc server/client system: smart recommendation and efficient management of life science literature.

PubMed

Iwasaki, Wataru; Yamamoto, Yasunori; Takagi, Toshihisa

2010-12-13

In this paper, we describe a server/client literature management system specialized for the life science domain, the TogoDoc system (Togo, pronounced Toe-Go, is a romanization of a Japanese word for integration). The server and the client program cooperate closely over the Internet to provide life scientists with an effective literature recommendation service and efficient literature management. The content-based and personalized literature recommendation helps researchers to isolate interesting papers from the "tsunami" of literature, in which, on average, more than one biomedical paper is added to MEDLINE every minute. Because researchers these days need to cover updates of much wider topics to generate hypotheses using massive datasets obtained from public databases or omics experiments, the importance of having an effective literature recommendation service is rising. The automatic recommendation is based on the content of personal literature libraries of electronic PDF papers. The client program automatically analyzes these files, which are sometimes deeply buried in storage disks of researchers' personal computers. Just saving PDF papers to the designated folders makes the client program automatically analyze and retrieve metadata, rename file names, synchronize the data to the server, and receive the recommendation lists of newly published papers, thus accomplishing effortless literature management. In addition, the tag suggestion and associative search functions are provided for easy classification of and access to past papers (researchers who read many papers sometimes only vaguely remember or completely forget what they read in the past). The TogoDoc system is available for both Windows and Mac OS X and is free. The TogoDoc Client software is available at http://tdc.cb.k.u-tokyo.ac.jp/, and the TogoDoc server is available at https://docman.dbcls.jp/pubmed_recom.

TogoDoc Server/Client System: Smart Recommendation and Efficient Management of Life Science Literature

PubMed Central

Takagi, Toshihisa

2010-01-01

In this paper, we describe a server/client literature management system specialized for the life science domain, the TogoDoc system (Togo, pronounced Toe-Go, is a romanization of a Japanese word for integration). The server and the client program cooperate closely over the Internet to provide life scientists with an effective literature recommendation service and efficient literature management. The content-based and personalized literature recommendation helps researchers to isolate interesting papers from the “tsunami” of literature, in which, on average, more than one biomedical paper is added to MEDLINE every minute. Because researchers these days need to cover updates of much wider topics to generate hypotheses using massive datasets obtained from public databases or omics experiments, the importance of having an effective literature recommendation service is rising. The automatic recommendation is based on the content of personal literature libraries of electronic PDF papers. The client program automatically analyzes these files, which are sometimes deeply buried in storage disks of researchers' personal computers. Just saving PDF papers to the designated folders makes the client program automatically analyze and retrieve metadata, rename file names, synchronize the data to the server, and receive the recommendation lists of newly published papers, thus accomplishing effortless literature management. In addition, the tag suggestion and associative search functions are provided for easy classification of and access to past papers (researchers who read many papers sometimes only vaguely remember or completely forget what they read in the past). The TogoDoc system is available for both Windows and Mac OS X and is free. The TogoDoc Client software is available at http://tdc.cb.k.u-tokyo.ac.jp/, and the TogoDoc server is available at https://docman.dbcls.jp/pubmed_recom. PMID:21179453

Evaluation of an Educational Computer Programme as a Change Agent in Science Classrooms

NASA Astrophysics Data System (ADS)

Muwanga-Zake, Johnnie Wycliffe Frank

2007-12-01

I report on benefits from 26 teacher-participant evaluators of a computer game designed to motivate learning and to ease conceptual understanding of biology in South Africa. Using a developmental, social constructivist and interpretative model, the recommendation is to include the value systems and needs of end-users (through social dialogue); curriculum issues (learning theories in the ECP and those the education authorities recommend, as well as ECP-curriculum integration); the nature of the subject the ECP presents (e.g., Nature of Science); and the compatibility of the ECP with school computers.

Mining drug-disease relationships as a complement to medical genetics-based drug repositioning: Where a recommendation system meets genome-wide association studies.

PubMed

Wang, H; Gu, Q; Wei, J; Cao, Z; Liu, Q

2015-05-01

A novel recommendation-based drug repositioning strategy is presented to simultaneously determine novel drug indications and side effects in one integrated framework. This strategy provides a complementary method to medical genetics-based drug repositioning, which reduces the occurrence of false positives in medical genetics-based drug repositioning, resulting in a ranked list of new candidate indications and/or side effects with different confidence levels. Several new drug indications and side effects are reported with high prediction confidences. © 2015 American Society for Clinical Pharmacology and Therapeutics.

Research on the performance evaluation of agricultural products supply chain integrated operation

NASA Astrophysics Data System (ADS)

Jiang, Jiake; Wang, Xifu; Liu, Yang

2017-04-01

The agricultural product supply chain integrated operation can ensure the quality and efficiency of agricultural products, and achieve the optimal goal of low cost and high service. This paper establishes a performance evaluation index system of agricultural products supply chain integration operation based on the development status of agricultural products and SCOR, BSC and KPI model. And then, we constructing rough set theory and BP neural network comprehensive evaluation model with the aid of Rosetta and MATLAB tools and the case study is about the development of agricultural products integrated supply chain in Jing-Jin-Ji region. And finally, we obtain the corresponding performance results, and give some improvement measures and management recommendations to the managers.

A feasibility study for advanced technology integration for general aviation

NASA Technical Reports Server (NTRS)

Kohlman, D. L.; Matsuyama, G. T.; Hawley, K. E.; Meredith, P. T.

1980-01-01

An investigation was conducted to identify candidate technologies and specific developments which offer greatest promise for improving safety, fuel efficiency, performance, and utility of general aviation airplanes. Interviews were conducted with general aviation airframe and systems manufacturers and NASA research centers. The following technologies were evaluated for use in airplane design tradeoff studies conducted during the study: avionics, aerodynamics, configurations, structures, flight controls, and propulsion. Based on industry interviews and design tradeoff studies, several recommendations were made for further high payoff research. The most attractive technologies for use by the general aviation industry appear to be advanced engines, composite materials, natural laminar flow airfoils, and advanced integrated avionics systems. The integration of these technologies in airplane design can yield significant increases in speeds, ranges, and payloads over present aircraft with 40 percent to 50 percent reductions in fuel used.

Psychosocial determinants of physicians' acceptance of recommendations by antibiotic computerised decision support systems: A mixed methods study.

PubMed

Chow, Angela; Lye, David C B; Arah, Onyebuchi A

2015-03-01

Antibiotic computerised decision support systems (CDSSs) were developed to facilitate optimal prescribing, but acceptance of their recommendations has remained low. We aimed to evaluate physicians' perceptions and attitudes toward antibiotic CDSSs and determine psychosocial factors associated with acceptance of CDSS recommendations for empirical therapy. A mixed methods study was conducted in an adult tertiary-care hospital in Singapore, with its in-house antibiotic CDSS that integrates antimicrobial stewardship with electronic prescribing. Focus group discussions were conducted among purposively sampled physicians and data were analysed using the framework approach. Emerging themes were included in the questionnaire with newly developed scales for the subsequent cross-sectional survey involving all physicians. Principal components analysis was performed to derive the latent factor structure that was later applied in multivariate analyses. Physicians expressed confidence in the credibility of CDSS recommendations. Junior physicians accepted CDSS recommendations most of the time, whilst senior physicians acknowledged overriding recommendations in complex patients with multiple infections or allergies. Willingness to consult the CDSS for common and complex infections (OR=1.68, 95% CI 1.16-2.44) and preference for personal or team decision (OR=0.61, 95% CI 0.43-0.85) were associated with acceptance of CDSS recommendations. Cronbach's α for scales measuring physicians' attitudes and perceptions towards acceptance of CDSS recommendations ranged from 0.64 to 0.88. Physicians' willingness to consult an antibiotic CDSS determined acceptance of its recommendations. Physicians would choose to exercise their own or clinical team's decision over CDSS recommendations in complex patient situations when the antibiotic prescribing needs were not met. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Fostering Integrity in Research

NASA Astrophysics Data System (ADS)

McNutt, M. K.

2017-12-01

The responsible conduct of research requires that all involved in the research enterprise - researchers, sponsors, reviewers, publishers, and communicators - adhere to a set of integrity principles to protect the public's investment. Given the increasing complexity and globalization of the research enterprise, the National Academies recently re-examined and updated its integrity recommendations for researchers in the report Fostering Integrity in Research, with sponsorship from the National Science Foundation. Major departures from the previous recommendations 25-years earlier are the recognition that practices that were previously classified as merely questionable are indeed detrimental to the responsible conduct of research. Furthermore, the report concludes that there has been insufficient effort to respond to the threats that lapses in research integrity pose to the quality of research products and the reputation of researchers as deserving of the public trust. It recommends the creation of an independent, non-profit entity dedicated to promoting research integrity by serving as a resource and clearing house for expertise, advice, materials, and best practices on fostering research integrity and responding to allegations of research misconduct.

Information science team

NASA Technical Reports Server (NTRS)

Billingsley, F.

1982-01-01

Concerns are expressed about the data handling aspects of system design and about enabling technology for data handling and data analysis. The status, contributing factors, critical issues, and recommendations for investigations are listed for data handling, rectification and registration, and information extraction. Potential supports to individual P.I., research tasks, systematic data system design, and to system operation. The need for an airborne spectrometer class instrument for fundamental research in high spectral and spatial resolution is indicated. Geographic information system formatting and labelling techniques, very large scale integration, and methods for providing multitype data sets must also be developed.

Work-life integration in neuropsychology: a review of the existing literature and preliminary recommendations.

PubMed

Feigon, Maia; Block, Cady; Guidotti Breting, Leslie; Boxley, Laura; Dawson, Erica; Cobia, Derin

2018-02-01

The purpose of the current review paper is to identify and describe challenges to work-life integration in neuropsychology, and from this review extrapolate an initial set of recommendations and present a set of scenarios in which the recommendations might apply in the hopes of improving quality of life for current and prospective neuropsychologists. Specific areas of focus include diversity, early and mid-career transitions, and potential barriers to advancement in specific practice settings. A broad review was conducted of extant literature on work-life integration. There is scant scientific literature in this area that is specific to neuropsychologists, or even psychology as a whole. Subsequently, the majority of this review was collected from more developed literatures in business and medical fields. The authors then provided recommendations based on experiences in their respective careers. Attempts were made to promote generalizability of recommendations for neuropsychologists in different settings. Evidence supports a potentially adverse impact on quality of life and overall life satisfaction when work and personal lives conflict. This manuscript identifies some of the potential risks when work and life responsibilities are not well integrated. It is anticipated this will serve as a catalyst for future studies on work-life integration in the field of neuropsychology, specifically.

Liquid rocket booster integration study. Volume 3: Study products. Part 2: Sections 8-19

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is part two of the study products section of the five volume series.

Integrating Personalized and Community Services for Mobile Travel Planning and Management

NASA Astrophysics Data System (ADS)

Yu, Chien-Chih

Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.

Design Of Combined Stochastic Feedforward/Feedback Control

NASA Technical Reports Server (NTRS)

Halyo, Nesim

1989-01-01

Methodology accommodates variety of control structures and design techniques. In methodology for combined stochastic feedforward/feedback control, main objectives of feedforward and feedback control laws seen clearly. Inclusion of error-integral feedback, dynamic compensation, rate-command control structure, and like integral element of methodology. Another advantage of methodology flexibility to develop variety of techniques for design of feedback control with arbitrary structures to obtain feedback controller: includes stochastic output feedback, multiconfiguration control, decentralized control, or frequency and classical control methods. Control modes of system include capture and tracking of localizer and glideslope, crab, decrab, and flare. By use of recommended incremental implementation, control laws simulated on digital computer and connected with nonlinear digital simulation of aircraft and its systems.

Liquid rocket booster integration study. Volume 3, part 1: Study products

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is part one of the study products section of the five volume series.

A feasibility study: Forest Fire Advanced System Technology (FFAST)

NASA Technical Reports Server (NTRS)

Mcleod, R. G.; Martin, T. Z.; Warren, J.

1983-01-01

The National Aeronautics and Space Administration/Jet Propulsion Laboratory and the United States Department of Agriculture Forest Service completed a feasibility study that examined the potential uses of advanced technology in forest fires mapping and detection. The current and future (1990's) information needs in forest fire management were determined through interviews. Analysis shows that integrated information gathering and processing is needed. The emerging technologies that were surveyed and identified as possible candidates for use in an end to end system include ""push broom'' sensor arrays, automatic georeferencing, satellite communication links, near real or real time image processing, and data integration. Matching the user requirements and the technologies yielded a ""strawman'' system configuration. The feasibility study recommends and outlines the implementation of the next phase for this project, a two year, conceptual design phase to define a system that warrants continued development.

Design and Integration of an All-Magnetic Attitude Control System for FASTSAT-HSV01's Multiple Pointing Objectives

NASA Technical Reports Server (NTRS)

DeKock, Brandon; Sanders, Devon; Vanzwieten, Tannen; Capo-Lugo, Pedro

2011-01-01

The FASTSAT-HSV01 spacecraft is a microsatellite with magnetic torque rods as it sole attitude control actuator. FASTSAT s multiple payloads and mission functions require the Attitude Control System (ACS) to maintain Local Vertical Local Horizontal (LVLH)-referenced attitudes without spin-stabilization, while the pointing errors for some attitudes be significantly smaller than the previous best-demonstrated for this type of control system. The mission requires the ACS to hold multiple stable, unstable, and non-equilibrium attitudes, as well as eject a 3U CubeSat from an onboard P-POD and recover from the ensuing tumble. This paper describes the Attitude Control System, the reasons for design choices, how the ACS integrates with the rest of the spacecraft, and gives recommendations for potential future applications of the work.

Identification of climate-resilient integrated nutrient management practices for rice-rice cropping system--an empirical approach to uphold food security.

PubMed

Subash, N; Gangwar, B; Singh, Rajbir; Sikka, A K

2015-01-01

Yield datasets of long-term experiments on integrated nutrient management in rice-rice cropping systems were used to investigate the relationship of variability in rainfall, temperature, and integrated nutrient management (INM) practices in rice-rice cropping system in three different agroecological regions of India. Twelve treatments with different combinations of inorganic (chemical fertilizer) and organic (farmyard manure, green manure, and paddy straw) were compared with farmer's conventional practice. The intraseasonal variations in rice yields are largely driven by rainfall during kharif rice and by temperature during rabi rice. Half of the standard deviation from the average monthly as well as seasonal rainfall during kharif rice and 1 °C increase or decrease from the average maximum and minimum temperature during rabi rice has been taken as the classification of yield groups. The trends in the date of effective onset of monsoon indicate a 36-day delay during the 30-year period at Rajendranagar, which is statistically significant at 95 % confidence level. The mean annual maximum temperature shows an increasing trend in all the study sites. The length of monsoon also showed a shrinking trend in the rate of 40 days during the 30-year study period at Rajendranagar representing a semiarid region. At Bhubaneshwar, the application of 50 % recommended NPK through chemical fertilizers and 50 % N through green manure resulted in an overall average higher increase of 5.1 % in system productivity under both excess and deficit rainfall years and also during the years having seasonal mean maximum temperature ≥35 °C. However, at Jorhat, the application of 50 % recommended NPK through chemical fertilizers and 50 % N through straw resulted in an overall average higher increase of 7.4 % in system productivity, while at Rajendranagar, the application of 75 % NPK through chemical fertilizers and 25 % N through green manusre resulted in an overall average higher increase of 8.8 % in system productivity. This study highlights the adaptive capacity of different integrated nutrient management practices to rainfall and temperature variability under a rice-rice cropping system in humid, subhumid, and semiarid ecosystems.

Implementation of a next-generation electronic nursing records system based on detailed clinical models and integration of clinical practice guidelines.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Chung, Eunja; Lee, Hyunsook

2013-12-01

The purpose of this paper is to describe the components of a next-generation electronic nursing records system ensuring full semantic interoperability and integrating evidence into the nursing records system. A next-generation electronic nursing records system based on detailed clinical models and clinical practice guidelines was developed at Seoul National University Bundang Hospital in 2013. This system has two components, a terminology server and a nursing documentation system. The terminology server manages nursing narratives generated from entity-attribute-value triplets of detailed clinical models using a natural language generation system. The nursing documentation system provides nurses with a set of nursing narratives arranged around the recommendations extracted from clinical practice guidelines. An electronic nursing records system based on detailed clinical models and clinical practice guidelines was successfully implemented in a hospital in Korea. The next-generation electronic nursing records system can support nursing practice and nursing documentation, which in turn will improve data quality.

The Flinders experiment in medical education revisited.

PubMed

Geffen, L B; Birkett, D J; Alpers, J H

The undergraduate medical curriculum of the Flinders University of South Australia is reviewed and evaluated against American recommendations for the basic education of doctors practising in the 21st century. Two previous articles in The Medical Journal of Australia describing earlier versions of the Flinders curriculum and the report on General Professional Education for the Physician of the Association of American Medical Colleges. The Flinders curriculum attempts to fully integrate the teaching of medical science and clinical disciplines. The earliest version of the curriculum emphasised horizontal integration of normal structure and function of body systems, followed by abnormalities of these systems, and finally clinical practice. The second version introduced vertical integration of basic science and clinical medicine within a body system. The present version attempts to balance the demands of horizontal and vertical integration. An important feature of all versions is the large proportion of time allowed for elective studies in most years of the course. The Flinders curriculum has been able to adapt to the changing needs of medical education because its organisation is relatively free from the constraints of departmental rivalry over resources.

An enhanced security solution for electronic medical records based on AES hybrid technique with SOAP/XML and SHA-1.

PubMed

Kiah, M L Mat; Nabi, Mohamed S; Zaidan, B B; Zaidan, A A

2013-10-01

This study aims to provide security solutions for implementing electronic medical records (EMRs). E-Health organizations could utilize the proposed method and implement recommended solutions in medical/health systems. Majority of the required security features of EMRs were noted. The methods used were tested against each of these security features. In implementing the system, the combination that satisfied all of the security features of EMRs was selected. Secure implementation and management of EMRs facilitate the safeguarding of the confidentiality, integrity, and availability of e-health organization systems. Health practitioners, patients, and visitors can use the information system facilities safely and with confidence anytime and anywhere. After critically reviewing security and data transmission methods, a new hybrid method was proposed to be implemented on EMR systems. This method will enhance the robustness, security, and integration of EMR systems. The hybrid of simple object access protocol/extensible markup language (XML) with advanced encryption standard and secure hash algorithm version 1 has achieved the security requirements of an EMR system with the capability of integrating with other systems through the design of XML messages.

Study of component technologies for fuel cell on-site integrated energy systems

NASA Technical Reports Server (NTRS)

Lee, W. D.; Mathias, S.

1980-01-01

Heating, ventilation and air conditioning equipment are integrated with three types of fuel cells. System design and computer simulations are developed to utilize the thermal energy discharge of the fuel in the most cost effective manner. The fuel provides all of the electric needs and a loss of load probability analysis is used to ensure adequate power plant reliability. Equipment cost is estimated for each of the systems analyzed. A levelized annual cost reflecting owning and operating costs including the cost of money was used to select the most promising integrated system configurations. Cash flows are presented for the most promising 16 systems. Several systems for the 96 unit apartment complex (a retail store was also studied) were cost competitive with both gas and electric based conventional systems. Thermal storage is shown to be beneficial and the optimum absorption chiller sizing (waste heat recovery) in connection with electric chillers are developed. Battery storage was analyzed since the system is not electric grid connected. Advanced absorption chillers were analyzed as well. Recommendations covering financing, technical development, and policy issues are given to accelerate the commercialization of the fuel cell for on-site power generation in buildings.

PubMedReco: A Real-Time Recommender System for PubMed Citations.

PubMed

Samuel, Hamman W; Zaïane, Osmar R

2017-01-01

We present a recommender system, PubMedReco, for real-time suggestions of medical articles from PubMed, a database of over 23 million medical citations. PubMedReco can recommend medical article citations while users are conversing in a synchronous communication environment such as a chat room. Normally, users would have to leave their chat interface to open a new web browser window, and formulate an appropriate search query to retrieve relevant results. PubMedReco automatically generates the search query and shows relevant citations within the same integrated user interface. PubMedReco analyzes relevant keywords associated with the conversation and uses them to search for relevant citations using the PubMed E-utilities programming interface. Our contributions include improvements to the user experience for searching PubMed from within health forums and chat rooms, and a machine learning model for identifying relevant keywords. We demonstrate the feasibility of PubMedReco using BMJ's Doc2Doc forum discussions.

Indicators and measurement tools for health system integration: a knowledge synthesis protocol.

PubMed

Oelke, Nelly D; Suter, Esther; da Silva Lima, Maria Alice Dias; Van Vliet-Brown, Cheryl

2015-07-29

Health system integration is a key component of health system reform with the goal of improving outcomes for patients, providers, and the health system. Although health systems continue to strive for better integration, current delivery of health services continues to be fragmented. A key gap in the literature is the lack of information on what successful integration looks like and how to measure achievement towards an integrated system. This multi-site study protocol builds on a prior knowledge synthesis completed by two of the primary investigators which identified 10 key principles that collectively support health system integration. The aim is to answer two research questions: What are appropriate indicators for each of the 10 key integration principles developed in our previous knowledge synthesis and what measurement tools are used to measure these indicators? To enhance generalizability of the findings, a partnership between Canada and Brazil was created as health system integration is a priority in both countries and they share similar contexts. This knowledge synthesis will follow an iterative scoping review process with emerging information from knowledge-user engagement leading to the refinement of research questions and study selection. This paper describes the methods for each phase of the study. Research questions were developed with stakeholder input. Indicator identification and prioritization will utilize a modified Delphi method and patient/user focus groups. Based on priority indicators, a search of the literature will be completed and studies screened for inclusion. Quality appraisal of relevant studies will be completed prior to data extraction. Results will be used to develop recommendations and key messages to be presented through integrated and end-of-grant knowledge translation strategies with researchers and knowledge-users from the three jurisdictions. This project will directly benefit policy and decision-makers by providing an easy accessible set of indicators and tools to measure health system integration across different contexts and cultures. Being able to evaluate the success of integration strategies and initiatives will lead to better health system design and improved health outcomes for patients.

Increasing consumer demand for tobacco treatments: Ten design recommendations for clinicians and healthcare systems.

PubMed

Woods, Susan Swartz; Jaén, Carlos Roberto

2010-03-01

Health professionals play an important role in addressing patient tobacco use in clinical settings. While there is clear evidence that identifying tobacco use and assisting smokers in quitting affects outcomes, challenges to improve routine, clinician-delivered tobacco intervention persist. The Consumer Demand Initiative has identified simple design principles to increase consumers' use of proven tobacco treatments. Applying these design strategies to activities across the healthcare system, we articulate ten recommendations that can be implemented in the context of most clinical systems where most clinicians work. The recommendations are: (1) reframe the definition of success, (2) portray proven treatments as the best care, (3) redesign the 5A's of tobacco intervention, (4) be ready to deliver the right treatment at the right time, (5) move tobacco from the social history to the problem list, (6) use words as therapy and language that makes sense, (7) fit tobacco treatment into clinical team workflows, (8) embed tobacco treatment into health information technology, (9) make every encounter an opportunity to intervene, and (10) end social disparities for tobacco users. Clinical systems need to change to improve tobacco treatment implementation. The consumer- and clinician-centered recommendations provide a roadmap that focuses on increasing clinician performance through greater understanding of the clinician's role in helping tobacco users, highlighting the value of evidence-based tobacco treatments, employing shared decision-making skills, and integrating routine tobacco treatment into clinical system routines. Published by Elsevier Inc.

Global Noise Studies for CMS Tracker Upgrade

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

Arteche, F.; /Zaragoza, ITA; Esteban, C.

The characterization of the noise emissions of DC-DC converters at system level is critical to optimize the design of the detector and define rules for the integration strategy. This paper presents the impedance effects on the noise emissions of DC-DC converters at system level. Conducted and radiated noise emissions at the input and at the output from DC-DC converters have been simulated for different types of power network and FEE impedances. System aspects as granularity, stray capacitances of the system and different working conditions of the DC-DC converters are presented too. This study has been carried out using simulation modelsmore » of noise emissions of DC-DC converters in the real scenario. The results of these studies show important recommendations and criteria to be applied to integrate the DC-DC converters and decrease the system noise level.« less

Democratization and integration of genomic profiling tools.

PubMed

Sussman, Michael R; Huttlin, Edward L; Wohlbach, Dana J

2009-01-01

Systems biology is a comprehensive means of creating a complete understanding of how all components of an organism work together to maintain and procreate life. By quantitatively profiling one at a time, the effect of thousands and millions of genetic and environmental perturbations on the cell, systems biologists are attempting to recreate and measure the effect of the many different states that have been explored during the 3 billion years in which life has evolved. A key aspect of this work is the development of innovative new approaches to quantify changes in the transcriptome, proteome, and metabolome. In this chapter we provide a review and evaluation of several genomic profiling techniques used in plant systems biology as well as make recommendations for future progress in their use and integration.

Context Aware Recommendations in the Course Enrolment Process Based on Curriculum Guidelines

ERIC Educational Resources Information Center

Ajanovski, Vangel V.

2013-01-01

This research is a part of an ongoing project for development of an integrated student information system, aiming to incorporate self-adaptivity, personalization and social navigation, both in the overall management of university processes, and throughout the course work. In this paper the focus is on the advancement of the existing course…

Space Tug avionics definition study. Volume 4: Supporting trade studies and analyses

NASA Technical Reports Server (NTRS)

1975-01-01

Analyses and trade studies were performed for the evaluation of the most desirable solutions to space tug subsystem requirements. These were accomplished at system, subsystem, and at component levels. The criteria, the candidate options evaluated, the selection process, and the recommended solutions that have been integrated together in the configuration descriptions are reported.

A New Vision for Integrated Breast Care.

DTIC Science & Technology

1999-09-01

management with recommendations for strategic information systems use and overall process improvements. " Wrote the business plan for a physician group... business and marketing plans for physician network expansion. Performed market research and internal operational and strategic analyses. Identified...Berkeley Master of Business Administration (MBA) May 1994 • Concentration: Marketing and Strategic Planning * Event Chairman, MBA Challenge for Charity

Ceramics potential in automotive powerplants

NASA Technical Reports Server (NTRS)

Mclean, A. F.

1983-01-01

The paper addresses the potential that ceramic materials can play an important role in future automotive powerplants - both advanced heat engines and advanced battery systems. A number of related experimental programs are reviewed including ceramics for gasoline and diesel piston engines, gas turbine and Stirling Engines and sodium-sulfur batteries. A strong integrated program to develop ceramics technology is recommended.

urCF: An Approach to Integrating User Reviews into Memory-Based Collaborative Filtering

ERIC Educational Resources Information Center

Zhang, Zhenxue

2013-01-01

Blessed by the Internet age, many online retailers (e.g., Amazon.com) have deployed recommender systems to help their customers identify products that may be of their interest in order to improve cross-selling and enhance customer loyalty. Collaborative Filtering (CF) is the most successful technique among different approaches to generating…

78 FR 68832 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... process for institutions of higher education under Title IV, of the HEA, together with recommendations for... System at: www.gpo.gov/fdsys . At this site you can view this document, as well as all other documents of... documents of the Department published in the Federal Register by using the article search feature at: www...

Integrating natural and social sciences to manage sustainably vectors of change in the marine environment: Dogger Bank transnational case study

NASA Astrophysics Data System (ADS)

Burdon, Daryl; Boyes, Suzanne J.; Elliott, Michael; Smyth, Katie; Atkins, Jonathan P.; Barnes, Richard A.; Wurzel, Rüdiger K.

2018-02-01

The management of marine resources is a complex process driven by the dynamics of the natural system and the influence of stakeholders including policy-makers. An integration of natural and social sciences research is required by policy-makers to better understand, and manage sustainably, natural changes and anthropogenic activities within particular marine systems. Given the uncertain development of activities in the marine environment, future scenarios assessments can be used to investigate whether marine policy measures are robust and sustainable. This paper develops an interdisciplinary framework, which incorporates future scenarios assessments, and identifies four main types of evaluation needed to integrate natural and social sciences research to support the integrated management of the marine environment: environmental policy and governance assessments; ecosystem services, indicators and valuation; modelling tools for management evaluations, and risk assessment and risk management. The importance of stakeholder engagement within each evaluation method is highlighted. The paper focuses on the transnational spatial marine management of the Dogger Bank, in the central North Sea, a site which is very important ecologically, economically and politically. Current management practices are reviewed, and research tools to support future management decisions are applied and discussed in relation to two main vectors of change affecting the Dogger Bank, namely commercial fisheries and offshore wind farm developments, and in relation to the need for nature conservation. The input of local knowledge through stakeholder engagement is highlighted as a necessary requirement to produce site-specific policy recommendations for the future management of the Dogger Bank. We present wider policy recommendations to integrate natural and social sciences in a global marine context.

ECLSS Integration Analysis: Advanced ECLSS Subsystem and Instrumentation Technology Study for the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

1990-01-01

In his July 1989 space policy speech, President Bush proposed a long range continuing commitment to space exploration and development. Included in his goals were the establishment of permanent lunar and Mars habitats and the development of extended duration space transportation. In both cases, a major issue is the availability of qualified sensor technologies for use in real-time monitoring and control of integrated physical/chemical/biological (p/c/b) Environmental Control and Life Support Systems (ECLSS). The purpose of this study is to determine the most promising instrumentation technologies for future ECLSS applications. The study approach is as follows: 1. Precursor ECLSS Subsystem Technology Trade Study - A database of existing and advanced Atmosphere Revitalization (AR) and Water Recovery and Management (WRM) ECLSS subsystem technologies was created. A trade study was performed to recommend AR and WRM subsystem technologies for future lunar and Mars mission scenarios. The purpose of this trade study was to begin defining future ECLSS instrumentation requirements as a precursor to determining the instrumentation technologies that will be applicable to future ECLS systems. 2. Instrumentation Survey - An instrumentation database of Chemical, Microbial, Conductivity, Humidity, Flowrate, Pressure, and Temperature sensors was created. Each page of the sensor database report contains information for one type of sensor, including a description of the operating principles, specifications, and the reference(s) from which the information was obtained. This section includes a cursory look at the history of instrumentation on U.S. spacecraft. 3. Results and Recommendations - Instrumentation technologies were recommended for further research and optimization based on a consideration of both of the above sections. A sensor or monitor technology was recommended based on its applicability to future ECLS systems, as defined by the ECLSS Trade Study (1), and on whether its characteristics were considered favorable relative to similar instrumentation technologies (competitors), as determined from the Instrumentation Survey (2). The instrumentation technologies recommended by this study show considerable potential for development and promise significant returns if research efforts are invested.

[Declared dead? Recommendations regarding integrated care from the perspective of German statutory health insurance].

PubMed

Amelung, Volker; Wolf, S; Ozegowski, S; Eble, S; Hildebrandt, H; Knieps, F; Lägel, R; Schlenker, R-U; Sjuts, R

2015-04-01

The traditional separation of health care into sectors in Germany causes communication problems that hinder continuous, patient-oriented care. This is most evident in the transition from inpatient to outpatient care. That said, there are also breaks in the flow of information, a lack of supply, or even incorrect information flowing within same-sector care. The transition from a division of functions into sectors to a patient-oriented process represents a change in the paradigm of health care that can only be successfully completed with considerable effort. Germany's statutory health insurance (SHI) funds play a key role here, as they are the contracting parties as well as the financiers of integrated care, and are strategically located at the center of the development process.The objective of this article is to explore how Germany's SHI funds view integrated care, what they regard as being the drivers of and barriers to transitioning to such a system, and what recommendations they can provide with regard to the further development of integrated care. For this purpose semi-structured interviews with board members and those responsible for implementing integrated care into the operations of ten SHI funds representing more than half of Germany's SHI-insured population were conducted. According to the interviewees, a better framework for integrated care urgently needs to be developed and rendered more receptive to innovation.Only in this way will the widespread stagnation of the past several years be overcome. The deregulation of § 140a-d SGB V and the establishment of a uniform basis for new forms of care in terms of a new innovation clause are among the central recommendations of this article. The German federal government's innovation fund was met with great hope, but also implied risks. Nonetheless, the new law designed to strengthen health care overall generated high expectations.

Fully Integrated e-Services for Prevention, Diagnosis, and Treatment of Sexually Transmitted Infections: Results of a 4-County Study in California

PubMed Central

Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Teresa P.; Padian, Nancy; Blake, Diane R.; Gaydos, Charlotte A.

2014-01-01

Objectives. We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments. Methods. In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures. Results. During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study. Conclusions. The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost. PMID:25320878

Fully integrated e-services for prevention, diagnosis, and treatment of sexually transmitted infections: results of a 4-county study in California.

PubMed

Spielberg, Freya; Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Teresa P; Padian, Nancy; Blake, Diane R; Gaydos, Charlotte A

2014-12-01

We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments. In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures. During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study. The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost.

Systems identification and application systems development for monitoring the physiological and health status of crewmen in space

NASA Technical Reports Server (NTRS)

Leonard, J. I.; Furukawa, S.; Vannordstrand, P. C.

1975-01-01

The use of automated, analytical techniques to aid medical support teams is suggested. Recommendations are presented for characterizing crew health in terms of: (1) wholebody function including physiological, psychological and performance factors; (2) a combination of critical performance indexes which consist of multiple factors of measurable parameters; (3) specific responses to low noise level stress tests; and (4) probabilities of future performance based on present and periodic examination of past performance. A concept is proposed for a computerized real time biomedical monitoring and health care system that would have the capability to integrate monitored data, detect off-nominal conditions based on current knowledge of spaceflight responses, predict future health status, and assist in diagnosis and alternative therapies. Mathematical models could play an important role in this approach, especially when operating in a real time mode. Recommendations are presented to update the present health monitoring systems in terms of recent advances in computer technology and biomedical monitoring systems.

Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline.

PubMed

Lyman, Gary H; Greenlee, Heather; Bohlke, Kari; Bao, Ting; DeMichele, Angela M; Deng, Gary E; Fouladbakhsh, Judith M; Gil, Brigitte; Hershman, Dawn L; Mansfield, Sami; Mussallem, Dawn M; Mustian, Karen M; Price, Erin; Rafte, Susan; Cohen, Lorenzo

2018-06-11

Purpose The Society for Integrative Oncology (SIO) produced an evidence-based guideline on use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. ASCO considered the guideline for endorsement. Methods The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications. SIO systematic reviews focused on randomized controlled trials that were published from 1990 through 2015. The SIO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations. Results The ASCO Expert Panel determined that the recommendations in the SIO guideline-published in 2017-are clear, thorough, and based on the most relevant scientific evidence. ASCO endorsed the guideline with a few added discussion points. Recommendations Key recommendations include the following: Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-l-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects. Additional information is available at: www.asco.org/supportive-care-guidelines .

Multi-method laboratory user evaluation of an actionable clinical performance information system: Implications for usability and patient safety.

PubMed

Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

2018-01-01

Electronic audit and feedback (e-A&F) systems are used worldwide for care quality improvement. They measure health professionals' performance against clinical guidelines, and some systems suggest improvement actions. However, little is known about optimal interface designs for e-A&F, in particular how to present suggested actions for improvement. We developed a novel theory-informed system for primary care (the Performance Improvement plaN GeneratoR; PINGR) that covers the four principal interface components: clinical performance summaries; patient lists; detailed patient-level information; and suggested actions. As far as we are aware, this is the first report of an e-A&F system with all four interface components. (1) Use a combination of quantitative and qualitative methods to evaluate the usability of PINGR with target end-users; (2) refine existing design recommendations for e-A&F systems; (3) determine the implications of these recommendations for patient safety. We recruited seven primary care physicians to perform seven tasks with PINGR, during which we measured on-screen behaviour and eye movements. Participants subsequently completed usability questionnaires, and were interviewed in-depth. Data were integrated to: gain a more complete understanding of usability issues; enhance and explain each other's findings; and triangulate results to increase validity. Participants committed a median of 10 errors (range 8-21) when using PINGR's interface, and completed a median of five out of seven tasks (range 4-7). Errors violated six usability heuristics: clear response options; perceptual grouping and data relationships; representational formats; unambiguous description; visually distinct screens for confusable items; and workflow integration. Eye movement analysis revealed the integration of components largely supported effective user workflow, although the modular design of clinical performance summaries unnecessarily increased cognitive load. Interviews and questionnaires revealed PINGR is user-friendly, and that improved information prioritisation could further promote useful user action. Comparing our results with the wider usability literature we refine a previously published set of interface design recommendations for e-A&F. The implications for patient safety are significant regarding: user engagement; actionability; and information prioritisation. Our results also support adopting multi-method approaches in usability studies to maximise issue discovery and the credibility of findings. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

NHF-McMaster Guideline on Care Models for Haemophilia Management.

PubMed

Pai, M; Key, N S; Skinner, M; Curtis, R; Feinstein, M; Kessler, C; Lane, S J; Makris, M; Riker, E; Santesso, N; Soucie, J M; Yeung, C H T; Iorio, A; Schünemann, H J

2016-07-01

This guideline was developed to identify evidence-based best practices in haemophilia care delivery, and discuss the range of care providers and services that are most important to optimize outcomes for persons with haemophilia (PWH) across the United States. The guideline was developed following specific methods described in detail in this supplement and based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluation approach). Direct evidence from published literature and the haemophilia community, as well as indirect evidence from other chronic diseases, were reviewed, synthesized and applied to create evidence-based recommendations. The Guideline panel suggests that the integrated care model be used over non-integrated care models for PWH (conditional recommendation, moderate certainty in the evidence). For PWH with inhibitors and those at high risk for inhibitor development, the same recommendation was graded as strong, with moderate certainty in the evidence. The panel suggests that a haematologist, a specialized haemophilia nurse, a physical therapist, a social worker and round-the-clock access to a specialized coagulation laboratory be part of the integrated care team, over an integrated care team that does not include all of these components (conditional recommendation, very low certainty in the evidence). Based on available evidence, the integrated model of care in its current structure, is suggested for optimal care of PWH. There is a need for further appropriately designed studies that address unanswered questions about specific outcomes and the optimal structure of the integrated care delivery model in haemophilia. © 2016 John Wiley & Sons Ltd.

Special Session 4: Astronomy Education between Past and Future

NASA Astrophysics Data System (ADS)

de Greve, Jean-Pierre

2010-11-01

The special session aims at discussing an integrated approach of the different efforts to increase and promote the teaching and learning of astronomy in the world, with emphasis on developing countries. To this end, attention will be given to research on education, specifically in the field of physics, to best practices of the use of astronomy in educational systems (specifically in developing countries), and to innovative learning initiatives other than formal education. The Special Session aims also at creating a universal perspective wherein modern (post-Copernican) astronomy will presented as an intellectual cumulus. The objective of the session is to disseminate best practices in teaching and learning activities of astronomy and to give an opportunity to learn about initiatives in different cultural and socio-economic settings. The special session also wants to give food-for-thought and proposals for reflection for an integrative approach, and for optimization processes, to enhance the interest in astronomy and its role as a trigger towards science education in the educational systems, with emphasis on the developing countries. The outcome should be a sensitization of teachers and students alike to the concept of a universal history of astronomy and creation of some reliable source material which can be used as a teaching aid in a culture-specific context. The outcome could be a set of recommendations for future integrated actions, and eventually recommendations on new initiatives, framed into the new decadal policy plan.

Research on Psychotherapy Integration: Recommendations and Conclusions from an NIMH Workshop.

ERIC Educational Resources Information Center

Wolfe, Barry E.; Goldfried, Marvin R.

1988-01-01

Describes National Institute of Mental Health (NIMH) workshop (March 1986) which invited 14 psychotherapy researchers to consider key issues associated with psychotherapy integration. Discusses recommendations developed to initiate a research program encompassing conceptual clarification, efficacy studies of systematic eclectic therapies, the role…

Security System Software

NASA Technical Reports Server (NTRS)

1993-01-01

C Language Integration Production System (CLIPS), a NASA-developed expert systems program, has enabled a security systems manufacturer to design a new generation of hardware. C.CURESystem 1 Plus, manufactured by Software House, is a software based system that is used with a variety of access control hardware at installations around the world. Users can manage large amounts of information, solve unique security problems and control entry and time scheduling. CLIPS acts as an information management tool when accessed by C.CURESystem 1 Plus. It asks questions about the hardware and when given the answer, recommends possible quick solutions by non-expert persons.

Targeted Research and Technology Within NASA's Living With a Star Program

NASA Technical Reports Server (NTRS)

Hesse, Michael

2003-01-01

NASA's Living With a Star (LWS) initiative is a systematic, goal-oriented research program targeting those aspects of the Sun-Earth system that affect society. The Targeted Research and Technology (TR&T) component of LWS provides the theory, modeling, and data analysis necessary to enable an integrated, system-wide picture of Sun-Earth connection science with societal relevance. Recognizing the central and essential role that TR&T would have for the success of the LWS initiative, the LWS Science Architecture Team (SAT) recommended that a Science Definition Team (SDT), with the same status as a flight mission definition team, be formed to design and coordinate a TR&T program having prioritized goals and objectives that focused on practical societal benefits. This report details the SDT recommendations for the TR&T program.

Functional requirements for the man-vehicle systems research facility. [identifying and correcting human errors during flight simulation

NASA Technical Reports Server (NTRS)

Clement, W. F.; Allen, R. W.; Heffley, R. K.; Jewell, W. F.; Jex, H. R.; Mcruer, D. T.; Schulman, T. M.; Stapleford, R. L.

1980-01-01

The NASA Ames Research Center proposed a man-vehicle systems research facility to support flight simulation studies which are needed for identifying and correcting the sources of human error associated with current and future air carrier operations. The organization of research facility is reviewed and functional requirements and related priorities for the facility are recommended based on a review of potentially critical operational scenarios. Requirements are included for the experimenter's simulation control and data acquisition functions, as well as for the visual field, motion, sound, computation, crew station, and intercommunications subsystems. The related issues of functional fidelity and level of simulation are addressed, and specific criteria for quantitative assessment of various aspects of fidelity are offered. Recommendations for facility integration, checkout, and staffing are included.

Guide for Regional Integrated Assessments: Handbook of Methods and Procedures, Version 5.1. Appendix 1

NASA Technical Reports Server (NTRS)

Rosenzweig, Cynthia E.; Jones, James W.; Hatfield, Jerry; Antle, John; Ruane, Alex; Boote, Ken; Thorburn, Peter; Valdivia, Roberto; Porter, Cheryl; Janssen, Sander;

Recommendations resulting from the SPDS Community-Wide Workshop

NASA Technical Reports Server (NTRS)

1993-01-01

The Data Systems Panel identified three critical functionalities of a Space Physics Data System (SPDS): the delivery of self-documenting data, the existence of a matrix of translators between various standard formats (IDFS, CDF, netCDF, HDF, TENNIS, UCLA flat file, and FITS), and a network-based capability for browsing and examining inventory records for the system's data holdings. The recommendations resulting from the workshop include the philosophy, funding, and objectives of a SPDS. Access to quality data is seen as the most important objective by the Policy Panel, with curation and information about the data being integral parts of any accessible data set. The Data Issues Panel concluded that the SPDS can supply encouragement, guidelines, and ultimately provide a mechanism for financial support for data archiving, restoration, and curation. The Software Panel of the SPDS focused on defining the requirements and priorities for SPDS to support common data analysis and data visualization tools and packages.

Hydro power flexibility for power systems with variable renewable energy sources: an IEA Task 25 collaboration: Hydro power flexibility for power systems

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

Huertas-Hernando, Daniel; Farahmand, Hossein; Holttinen, Hannele

2016-06-20

Hydro power is one of the most flexible sources of electricity production. Power systems with considerable amounts of flexible hydro power potentially offer easier integration of variable generation, e.g., wind and solar. However, there exist operational constraints to ensure mid-/long-term security of supply while keeping river flows and reservoirs levels within permitted limits. In order to properly assess the effective available hydro power flexibility and its value for storage, a detailed assessment of hydro power is essential. Due to the inherent uncertainty of the weather-dependent hydrological cycle, regulation constraints on the hydro system, and uncertainty of internal load as wellmore » as variable generation (wind and solar), this assessment is complex. Hence, it requires proper modeling of all the underlying interactions between hydro power and the power system, with a large share of other variable renewables. A summary of existing experience of wind integration in hydro-dominated power systems clearly points to strict simulation methodologies. Recommendations include requirements for techno-economic models to correctly assess strategies for hydro power and pumped storage dispatch. These models are based not only on seasonal water inflow variations but also on variable generation, and all these are in time horizons from very short term up to multiple years, depending on the studied system. Another important recommendation is to include a geographically detailed description of hydro power systems, rivers' flows, and reservoirs as well as grid topology and congestion.« less

Energy Systems Integration Facility (ESIF) External Stakeholders Workshop: Workshop Proceedings, 9 October 2008, Golden, Colorado

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

Komomua, C.; Kroposki, B.; Mooney, D.

2009-01-01

On October 9, 2008, NREL hosted a workshop to provide an opportunity for external stakeholders to offer insights and recommendations on the design and functionality of DOE's planned Energy Systems Infrastructure Facility (ESIF). The goal was to ensure that the planning for the ESIF effectively addresses the most critical barriers to large-scale energy efficiency (EE) and renewable energy (RE) deployment. This technical report documents the ESIF workshop proceedings.

An integrated policy framework for the sustainable exploitation of biomass for bioenergy from marginal lands

NASA Astrophysics Data System (ADS)

Panoutsou, Calliope

2017-04-01

Currently, there are not sufficiently tailored policies focusing on biomass and bioenergy from marginal lands. This paper will provide an integrated policy framework and recommendations to facilitate understanding for the market sectors involved and the key principles which can be used to form future sustainable policies for this issue. The work will focus at EU level policy recommendations and discuss how these can interrelate with national and regional level policies to promote the usage of marginal lands for biomass and bioenergy. Recommended policy measures will be based on the findings of the Biomass Policies (www.biomasspolicies.eu) and S2Biom (www.s2biom.eu) projects and will be prepared taking into account the key influencing factors (technical, environmental, social and economic) on biomass and bioenergy from marginal lands: • across different types of marginality (biophysical such as: low temperature, dryness, excess soil moisture, poor chemical properties, steep slope, etc., and socio-economic resulting from lack of economic competitiveness in certain regions and crops, abandonment or rural areas, etc.) • across the different stages of the biomass value chain (supply, logistics, conversion, distribution and end-use). The aim of recommendations will be to inform policy makers on how to distinguish key policy related attributes across biomass and bioenergy from marginal lands, measure them and prioritise actions with a 'system' based approach.

National Institutes of Health Pathways to Prevention Workshop: Methods for Evaluating Natural Experiments in Obesity.

PubMed

Emmons, Karen M; Doubeni, Chyke A; Fernandez, Maria E; Miglioretti, Diana L; Samet, Jonathan M

2018-06-05

On 5 and 6 December 2017, the National Institutes of Health (NIH) convened the Pathways to Prevention Workshop: Methods for Evaluating Natural Experiments in Obesity to identify the status of methods for assessing natural experiments to reduce obesity, areas in which these methods could be improved, and research needs for advancing the field. This article considers findings from a systematic evidence review on methods for evaluating natural experiments in obesity, workshop presentations by experts and stakeholders, and public comment. Research gaps are identified, and recommendations related to 4 key issues are provided. Recommendations on population-based data sources and data integration include maximizing use and sharing of existing surveillance and research databases and ensuring significant effort to integrate and link databases. Recommendations on measurement include use of standardized and validated measures of obesity-related outcomes and exposures, systematic measurement of co-benefits and unintended consequences, and expanded use of validated technologies for measurement. Study design recommendations include improving guidance, documentation, and communication about methods used; increasing use of designs that minimize bias in natural experiments; and more carefully selecting control groups. Cross-cutting recommendations target activities that the NIH and other funders might undertake to improve the rigor of natural experiments in obesity, including training and collaboration on modeling and causal inference, promoting the importance of community engagement in the conduct of natural experiments, ensuring maintenance of relevant surveillance systems, and supporting extended follow-up assessments for exemplar natural experiments. To combat the significant public health threat posed by obesity, researchers should continue to take advantage of natural experiments. The recommendations in this report aim to strengthen evidence from such studies.

Simulation of diurnal thermal energy storage systems: Preliminary results

NASA Astrophysics Data System (ADS)

Katipamula, S.; Somasundaram, S.; Williams, H. R.

1994-12-01

This report describes the results of a simulation of thermal energy storage (TES) integrated with a simple-cycle gas turbine cogeneration system. Integrating TES with cogeneration can serve the electrical and thermal loads independently while firing all fuel in the gas turbine. The detailed engineering and economic feasibility of diurnal TES systems integrated with cogeneration systems has been described in two previous PNL reports. The objective of this study was to lay the ground work for optimization of the TES system designs using a simulation tool called TRNSYS (TRaNsient SYstem Simulation). TRNSYS is a transient simulation program with a sequential-modular structure developed at the Solar Energy Laboratory, University of Wisconsin-Madison. The two TES systems selected for the base-case simulations were: (1) a one-tank storage model to represent the oil/rock TES system; and (2) a two-tank storage model to represent the molten nitrate salt TES system. Results of the study clearly indicate that an engineering optimization of the TES system using TRNSYS is possible. The one-tank stratified oil/rock storage model described here is a good starting point for parametric studies of a TES system. Further developments to the TRNSYS library of available models (economizer, evaporator, gas turbine, etc.) are recommended so that the phase-change processes is accurately treated.

After Integration; Problems of Race Relations in the High School Today. A Study of Madison High School with Recommendations for New York City Schools.

ERIC Educational Resources Information Center

New York City Commission on Human Rights, NY.

This report first presents a narrative and analysis of the process and aftermath of the integration of Madison High School in Brooklyn, New York City. Then 13 recommendations are stated, among which are the following: (1) Board of Education should establish a special unit to provide technical assistance for integrated schools; (2) the New York…

Ergonomics action research II: a framework for integrating HF into work system design.

PubMed

Neumann, W P; Village, J

2012-01-01

This paper presents a conceptual framework that can support efforts to integrate human factors (HF) into the work system design process, where improved and cost-effective application of HF is possible. The framework advocates strategies of broad stakeholder participation, linking of performance and health goals, and process focussed change tools that can help practitioners engage in improvements to embed HF into a firm's work system design process. Recommended tools include business process mapping of the design process, implementing design criteria, using cognitive mapping to connect to managers' strategic goals, tactical use of training and adopting virtual HF (VHF) tools to support the integration effort. Consistent with organisational change research, the framework provides guidance but does not suggest a strict set of steps. This allows more adaptability for the practitioner who must navigate within a particular organisational context to secure support for embedding HF into the design process for improved operator wellbeing and system performance. There has been little scientific literature about how a practitioner might integrate HF into a company's work system design process. This paper proposes a framework for this effort by presenting a coherent conceptual framework, process tools, design tools and procedural advice that can be adapted for a target organisation.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project

NASA Technical Reports Server (NTRS)

Shively, Jay

2017-01-01

Over the past 5 years, the UAS integration into the NAS project has worked to reduce technical barriers to integration. A major focus of this work has been in support of RTCA SC-228. This committee has recently published the first UAS integration minimum performance standards (MOPS). This work has spanned detect and avoid (DAA) as well as command and control comm datalinks. I will discuss DAA efforts with focus on the human systems work. I will discuss how automation was discussed and addressed within this context. ICAO stood up a remotely piloted aircraft systems (RPAS) panel in 2014. They have developed an RPAS manual and are now working to revise existing annexes and standards and recommended practices. The Human In The System (HITS) has worked to infuse human factors guidelines into those documents. I will discuss that effort as well as how ICAO has defined and address autonomy. There is a great deal of interest in the control of multiple vehicles by a single operator. The UAS EXCOM Science and Research Panel (SARP) is holding a workshop on this topic in late June. I will discuss research performed on this topic when I worked for the Army and on-going work within the division and a NATO working group on Human-Autonomy Teaming.

A social-ecological systems approach for environmental management.

PubMed

Virapongse, Arika; Brooks, Samantha; Metcalf, Elizabeth Covelli; Zedalis, Morgan; Gosz, Jim; Kliskey, Andrew; Alessa, Lilian

2016-08-01

Urgent environmental issues are testing the limits of current management approaches and pushing demand for innovative approaches that integrate across traditional disciplinary boundaries. Practitioners, scholars, and policy-makers alike call for increased integration of natural and social sciences to develop new approaches that address the range of ecological and societal impacts of modern environmental issues. From a theoretical perspective, social-ecological systems (SES) science offers a compelling approach for improved environmental management through the application of transdisciplinary and resilience concepts. A framework for translating SES theory into practice, however, is lacking. In this paper, we define the key components of an SES-based environmental management approach. We offer recommendations for integrating an SES approach into existing environmental management practices. Results presented are useful for management professionals that seek to employ an SES environmental management approach and scholars aiming to advance the theoretical foundations of SES science for practical application. Published by Elsevier Ltd.

Remote video assessment for missile launch facilities

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

Wagner, G.G.; Stewart, W.A.

1995-07-01

The widely dispersed, unmanned launch facilities (LFs) for land-based ICBMs (intercontinental ballistic missiles) currently do not have visual assessment capability for existing intrusion alarms. The security response force currently must assess each alarm on-site. Remote assessment will enhance manpower, safety, and security efforts. Sandia National Laboratories was tasked by the USAF Electronic Systems Center to research, recommend, and demonstrate a cost-effective remote video assessment capability at missile LFs. The project`s charter was to provide: system concepts; market survey analysis; technology search recommendations; and operational hardware demonstrations for remote video assessment from a missile LF to a remote security center viamore » a cost-effective transmission medium and without using visible, on-site lighting. The technical challenges of this project were to: analyze various video transmission media and emphasize using the existing missile system copper line which can be as long as 30 miles; accentuate and extremely low-cost system because of the many sites requiring system installation; integrate the video assessment system with the current LF alarm system; and provide video assessment at the remote sites with non-visible lighting.« less

Integration of a Clinical Pharmacist into an Interdisciplinary Palliative Care Outpatient Clinic.

PubMed

DiScala, Sandra Lee; Onofrio, Sarah; Miller, Maura; Nazario, Mitchell; Silverman, Michael

2017-11-01

The primary objective of this quality improvement (QI) project was to determine if the Interdisciplinary Palliative Care Outpatient Clinic (IPCOC) at the West Palm Beach Veterans Affairs Medical Center offered improved symptom assessment and palliative care treatment outcomes. Secondary objectives were to identify, classify, and resolve medication problems and calculate the number of pharmacist recommendations accepted by prescribing providers. An IPCOC was created by selecting disciplines for a core group including a nurse practitioner, clinical pharmacist, social worker, chaplain, and physician. Consult referrals were recruited by providing educational sessions. The patient assessments were completed using the Edmonton Symptom Assessment System: (revised version; ESAS-R). The clinical pharmacist classified and resolved drug-related problems. The pharmacy resident telephoned veterans for completion of the "Patient Assessment: Overall Satisfaction with Outpatient Palliative Care Clinic." Seventeen consults were received, 6 patients were excluded, and 11 were seen in clinic. One (9%) of 11 patients met the outcomes measure of system assessment documentation in the past year. At completion, 11 (100%) of 11 patients met the outcomes data measure. The Patient Satisfaction Assessment revealed veterans strongly agree to recommend the IPCOC. The clinical pharmacist identified 20 drug-related problems, made 16 recommendations, had a 93.7% implementation rate, and facilitated implementation of medication changes. This QI project demonstrates that an IPCOC improved symptom assessment and palliative care outcomes in addition to resolution of medication prescribing issues in veterans with advanced cancer by integration of a clinical pharmacist into the core team.

Physicians’, Nurses’, and Medical Assistants’ Perceptions of the Human Papillomavirus Vaccine in a Large Integrated Health Care System

PubMed Central

Mills, Jordan; Van Winkle, Patrick; Shen, Macy; Hong, Christina; Hudson, Sharon

2016-01-01

Context Vaccination against the human papillomavirus (HPV) decreases risks of cancer and genital warts and the need for gynecologic procedures, yet nationwide vaccination rates are low. Previous surveys exploring this phenomenon have not included input from nurses and medical assistants, who play integral roles in HPV vaccine delivery. Objective To understand perceptions of HPV vaccine delivery among physicians, nurses, and medical assistants in a large integrated health care system in Southern California. Design Online surveys were sent to 13 nurse administrators and 75 physicians. Physicians were instructed to forward the survey to nurses and medical assistants with whom they work. Results A total of 76 surveys were completed, consisting of 52 physicians, 16 clinical nurses and medical assistants, and 8 nurse administrators. Physicians’ perceptions of vaccine safety or strength of recommendation did not differ by specialty department. Physicians reportedly perceived the HPV vaccine as safer than did clinical nurses and medical assistants (p < 0.001), who indicated they wanted more education on the safety and efficacy of the vaccine before being comfortable strongly recommending it. Respondents advised that all clinicians could improve in their roles as HPV vaccine advocates through patient counseling and providing informational literature and that workflow standardization was needed to minimize missed vaccination opportunities. Conclusion Physicians reportedly perceive the HPV vaccine as safer compared with nurses and medical assistants. Both groups think that more education of nonphysician staff is needed. Having proper systems in place is also vital to improving vaccination compliance. PMID:27643974

Space Construction Automated Fabrication Experiment Definition Study (SCAFEDS). Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1978-01-01

The techniques, processes, and equipment required for automatic fabrication and assembly of structural elements in space using the space shuttle as a launch vehicle and construction base were investigated. Additional construction/systems/operational techniques, processes, and equipment which can be developed/demonstrated in the same program to provide further risk reduction benefits to future large space systems were included. Results in the areas of structure/materials, fabrication systems (beam builder, assembly jig, and avionics/controls), mission integration, and programmatics are summarized. Conclusions and recommendations are given.

New space sensor and mesoscale data analysis

NASA Technical Reports Server (NTRS)

Hickey, John S.

1987-01-01

The developed Earth Science and Application Division (ESAD) system/software provides the research scientist with the following capabilities: an extensive data base management capibility to convert various experiment data types into a standard format; and interactive analysis and display package (AVE80); an interactive imaging/color graphics capability utilizing the Apple III and IBM PC workstations integrated into the ESAD computer system; and local and remote smart-terminal capability which provides color video, graphics, and Laserjet output. Recommendations for updating and enhancing the performance of the ESAD computer system are listed.

A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy.

PubMed

Liu, Dora; Ahmet, Alexandra; Ward, Leanne; Krishnamoorthy, Preetha; Mandelcorn, Efrem D; Leigh, Richard; Brown, Jacques P; Cohen, Albert; Kim, Harold

2013-08-15

Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing's syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors.

Exploration Blueprint: Data Book

NASA Technical Reports Server (NTRS)

Drake, Bret G. (Editor)

2007-01-01

The material contained in this report was compiled to capture the work performed by the National Aeronautics and Space Administration's (NASA's) Exploration study team in the late 2002 timeframe. The "Exploration Blueprint Data Book" documents the analyses and findings of the 90-day Agency-wide study conducted from September - November 2002. During the summer of 2002, the NASA Deputy Administrator requested that a study be performed with the following objectives: (1) Develop the rationale for exploration beyond low-Earth orbit (2) Develop roadmaps for how to accomplish the first steps through humans to Mars (3) Develop design reference missions as a basis for the roadmaps 4) Make recommendations on what can be done now to effect this future This planning team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond LEO through the human exploration of Mars. The previous NASA Exploration Team activities laid the foundation and framework for development of NASA's Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the "Stepping Stone" approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low-Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars.

Exploration Blueprint: Data Book

NASA Astrophysics Data System (ADS)

Drake, Bret G.

2007-02-01

The material contained in this report was compiled to capture the work performed by the National Aeronautics and Space Administration's (NASA's) Exploration study team in the late 2002 timeframe. The "Exploration Blueprint Data Book" documents the analyses and findings of the 90-day Agency-wide study conducted from September - November 2002. During the summer of 2002, the NASA Deputy Administrator requested that a study be performed with the following objectives: (1) Develop the rationale for exploration beyond low-Earth orbit (2) Develop roadmaps for how to accomplish the first steps through humans to Mars (3) Develop design reference missions as a basis for the roadmaps 4) Make recommendations on what can be done now to effect this future This planning team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond LEO through the human exploration of Mars. The previous NASA Exploration Team activities laid the foundation and framework for development of NASA's Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the "Stepping Stone" approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low-Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars.

Solar thermal central receivers for industrial process heat generation: User views and recommendations for commercialization

NASA Astrophysics Data System (ADS)

Fish, M. J.

1981-08-01

Results of recent meetings with several private industrial groups in which solar thermal central receivers were discussed in depth as a potential for industrial process heat generation are summarized. Topics covering potential economics, technical requirements, and actions to promote commercialization of the technology are presented. These findings are then translated into recommendations for commercialization in private industrial markets. Key points include the need for small scale systems integration projects in addition to the 10 MW/sub e/ plant under construction at Barstow, CA, and the adoption of financial incentives, such as tax credits, for getting the early commercial plants built.

Research in software allocation for advanced manned mission communications and tracking systems

NASA Technical Reports Server (NTRS)

Warnagiris, Tom; Wolff, Bill; Kusmanoff, Antone

1990-01-01

An assessment of the planned processing hardware and software/firmware for the Communications and Tracking System of the Space Station Freedom (SSF) was performed. The intent of the assessment was to determine the optimum distribution of software/firmware in the processing hardware for maximum throughput with minimum required memory. As a product of the assessment process an assessment methodology was to be developed that could be used for similar assessments of future manned spacecraft system designs. The assessment process was hampered by changing requirements for the Space Station. As a result, the initial objective of determining the optimum software/firmware allocation was not fulfilled, but several useful conclusions and recommendations resulted from the assessment. It was concluded that the assessment process would not be completely successful for a system with changing requirements. It was also concluded that memory requirements and hardware requirements were being modified to fit as a consequence of the change process, and although throughput could not be quantitized, potential problem areas could be identified. Finally, inherent flexibility of the system design was essential for the success of a system design with changing requirements. Recommendations resulting from the assessment included development of common software for some embedded controller functions, reduction of embedded processor requirements by hardwiring some Orbital Replacement Units (ORUs) to make better use of processor capabilities, and improvement in communications between software development personnel to enhance the integration process. Lastly, a critical observation was made regarding the software integration tasks did not appear to be addressed in the design process to the degree necessary for successful satisfaction of the system requirements.

Opportunities for Launch Site Integrated System Health Engineering and Management

NASA Technical Reports Server (NTRS)

Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

2005-01-01

The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

SIGAR: Special Inspector General for Afghanistan Reconstruction

DTIC Science & Technology

2009-10-30

effectively . SIGAR has recommended that U.S. civilian agencies and military commands work together to develop an integrated management information sys- tem...amnesties and developing a reintegration program. The 11 Transformative Effects • Population Security • Elections and Continuity of Governance...national economies, to assisting in the develop - ment of effective , accessible, independent legal systems for a more transparent and accountable

A M-Health Platform for Supporting Clinical Data Integration and Service Delivery: An Example from Augmentative and Alternative Communication Intervention

ERIC Educational Resources Information Center

Wang, Erh-Hsuan

2016-01-01

Improving the quality of healthcare while simultaneously reducing its overall costs remains a challenge. One of the recommended approaches for achieving this goal is to build high quality data collection and reporting systems to facilitate evidence-based practice (EBP), which emphasizes the importance of using the solid evidence available to make…

Calmness Fosters Compassionate Connections: Integrating Mindfulness to Support Diverse Parents, Their Young Children, and the Providers Who Serve Them

ERIC Educational Resources Information Center

Shahmoon-Shanok, Rebecca; Stevenson, Howard Carlton

2015-01-01

This article introduces and recommends mindfulness as a significant resource for earliest childhood practice, especially for parents and providers. Mindfulness is defined as it is coming to be understood and used by increasing numbers of people and systems in North America. The article also addresses how mindfulness is sometimes expressed and…

Operational Exercise Integration Recommendations for DoD Cyber Ranges

DTIC Science & Technology

2015-08-05

be the precision and recall of a security information and event management (SIEM) system ’s notifications of unauthorized access to that directory...network traffic, port scanning Deplete Resources TCP flooding, memory leak exploitation Injection Cross-site scripting attacks, SQL injection Deceptive...requirements for personnel development; tactics, techniques, and procedures (TTPs) devel- opment; and mission rehearsals . While unique in their own

Focus on Learning: A Report on Reorganizing General and Special Education in New York City.

ERIC Educational Resources Information Center

Fruchter, Norm; And Others

This report is the result of a year-long evaluation of special education in New York City (New York) and presents major recommendations for reorganizing general and special education. It proposes a school-based model with an integrated general/special education system, and use of an enrichment allocation from merged special and general education…

A System-Level Approach to Overweight and Obesity in the Veterans Health Administration.

PubMed

Raffa, Susan D; Maciejewski, Matthew L; Zimmerman, Lindsey E; Damschroder, Laura J; Estabrooks, Paul A; Ackermann, Ronald T; Tsai, Adam G; Histon, Trina; Goldstein, Michael G

2017-04-01

Healthcare systems are challenged by steady increases in the number of patients who are overweight and obese. Large-scale, evidence-based behavioral approaches for addressing overweight and obesity have been successfully implemented in systems such as the Veterans Health Administration (VHA). These population-based interventions target reduction in risk for obesity-associated conditions through lifestyle change and weight loss, and are associated with modest weight loss. Despite the fact that VHA has increased the overall reach of these behavioral interventions, the number of high-risk overweight and obese patients continues to rise. Recommendations for weight loss medications and bariatric surgery are included in clinical practice guidelines for the management of overweight and obesity, but these interventions are underutilized. During a recent state of the art conference on weight management held by VHA, subject matter experts identified challenges and gaps, as well as potential solutions and overarching policy recommendations, for implementing an integrated system-wide approach for improving population-based weight management.

NASA Electronic Library System (NELS) optimization

NASA Technical Reports Server (NTRS)

Pribyl, William L.

1993-01-01

This is a compilation of NELS (NASA Electronic Library System) Optimization progress/problem, interim, and final reports for all phases. The NELS database was examined, particularly in the memory, disk contention, and CPU, to discover bottlenecks. Methods to increase the speed of NELS code were investigated. The tasks included restructuring the existing code to interact with others more effectively. An error reporting code to help detect and remove bugs in the NELS was added. Report writing tools were recommended to integrate with the ASV3 system. The Oracle database management system and tools were to be installed on a Sun workstation, intended for demonstration purposes.

A Preliminary Research Plan for Development of a Photosynthetic Link in a Closed Ecological Life Support System

NASA Technical Reports Server (NTRS)

Morgan, P. W.

1979-01-01

The use of higher plants in a closed ecological life support system for long duration space missions involving large numbers of people is considered. The approach to planning and developing both the habitat for a long term space mission and closed ecological life support systems are discussed with emphasis on environmental compatibility and integrated systems design. The requirements of photosynthetic processes are summarized and evaluated in terms of their availability within a closed ecological life support environment. Specific references are recommended as a data base for future research on this topic.

Conceptual design of thermal energy storage systems for near-term electric utility applications

NASA Technical Reports Server (NTRS)

Hall, E. W.

1980-01-01

Promising thermal energy storage systems for midterm applications in conventional electric utilities for peaking power generation are evaluated. Conceptual designs of selected thermal energy storage systems integrated with conventional utilities are considered including characteristics of alternate systems for peaking power generation, viz gas turbines and coal fired cycling plants. Competitive benefit analysis of thermal energy storage systems with alternate systems for peaking power generation and recommendations for development and field test of thermal energy storage with a conventional utility are included. Results indicate that thermal energy storage is only marginally competitive with coal fired cycling power plants and gas turbines for peaking power generation.

Integrated System for Retrieval, Transportation and Consolidated Storage of Used Nuclear Fuel in the US - 13312

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

Bracey, William; Bondre, Jayant; Shelton, Catherine

2013-07-01

The current inventory of used nuclear fuel assemblies (UNFAs) from commercial reactor operations in the United States totals approximately 65,000 metric tons or approximately 232,000 UNFAs primarily stored at the 104 operational reactors in the US and a small number of decommissioned reactors. This inventory is growing at a rate of roughly 2,000 to 2,400 metric tons each year, (Approx. 7,000 UNFAs) as a result of ongoing commercial reactor operations. Assuming an average of 10 metric tons per storage/transportation casks, this inventory of commercial UNFAs represents about 6,500 casks with an additional of about 220 casks every year. In Januarymore » 2010, the Blue Ribbon Commission (BRC) [1] was directed to conduct a comprehensive review of policies for managing the back end of the nuclear fuel cycle and recommend a new plan. The BRC issued their final recommendations in January 2012. One of the main recommendations is for the United States to proceed promptly to develop one or more consolidated storage facilities (CSF) as part of an integrated, comprehensive plan for safely managing the back end of the nuclear fuel cycle. Based on its extensive experience in storage and transportation cask design, analysis, licensing, fabrication, and operations including transportation logistics, Transnuclear, Inc. (TN), an AREVA Subsidiary within the Logistics Business Unit, is engineering an integrated system that will address the complete process of commercial UNFA management. The system will deal with UNFAs in their current storage mode in various configurations, the preparation including handling and additional packaging where required and transportation of UNFAs to a CSF site, and subsequent storage, operation and maintenance at the CSF with eventual transportation to a future repository or recycling site. It is essential to proceed by steps to ensure that the system will be the most efficient and serve at best its purpose by defining: the problem to be resolved, the criteria to evaluate the solutions, and the alternative solutions. The complexity of the project is increasing with time (more fuel assemblies, new storage systems, deteriorating logistics infrastructure at some sites, etc.) but with the uncertainty on the final disposal path, flexibility and simplicity will be critical. (authors)« less

Implementation hurdles of an interactive, integrated, point-of-care computerised decision support system for hospital antibiotic prescription.

PubMed

Chow, A L; Ang, A; Chow, C Z; Ng, T M; Teng, C; Ling, L M; Ang, B S; Lye, D C

2016-02-01

Antimicrobial stewardship is used to combat antimicrobial resistance. In Singapore, a tertiary hospital has integrated a computerised decision support system, called Antibiotic Resistance Utilisation and Surveillance-Control (ARUSC), into the electronic inpatient prescribing system. ARUSC is launched either by the physician to seek guidance for an infectious disease condition or via auto-trigger when restricted antibiotics are prescribed. This paper describes the implementation of ARUSC over three phases from 1 May 2011 to 30 April 2013, compared factors between ARUSC launches via auto-trigger and for guidance, examined factors associated with acceptance of ARUSC recommendations, and assessed user acceptability. During the study period, a monthly average of 9072 antibiotic prescriptions was made, of which 2370 (26.1%) involved ARUSC launches. Launches via auto-trigger comprised 48.1% of ARUSC launches. In phase 1, 23% of ARUSC launches were completed. This rose to 38% in phase 2, then 87% in phase 3, as escapes from the ARUSC programme were sequentially disabled. Amongst completed launches for guidance, 89% of ARUSC recommendations were accepted versus 40% amongst completed launches via auto-trigger. Amongst ARUSC launches for guidance, being from a medical department [adjusted odds ratio (aOR)=1.20, 95% confidence interval (CI) 1.04-1.37] and ARUSC launch during on-call (aOR=1.81, 95% CI 1.61-2.05) were independently associated with acceptance of ARUSC recommendations. Junior physicians found ARUSC useful. Senior physicians found ARUSC reliable but admitted to having preferences for antibiotics that may conflict with ARUSC. Hospital-wide implementation of ARUSC encountered hurdles from physicians. With modifications, the completion rate improved. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

A Personalized Electronic Movie Recommendation System Based on Support Vector Machine and Improved Particle Swarm Optimization

PubMed Central

Wang, Xibin; Luo, Fengji; Qian, Ying; Ranzi, Gianluca

2016-01-01

With the rapid development of ICT and Web technologies, a large an amount of information is becoming available and this is producing, in some instances, a condition of information overload. Under these conditions, it is difficult for a person to locate and access useful information for making decisions. To address this problem, there are information filtering systems, such as the personalized recommendation system (PRS) considered in this paper, that assist a person in identifying possible products or services of interest based on his/her preferences. Among available approaches, collaborative Filtering (CF) is one of the most widely used recommendation techniques. However, CF has some limitations, e.g., the relatively simple similarity calculation, cold start problem, etc. In this context, this paper presents a new regression model based on the support vector machine (SVM) classification and an improved PSO (IPSO) for the development of an electronic movie PRS. In its implementation, a SVM classification model is first established to obtain a preliminary movie recommendation list based on which a SVM regression model is applied to predict movies’ ratings. The proposed PRS not only considers the movie’s content information but also integrates the users’ demographic and behavioral information to better capture the users’ interests and preferences. The efficiency of the proposed method is verified by a series of experiments based on the MovieLens benchmark data set. PMID:27898691

A Personalized Electronic Movie Recommendation System Based on Support Vector Machine and Improved Particle Swarm Optimization.

PubMed

Wang, Xibin; Luo, Fengji; Qian, Ying; Ranzi, Gianluca

2016-01-01

With the rapid development of ICT and Web technologies, a large an amount of information is becoming available and this is producing, in some instances, a condition of information overload. Under these conditions, it is difficult for a person to locate and access useful information for making decisions. To address this problem, there are information filtering systems, such as the personalized recommendation system (PRS) considered in this paper, that assist a person in identifying possible products or services of interest based on his/her preferences. Among available approaches, collaborative Filtering (CF) is one of the most widely used recommendation techniques. However, CF has some limitations, e.g., the relatively simple similarity calculation, cold start problem, etc. In this context, this paper presents a new regression model based on the support vector machine (SVM) classification and an improved PSO (IPSO) for the development of an electronic movie PRS. In its implementation, a SVM classification model is first established to obtain a preliminary movie recommendation list based on which a SVM regression model is applied to predict movies' ratings. The proposed PRS not only considers the movie's content information but also integrates the users' demographic and behavioral information to better capture the users' interests and preferences. The efficiency of the proposed method is verified by a series of experiments based on the MovieLens benchmark data set.

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

Liu, Xiaobing; Malhotra, Mini; Walburger, Adam

This paper summarizes a case study of an innovative ground source heat pump (GSHP) system that uses flooded mines as a heat source and heat sink. This GSHP system provides space conditioning to a 56,000 sq ft 2(5,203 m 2) newly constructed research facility, in conjunction with supplementary existing steam heating and air-cooled chiller systems. Heat transfer performance and overall efficiency of the GSHP system were analysed using the available measured data from January through July 2014. The performance analysis identified some issues with using mine water for cooling and the integration of the GSHP system with the existing steammore » heating system. Recommendations were made to improve the control and operation of the GSHP system. These recommendations, in conjunction with the available measured data, were used to predict the annual energy use of the system. Finally, the energy and cost savings and CO 2 emission reduction potential of the GSHP system were estimated by comparing with a baseline scenario. This case study provides insights into the performance of and potential issues with the mine-water source heat pump system, which is relatively under-explored compared to other GSHP system designs and configurations.« less

Integrated orbital servicing study follow-on. Volume 3: Engineering test unit and controls

NASA Technical Reports Server (NTRS)

1978-01-01

A one-g servicing demonstration system which can be used to investigate and develop, in a real time hands-on situation, a wide variety of the mechanism and control system aspects of orbital servicing in the form of module exchange is described including the engineering test unit and the servicer servo drive console. A series of recommendations for future work is given concerning the control problem and more efficient module exchanges, mechanical elements, and electronics.

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

Kalugin, A. V., E-mail: Kalugin-AV@nrcki.ru; Tebin, V. V.

The specific features of calculation of the effective multiplication factor using the Monte Carlo method for weakly coupled and non-asymptotic multiplying systems are discussed. Particular examples are considered and practical recommendations on detection and Monte Carlo calculation of systems typical in numerical substantiation of nuclear safety for VVER fuel management problems are given. In particular, the problems of the choice of parameters for the batch mode and the method for normalization of the neutron batch, as well as finding and interpretation of the eigenvalue spectrum for the integral fission matrix, are discussed.

ATHENA: A Personalized Platform to Promote an Active Lifestyle and Wellbeing Based on Physical, Mental and Social Health Primitives

PubMed Central

Fahim, Muhammad; Idris, Muhammad; Ali, Rahman; Nugent, Christopher; Kang, Byeong; Huh, Eui-Nam; Lee, Sungyoung

2014-01-01

Technology provides ample opportunities for the acquisition and processing of physical, mental and social health primitives. However, several challenges remain for researchers as how to define the relationship between reported physical activities, mood and social interaction to define an active lifestyle. We are conducting a project, ATHENA(activity-awareness for human-engaged wellness applications) to design and integrate the relationship between these basic health primitives to approximate the human lifestyle and real-time recommendations for wellbeing services. Our goal is to develop a system to promote an active lifestyle for individuals and to recommend to them valuable interventions by making comparisons to their past habits. The proposed system processes sensory data through our developed machine learning algorithms inside smart devices and utilizes cloud infrastructure to reduce the cost. We exploit big data infrastructure for massive sensory data storage and fast retrieval for recommendations. Our contributions include the development of a prototype system to promote an active lifestyle and a visual design capable of engaging users in the goal of increasing self-motivation. We believe that our study will impact the design of future ubiquitous wellness applications. PMID:24859031

Update of the Mexican College of Rheumatology guidelines for the pharmacologic treatment of rheumatoid arthritis.

PubMed

Cardiel, Mario H; Díaz-Borjón, Alejandro; Vázquez del Mercado Espinosa, Mónica; Gámez-Nava, Jorge Iván; Barile Fabris, Leonor A; Pacheco Tena, César; Silveira Torre, Luis H; Pascual Ramos, Virginia; Goycochea Robles, María Victoria; Aguilar Arreola, Jorge Enrique; González Díaz, Verónica; Alvarez Nemegyei, José; González-López, Laura del Carmen; Salazar Páramo, Mario; Portela Hernández, Margarita; Castro Colín, Zully; Xibillé Friedman, Daniel Xavier; Alvarez Hernández, Everardo; Casasola Vargas, Julio; Cortés Hernández, Miguel; Flores-Alvarado, Diana E; Martínez Martínez, Laura A; Vega-Morales, David; Flores-Suárez, Luis Felipe; Medrano Ramírez, Gabriel; Barrera Cruz, Antonio; García González, Adolfo; López López, Susana Marisela; Rosete Reyes, Alejandra; Espinosa Morales, Rolando

2014-01-01

The pharmacologic management of rheumatoid arthritis has progressed substantially over the past years. It is therefore desirable that existing information be periodically updated. There are several published international guidelines for the treatment of rheumatoid arthritis that hardly adapt to the Mexican health system because of its limited healthcare resources. Hence, it is imperative to unify the existing recommendations and to incorporate them to a set of clinical, updated recommendations; the Mexican College of Rheumatology developed these recommendations in order to offer an integral management approach of rheumatoid arthritis according to the resources of the Mexican health system. To review, update and improve the available evidence within clinical practice guidelines on the pharmacological management of rheumatoid arthritis and produce a set of recommendations adapted to the Mexican health system, according to evidence available through December 2012. The working group was composed of 30 trained and experienced rheumatologists with a high quality of clinical knowledge and judgment. Recommendations were based on the highest quality evidence from the previously established treatment guidelines, meta-analysis and controlled clinical trials for the adult population with rheumatoid arthritis. During the conformation of this document, each working group settled the existing evidence from the different topics according to their experience. Finally, all the evidence and decisions were unified into a single document, treatment algorithm and drug standardization tables. This update of the Mexican Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis provides the highest quality information available at the time the working group undertook this review and contextualizes its use for the complex Mexican health system. Copyright © 2013 Elsevier España, S.L. All rights reserved.

A summary and integration of research concerning single pilot IFR operational problems

NASA Technical Reports Server (NTRS)

Chapman, G. C.

1983-01-01

A review of seven research studies pertaining to Single Pilot IFR (SPIFR) operations was performed. Two studies were based on questionnaire surveys; two based on National Transportation Safety Board (NTSB) reports; two were based on Aviation Safety Reporting System (ASRS) incident reports, and one report used event analysis and statistics to forecast problems. The results obtained in each study were extracted and integrated. Results were synthesized and key issues pertaining to SPIFR operations problems were identified. The research that was recommended by the studies and that addressed the key issues is catalogued for each key issue.

1992 NASA Life Support Systems Analysis workshop

NASA Technical Reports Server (NTRS)

Evanich, Peggy L.; Crabb, Thomas M.; Gartrell, Charles F.

1992-01-01

The 1992 Life Support Systems Analysis Workshop was sponsored by NASA's Office of Aeronautics and Space Technology (OAST) to integrate the inputs from, disseminate information to, and foster communication among NASA, industry, and academic specialists. The workshop continued discussion and definition of key issues identified in the 1991 workshop, including: (1) modeling and experimental validation; (2) definition of systems analysis evaluation criteria; (3) integration of modeling at multiple levels; and (4) assessment of process control modeling approaches. Through both the 1991 and 1992 workshops, NASA has continued to seek input from industry and university chemical process modeling and analysis experts, and to introduce and apply new systems analysis approaches to life support systems. The workshop included technical presentations, discussions, and interactive planning, with sufficient time allocated for discussion of both technology status and technology development recommendations. Key personnel currently involved with life support technology developments from NASA, industry, and academia provided input to the status and priorities of current and future systems analysis methods and requirements.

Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system.

PubMed

Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

2016-10-01

Audit and Feedback (A&F) is a widely used quality improvement technique that measures clinicians' clinical performance and reports it back to them. Computerised A&F (e-A&F) system interfaces may consist of four key components: (1) Summaries of clinical performance; (2) Patient lists; (3) Patient-level data; (4) Recommended actions. There is a lack of evidence regarding how to best design e-A&F interfaces; establishing such evidence is key to maximising usability, and in turn improving patient safety. To evaluate the usability of a novel theoretically-informed and research-led e-A&F system for primary care (the Performance Improvement plaN GeneratoR: PINGR). (1) Describe PINGR's design, rationale and theoretical basis; (2) Identify usability issues with PINGR; (3) Understand how these issues may interfere with the cognitive goals of end-users; (4) Translate the issues into recommendations for the user-centred design of e-A&F systems. Eight experienced health system evaluators performed a usability inspection using an innovative hybrid approach consisting of five stages: (1) Development of representative user tasks, Goals, and Actions; (2) Combining Heuristic Evaluation and Cognitive Walkthrough methods into a single protocol to identify usability issues; (3) Consolidation of issues; (4) Severity rating of consolidated issues; (5) Analysis of issues according to usability heuristics, interface components, and Goal-Action structure. A final list of 47 issues were categorised into 8 heuristic themes. The most error-prone heuristics were 'Consistency and standards' (13 usability issues; 28% of the total) and 'Match between system and real world' (n=10, 21%). The recommended actions component of the PINGR interface had the most usability issues (n=21, 45%), followed by patient-level data (n=5, 11%), patient lists (n=4, 9%), and summaries of clinical performance (n=4, 9%). The most error-prone Actions across all user Goals were: (1) Patient selection from a list; (2) Data identification from a figure (both population-level and patient-level); (3) Disagreement with a system recommendation. By contextualising our findings within the wider literature on health information system usability, we provide recommendations for the design of e-A&F system interfaces relating to their four key components, in addition to how they may be integrated within a system. Copyright © 2016. Published by Elsevier Ireland Ltd.

Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries.

PubMed

Patel, L N; Detjen, A K

2017-06-21

Introduction: Childhood tuberculosis (TB) and undernutrition are major global public health challenges. In 2015, although an estimated 1 million children aged <15 years developed TB, the majority of the cases remain undiagnosed, partly due to a lack of awareness and capacity by providers who serve as the first point of care for sick children. This calls for better integration of TB with child health and nutrition services. TB can cause or worsen undernutrition, and undernutrition increases the risk of TB. Methods: Guidelines for the management of acute malnutrition from 17 high TB burden countries were reviewed to gather information on TB symptom screening, exposure history, and treatment. Results: Seven (41%) countries recommend routine TB screening among children with acute malnutrition, and six (35%) recommend obtaining a TB exposure history. Conclusion: TB screening is not consistently included in guidelines for acute malnutrition in high TB burden countries. Routine TB risk assessment, especially history of TB exposure, among acutely malnourished children, combined with improved linkages with TB services, would help increase TB case finding and could impact outcomes. Operational research on how best to integrate services at different levels of the health care system is needed.

Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries

PubMed Central

Detjen, A. K.

2017-01-01

Introduction: Childhood tuberculosis (TB) and undernutrition are major global public health challenges. In 2015, although an estimated 1 million children aged <15 years developed TB, the majority of the cases remain undiagnosed, partly due to a lack of awareness and capacity by providers who serve as the first point of care for sick children. This calls for better integration of TB with child health and nutrition services. TB can cause or worsen undernutrition, and undernutrition increases the risk of TB. Methods: Guidelines for the management of acute malnutrition from 17 high TB burden countries were reviewed to gather information on TB symptom screening, exposure history, and treatment. Results: Seven (41%) countries recommend routine TB screening among children with acute malnutrition, and six (35%) recommend obtaining a TB exposure history. Conclusion: TB screening is not consistently included in guidelines for acute malnutrition in high TB burden countries. Routine TB risk assessment, especially history of TB exposure, among acutely malnourished children, combined with improved linkages with TB services, would help increase TB case finding and could impact outcomes. Operational research on how best to integrate services at different levels of the health care system is needed. PMID:28695083

Adaptation and Integration of Permanent Immigrants Seminar (4th, Geneva, Switzerland, May 8-11, 1979).

ERIC Educational Resources Information Center

International Migration, 1979

1979-01-01

This document contains working papers prepared for a seminar on Adaptation and Integration of Permanent Immigrants, along with general and specific recommendations formulated by seminar participants. Conclusions and recommendations from each paper are presented in English, French, and Spanish; the conference papers themselves are presented only in…

Patient centredness in integrated care: results of a qualitative study based on a systems theoretical framework

PubMed Central

Lüdecke, Daniel

2014-01-01

Introduction Health care providers seek to improve patient-centred care. Due to fragmentation of services, this can only be achieved by establishing integrated care partnerships. The challenge is both to control costs while enhancing the quality of care and to coordinate this process in a setting with many organisations involved. The problem is to establish control mechanisms, which ensure sufficiently consideration of patient centredness. Theory and methods Seventeen qualitative interviews have been conducted in hospitals of metropolitan areas in northern Germany. The documentary method, embedded into a systems theoretical framework, was used to describe and analyse the data and to provide an insight into the specific perception of organisational behaviour in integrated care. Results The findings suggest that integrated care partnerships rely on networks based on professional autonomy in the context of reliability. The relationships of network partners are heavily based on informality. This correlates with a systems theoretical conception of organisations, which are assumed autonomous in their decision-making. Conclusion and discussion Networks based on formal contracts may restrict professional autonomy and competition. Contractual bindings that suppress the competitive environment have negative consequences for patient-centred care. Drawbacks remain due to missing self-regulation of the network. To conclude, less regimentation of integrated care partnerships is recommended. PMID:25411573

Patient centredness in integrated care: results of a qualitative study based on a systems theoretical framework.

PubMed

Lüdecke, Daniel

2014-10-01

Health care providers seek to improve patient-centred care. Due to fragmentation of services, this can only be achieved by establishing integrated care partnerships. The challenge is both to control costs while enhancing the quality of care and to coordinate this process in a setting with many organisations involved. The problem is to establish control mechanisms, which ensure sufficiently consideration of patient centredness. Seventeen qualitative interviews have been conducted in hospitals of metropolitan areas in northern Germany. The documentary method, embedded into a systems theoretical framework, was used to describe and analyse the data and to provide an insight into the specific perception of organisational behaviour in integrated care. The findings suggest that integrated care partnerships rely on networks based on professional autonomy in the context of reliability. The relationships of network partners are heavily based on informality. This correlates with a systems theoretical conception of organisations, which are assumed autonomous in their decision-making. Networks based on formal contracts may restrict professional autonomy and competition. Contractual bindings that suppress the competitive environment have negative consequences for patient-centred care. Drawbacks remain due to missing self-regulation of the network. To conclude, less regimentation of integrated care partnerships is recommended.

The Design and Testing of the LSSIF Advanced Thermal Control System

NASA Technical Reports Server (NTRS)

Henson, Robert A.; Keller, John R.

1995-01-01

The Life Support Systems Integration Facility (LSSIF) provides a platform to design and evaluate advanced manned space systems at NASA Johnson Space Center (JSC). The LSSIF Early Human Testing Initiative requires the integration of such subsystems to enable human occupancy of the 6 meter chamber for a 90 day closed volume test. The Advanced Thermal Control System (TCS) is an important component of the integrated system by supplying coolant to the subsystems within the chamber, such as the Air Revitalization System. The TCS incorporates an advanced high efficiency, heat pump to reject waste heat from the chamber to an external sink or 'lift' temperature that emulates a Lunar environment. The heat pump is the High Lift Heat Pump, developed by Foster-Miller, Inc., and is the main test article of the TCS. The heat pump prototype utilizes a non-CFC refrigerant in a design where the thermal requirements exceed existing terrestrial technology. These operating requirements provide a unique opportunity to design and test an advanced integrated thermal system and the associated controls. The design, control, and systems integration of the heat pump and the TCS also have terrestrial technology application. This paper addresses the design of the TCS and the heat pump, along with the control scheme to fully test the heat pump. Design approaches utilized in the LSSIF TCS are promoted for implementation in terrestrial thermal systems. The results of the preliminary thermal and fluid analyses used to develop the control of the thermal systems will also be discussed. The paper includes objectives for the 90 day human test and the test setup. Finally, conclusions will be drawn and recommendations for Earth design application are submitted.

Methods and metrics challenges of delivery-system research

PubMed Central

2012-01-01

Background Many delivery-system interventions are fundamentally about change in social systems (both planned and unplanned). This systems perspective raises a number of methodological challenges for studying the effects of delivery-system change--particularly for answering questions related to whether the change will work under different conditions and how the change is integrated (or not) into the operating context of the delivery system. Methods The purpose of this paper is to describe the methodological and measurement challenges posed by five key issues in delivery-system research: (1) modeling intervention context; (2) measuring readiness for change; (3) assessing intervention fidelity and sustainability; (4) assessing complex, multicomponent interventions; and (5) incorporating time in delivery-system models to discuss recommendations for addressing these issues. For each issue, we provide recommendations for how research may be designed and implemented to overcome these challenges. Results and conclusions We suggest that a more refined understanding of the mechanisms underlying delivery-system interventions (treatment theory) and the ways in which outcomes for different classes of individuals change over time are fundamental starting points for capturing the heterogeneity in samples of individuals exposed to delivery-system interventions. To support the research recommendations outlined in this paper and to advance understanding of the "why" and "how" questions of delivery-system change and their effects, funding agencies should consider supporting studies with larger organizational sample sizes; longer duration; and nontraditional, mixed-methods designs. A version of this paper was prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services for presentation and discussion at a meeting on "The Challenge and Promise of Delivery System Research," held in Sterling, VA, on February 16-17, 2011. The opinions in the paper are those of the author and do not represent the views or recommendations of AHRQ or the US Department of Health and Human Services.1 PMID:22409885

[Guidelines for budget impact analysis of health technologies in Brazil].

PubMed

Ferreira-Da-Silva, Andre Luis; Ribeiro, Rodrigo Antonini; Santos, Vânia Cristina Canuto; Elias, Flávia Tavares Silva; d'Oliveira, Alexandre Lemgruber Portugal; Polanczyk, Carisi Anne

2012-07-01

Budget impact analysis (BIA) provides operational financial forecasts to implement new technologies in healthcare systems. There were no previous specific recommendations to conduct such analyses in Brazil. This paper reviews BIA methods for health technologies and proposes BIA guidelines for the public and private Brazilian healthcare system. The following recommendations were made: adopt the budget administrator's perspective; use a timeframe of 1 to 5 years; compare reference and alternative scenarios; consider the technology's rate of incorporation; estimate the target population by either an epidemiological approach or measured demand; consider restrictions on technologies' indication or factors that increase the demand for them; consider direct and averted costs; do not adjust for inflation or discounts; preferably, integrate information on a spreadsheet; calculate the incremental budget impact between scenarios; and summarize information in a budget impact report.

Targeted Research and Technology Within NASA's Living With a Star Program

NASA Technical Reports Server (NTRS)

Antiochos, Spiro; Baker, Kile; Bellaire, Paul; Blake, Bern; Crowley, Geoff; Eddy, Jack; Goodrich, Charles; Gopalswamy, Nat; Gosling, Jack; Hesse, Michael

2004-01-01

Targeted Research & Technology (TR&T) NASA's Living With a Star (LWS) initiative is a systematic, goal-oriented research program targeting those aspects of the Sun-Earth system that affect society. The Targeted Research and Technology (TR&T) component of LWS provides the theory, modeling, and data analysis necessary to enable an integrated, system-wide picture of Sun-Earth connection science with societal relevance. Recognizing the central and essential role that TR&T would have for the success of the LWS initiative, the LWS Science Architecture Team (SAT) recommended that a Science Definition Team (SDT), with the same status as a flight mission definition team, be formed to design and coordinate a TR&T program having prioritized goals and objectives that focused on practical societal benefits. This report details the SDT recommendations for the TR&T program.

Integrative care for the management of low back pain: use of a clinical care pathway.

PubMed

Maiers, Michele J; Westrom, Kristine K; Legendre, Claire G; Bronfort, Gert

2010-10-29

For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to guide treatment by an integrative group of providers within a randomized controlled trial. A clinical care pathway was used by a multidisciplinary group of providers, which included acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary care physicians. Treatment recommendations were based on an evidence-informed practice model, and reached by group consensus. Research study participants were empowered to select one of the treatment recommendations proposed by the integrative group. Common principles and benchmarks were established to guide treatment management throughout the study. Thirteen providers representing 5 healthcare professions collaborated to provide integrative care to study participants. On average, 3 to 4 treatment plans, each consisting of 2 to 3 modalities, were recommended to study participants. Exercise, massage, and acupuncture were both most commonly recommended by the team and selected by study participants. Changes to care commonly incorporated cognitive behavioral therapy into treatment plans. This clinical care pathway was a useful tool for the consistent application of evidence-based care for low back pain in the context of an integrative setting. ClinicalTrials.gov NCT00567333.

A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services.

PubMed

Reynolds, Heidi W; Sutherland, Elizabeth G

2013-05-06

Because of the current emphasis and enthusiasm focused on integration of health systems, there is a risk of piling resources into integrated strategies without the necessary systems in place to monitor their progress adequately or to measure impact, and to learn from these efforts. The rush to intervene without adequate monitoring and evaluation will continue to result in a weak evidence base for decision making and resource allocation. Program planning and implementation are inextricability linked to monitoring and evaluation. Country level guidance is needed to identify country-specific integrated strategies, thereby increasing country ownership. This paper focuses on integrated health services but takes into account how health services are influenced by the health system, managed by programs, and made up of interventions. We apply the principles in existing comprehensive monitoring and evaluation (M&E) frameworks in order to outline a systematic approach to the M&E of integration for the country level. The approach is grounded by first defining the country-specific health challenges that integration is intended to affect. Priority points of contact for care can directly influence health, and essential packages of integration for all major client presentations need to be defined. Logic models are necessary to outline the plausible causal pathways and define the inputs, roles and responsibilities, indicators, and data sources across the health system. Finally, we recommend improvements to the health information system and in data use to ensure that data are available to inform decisions, because changes in the M&E function to make it more integrated will also facilitate integration in the service delivery, planning, and governance components. This approach described in the paper is the ideal, but its application at the country level can help reveal gaps and guide decisions related to what health services to prioritize for integration, help plan for how to strengthen systems to support health services, and ultimately establish an evidence base to inform investments in health care. More experience is needed to understand if the approach is feasible; similarly, more emphasis is needed on documenting the process of designing and implemented integrated interventions at the national level.

A call for integrating a mental health perspective into systems of care for abused and neglected infants and young children.

PubMed

Osofsky, Joy D; Lieberman, Alicia F

2011-01-01

A system of care for abused and neglected infants and young children should adopt a comprehensive perspective, with mental health considerations systematically incorporated into policies and decisions affecting children and their families. Children age birth to 5 years have disproportionately high rates of maltreatment, with long-term consequences for their mental and physical health. Research on normal development and developmental psychopathology has shown that early development unfolds in an ecology of transactional influences among biological, interpersonal, and environmental domains. Psychologists should collaborate with other early intervention disciplines to create systems of care based on an ecological-transactional model of development that includes early mental health principles in order to serve the needs of these young children. Didactic courses, practicums, and internships in infant and early childhood mental health should become integral components of undergraduate and graduate curricula in psychology in order to build capacity to achieve this goal. Recommendations are offered for systemic change by integrating infant and early childhood mental health principles into existing systems of care for young children and their families. PsycINFO Database Record (c) 2010 APA, all rights reserved.

PubMed Central

CICIRIELLO, E.

2016-01-01

SUMMARY Non-uniform, late, or inappropriate care of childhood with permanent hearing impairment (PHI) predisposes many children to develop communicative- behaviour problems and impaired psychosocial adjustment that can persist in adolescence and adulthood.In March 2014, the CCM (Centro Controllo Malattie or Disease Control Centre) of the Italian Ministry of Health funded a project entitled " Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". The project involved 5 tertiary centres with UNHS programs formally approved by the Region. The main purpose of the project is to define and launch an integrated regionally-based public health model for identification, diagnosis and intervention of childhood PHI. The first phase of the project investigated the state of art and produced recommendations for positive changes in identification, diagnosis, therapy and care of childhood PHI in Italy, taking into account diagnostic and treatment innovations, family empowerment, treatment alliance and an interdisciplinary approach. Recommendations drawn from this initial phase will represent the basis for a regional system for early intervention that is validated, integrated and shared between the five regions. PMID:27054384

Forging a poison prevention and control system: report of an Institute of Medicine committee.

PubMed

Guyer, Bernard; Mavor, Anne

2005-01-01

The Committee forged a vision for a national poison prevention and control system that broadly integrates the current network of poison control centers with state and local public health departments responsible for monitoring populations. Implementing the Committee's recommendations, however, will require leadership from the Congress and the federal agencies to whom the report is addressed: HRSA and CDC. The next steps include amendments to existing legislation to establish the national system and to secure federal funding to assure stability of the system and systematic oversight by the federal agencies to hold all parties accountable for the performance of the system.

Comparison of A-SMGCS Requirements with Observed Performance of an Integrated Airport CNS System

NASA Technical Reports Server (NTRS)

Young, Steven D.

1997-01-01

The International Civil Aviation Organization (ICAO) has recently drafted a reference document describing the operational requirements for Advanced Surface Movement Guidance and Control Systems (A-SMGCS). During the summer of 1997, NASA, the FAA, industry, and academia partners demonstrated a holistic system approach that has the potential to meet many of the proposed A-SMGCS requirements. An assessment of the field tested system and data resulting from the field testing is presented to determine its compliance with A-SMGCS requirements. In those areas where compliance was not demonstrated, a recommendation is presented suggesting further research or a modification of the system architecture.

Selection of a method to rate the strength of scientific evidence for AORN recommendations.

PubMed

Steelman, Victoria M; Pape, Theresa; King, Cecil A; Graling, Paula; Gaberson, Kathleen B

2011-04-01

The use of scientific evidence to support national recommendations about clinical decisions has become an expectation of multidisciplinary health care organizations. The objectives of this project were to identify the most applicable evidence-rating method for perioperative nursing practice, evaluate the reliability of this method for perioperative nursing recommendations, and identify barriers and facilitators to adoption of this method for AORN recommendations. A panel of perioperative nurse experts evaluated 46 evidence-rating systems for quality, quantity, and consistency. We rated the methods that fully covered all three domains on five aspects of applicability to perioperative nursing practice recommendations. The Oncology Nursing Society's method was rated highest for all five aspects of applicability, and interrater reliability of this method for perioperative recommendations was 100%. Potential barriers to implementation of the rating method include knowledge deficit, staff resources, resistance to change, and fear of showing that lower levels of evidence support some recommendations. Facilitators included education, resource allocation, and starting small. Barriers and facilitators will be considered by the implementation team that will develop a plan to achieve integration of evidence rating into AORN documents. The AORN Board of Directors approved adoption of this method in June 2010. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Data on performance of air stripping tower- PAC integrated system for removing of odor, taste, dye and organic materials from drinking water-A case study in Saqqez, Iran.

PubMed

Pirsaheb, Meghdad; Mohammadi, Jalil; Khosravi, Touba; Sharafi, Hooshmnd; Moradi, Masoud

2018-06-01

Unpleasant taste or smell are more importantly constituents of drinking-water, lead to complaints from consumers. Dye and organic matter as well change in disinfection practice may generate taste and an odorous compound in treated water. According to low efficiency of conventional methods to remove taste and odor compounds, present study was aimed to evaluate the performance of air stripping tower- Poly Aluminum Chloride (PAC) integrated system to remove odor and taste, dye and organic materials from drinking water. Different air to water ratio and PAC doses were used to remove considered parameters in certain condition. The results of this study indicated that the maximum removal efficiency of 86.2, 76.47, 58.46 and 41.27% of taste and odor, dye, COD and TOC were achieved by the air stripping tower- PAC integrated system, respectively. However, the physico-chemical characteristics of water and adsorbent effect on the of substances removal efficiency considerably. It can be stated that the air striping tower - PAC integrated system is able to reduce the odor and taste-causing substances and organic matter to a level which is recommended by the Institute of Standards and Industrial Research of Iran.

Computer integration of engineering design and production: A national opportunity

NASA Astrophysics Data System (ADS)

1984-10-01

The National Aeronautics and Space Administration (NASA), as a purchaser of a variety of manufactured products, including complex space vehicles and systems, clearly has a stake in the advantages of computer-integrated manufacturing (CIM). Two major NASA objectives are to launch a Manned Space Station by 1992 with a budget of $8 billion, and to be a leader in the development and application of productivity-enhancing technology. At the request of NASA, a National Research Council committee visited five companies that have been leaders in using CIM. Based on these case studies, technical, organizational, and financial issues that influence computer integration are described, guidelines for its implementation in industry are offered, and the use of CIM to manage the space station program is recommended.

Computer integration of engineering design and production: A national opportunity

NASA Technical Reports Server (NTRS)

1984-01-01

The National Aeronautics and Space Administration (NASA), as a purchaser of a variety of manufactured products, including complex space vehicles and systems, clearly has a stake in the advantages of computer-integrated manufacturing (CIM). Two major NASA objectives are to launch a Manned Space Station by 1992 with a budget of $8 billion, and to be a leader in the development and application of productivity-enhancing technology. At the request of NASA, a National Research Council committee visited five companies that have been leaders in using CIM. Based on these case studies, technical, organizational, and financial issues that influence computer integration are described, guidelines for its implementation in industry are offered, and the use of CIM to manage the space station program is recommended.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project KDP-C Review

NASA Technical Reports Server (NTRS)

Grindle, Laurie; Sakahara, Robert; Hackenberg, Davis; Johnson, William

2017-01-01

The topics discussed are the UAS-NAS project life-cycle and ARMD thrust flow down, as well as the UAS environments and how we operate in those environments. NASA's Armstrong Flight Research Center at Edwards, CA, is leading a project designed to help integrate unmanned air vehicles into the world around us. The Unmanned Aircraft Systems Integration in the National Airspace System project, or UAS in the NAS, will contribute capabilities designed to reduce technical barriers related to safety and operational challenges associated with enabling routine UAS access to the NAS. The project falls under the Integrated Systems Research Program office managed at NASA Headquarters by the agency's Aeronautics Research Mission Directorate. NASA's four aeronautics research centers - Armstrong, Ames Research Center, Langley Research Center, and Glenn Research Center - are part of the technology development project. With the use and diversity of unmanned aircraft growing rapidly, new uses for these vehicles are constantly being considered. Unmanned aircraft promise new ways of increasing efficiency, reducing costs, enhancing safety and saving lives 460265main_ED10-0132-16_full.jpg Unmanned aircraft systems such as NASA's Global Hawks (above) and Predator B named Ikhana (below), along with numerous other unmanned aircraft systems large and small, are the prime focus of the UAS in the NAS effort to integrate them into the national airspace. Credits: NASA Photos 710580main_ED07-0243-37_full.jpg The UAS in the NAS project envisions performance-based routine access to all segments of the national airspace for all unmanned aircraft system classes, once all safety-related and technical barriers are overcome. The project will provide critical data to such key stakeholders and customers as the Federal Aviation Administration and RTCA Special Committee 203 (formerly the Radio Technical Commission for Aeronautics) by conducting integrated, relevant system-level tests to adequately address safety and operational challenges of national airspace access by unmanned aircraft systems, or UAS. In the process, the project will work with other key stakeholders to define necessary deliverables and products to help enable such access. Within the project, NASA is focusing on five sub-projects. These five focus areas include assurance of safe separation of unmanned aircraft from manned aircraft when flying in the national airspace; safety-critical command and control systems and radio frequencies to enable safe operation of UAS; human factors issues for ground control stations; airworthiness certification standards for UAS avionics and integrated tests and evaluation designed to determine the viability of emerging UAS technology. Five Focus Areas of the UAS Integration in the NAS Project Separation Assurance Provide an assessment of how planned Next Generation Air Transportation System (NextGen) separation assurance systems, with different functional allocations, perform for UAS in mixed operations with manned aircraft Assess the applicability to UAS and the performance of NASA NextGen separation assurance systems in flight tests with realistic latencies and uncertain trajectories Assess functional allocations ranging from today's ground-based, controller-provided aircraft separation to fully autonomous airborne self-separation Communications Develop data and rationale to obtain appropriate frequency spectrum allocations to enable safe and efficient operation of UAS in the NAS Develop and validate candidate secure safety-critical command and control system/subsystem test equipment for UAS that complies with UAS international/national frequency regulations, standards and recommended practices and minimum operational and aviation system performance standards for UAS Perform analysis to support recommendations for integration of safety-critical command and control systems and air traffic control communications to ensure safe and efficient operation of UAS in the NAS Human Systems Integration Develop a research test bed and database to provide data and proof of concept for GCS - ground control station - operations in the NAS Coordinate with standards organizations to develop human-factors guidelines for GCS operation in the NAS Certification Define a UAS classification scheme and approach to determining Federal Aviation Regulation airworthiness requirements applicable to all UAS digital avionics Provide hazard and risk-related data to support development of type design criteria and best development practices Integrated Tests and Evaluation Integrate and test mature concepts from technical elements to demonstrate and test viability Evaluate the performance of technology development in a relevant environment (full-mission, human-in-the-loop simulations and flight tests)

Prediction of Central Nervous System Side Effects Through Drug Permeability to Blood-Brain Barrier and Recommendation Algorithm.

PubMed

Fan, Jun; Yang, Jing; Jiang, Zhenran

2018-04-01

Drug side effects are one of the public health concerns. Using powerful machine-learning methods to predict potential side effects before the drugs reach the clinical stages is of great importance to reduce time consumption and protect the security of patients. Recently, researchers have proved that the central nervous system (CNS) side effects of a drug are closely related to its permeability to the blood-brain barrier (BBB). Inspired by this, we proposed an extended neighborhood-based recommendation method to predict CNS side effects using drug permeability to the BBB and other known features of drug. To the best of our knowledge, this is the first attempt to predict CNS side effects considering drug permeability to the BBB. Computational experiments demonstrated that drug permeability to the BBB is an important factor in CNS side effects prediction. Moreover, we built an ensemble recommendation model and obtained higher AUC score (area under the receiver operating characteristic curve) and AUPR score (area under the precision-recall curve) on the data set of CNS side effects by integrating various features of drug.

An Examination of New York State's Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.

PubMed

Scharf, Deborah M; Breslau, Joshua; Hackbarth, Nicole Schmidt; Kusuke, Daniela; Staplefoote, B Lynette; Pincus, Harold Alan

2014-12-30

The poor physical health of adults with serious mental illnesses is a public health crisis. Greater integration of mental health and primary medical care services at the clinic and system levels could address this need. In New York state, there are several ongoing initiatives that promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This study examines three initiatives. Data were collected by RAND through site visits and surveys of mental health clinic administrators and associated professionals. Results showed that Primary and Behavioral Health Care Integration grantees developed infrastructure that supported a broad scope of primary and preventive health care services; these broad changes appeared to contribute to clinic-wide culture shifts toward integration and shared accountability for consumers' "whole person" health. Clinics participating in the Medicaid Incentive tended to implement only those services for which they could bill, which resulted in newly identified consumer physical health care needs but did not help consumers to connect to physical health care services. Finally, while administrators and providers were optimistic that Medicaid Health Homes have potential to improve access to care for adults with serious mental illness, the newness of the initiative made it difficult to assess the degree to which Health Home networks would meet these goals. We conclude with recommendations to state policymakers, clinical providers, and technical assistance providers and recommendations for future research, all designed to strengthen New York state's integrated care initiatives for adults with serious mental illness.

Metadata Standard and Data Exchange Specifications to Describe, Model, and Integrate Complex and Diverse High-Throughput Screening Data from the Library of Integrated Network-based Cellular Signatures (LINCS).

PubMed

Vempati, Uma D; Chung, Caty; Mader, Chris; Koleti, Amar; Datar, Nakul; Vidović, Dušica; Wrobel, David; Erickson, Sean; Muhlich, Jeremy L; Berriz, Gabriel; Benes, Cyril H; Subramanian, Aravind; Pillai, Ajay; Shamu, Caroline E; Schürer, Stephan C

2014-06-01

The National Institutes of Health Library of Integrated Network-based Cellular Signatures (LINCS) program is generating extensive multidimensional data sets, including biochemical, genome-wide transcriptional, and phenotypic cellular response signatures to a variety of small-molecule and genetic perturbations with the goal of creating a sustainable, widely applicable, and readily accessible systems biology knowledge resource. Integration and analysis of diverse LINCS data sets depend on the availability of sufficient metadata to describe the assays and screening results and on their syntactic, structural, and semantic consistency. Here we report metadata specifications for the most important molecular and cellular components and recommend them for adoption beyond the LINCS project. We focus on the minimum required information to model LINCS assays and results based on a number of use cases, and we recommend controlled terminologies and ontologies to annotate assays with syntactic consistency and semantic integrity. We also report specifications for a simple annotation format (SAF) to describe assays and screening results based on our metadata specifications with explicit controlled vocabularies. SAF specifically serves to programmatically access and exchange LINCS data as a prerequisite for a distributed information management infrastructure. We applied the metadata specifications to annotate large numbers of LINCS cell lines, proteins, and small molecules. The resources generated and presented here are freely available. © 2014 Society for Laboratory Automation and Screening.

Manpower Planning for New Weapon Systems

DTIC Science & Technology

1978-12-01

Logistics) take the following actions : 1. Institute formal, post-DSARC management reviews of integrated logistic support implementation to verify...that actions are being taken to minimize manpower and other support resource requirements. 2. Urge the Army, Navy and Marine Corps to press on with...examines how manpower planning actually is done by the military services, and recommends actions by the Assistant Secretary of Defense (Manpower Reserve

Personnel Selection Influences on Remotely-Piloted Aircraft Human-System Integration

DTIC Science & Technology

2015-01-30

measured by current selection methods (for a summary, see 9, 33). In the Williams , Carretta, Kirkendall, Barron, Stewart, and Rose study (33), Air...other characteristics. See Williams et al. (33) for the complete list of SAOCs. Williams et al. (33) made several recommendations regarding RPA...exaggerate their positive qualities and minimize those they consider negative when confronted with personality testing. Williams and King (32) compared

Substance Abuse Treatment for Persons with HIV/AIDS. Treatment Improvement Protocol (TIP) Series 37.

ERIC Educational Resources Information Center

CDM Group, Inc.

The role of substance abuse in the transmission of HIV and AIDS is clear, and the current trend in the pandemic shows that a disproportionate number of minorities in inner cities are affected or are at risk for contracting HIV. The recommendations and guidelines in this TIP support the creation of a comprehensive, integrated system of care for…

Integrated Sensor Architecture (ISA) for Live Virtual Constructive (LVC) Environments

DTIC Science & Technology

2014-03-01

connect, publish their needs and capabilities, and interact with other systems even on disadvantaged networks. Within the ISA project, three levels of...constructive, disadvantaged network, sensor 1. INTRODUCTION In 2003 the Networked Sensors for the Future Force (NSFF) Advanced Technology Demonstration...While this combination is less optimal over disadvantaged networks, and we do not recommend it there, TCP and TLS perform adequately over networks with

Remote sensing training for Corps of Engineering personnel: The university training module concept

NASA Technical Reports Server (NTRS)

1982-01-01

A concept to permit Corps of Engineers personnel to obtain and maintain an appropriate level of individual proficiency in the application of remote sensing to water resource management is described. Recommendations are made for specific training courses and include structure and staffing requirements, syllabi and methods of operation, supporting materials, and procedures for integrating information systems management into the University Training Modules.

Awareness and implementation of the 2000 United States public health service tobacco dependence treatment guideline in a public hospital system.

PubMed

Moody-Thomas, Sarah; Horswell, Ronald; Celestin, Michael D; Dellinger, Amy B; Kaiser, Michael; Butler, Michael

2011-04-01

The 2000 United States Public Health Service (USPHS) clinical practice guideline, "Treating Tobacco Use and Dependence," recommends systems interventions to integrate the treatment of tobacco into routine health care. The Tobacco Control Initiative employed a systems approach to integrate evidence-based treatment for tobacco use into patient care practices in Louisiana's safety net health care system. The purpose of this study was to assess changes in awareness and implementation of the USPHS clinical practice guideline. Surveys were administered to a purposive sample of hospital personnel from key departments in the Louisiana State University system of public hospitals in 2003 (n = 24) and 2007 (n = 44). Perceptions of implementation success improved for 50 of 59 distinct survey items. Rasch scaling was used to assess overall (scaled) change and showed substantial improvement from 2003 to 2007 (P < 0.001). Survey items also were grouped into 6 logical key concept sets. Improvement occurred in perceptions for all 6 key concepts; however, not uniformly. Results of the 2003 and 2007 surveys illustrate the potential effectiveness of using a systems approach to integrate the assessment and treatment of tobacco use into routine care practices in a public health care delivery system that serves medically vulnerable populations.

Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

PubMed

Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

2016-07-07

Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

Towards Integrated Health Technology Assessment for Improving Decision Making in Selected Countries.

PubMed

Oortwijn, Wija; Determann, Domino; Schiffers, Krijn; Tan, Siok Swan; van der Tuin, Jeroen

2017-09-01

To assess the level of comprehensiveness of health technology assessment (HTA) practices around the globe and to formulate recommendations for enhancing legitimacy and fairness of related decision-making processes. To identify best practices, we developed an evaluation framework consisting of 13 criteria on the basis of the INTEGRATE-HTA model (integrative perspective on assessing health technologies) and the Accountability for Reasonableness framework (deliberative appraisal process). We examined different HTA systems in middle-income countries (Argentina, Brazil, and Thailand) and high-income countries (Australia, Canada, England, France, Germany, Scotland, and South Korea). For this purpose, desk research and structured interviews with relevant key stakeholders (N = 32) in the selected countries were conducted. HTA systems in Canada, England, and Scotland appear relatively well aligned with our framework, followed by Australia, Germany, and France. Argentina and South Korea are at an early stage, whereas Brazil and Thailand are at an intermediate level. Both desk research and interviews revealed that scoping is often not part of the HTA process. In contrast, providing evidence reports for assessment is well established. Indirect and unintended outcomes are increasingly considered, but there is room for improvement. Monitoring and evaluation of the HTA process is not well established across countries. Finally, adopting transparent and robust processes, including stakeholder consultation, takes time. This study presents a framework for assessing the level of comprehensiveness of the HTA process in a country. On the basis of applying the framework, we formulate recommendations on how the HTA community can move toward a more integrated decision-making process using HTA. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey.

PubMed

Hansen, Dominique; Rovelo Ruiz, Gustavo; Doherty, Patrick; Iliou, Marie-Christine; Vromen, Tom; Hinton, Sally; Frederix, Ines; Wilhelm, Matthias; Schmid, Jean-Paul; Abreu, Ana; Ambrosetti, Marco; Garcia-Porrero, Esteban; Coninx, Karin; Dendale, Paul

2018-05-01

Background Although disease-specific exercise guidelines for cardiovascular disease (CVD) are widely available, it remains uncertain whether these different exercise guidelines are integrated properly for patients with different CVDs. The aim of this study was to assess the inter-clinician variance in exercise prescription for patients with various CVDs and to compare these prescriptions with recommendations from the EXercise Prescription in Everyday practice and Rehabilitative Training (EXPERT) tool, a digital decision support system for integrated state-of-the-art exercise prescription in CVD. Design The study was a prospective observational survey. Methods Fifty-three CV rehabilitation clinicians from nine European countries were asked to prescribe exercise intensity (based on percentage of peak heart rate (HR peak )), frequency, session duration, programme duration and exercise type (endurance or strength training) for the same five patients. Exercise prescriptions were compared between clinicians, and relationships with clinician characteristics were studied. In addition, these exercise prescriptions were compared with recommendations from the EXPERT tool. Results A large inter-clinician variance was found for prescribed exercise intensity (median (interquartile range (IQR)): 83 (13) % of HR peak ), frequency (median (IQR): 4 (2) days/week), session duration (median (IQR): 45 (18) min/session), programme duration (median (IQR): 12 (18) weeks), total exercise volume (median (IQR): 1215 (1961) peak-effort training hours) and prescription of strength training exercises (prescribed in 78% of all cases). Moreover, clinicians' exercise prescriptions were significantly different from those of the EXPERT tool ( p < 0.001). Conclusions This study reveals significant inter-clinician variance in exercise prescription for patients with different CVDs and disagreement with an integrated state-of-the-art system for exercise prescription, justifying the need for standardization efforts regarding integrated exercise prescription in CV rehabilitation.

Bi-Level Integrated System Synthesis (BLISS) for Concurrent and Distributed Processing

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, Jaroslaw; Altus, Troy D.; Phillips, Matthew; Sandusky, Robert

2002-01-01

The paper introduces a new version of the Bi-Level Integrated System Synthesis (BLISS) methods intended for optimization of engineering systems conducted by distributed specialty groups working concurrently and using a multiprocessor computing environment. The method decomposes the overall optimization task into subtasks associated with disciplines or subsystems where the local design variables are numerous and a single, system-level optimization whose design variables are relatively few. The subtasks are fully autonomous as to their inner operations and decision making. Their purpose is to eliminate the local design variables and generate a wide spectrum of feasible designs whose behavior is represented by Response Surfaces to be accessed by a system-level optimization. It is shown that, if the problem is convex, the solution of the decomposed problem is the same as that obtained without decomposition. A simplified example of an aircraft design shows the method working as intended. The paper includes a discussion of the method merits and demerits and recommendations for further research.

Steering operational synergies in terrestrial observation networks: opportunity for advancing Earth system dynamics modelling

NASA Astrophysics Data System (ADS)

Baatz, Roland; Sullivan, Pamela L.; Li, Li; Weintraub, Samantha R.; Loescher, Henry W.; Mirtl, Michael; Groffman, Peter M.; Wall, Diana H.; Young, Michael; White, Tim; Wen, Hang; Zacharias, Steffen; Kühn, Ingolf; Tang, Jianwu; Gaillardet, Jérôme; Braud, Isabelle; Flores, Alejandro N.; Kumar, Praveen; Lin, Henry; Ghezzehei, Teamrat; Jones, Julia; Gholz, Henry L.; Vereecken, Harry; Van Looy, Kris

2018-05-01

Advancing our understanding of Earth system dynamics (ESD) depends on the development of models and other analytical tools that apply physical, biological, and chemical data. This ambition to increase understanding and develop models of ESD based on site observations was the stimulus for creating the networks of Long-Term Ecological Research (LTER), Critical Zone Observatories (CZOs), and others. We organized a survey, the results of which identified pressing gaps in data availability from these networks, in particular for the future development and evaluation of models that represent ESD processes, and provide insights for improvement in both data collection and model integration. From this survey overview of data applications in the context of LTER and CZO research, we identified three challenges: (1) widen application of terrestrial observation network data in Earth system modelling, (2) develop integrated Earth system models that incorporate process representation and data of multiple disciplines, and (3) identify complementarity in measured variables and spatial extent, and promoting synergies in the existing observational networks. These challenges lead to perspectives and recommendations for an improved dialogue between the observation networks and the ESD modelling community, including co-location of sites in the existing networks and further formalizing these recommendations among these communities. Developing these synergies will enable cross-site and cross-network comparison and synthesis studies, which will help produce insights around organizing principles, classifications, and general rules of coupling processes with environmental conditions.

Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.

PubMed

Robinson, Karen A; Chou, Roger; Berkman, Nancy D; Newberry, Sydne J; Fu, Rongwei; Hartling, Lisa; Dryden, Donna; Butler, Mary; Foisy, Michelle; Anderson, Johanna; Motu'apuaka, Makalapua; Relevo, Rose; Guise, Jeanne-Marie; Chang, Stephanie

2016-02-01

As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews. A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations. Discussions were informed by a literature scan and by interviews with organizations that conduct systematic reviews. Twelve recommendations were developed addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence. We provide preliminary guidance for an efficient and unbiased approach to integrating existing systematic reviews with primary studies in a new review. Copyright © 2016 Elsevier Inc. All rights reserved.

Planetary Sample Caching System Design Options

NASA Technical Reports Server (NTRS)

Collins, Curtis; Younse, Paulo; Backes, Paul

2009-01-01

Potential Mars Sample Return missions would aspire to collect small core and regolith samples using a rover with a sample acquisition tool and sample caching system. Samples would need to be stored in individual sealed tubes in a canister that could be transfered to a Mars ascent vehicle and returned to Earth. A sample handling, encapsulation and containerization system (SHEC) has been developed as part of an integrated system for acquiring and storing core samples for application to future potential MSR and other potential sample return missions. Requirements and design options for the SHEC system were studied and a recommended design concept developed. Two families of solutions were explored: 1)transfer of a raw sample from the tool to the SHEC subsystem and 2)transfer of a tube containing the sample to the SHEC subsystem. The recommended design utilizes sample tool bit change out as the mechanism for transferring tubes to and samples in tubes from the tool. The SHEC subsystem design, called the Bit Changeout Caching(BiCC) design, is intended for operations on a MER class rover.

Study of thermal control systems for orbiting power systems. Materials experiment carrier thermal control system study

NASA Technical Reports Server (NTRS)

Fleming, M. L.

1980-01-01

Four possible arrangements of the materials experiment carrier (MEC) and power system (PS) thermal control loops were defined which would provide one kW of heat rejection for each kW of power to the MEC payload. These arrangements were compared to the baseline reference concept which provides only 16 kW heat rejection to show the cost of obtaining symmetry in terms of dollars, weight, complexity, growth potential, ease of integration, technology and total launch weight. The results of these comparisons was that the concept which splits the PS thermal control loop into two systems, one to reject PS waste heat and one payload waste heat, appeared favorable. The fluid selection study resulted in recommendation of FC72 as the MEC heat transport fluid based on the thermal and physical characteristics. The coatings reviewed indicated anodized and alodine treated aluminum surfaces or silver teflon are the best choices for the MEC vehicle where durability is an important factor. For high temperature radiators silver teflon or zinc orthotitanate are recommended choices.

Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations.

PubMed

Oddo, Mauro; Poole, Daniele; Helbok, Raimund; Meyfroidt, Geert; Stocchetti, Nino; Bouzat, Pierre; Cecconi, Maurizio; Geeraerts, Thomas; Martin-Loeches, Ignacio; Quintard, Hervé; Taccone, Fabio Silvio; Geocadin, Romergryko G; Hemphill, Claude; Ichai, Carole; Menon, David; Payen, Jean-François; Perner, Anders; Smith, Martin; Suarez, José; Videtta, Walter; Zanier, Elisa R; Citerio, Giuseppe

2018-04-01

To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated. The consensus focused on three main topics: (1) general fluid resuscitation and maintenance in neurointensive care patients, (2) hyperosmolar fluids for intracranial pressure control, (3) fluid management in delayed cerebral ischemia after subarachnoid haemorrhage. After an extensive literature search, the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were applied to assess the quality of evidence (from high to very low), to formulate treatment recommendations as strong or weak, and to issue best practice statements when applicable. A modified Delphi process based on the integration of evidence provided by the literature and expert opinions-using a sequential approach to avoid biases and misinterpretations-was used to generate the final consensus statement. The final consensus comprises a total of 32 statements, including 13 strong recommendations and 17 weak recommendations. No recommendations were provided for two statements. We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.

Are human service agencies ready for disasters? Findings from a mixed-methods needs assessment and planning project.

PubMed

Hipper, Thomas J; Orr, Ashley; Chernak, Esther

2015-01-01

A mixed-methods design was used to assess the current capacity of human service agencies to provide services in a major disaster, identify challenges and successful strategies for providing those services, and formulate specific recommendations for government planners and the nonprofit sector to promote the integration of human service agencies into emergency preparedness and response. A web-based survey was completed by 188 unique human service agencies, 31 semistructured interviews were conducted with human service agency and government leaders from southeastern Pennsylvania and the mid-Atlantic region, and a collaborative planning meeting was held to review the findings and develop systems-based recommendations. Survey results indicated that human service agencies serve the most vulnerable communities during disasters and would welcome integration into preparedness and response plans, but they currently face challenges that include a lack of real-time communication and opportunities for collaborative planning with government partners. Interview findings were grouped according to 5 themes that emerged: capacity, coordination, communication, training, and leadership. This study identified recommendations to assist human service agencies, local health departments, and emergency management agencies as they work to ensure that needed human services are available during disasters, despite the resource challenges that most agencies face.

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

PubMed

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

2009-01-01

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

Research safety vehicle program (Phase II) specification review. Volume II. Final technical report, Jul 1975--Nov 1976

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

Pugliese, S.M.

1977-02-01

In Phase I of the Research Safety Vehicle Program (RSV), preliminary design and performance specifications were developed for a mid-1980's vehicle that integrates crashworthiness and occupant safety features with material resource conservation, economy, and producibility. Phase II of the program focused on development of the total vehicle design via systems engineering and integration analyses. As part of this effort, it was necessary to continuously review the Phase I recommended performance specification in relation to ongoing design/test activities. This document contains the results of analyses of the Phase I specifications. The RSV is expected to satisfy all of the producibility andmore » safety related specifications, i.e., handling and stability systems, crashworthiness, occupant protection, pedestrian/cyclist protection, etc.« less

Constructed Rain Garden Systems for Stormwater Quality Control under Tropical Climates

NASA Astrophysics Data System (ADS)

Mohd Sidek, Lariyah; Elyza Muha, Norshafa; Noor, Nur Asmaliza Md; Basri, Hidayah

2013-06-01

Malaysia has taken an integrated approach to manage storm water that is increasingly becoming a problem in big cities. Rain gardens are recommended as green technology for a new storm water management in Malaysia. The approach is applied in urban planning and design that integrates the total water cycle management into the development process areas. Rain gardens have been effective in reducing peak discharge and consistently reduce the number of storm water pollutants. This paper will examine some of guidelines, laboratory studies and field monitoring that shows great potential and benefit of rain garden. The preliminary results for rain garden performance were reported in this paper. The findings from this research will open avenues for researchers to advance the knowledge in rain garden systems to achieve the sustainable development in Malaysia.

Structural integrity of wind tunnel wooden fan blades

NASA Technical Reports Server (NTRS)

Young, Clarence P., Jr.; Wingate, Robert T.; Rooker, James R.; Mort, Kenneth W.; Zager, Harold E.

1991-01-01

Information is presented which was compiled by the NASA Inter-Center Committee on Structural Integrity of Wooden Fan Blades and is intended for use as a guide in design, fabrication, evaluation, and assurance of fan systems using wooden blades. A risk assessment approach for existing NASA wind tunnels with wooden fan blades is provided. Also, state of the art information is provided for wooden fan blade design, drive system considerations, inspection and monitoring methods, and fan blade repair. Proposed research and development activities are discussed, and recommendations are provided which are aimed at future wooden fan blade design activities and safely maintaining existing NASA wind tunnel fan blades. Information is presented that will be of value to wooden fan blade designers, fabricators, inspectors, and wind tunnel operations personnel.

ATM test and integration. [Skylab Apollo Telescope Mount

NASA Technical Reports Server (NTRS)

Moore, J. W.; Mitchell, J. R.

1974-01-01

The test and checkout philosophy of the test program for the Skylab ATM module and the overall test flow including in-process, post-manufacturing, vibration, thermal vacuum, and prelaunch checkout activities are described. Capabilities and limitations of the test complex and its use of automation are discussed. Experiences with the organizational principle of using a dedicated test team for all checkout activities are reported. Material on the development of the ATM subsystems, the experimental program and the requirements of the scientific community, and the integration and verification of the complex systems/subsystems of the ATM are presented. The performance of the ATM test program in such areas as alignment, systems and subsystems, contamination control, and experiment operation is evaluated. The conclusions and recommendations resulting from the ATM test program are enumerated.

Integrated optics to improve resolution on multiple configuration

NASA Astrophysics Data System (ADS)

Liu, Hua; Ding, Quanxin; Guo, Chunjie; Zhou, Liwei

2015-04-01

Inspired to in order to reveal the structure to improve imaging resolution, further technical requirement is proposed in some areas of the function and influence on the development of multiple configuration. To breakthrough diffraction limit, smart structures are recommended as the most efficient and economical method, while by used to improve the system performance, especially on signal to noise ratio and resolution. Integrated optics were considered in the selection, with which typical multiple configuration, by use the method of simulation experiment. Methodology can change traditional design concept and to develop the application space. Our calculations using multiple matrix transfer method, also the correlative algorithm and full calculations, show the expected beam shaping through system and, in particular, the experimental results will support our argument, which will be reported in the presentation.

A Mentoring Opportunity: A Joint Effort in Writing Letters of Recommendation.

PubMed

Master, Zubin

2017-01-01

Integrity in writing letters of recommendation is important to academic research because it is an influential criterion used pervasively in peer review. While research in the integrity of recommendation letters has concentrated on contents of the letter, bias, and reliability, few have questioned the process of letter writing. Here, I argue that letter writing should be a joint opportunity between mentor/supervisor/advisor and trainee. It results in more compelling letters, may prevent errors and the use of biased language, and serves as an excellent mentoring opportunity promoting self-reflection.

Human Factors Interface with Systems Engineering for NASA Human Spaceflights

NASA Technical Reports Server (NTRS)

Wong, Douglas T.

2009-01-01

This paper summarizes the past and present successes of the Habitability and Human Factors Branch (HHFB) at NASA Johnson Space Center s Space Life Sciences Directorate (SLSD) in including the Human-As-A-System (HAAS) model in many NASA programs and what steps to be taken to integrate the Human-Centered Design Philosophy (HCDP) into NASA s Systems Engineering (SE) process. The HAAS model stresses systems are ultimately designed for the humans; the humans should therefore be considered as a system within the systems. Therefore, the model places strong emphasis on human factors engineering. Since 1987, the HHFB has been engaging with many major NASA programs with much success. The HHFB helped create the NASA Standard 3000 (a human factors engineering practice guide) and the Human Systems Integration Requirements document. These efforts resulted in the HAAS model being included in many NASA programs. As an example, the HAAS model has been successfully introduced into the programmatic and systems engineering structures of the International Space Station Program (ISSP). Success in the ISSP caused other NASA programs to recognize the importance of the HAAS concept. Also due to this success, the HHFB helped update NASA s Systems Engineering Handbook in December 2007 to include HAAS as a recommended practice. Nonetheless, the HAAS model has yet to become an integral part of the NASA SE process. Besides continuing in integrating HAAS into current and future NASA programs, the HHFB will investigate incorporating the Human-Centered Design Philosophy (HCDP) into the NASA SE Handbook. The HCDP goes further than the HAAS model by emphasizing a holistic and iterative human-centered systems design concept.

Integrating NASA's Land Analysis System (LAS) image processing software with an appropriate Geographic Information System (GIS): A review of candidates in the public domain

NASA Technical Reports Server (NTRS)

Rochon, Gilbert L.

1989-01-01

A user requirements analysis (URA) was undertaken to determine and appropriate public domain Geographic Information System (GIS) software package for potential integration with NASA's LAS (Land Analysis System) 5.0 image processing system. The necessity for a public domain system was underscored due to the perceived need for source code access and flexibility in tailoring the GIS system to the needs of a heterogenous group of end-users, and to specific constraints imposed by LAS and its user interface, Transportable Applications Executive (TAE). Subsequently, a review was conducted of a variety of public domain GIS candidates, including GRASS 3.0, MOSS, IEMIS, and two university-based packages, IDRISI and KBGIS. The review method was a modified version of the GIS evaluation process, development by the Federal Interagency Coordinating Committee on Digital Cartography. One IEMIS-derivative product, the ALBE (AirLand Battlefield Environment) GIS, emerged as the most promising candidate for integration with LAS. IEMIS (Integrated Emergency Management Information System) was developed by the Federal Emergency Management Agency (FEMA). ALBE GIS is currently under development at the Pacific Northwest Laboratory under contract with the U.S. Army Corps of Engineers' Engineering Topographic Laboratory (ETL). Accordingly, recommendations are offered with respect to a potential LAS/ALBE GIS linkage and with respect to further system enhancements, including coordination with the development of the Spatial Analysis and Modeling System (SAMS) GIS in Goddard's IDM (Intelligent Data Management) developments in Goddard's National Space Science Data Center.

All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.

PubMed

Jensen, Roxanne E; Snyder, Claire F; Basch, Ethan; Frank, Lori; Wu, Albert W

2016-11-01

In recent years, patient-reported outcomes have become increasingly collected and integrated into electronic health records. However, there are few cross-cutting recommendations and limited guidance available in this rapidly developing research area. Our goal is to report key findings from a 2013 Patient-Centered Outcomes Research Institute workshop on this topic and a summary of actions that followed from the workshop, and present resulting recommendations that address patient, clinical and research/quality improvement barriers to regular use. These findings provide actionable guidance across research and practice settings to promote and sustain widespread adoption of patient-reported outcomes across patient populations, healthcare settings and electronic health record systems.

Recommended Practice for Pressure Measurements and Calculation of Effective Pumping Speeds During Electric Propulsion Testing

NASA Technical Reports Server (NTRS)

Dankanich, John W.; Walker, Mitchell; Swiatek, Michael W.; Yim, John T.

2013-01-01

The electric propulsion community has been implored to establish and implement a set of universally applicable test standards during the research, development, and qualification of electric propulsion systems. Variability between facility-to-facility and more importantly ground-to-flight performance can result in large margins in application or aversion to mission infusion. Performance measurements and life testing under appropriate conditions can be costly and lengthy. Measurement practices must be consistent, accurate, and repeatable. Additionally, the measurements must be universally transportable across facilities throughout the development, qualification, spacecraft integration, and on-orbit performance. A recommended practice for making pressure measurements, pressure diagnostics, and calculating effective pumping speeds with justification is presented.

Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings.

PubMed

Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P; Kravitz, Richard L; Owen, Richard R; Sullivan, J Greer; Wu, Albert W; Di Capua, Paul; Hoagwood, Kimberly Eaton

2015-09-01

Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context.

Microtechnology management considering test and cost aspects for stacked 3D ICs with MEMS

NASA Astrophysics Data System (ADS)

Hahn, K.; Wahl, M.; Busch, R.; Grünewald, A.; Brück, R.

2018-01-01

Innovative automotive systems require complex semiconductor devices currently only available in consumer grade quality. The European project TRACE will develop and demonstrate methods, processes, and tools to facilitate usage of Consumer Electronics (CE) components to be deployable more rapidly in the life-critical automotive domain. Consumer electronics increasingly use heterogeneous system integration methods and "More than Moore" technologies, which are capable to combine different circuit domains (Analog, Digital, RF, MEMS) and which are integrated within SiP or 3D stacks. Making these technologies or at least some of the process steps available under automotive electronics requirements is an important goal to keep pace with the growing demand for information processing within cars. The approach presented in this paper aims at a technology management and recommendation system that covers technology data, functional and non-functional constraints, and application scenarios, and that will comprehend test planning and cost consideration capabilities.

Airspace Technology Demonstration 2 (ATD-2) Technology Description Document (TDD)

NASA Technical Reports Server (NTRS)

Ging, Andrew; Engelland, Shawn; Capps, Al; Eshow, Michelle; Jung, Yoon; Sharma, Shivanjli; Talebi, Ehsan; Downs, Michael; Freedman, Cynthia; Ngo, Tyler;

Using information technology to improve adult immunization delivery in an integrated urban health system.

PubMed

Swenson, Carolyn J; Appel, Alicia; Sheehan, Moira; Hammer, Anne; Fenner, Zita; Phibbs, Stephanie; Harbrecht, Marjie; Main, Deborah S

2012-01-01

Adult immunizations prevent morbidity and mortality yet coverage remains suboptimal, in part due to missed opportunities. Clinical decision support systems (CDSSs) can improve immunization rates when integrated into routine work flow, implemented wherever care is delivered, and used by staff who can act on the recommendation. An adult immunization improvement project was undertaken in a large integrated, safety-net health care system. A CDSS was developed to query patient records and identify patients eligible for pneumococcal, influenza, or tetanus immunization and then generate a statement that recommends immunization or indicates a previous refusal. A new agency policy authorized medical assistants and nurses in clinics, and nurses in the hospital, to use the CDSS as a standing order. Immunization delivery work flow was standardized, and staff received feedback on immunization rates. The CDSS identified more patients than a typical paper standing order and can be easily modified to incorporate changes in vaccine indications. The intervention led to a 10% improvement in immunization rates in adults 65 years of age or older and in younger adults with diabetes or chronic obstructive pulmonary disease. Overall, the improvements were sustained beyond the project period. The CDSS was expanded to encompass additional vaccines. Interdepartmental collaboration was critical to identify needs, challenges, and solutions. Implementing the standing order policy in clinics and the hospital usually allowed immunizations to be taken out of the hands of clinicians. As an on-demand tool, CDSS must be used at each patient encounter to avoid missed opportunities. Staff retraining accompanied by ongoing assessment of immunization rates, work flow, and missed opportunities to immunize patients are critical to sustain and enhance improvements.

e_Disease Management. A system for the management of the chronic conditions.

PubMed

Guillén, Sergio; Meneu, Maria Teresa; Serafin, Riccardo; Arredondo, Maria Teresa; Castellano, Elena; Valdivieso, Bernardo

2010-01-01

Disease Management (DM) is a system of coordinated healthcare intervention and communications for populations with conditions in which patient self-care efforts are significant. e-DM makes reference to processes of DM based on clinical guidelines sustained in the scientific medical evidence and supported by the intervention of Information and Telecommunication Technology (ICT) in all levels where these plans are developed. This paper discusses the design and implementation of a e-DM system which meets the requirements for the integrated chronic disease management following the recommendations of the Disease Management Association and the American Heart Association.

Central Nervous System Cancers, Version 2.2014

PubMed Central

Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Brem, Henry; Brown, Paul; Butowski, Nicholas; Chamberlain, Marc C.; DeAngelis, Lisa M.; Fenstermaker, Robert A.; Friedman, Allan; Gilbert, Mark R.; Hattangadi-Gluth, Jona; Hesser, Deneen; Holdhoff, Matthias; Junck, Larry; Lawson, Ronald; Loeffler, Jay S.; Moots, Paul L.; Mrugala, Maciej M.; Newton, Herbert B.; Raizer, Jeffrey J.; Recht, Lawrence; Shonka, Nicole; Shrieve, Dennis C.; Sills, Allen K.; Swinnen, Lode J.; Tran, David; Tran, Nam; Vrionis, Frank D.; Wen, Patrick Yung; McMillian, Nicole R.; Ho, Maria

2015-01-01

The NCCN Guidelines for Central Nervous System Cancers provide multidisciplinary recommendations for the clinical management of patients with cancers of the central nervous system. These NCCN Guidelines Insights highlight recent updates regarding the management of metastatic brain tumors using radiation therapy. Use of stereotactic radiosurgery (SRS) is no longer limited to patients with 3 or fewer lesions, because data suggest that total disease burden, rather than number of lesions, is predictive of survival benefits associated with the technique. SRS is increasingly becoming an integral part of management of patients with controlled, low-volume brain metastases. PMID:25361798

A voyage to Mars: A challenge to collaboration between man and machines

NASA Technical Reports Server (NTRS)

Statler, Irving C.

1991-01-01

A speech addressing the design of man machine systems for exploration of space beyond Earth orbit from the human factors perspective is presented. Concerns relative to the design of automated and intelligent systems for the NASA Space Exploration Initiative (SEI) missions are largely based on experiences with integrating humans and comparable systems in aviation. The history, present status, and future prospect, of human factors in machine design are discussed in relation to a manned voyage to Mars. Three different cases for design philosophy are presented. The use of simulation is discussed. Recommendations for required research are given.

A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy

PubMed Central

2013-01-01

Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing’s syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors. PMID:23947590

[Capacity of the legal framework of public health institutions in Mexico to support their functional integration].

PubMed

Ibarra, Ignacio; Martínez, Gabriel; Aguilera, Nelly; Orozco, Emanuel; Fajardo-Dolci, Germán E; González-Block, Miguel A

2013-01-01

Evaluate the capacity of the federal legal framework to govern financing of health institutions in the public sector through innovative schemes--otherwise known as functional integration--, enabling them to purchase and sell health services to and from other public providers as a strategy to improve their performance. Based on indicators of normative alignment with respect to functional integration across public health provider and governance institutions, content analysis was undertaken of national health programs and relevant laws and guidelines for financial coordination. Significant progress was identified in the implementation of agreements for the coordination of public institutions. While the legal framework provides for a National Health System and a health sector, gaps and contradictions limit their scope. The General Register of Health is also moving forward, yet it lacks the necessary legal foundation to become a comprehensive tool for integration. The medical service exchange agreements are also moving forward based on tariffs and shared guidelines. However, there is a lack of incentives to promote the expansion of these agreements. It is recommended to update the legal framework for the coordination of the National Health System, ensuring a more harmonious and general focus to provide functional integration with the needed impulse.

Budgeting of major nutrients and the mitigation options for nutrient mining in semi-arid tropical agro-ecosystem of Tamil Nadu, India using NUTMON model.

PubMed

Surendran, U; Rama Subramoniam, S; Raja, P; Kumar, V; Murugappan, V

2016-04-01

Mining of nutrients from soil is a major problem in developing countries causing soil degradation and threaten long-term food production. The present study attempts to apply NUTrient MONitoring (NUTMON) model for carrying out nutrient budgeting to assess the stocks and flows of nitrogen (N), phosphorus (P), and potassium (K) in defined geographical unit based on the inputs, viz., mineral fertilizers, manures, atmospheric deposition, and sedimentation, and outputs, viz., harvested crop produces, residues, leaching, denitrification, and erosion losses. The study area covers Coimbatore and Erode Districts, which are potential agricultural areas in western agro-ecological zone of Tamil Nadu, India. The calculated nutrient balances for both the districts at district scale, using NUTMON methodology, were negative for nitrogen (N -3.3 and -10.1 kg ha(-1)) and potassium (K -58.6 and -9.8 kg ha(-1)) and positive for phosphorus (P +14.5 and 20.5 kg ha(-1)). Soil nutrient pool has to adjust the negative balance of N and K; there will be an expected mining of nutrient from the soil reserve. A strategy was attempted for deriving the fertilizer recommendation using Decision Support System for Integrated Fertilizer Recommendation (DSSIFER) to offset the mining in selected farms. The results showed that when DSSIFER recommended fertilizers are applied to crops, the nutrient balance was positive. NUTMON-Toolbox with DSSIFER would serve the purpose on enhancing soil fertility, productivity, and sustainability. The management options to mitigate nutrient mining with an integrated system approach are also discussed.

Research and development activities in unified control-structure modeling and design

NASA Technical Reports Server (NTRS)

Nayak, A. P.

1985-01-01

Results of work sponsored by JPL and other organizations to develop a unified control/structures modeling and design capability for large space structures is presented. Recent analytical results are presented to demonstrate the significant interdependence between structural and control properties. A new design methodology is suggested in which the structure, material properties, dynamic model and control design are all optimized simultaneously. The development of a methodology for global design optimization is recommended as a long term goal. It is suggested that this methodology should be incorporated into computer aided engineering programs, which eventually will be supplemented by an expert system to aid design optimization. Recommendations are also presented for near term research activities at JPL. The key recommendation is to continue the development of integrated dynamic modeling/control design techniques, with special attention given to the development of structural models specially tailored to support design.

Child neurology practice guidelines: past, present, and future.

PubMed

Hurwitz, Benjamin A; Hurwitz, Kathleen Bretzius; Ashwal, Stephen

2015-03-01

Practice guidelines have been developed in child neurology during the last fifteen years to address important clinical questions and provide evidence-based recommendations for patient care. This review describes the guideline development process and how it has evolved to meet the needs of child neurologists. Several current child neurology guidelines are reviewed and the advantages and disadvantages of guidelines, as well as the legal consequences of using them to determine a standard of care are discussed. The future of guidelines and of their influence on integrated support systems also is considered. Child neurology practice guidelines are a helpful resource for clinicians, families and institutions as they provide evidence-based recommendations concerning the diagnosis and management of common neurological conditions affecting children. Incorporating consensus processes has allowed expansion of clinically relevant recommendations that has increased the utility of guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Guide for inservice inspection of ground-based pressure vessels and systems

NASA Technical Reports Server (NTRS)

1976-01-01

This guide includes recommendations for inservice inspection and recertification of ground based, unfired pressure vessels and all pressurized systems including those served by fired pressure vessels hereinafter referred to as pressure vessels, systems and components of systems. It covers the vast array of pound based industrial and special purpose pressurized components and systems used at NASA field installations for research and development and those utility systems and components that require more than routine maintenance to insure continued structural integrity for their useful life. Through surveillance and correction of inservice deterioration, NASA will maintain a safe working environment for their own and contractor personnel, safety for the public sector and protection against loss of capital investment.

A health record integrated clinical decision support system to support prescriptions of pharmaceutical drugs in patients with reduced renal function: design, development and proof of concept.

PubMed

Shemeikka, Tero; Bastholm-Rahmner, Pia; Elinder, Carl-Gustaf; Vég, Anikó; Törnqvist, Elisabeth; Cornelius, Birgitta; Korkmaz, Seher

2015-06-01

To develop and verify proof of concept for a clinical decision support system (CDSS) to support prescriptions of pharmaceutical drugs in patients with reduced renal function, integrated in an electronic health record system (EHR) used in both hospitals and primary care. A pilot study in one geriatric clinic, one internal medicine admission ward and two outpatient healthcare centers was evaluated with a questionnaire focusing on the usefulness of the CDSS. The usage of the system was followed in a log. The CDSS is considered to increase the attention on patients with impaired renal function, provides a better understanding of dosing and is time saving. The calculated glomerular filtration rate (eGFR) and the dosing recommendation classification were perceived useful while the recommendation texts and background had been used to a lesser extent. Few previous systems are used in primary care and cover this number of drugs. The global assessment of the CDSS scored high but some elements were used to a limited extent possibly due to accessibility or that texts were considered difficult to absorb. Choosing a formula for the calculation of eGFR in a CDSS may be problematic. A real-time CDSS to support kidney-related drug prescribing in both hospital and outpatient settings is valuable to the physicians. It has the potential to improve quality of drug prescribing by increasing the attention on patients with renal insufficiency and the knowledge of their drug dosing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Advanced vehicle systems assessment. Volume 3: Systems assessment

NASA Technical Reports Server (NTRS)

Hardy, K.

1985-01-01

The systems analyses integrate the advanced component and vehicle characteristics into conceptual vehicles with identical performance (for a given application) and evaluates the vehicles in typical use patterns. Initial and life-cycle costs are estimated and compared to conventional reference vehicles with comparable technological advances, assuming the vehicles will be in competition in the early 1990s. Electric vans, commuter vehicles, and full-size vehicles, in addition to electric/heat-engine hybrid and fuel-cell powered vehicles, are addressed in terms of performance and economics. System and subsystem recommendations for vans and two-passenger commuter vehicles are based on the economic analyses in this volume.

Purified umbilical cord derived mesenchymal stem cell treatment in a case of systemic lupus erythematosus.

PubMed

Phillips, Christopher D; Wongsaisri, Pornpatcharin; Htut, Thein; Grossman, Terry

2017-12-01

Systemic lupus erythematosus (SLE) is a multiple organ system autoimmune disorder for which there is no known cure. We report a case of a young adult lady with SLE and Sjogren's with diagnostic and clinical resolution following purified umbilical cord derived mesenchymal stem cell (MSC) and globulin component protein macrophage activating factor (GcMAF) therapy in a combined multidisciplinary integrative medicine protocol. Our patient had complete reversal of all clinical and laboratory markers. We recommend a prospective randomized double blind study to assess the sustained efficacy of MSC and GcMAF in the treatment of autoimmune connective tissue diseases such as systemic lupus erythematosus.

Airline Operations Aid

NASA Technical Reports Server (NTRS)

1993-01-01

C Language Integrated Production System (CLIPS), a NASA-developed expert systems program, is used by American Airlines for three purposes: as a rapid prototyping tool; to develop production prototypes; and to develop production application. An example of the latter is CLIPS' use in "Hub S1AAshing," a knowledge based system that recommends contingency plans when severe schedule reductions must be made. Hub S1AAshing has replaced a manual, labor intensive process. It saves time and allows Operations Control Coordinators to handle more difficult situations. Because the system assimilates much of the information necessary to facilitate educated decision making, it minimizes negative impact in situations where it is impossible to operate all flights.

Formation of production structural units within a construction company using the systemic integrated method when implementing high-rise development projects

NASA Astrophysics Data System (ADS)

Lapidus, Azary; Abramov, Ivan

2018-03-01

Development of efficient algorithms for designing future operations is a vital element in construction business. This paper studies various aspects of a methodology required to determine the integration index for construction crews performing various process-related jobs. The main objective of the study outlined in this paper is to define the notion of integration in respect to a construction crew that performs complete cycles of construction and assembly works in order to find the optimal organizational solutions, using the integrated crew algorithm built specifically for that purpose. As seen in the sequence of algorithm elements, it was designed to focus on the key factors affecting the level of integration of a construction crew depending on the value of each of those elements. The multifactor modelling approach is used to assess the KPI of integrated construction crews involved in large-sale high-rise construction projects. The purpose of this study is to develop a theoretical recommendation and a scientific methodological provision of organizational and technological nature to ensure qualitative formation of integrated construction crews to increase their productivity during integrated implementation of multi-task construction phases. The key difference of the proposed solution from the already existing ones is that it requires identification of the degree of impact of each factor, including the change in the qualification level, on the integration index of each separate element in the organizational and technological system in construction (integrated construction crew).

Forest fire advanced system technology (FFAST) conceptual design study

NASA Technical Reports Server (NTRS)

Nichols, J. David; Warren, John R.

1987-01-01

The National Aeronautics and Space Administration's Jet Propulsion Laboratory (JPL) and the U.S. Department of Agriculture (USDA) Forest Service completed a conceptual design study that defined an integrated forest fire detection and mapping system that will be based upon technology available in the 1990s. Potential system configuration options in emerging and advanced technologies related to the conceptual design were identified and recommended for inclusion as preferred system components. System component technologies identified for an end-to-end system include airborne mounted, thermal infrared (IR) linear array detectors, automatic onboard georeferencing and signal processing, geosynchronous satellite communications links, and advanced data integration and display. Potential system configuration options were developed and examined for possible inclusion in the preferred system configuration. The preferred system configuration will provide increased performance and be cost effective over the system currently in use. Forest fire management user requirements and the system component emerging technologies were the basis for the system configuration design. The conceptual design study defined the preferred system configuration that warrants continued refinement and development, examined economic aspects of the current and preferred system, and provided preliminary cost estimates for follow-on system prototype development.

Bridging gaps in health information systems: a case study from Somaliland, Somalia.

PubMed

Askar, Ahmed; Ardakani, Malekafzali; Majdzade, Reza

2018-01-02

Reliable and timely health information is fundamental for health information systems (HIS) to work effectively. This case study aims to assess Somaliland HIS in terms of its contextual situation, major weaknesses and proposes key evidence-based recommendations. Data were collected through national level key informants' interviews, observations, group discussion and scoring using the HIS framework and assessment tool developed by World Health Organization Health Metrics Network (WHO/HMN). The study found major weaknesses including: no policy, strategic plan and legal framework in place; fragmented sub-information systems; Poor information and communications technology (ICT) infrastructure; poorly motivated and under-skilled personnel; dependence on unsustainable external funds; no census or civil registration in place; data from private health sector not captured; insufficient technical capacity to analyse data collected by HIS; and information is not widely shared, disseminated or utilized for decision-making. We recommend developing a national HIS strategic plan that harmonizes and directs collective efforts to become a more integrated, cost-effective and sustainable HIS.

E-health systems for management of MDR-TB in resource-poor environments: a decade of experience and recommendations for future work.

PubMed

Fraser, Hamish S F; Habib, Ali; Goodrich, Mark; Thomas, David; Blaya, Joaquin A; Fils-Aime, Joseph Reginald; Jazayeri, Darius; Seaton, Michael; Khan, Aamir J; Choi, Sharon S; Kerrison, Foster; Falzon, Dennis; Becerra, Mercedes C

2013-01-01

Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring. Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments. We describe here the experience with implementing these systems and evaluating many aspects of their performance, and review other systems for MDR-TB management. We recommend a new approach to information systems to address the barriers to scale up MDR-TB treatment, particularly access to the appropriate drugs and lab data. We propose moving away from fragmented, vertical systems to focus on common platforms, addressing all stages of TB care, support for open data standards and interoperability, care for a wide range of diseases including HIV, integration with mHealth applications, and ability to function in resource-poor environments.

White Paper: Movement System Diagnoses in Neurologic Physical Therapy.

PubMed

Hedman, Lois D; Quinn, Lori; Gill-Body, Kathleen; Brown, David A; Quiben, Myla; Riley, Nora; Scheets, Patricia L

2018-04-01

The APTA recently established a vision for physical therapists to transform society by optimizing movement to promote health and wellness, mitigate impairments, and prevent disability. An important element of this vision entails the integration of the movement system into the profession, and necessitates the development of movement system diagnoses by physical therapists. At this point in time, the profession as a whole has not agreed upon diagnostic classifications or guidelines to assist in developing movement system diagnoses that will consistently capture an individual's movement problems. We propose that, going forward, diagnostic classifications of movement system problems need to be developed, tested, and validated. The Academy of Neurologic Physical Therapy's Movement System Task Force was convened to address these issues with respect to management of movement system problems in patients with neurologic conditions. The purpose of this article is to report on the work and recommendations of the Task Force. The Task Force identified 4 essential elements necessary to develop and implement movement system diagnoses for patients with primarily neurologic involvement from existing movement system classifications. The Task Force considered the potential impact of using movement system diagnoses on clinical practice, education and, research. Recommendations were developed and provided recommendations for potential next steps to broaden this discussion and foster the development of movement system diagnostic classifications. The Task Force proposes that diagnostic classifications of movement system problems need to be developed, tested, and validated with the long-range goal to reach consensus on and adoption of a movement system diagnostic framework for clients with neurologic injury or disease states.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A198).

An Agent-Based Optimization Framework for Engineered Complex Adaptive Systems with Application to Demand Response in Electricity Markets

NASA Astrophysics Data System (ADS)

Haghnevis, Moeed

The main objective of this research is to develop an integrated method to study emergent behavior and consequences of evolution and adaptation in engineered complex adaptive systems (ECASs). A multi-layer conceptual framework and modeling approach including behavioral and structural aspects is provided to describe the structure of a class of engineered complex systems and predict their future adaptive patterns. The approach allows the examination of complexity in the structure and the behavior of components as a result of their connections and in relation to their environment. This research describes and uses the major differences of natural complex adaptive systems (CASs) with artificial/engineered CASs to build a framework and platform for ECAS. While this framework focuses on the critical factors of an engineered system, it also enables one to synthetically employ engineering and mathematical models to analyze and measure complexity in such systems. In this way concepts of complex systems science are adapted to management science and system of systems engineering. In particular an integrated consumer-based optimization and agent-based modeling (ABM) platform is presented that enables managers to predict and partially control patterns of behaviors in ECASs. Demonstrated on the U.S. electricity markets, ABM is integrated with normative and subjective decision behavior recommended by the U.S. Department of Energy (DOE) and Federal Energy Regulatory Commission (FERC). The approach integrates social networks, social science, complexity theory, and diffusion theory. Furthermore, it has unique and significant contribution in exploring and representing concrete managerial insights for ECASs and offering new optimized actions and modeling paradigms in agent-based simulation.

Communicable disease control programmes and health systems: an analytical approach to sustainability.

PubMed

Shigayeva, Altynay; Coker, Richard J

2015-04-01

There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Performance Analysis of a Ground Source Heat Pump System Using Mine Water as Heat Sink and Source

DOE PAGES

Liu, Xiaobing; Malhotra, Mini; Walburger, Adam; ...

2016-06-01

This paper summarizes a case study of an innovative ground source heat pump (GSHP) system that uses flooded mines as a heat source and heat sink. This GSHP system provides space conditioning to a 56,000 sq ft 2(5,203 m 2) newly constructed research facility, in conjunction with supplementary existing steam heating and air-cooled chiller systems. Heat transfer performance and overall efficiency of the GSHP system were analysed using the available measured data from January through July 2014. The performance analysis identified some issues with using mine water for cooling and the integration of the GSHP system with the existing steammore » heating system. Recommendations were made to improve the control and operation of the GSHP system. These recommendations, in conjunction with the available measured data, were used to predict the annual energy use of the system. Finally, the energy and cost savings and CO 2 emission reduction potential of the GSHP system were estimated by comparing with a baseline scenario. This case study provides insights into the performance of and potential issues with the mine-water source heat pump system, which is relatively under-explored compared to other GSHP system designs and configurations.« less

Identification of potent orally active factor Xa inhibitors based on conjugation strategy and application of predictable fragment recommender system.

PubMed

Ishihara, Tsukasa; Koga, Yuji; Iwatsuki, Yoshiyuki; Hirayama, Fukushi

2015-01-15

Anticoagulant agents have emerged as a promising class of therapeutic drugs for the treatment and prevention of arterial and venous thrombosis. We investigated a series of novel orally active factor Xa inhibitors designed using our previously reported conjugation strategy to boost oral anticoagulant effect. Structural optimization of anthranilamide derivative 3 as a lead compound with installation of phenolic hydroxyl group and extensive exploration of the P1 binding element led to the identification of 5-chloro-N-(5-chloro-2-pyridyl)-3-hydroxy-2-{[4-(4-methyl-1,4-diazepan-1-yl)benzoyl]amino}benzamide (33, AS1468240) as a potent factor Xa inhibitor with significant oral anticoagulant activity. We also reported a newly developed Free-Wilson-like fragment recommender system based on the integration of R-group decomposition with collaborative filtering for the structural optimization process. Copyright © 2014 Elsevier Ltd. All rights reserved.

Automatic inference of indexing rules for MEDLINE

PubMed Central

Névéol, Aurélie; Shooshan, Sonya E; Claveau, Vincent

2008-01-01

Background: Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. Methods: In this paper, we describe the use and the customization of Inductive Logic Programming (ILP) to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Results: Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI), a system producing automatic indexing recommendations for MEDLINE. Conclusion: We expect the sets of ILP rules obtained in this experiment to be integrated into MTI. PMID:19025687

Automatic inference of indexing rules for MEDLINE.

PubMed

Névéol, Aurélie; Shooshan, Sonya E; Claveau, Vincent

2008-11-19

Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. In this paper, we describe the use and the customization of Inductive Logic Programming (ILP) to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI), a system producing automatic indexing recommendations for MEDLINE. We expect the sets of ILP rules obtained in this experiment to be integrated into MTI.

Design and Implementation of a Threaded Search Engine for Tour Recommendation Systems

NASA Astrophysics Data System (ADS)

Lee, Junghoon; Park, Gyung-Leen; Ko, Jin-Hee; Shin, In-Hye; Kang, Mikyung

This paper implements a threaded scan engine for the O(n!) search space and measures its performance, aiming at providing a responsive tour recommendation and scheduling service. As a preliminary step of integrating POI ontology, mobile object database, and personalization profile for the development of new vehicular telematics services, this implementation can give a useful guideline to design a challenging and computation-intensive vehicular telematics service. The implemented engine allocates the subtree to the respective threads and makes them run concurrently exploiting the primitives provided by the operating system and the underlying multiprocessor architecture. It also makes it easy to add a variety of constraints, for example, the search tree is pruned if the cost of partial allocation already exceeds the current best. The performance measurement result shows that the service can run even in the low-power telematics device when the number of destinations does not exceed 15, with an appropriate constraint processing.

The evolution of school nursing data indicators in Massachusetts: recommendations for a national data set.

PubMed

Gapinski, Mary Ann; Sheetz, Anne H

2014-10-01

The National Association of School Nurses' research priorities include the recommendation that data reliability, quality, and availability be addressed to advance research in child and school health. However, identifying a national school nursing data set has remained a challenge for school nurses, school nursing leaders, school nurse professional organizations, and state school nurse consultants. While there is much agreement that school nursing data (with associated data integrity) is an incredibly powerful tool for multiple uses, the content of a national data set must be developed. In 1993, recognizing the unique power of data, Massachusetts began addressing the need for consistent school nurse data collection. With more than 20 years' experience--and much experimentation, pilot testing, and system modification--Massachusetts is now ready to share its data collection system and certain key indicators with other states, thus offering a beginning foundation for a national school nursing data set. © The Author(s) 2014.

Review of the Literature: Integrating Psychoneuroimmunology into Pediatric Chronic Illness Interventions

PubMed Central

Nassau, Jack H.; Tien, Karen; Fritz, Gregory K.

2012-01-01

Objective Provide an orientation to psychoneuroimmunology, a rationale for including assessments of immune function in intervention studies of pediatric chronic illness, review the current literature, and provide recommendations for future research. Methods Using electronic searches and previous reviews, selected and reviewed published studies in which immunological changes related to psychological interventions were assessed in pediatric samples. Results Eight studies were identified and included in the review. These utilized a range of interventions (e.g., disclosure and hypnosis) and included a variety of pediatric samples (e.g., those with asthma, HIV infection, or lupus). Conclusions Results suggest that psychological intervention can influence immune function in pediatric samples. Recommendations for advancing our knowledge by studying populations for whom the immune system plays an active role in disease pathophysiology, measuring disease-relevant immune mediators, studying pediatric patients under times of stress, and focusing on interventions aimed at altering the stress system are provided. PMID:17848391

A web-based system architecture for ontology-based data integration in the domain of IT benchmarking

NASA Astrophysics Data System (ADS)

Pfaff, Matthias; Krcmar, Helmut

2018-03-01

In the domain of IT benchmarking (ITBM), a variety of data and information are collected. Although these data serve as the basis for business analyses, no unified semantic representation of such data yet exists. Consequently, data analysis across different distributed data sets and different benchmarks is almost impossible. This paper presents a system architecture and prototypical implementation for an integrated data management of distributed databases based on a domain-specific ontology. To preserve the semantic meaning of the data, the ITBM ontology is linked to data sources and functions as the central concept for database access. Thus, additional databases can be integrated by linking them to this domain-specific ontology and are directly available for further business analyses. Moreover, the web-based system supports the process of mapping ontology concepts to external databases by introducing a semi-automatic mapping recommender and by visualizing possible mapping candidates. The system also provides a natural language interface to easily query linked databases. The expected result of this ontology-based approach of knowledge representation and data access is an increase in knowledge and data sharing in this domain, which will enhance existing business analysis methods.

Obstacles to the coordination of delivering integrated prenatal HIV, syphilis and hepatitis B testing services in Guangdong: using a needs assessment approach.

PubMed

Xia, Jianhong; Rutherford, Shannon; Ma, Yuanzhu; Wu, Li; Gao, Shuang; Chen, Tingting; Lu, Xiao; Zhang, Xiaozhuang; Chu, Cordia

2015-03-24

Integration of services for Prevention of Mother-To-Child Transmission of HIV (PMTCT) into routine maternal and child health care is promoted as a priority strategy by the WHO to facilitate the implementation of PMTCT. Integration of services emphasizes inter-sectoral coordination in the health systems to provide convenient services for clients. China has been integrating prenatal HIV, syphilis and hepatitis B testing services since 2009. However, as the individual health systems are complex, effective coordination among different health agencies is challenging. Few studies have examined the factors that affect the coordination of such complex systems. The aim of this study is to assess the effectiveness of and examine challenges for integrated service delivery. Findings will provide the basis for strategy development to enhance the effective delivery of integrated services. The research was conducted in Guangdong province in 2013 using a needs assessment approach that includes qualitative and quantitative methods. Quantitative data was collected through a survey and from routine monitoring for PMTCT and qualitative data was collected through stakeholder interviews. Routine monitoring data used to assess key indicators of coordination suggested numerous coordination problems. The rates of prenatal HIV (95%), syphilis (47%) and hepatitis B (47%) test were inconsistent. An average of only 20% of the HIV positive mothers was referred in the health systems. There were no regular meetings among different health agencies and the clients indicated complicated service processes. The major obstacles to the coordination of delivering these integrated services are lack of service resource integration; and lack of a mechanism for coordination of the health systems, with no uniform guidelines, clear roles or consistent evaluation. The key obstacles that have been identified in this study hinder the coordination of the delivery of integrated services. Our recommendations include: 1) Facilitate integration of the funding and information systems by fully combining the service resources of different health agencies into one unit; 2) Establish regular meetings to facilitate exchange of information and address problems; 3) Establish a client referral network between different health agencies with agreed guidelines, clear roles and consistent evaluation.

Electronic Design Automation: Integrating the Design and Manufacturing Functions

NASA Technical Reports Server (NTRS)

Bachnak, Rafic; Salkowski, Charles

1997-01-01

As the complexity of electronic systems grows, the traditional design practice, a sequential process, is replaced by concurrent design methodologies. A major advantage of concurrent design is that the feedback from software and manufacturing engineers can be easily incorporated into the design. The implementation of concurrent engineering methodologies is greatly facilitated by employing the latest Electronic Design Automation (EDA) tools. These tools offer integrated simulation of the electrical, mechanical, and manufacturing functions and support virtual prototyping, rapid prototyping, and hardware-software co-design. This report presents recommendations for enhancing the electronic design and manufacturing capabilities and procedures at JSC based on a concurrent design methodology that employs EDA tools.

Spacecraft level impacts of integrating concentrator solar arrays

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

Allen, D.M.; Piszczor, M.F. Jr.

1994-12-31

The paper describes the results of a study to determine the impacts of integrating concentrator solar arrays on spacecraft design and performance. First, concentrator array performance is summarized for the AEC-Able/Entech SCARLET array, the Ioffe refractive and reflective concepts being developed in Russia, the Martin Marietta SLATS system, and other concentrator concepts that have been designed or developed. Concentrator array performance is compared to rigid and flex blanket planar array technologies at the array level. Then other impacts on the spacecraft are quantified. Conclusions highlight the most important results as they relate to recommended approaches in developing concentrator arrays formore » satellites.« less

Integrating Genomic Resources with Electronic Health Records using the HL7 Infobutton Standard

PubMed Central

Overby, Casey Lynnette; Del Fiol, Guilherme; Rubinstein, Wendy S.; Maglott, Donna R.; Nelson, Tristan H.; Milosavljevic, Aleksandar; Martin, Christa L.; Goehringer, Scott R.; Freimuth, Robert R.; Williams, Marc S.

2016-01-01

Summary Background The Clinical Genome Resource (ClinGen) Electronic Health Record (EHR) Workgroup aims to integrate ClinGen resources with EHRs. A promising option to enable this integration is through the Health Level Seven (HL7) Infobutton Standard. EHR systems that are certified according to the US Meaningful Use program provide HL7-compliant infobutton capabilities, which can be leveraged to support clinical decision-making in genomics. Objectives To integrate genomic knowledge resources using the HL7 infobutton standard. Two tactics to achieve this objective were: (1) creating an HL7-compliant search interface for ClinGen, and (2) proposing guidance for genomic resources on achieving HL7 Infobutton standard accessibility and compliance. Methods We built a search interface utilizing OpenInfobutton, an open source reference implementation of the HL7 Infobutton standard. ClinGen resources were assessed for readiness towards HL7 compliance. Finally, based upon our experiences we provide recommendations for publishers seeking to achieve HL7 compliance. Results Eight genomic resources and two sub-resources were integrated with the ClinGen search engine via OpenInfobutton and the HL7 infobutton standard. Resources we assessed have varying levels of readiness towards HL7-compliance. Furthermore, we found that adoption of standard terminologies used by EHR systems is the main gap to achieve compliance. Conclusion Genomic resources can be integrated with EHR systems via the HL7 Infobutton standard using OpenInfobutton. Full compliance of genomic resources with the Infobutton standard would further enhance interoperability with EHR systems. PMID:27579472

Diverter Decision Aiding for In-Flight Diversions

NASA Technical Reports Server (NTRS)

Rudolph, Frederick M.; Homoki, David A.; Sexton, George A.

1990-01-01

It was determined that artificial intelligence technology can provide pilots with the help they need in making the complex decisions concerning en route changes in a flight plan. A diverter system should have the capability to take all of the available information and produce a recommendation to the pilot. Phase three illustrated that using Joshua to develop rules for an expert system and a Statice database provided additional flexibility by permitting the development of dynamic weighting of diversion relevant parameters. This increases the fidelity of the AI functions cited as useful in aiding the pilot to perform situational assessment, navigation rerouting, flight planning/replanning, and maneuver execution. Additionally, a prototype pilot-vehicle interface (PVI) was designed providing for the integration of both text and graphical based information. Advanced technologies were applied to PVI design, resulting in a hierarchical menu based architecture to increase the efficiency of information transfer while reducing expected workload. Additional efficiency was gained by integrating spatial and text displays into an integrated user interface.

Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana: Implications for integrative healthcare.

PubMed

Kretchy, Irene A; Okere, Harry A; Osafo, Joseph; Afrane, Barima; Sarkodie, Joseph; Debrah, Philip

2016-09-01

Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary and alternative medicine (TM-CAM) remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine. A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana. Participants' knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as well as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream allopathic healthcare in Ghana through improving knowledge, training as well as addressing concerns of safety and efficacy. These findings are discussed under the themes: the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants. The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration, practitioners' understanding of TM-CAM must be improved, with specific attention to issues of safety, regulation and evidence-based practice of TM-CAM products and services in Ghana.

Tethered satellite system dynamics and control review panel and related activities, phase 3

NASA Technical Reports Server (NTRS)

1991-01-01

Two major tests of the Tethered Satellite System (TSS) engineering and flight units were conducted to demonstrate the functionality of the hardware and software. Deficiencies in the hardware/software integration tests (HSIT) led to a recommendation for more testing to be performed. Selected problem areas of tether dynamics were analyzed, including verification of the severity of skip rope oscillations, verification or comparison runs to explore dynamic phenomena observed in other simulations, and data generation runs to explore the performance of the time domain and frequency domain skip rope observers.

Recommended Processes and Best Practices for Nondestructive Inspection (NDI) of Safety-Of-Flight Structures

DTIC Science & Technology

2008-10-01

Brausch, Lawrence Butkus, David Campbell, Tommy Mullis, and Michael Paulk Materials Integrity Branch System Support Division OCTOBER...PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S) John Brausch and Dr. Lawrence Butkus (AFRL/RXSA) David Campbell (76 MXSS/MXDEBB) Tommy Mullis (WRALC... David Forsyth, Texas Research Institute Austin, Inc. Dr. Matt Golis, Advanced Quality Concepts Ward Rummel, D&W Enterprises, LTD. 1 1.0

NASA Astrophysics Technology Needs

NASA Technical Reports Server (NTRS)

Stahl, H. Philip

2012-01-01

July 2010, NASA Office of Chief Technologist (OCT) initiated an activity to create and maintain a NASA integrated roadmap for 15 key technology areas which recommend an overall technology investment strategy and prioritize NASA?s technology programs to meet NASA?s strategic goals. Science Instruments, Observatories and Sensor Systems(SIOSS) roadmap addresses technology needs to achieve NASA?s highest priority objectives -- not only for the Science Mission Directorate (SMD), but for all of NASA.

2005 Defense Base Closure and Realignment Commission Report. Volume 1

DTIC Science & Technology

2005-01-01

and Beale, and 15 A-10 aircraft realigned by the recommended closures of W.K. Kellogg Airport Air Guard Station, MI, and NAS Willow Grove, PA...functions of the Missile Defense Agency, except the Command and Control Battle Management and Communications Directorate, to Redstone Arsenal, AL... of other ships in the battle group. Systems are functionally integrated and not 287 separable as independent components. Furthermore, based on BRAC

Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

ERIC Educational Resources Information Center

Kirschenbaum, Daniel S.; Gierut, Kristen

2013-01-01

Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

From Here to Autonomy.

PubMed

Endsley, Mica R

2017-02-01

As autonomous and semiautonomous systems are developed for automotive, aviation, cyber, robotics and other applications, the ability of human operators to effectively oversee and interact with them when needed poses a significant challenge. An automation conundrum exists in which as more autonomy is added to a system, and its reliability and robustness increase, the lower the situation awareness of human operators and the less likely that they will be able to take over manual control when needed. The human-autonomy systems oversight model integrates several decades of relevant autonomy research on operator situation awareness, out-of-the-loop performance problems, monitoring, and trust, which are all major challenges underlying the automation conundrum. Key design interventions for improving human performance in interacting with autonomous systems are integrated in the model, including human-automation interface features and central automation interaction paradigms comprising levels of automation, adaptive automation, and granularity of control approaches. Recommendations for the design of human-autonomy interfaces are presented and directions for future research discussed.

Hybrid propulsion technology program: Phase 1, volume 4

NASA Technical Reports Server (NTRS)

Claflin, S. E.; Beckman, A. W.

1989-01-01

The use of a liquid oxidizer-solid fuel hybrid propellant combination in booster rocket motors appears extremely attractive due to the integration of the best features of liquid and solid propulsion systems. The hybrid rocket combines the high performance, clean exhaust, and safety of liquid propellant engines with the low cost and simplicity of solid propellant motors. Additionally, the hybrid rocket has unique advantages such as an inert fuel grain and a relative insensitivity to fuel grain and oxidizer injection anomalies. The advantages mark the hybrid rocket as a potential replacement or alternative for current and future solid propellant booster systems. The issues are addressed and recommendations are made concerning oxidizer feed systems, injectors, and ignition systems as related to hybrid rocket propulsion. Early in the program a baseline hybrid configuration was established in which liquid oxygen would be injected through ports in a solid fuel whose composition is based on hydroxyl terminated polybutadiene (HTPB). Liquid oxygen remained the recommended oxidizer and thus all of the injector concepts which were evaluated assumed only liquid would be used as the oxidizer.

Impact reactivity of materials at very high oxygen pressure

NASA Technical Reports Server (NTRS)

Connor, H. W.; Minchey, J. G.; Crowder, R.; Davidson, R.

1983-01-01

The requirements for impact testing of materials in an oxygen atmosphere at pressures from 82.7 MPa (12,000 psi) to 172 MPa (25,000 psi) were evaluated. The impact tester system was evaluated for potential pressure increases from 69 MPa (10,000 psi) to 82.7 MPa (12,000 psi). The low pressure oxygen and nitrogen systems, the impact tower, the impact test cell, and the high pressure oxygen system were evaluated individually. Although the structural integrity of the impact test cell and the compressor were sufficient for operation at 82.7 MPa (12,000 psi), studies revealed possible material incompatibility at that pressure and above. It was recommended that if a component should be replaced for 82.7 MPa (12,000 psi) operation the replacement should meet the final objectives of 172 MPa (25,000 psi). Recommended changes in the system include; use of Monel 400 for pressures above 82.7 MPa (12,000 psi), use of bellows to replace the seal in the impact tester, use of a sapphire window attached to a fiber optic for event sensing, and use of a three diaphragm compressor.

Education and Training for Clinical Neuropsychologists in Integrated Care Settings.

PubMed

Roper, Brad L; Block, Cady K; Osborn, Katie; Ready, Rebecca E

2018-05-01

The increasing importance of integrated care necessitates that education and training experiences prepare clinical neuropsychologists for competent practice in integrated care settings, which includes (a) general competence related to an integrated/interdisciplinary approach and (b) competence specific to the setting. Formal neuropsychology training prepares neuropsychologists with a wide range of knowledge and skills in assessment, intervention, teaching/supervision, and research that are relevant to such settings. However, less attention has been paid to the knowledge and skills that directly address functioning within integrated teams, such as the ability to develop, maintain, and expand collaboration across disciplines, bidirectional clinical-research translation and implementation in integrated team settings, and how such collaboration contributes to clinical and research activities. Foundational knowledge and skills relevant to interdisciplinary systems have been articulated as part of competencies for entry into clinical neuropsychology, but their emphasis in education and training programs is unclear. Recommendations and resources are provided regarding how competencies relevant to integrated care can be provided across the continuum of education and training (i.e., doctoral, internship, postdoctoral, and post-licensure).

Feasibility study of an Integrated Program for Aerospace vehicle Design (IPAD). Volume 6: IPAD system development and operation

NASA Technical Reports Server (NTRS)

Redhed, D. D.; Tripp, L. L.; Kawaguchi, A. S.; Miller, R. E., Jr.

1973-01-01

The strategy of the IPAD implementation plan presented, proposes a three phase development of the IPAD system and technical modules, and the transfer of this capability from the development environment to the aerospace vehicle design environment. The system and technical module capabilities for each phase of development are described. The system and technical module programming languages are recommended as well as the initial host computer system hardware and operating system. The cost of developing the IPAD technology is estimated. A schedule displaying the flowtime required for each development task is given. A PERT chart gives the developmental relationships of each of the tasks and an estimate of the operational cost of the IPAD system is offered.

World Health Organization strong recommendations based on low-quality evidence (study quality) are frequent and often inconsistent with GRADE guidance.

PubMed

Alexander, Paul E; Brito, Juan P; Neumann, Ignacio; Gionfriddo, Michael R; Bero, Lisa; Djulbegovic, Benjamin; Stoltzfus, Rebecca; Montori, Victor M; Norris, Susan L; Schünemann, Holger J; Guyatt, Gordon H

2016-04-01

In 2007 the World Health Organization (WHO) adopted the GRADE system for development of public health guidelines. Previously we found that many strong recommendations issued by WHO are based on evidence for which there is only low or very low confidence in the estimates of effect (discordant recommendations). GRADE guidance indicates that such discordant recommendations are rarely appropriate but suggests five paradigmatic situations in which discordant recommendations may be warranted. We sought to provide insight into the many discordant recommendations in WHO guidelines. We examined all guidelines that used the GRADE method and were approved by the WHO Guideline Review Committee between 2007 and 2012. Teams of reviewers independently abstracted data from eligible guidelines and classified recommendations either into one of the five paradigms for appropriately-formulated discordant recommendations or into three additional categories in which discordant recommendations were inconsistent with GRADE guidance: 1) the evidence warranted moderate or high confidence (a misclassification of evidence) rather than low or very low confidence; 2) good practice statements; or 3) uncertainty in the estimates of effect would best lead to a conditional (weak) recommendation. The 33 eligible guidelines included 160 discordant recommendations, of which 98 (61.3%) addressed drug interventions and 132 (82.5%) provided some rationale (though not entirely explicit at times) for the strong recommendation. Of 160 discordant recommendations, 25 (15.6%) were judged consistent with one of the five paradigms for appropriate recommendations; 33 (21%) were based on evidence warranting moderate or high confidence in the estimates of effect; 29 (18%) were good practice statements; and 73 (46%) warranted a conditional, rather than a strong recommendation. WHO discordant recommendations are often inconsistent with GRADE guidance, possibly threatening the integrity of the process. Further training in GRADE methods for WHO guideline development group members may be necessary, along with further research on what motivates the formulation of such recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

A humidity controlled Nephelometer system to study the hygroscopic properties of aerosols in the marine environment

NASA Astrophysics Data System (ADS)

Vaishya, Aditya; O'Dowd, Colin; Jennings, S. Gerard

2010-05-01

A Humidograph system has been designed to study the hygroscopic properties of aerosols for different air-masses and for different seasons in the marine environment. Since ambient marine aerosols are likely to be found in a metastable state, and in accordance with recommendations of WMO/GAW to sample dry aerosol, a drying unit (Nafion based) is placed just after the inlet to dry the aerosols to a relative humidity (RH) < 40% so as not to misinterpret the optical properties of hygroscopic aerosols if they are on the descending branch of the hysteresis curve. The flow after the dryer is split into two, one going to a 3-wavelength TSI-3563 Integrating Nephelometer, and the other to a Gore-Tex based humidifier followed by a single-wavelength TSI-3561 Integrating Nephelometer. The humidifier is used to vary the RH from 40% to 90%. While the TSI-3563 Integrating Nephelometer will operate at RH < 40%, the TSI-3561 Integrating Nephelometer will operate under varying RH conditions. Software developed in LabVIEW is used to control the hardware components and to log the data in a predefined format. Results of the performance of the Humidograph system in the laboratory and at the Mace Head Atmospheric Research Station are presented.

A Knowledge-Modeling Approach to Integrate Multiple Clinical Practice Guidelines to Provide Evidence-Based Clinical Decision Support for Managing Comorbid Conditions.

PubMed

Abidi, Samina

2017-10-26

Clinical management of comorbidities is a challenge, especially in a clinical decision support setting, as it requires the safe and efficient reconciliation of multiple disease-specific clinical procedures to formulate a comorbid therapeutic plan that is both effective and safe for the patient. In this paper we pursue the integration of multiple disease-specific Clinical Practice Guidelines (CPG) in order to manage co-morbidities within a computerized Clinical Decision Support System (CDSS). We present a CPG integration framework-termed as COMET (Comorbidity Ontological Modeling & ExecuTion) that manifests a knowledge management approach to model, computerize and integrate multiple CPG to yield a comorbid CPG knowledge model that upon execution can provide evidence-based recommendations for handling comorbid patients. COMET exploits semantic web technologies to achieve (a) CPG knowledge synthesis to translate a paper-based CPG to disease-specific clinical pathways (CP) that include specialized co-morbidity management procedures based on input from domain experts; (b) CPG knowledge modeling to computerize the disease-specific CP using a Comorbidity CPG ontology; (c) CPG knowledge integration by aligning multiple ontologically-modeled CP to develop a unified comorbid CPG knowledge model; and (e) CPG knowledge execution using reasoning engines to derive CPG-mediated recommendations for managing patients with comorbidities. We present a web-accessible COMET CDSS that provides family physicians with CPG-mediated comorbidity decision support to manage Atrial Fibrillation and Chronic Heart Failure. We present our qualitative and quantitative analysis of the knowledge content and usability of COMET CDSS.

Innovative residential floor construction: Structural evaluation of steel joists with pre-formed web openings

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

Elhajj, N.R.

1999-03-01

Since 1992, the US Department of Housing and Urban Development has sponsored numerous studies to identify, evaluate, and implement innovative structural materials, such as cold-formed steel (CFS), in the residential market. The use of CFS is still very limited, partly because steel is not being effectively integrated into conventional home construction. One of the major barriers to the use of CFS floor joists is the impact it has on placement of large waste drains and ductwork installed in floor systems. This report provides an overview of tests conducted by the NAHB to integrate these systems with CFS. A brief literaturemore » review of relevant work followed by a detailed overview of the experimental and analytical approach are also provided. The report recommends adoption of the research findings in residential and commercial applications.« less

[The German program for disease management guidelines: evaluation by use of quality indicators].

PubMed

Kopp, Ina B; Geraedts, Max; Jäckel, Wilfried H; Altenhofen, Lutz; Thomeczek, Christian; Ollenschläger, Günter

2007-08-15

The Program for National Disease Management Guidelines (German DM-CPG Program) in Germany aims at the implementation of best-practice recommendations for prevention, acute care, rehabilitation and chronic care in the setting of disease management programs and integrated health-care systems. Like other guidelines, DM-CPG need to be assessed regarding their influence on structures, processes and outcomes of care. However, quality assessment in integrated health-care systems is challenging. On the one hand, a multitude of potential domains for measurement, actors and perspectives need to be considered. On the other hand, measures need to be identified that assess the function of the diagnostic and therapeutic chain in terms of cooperation and coordination of care. The article reviews methods and use of quality indicators in the context of the German DM-CPG Program.

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

PubMed

Murphy, Elizabeth V

2014-06-01

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

Reflection measurements for luminescent powders

NASA Astrophysics Data System (ADS)

Kroon, R. E.

2018-04-01

Luminescent materials are useful in applications varying from lighting and display technologies to document security features and medical research, amongst many others. Measurement of the excitation range is an important consideration, and absorption bands are often determined from a decrease in the measured diffuse reflectance of the material using a ultraviolet-visible (UV-vis) spectrophotometer with an integrating sphere. Such a system may provide questionable results when used to measure the reflectance of a luminescence material, which is demonstrated for a Tb doped silica phosphor, because the system cannot differentiate between the reflected light and luminescence. It is shown that more reliable results are achieved for this phosphor by measuring the reflectance using a synchronous zero-offset scan in a fluorescence spectrometer equipped with an integrating sphere. This method is therefore recommended instead of traditional reflectance measurements using a UV-vis spectrophotometer for luminescent powders.

Clinical Implementation of Pharmacogenetic Testing in a Hospital of the Spanish National Health System: Strategy and Experience Over 3 Years

PubMed Central

Dapia, Irene; Tong, Hoi Y.; Arias, Pedro; Muñoz, Mario; Tenorio, Jair; Hernández, Rafael; García García, Irene; Gordo, Gema; Ramírez, Elena; Frías, Jesús; Lapunzina, Pablo; Carcas, Antonio J.

2017-01-01

Abstract In 2014, we established a pharmacogenetics unit with the intention of facilitating the integration of pharmacogenetic testing into clinical practice. This unit was centered around two main ideas: i) individualization of clinical recommendations, and ii) preemptive genotyping in risk populations. Our unit is based on the design and validation of a single nucleotide polymorphism (SNP) microarray, which has allowed testing of 180 SNPs associated with drug response (PharmArray), and clinical consultation regarding the results. Herein, we report our experience in integrating pharmacogenetic testing into our hospital and we present the results of the 2,539 pharmacogenetic consultation requests received over the past 3 years in our unit. The results demonstrate the feasibility of implementing pharmacogenetic testing in clinical practice within a national health system. PMID:29193749

Towards an agent based traffic regulation and recommendation system for the on-road air quality control.

PubMed

Sadiq, Abderrahmane; El Fazziki, Abdelaziz; Ouarzazi, Jamal; Sadgal, Mohamed

2016-01-01

This paper presents an integrated and adaptive problem-solving approach to control the on-road air quality by modeling the road infrastructure, managing traffic based on pollution level and generating recommendations for road users. The aim is to reduce vehicle emissions in the most polluted road segments and optimizing the pollution levels. For this we propose the use of historical and real time pollution records and contextual data to calculate the air quality index on road networks and generate recommendations for reassigning traffic flow in order to improve the on-road air quality. The resulting air quality indexes are used in the system's traffic network generation, which the cartography is represented by a weighted graph. The weights evolve according to the pollution indexes and path properties and the graph is therefore dynamic. Furthermore, the systems use the available pollution data and meteorological records in order to predict the on-road pollutant levels by using an artificial neural network based prediction model. The proposed approach combines the benefits of multi-agent systems, Big data technology, machine learning tools and the available data sources. For the shortest path searching in the road network, we use the Dijkstra algorithm over Hadoop MapReduce framework. The use Hadoop framework in the data retrieve and analysis process has significantly improved the performance of the proposed system. Also, the agent technology allowed proposing a suitable solution in terms of robustness and agility.

The Guide to Community Preventive Services and Disability Inclusion.

PubMed

Hinton, Cynthia F; Kraus, Lewis E; Richards, T Anne; Fox, Michael H; Campbell, Vincent A

2017-12-01

Approximately 40 million people in the U.S. identify as having a serious disability, and people with disabilities experience many health disparities compared with the general population. The Guide to Community Preventive Services (The Community Guide) identifies evidence-based programs and policies recommended by the Community Preventive Services Task Force (Task Force) to promote health and prevent disease. The Community Guide was assessed to answer the questions: are Community Guide public health intervention recommendations applicable to people with disabilities, and are adaptations required? An assessment of 91 recommendations from The Community Guide was conducted for 15 health topics by qualitative analysis involving three data approaches: an integrative literature review (years 1980-2011), key informant interviews, and focus group discussion during 2011. Twenty-six recommended interventions would not need any adaptation to be of benefit to people with disabilities. Forty-one recommended interventions could benefit from adaptations in communication and technology; 33 could benefit from training adaptations; 31 from physical accessibility adaptations; and 16 could benefit from other adaptations, such as written policy changes and creation of peer support networks. Thirty-eight recommended interventions could benefit from one or more adaptations to enhance disability inclusion. As public health and healthcare systems implement Task Force recommendations, identifying and addressing barriers to full participation for people with disabilities is important so that interventions reach the entire population. With appropriate adaptations, implementation of recommendations from The Community Guide could be successfully expanded to address the needs of people with disabilities. Published by Elsevier Inc.

An Analysis of Methanol and Hydrogen Production via High-Temperature Electrolysis Using the Sodium Cooled Advanced Fast Reactor

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

Shannon M. Bragg-Sitton; Richard D. Boardman; Robert S. Cherry

2014-03-01

Integration of an advanced, sodium-cooled fast spectrum reactor into nuclear hybrid energy system (NHES) architectures is the focus of the present study. A techno-economic evaluation of several conceptual system designs was performed for the integration of a sodium-cooled Advanced Fast Reactor (AFR) with the electric grid in conjunction with wind-generated electricity. Cases in which excess thermal and electrical energy would be reapportioned within an integrated energy system to a chemical plant are presented. The process applications evaluated include hydrogen production via high temperature steam electrolysis and methanol production via steam methane reforming to produce carbon monoxide and hydrogen which feedmore » a methanol synthesis reactor. Three power cycles were considered for integration with the AFR, including subcritical and supercritical Rankine cycles and a modified supercritical carbon dioxide modified Brayton cycle. The thermal efficiencies of all of the modeled power conversions units were greater than 40%. A thermal efficiency of 42% was adopted in economic studies because two of the cycles either performed at that level or could potentially do so (subcritical Rankine and S-CO2 Brayton). Each of the evaluated hybrid architectures would be technically feasible but would demonstrate a different internal rate of return (IRR) as a function of multiple parameters; all evaluated configurations showed a positive IRR. As expected, integration of an AFR with a chemical plant increases the IRR when “must-take” wind-generated electricity is added to the energy system. Additional dynamic system analyses are recommended to draw detailed conclusions on the feasibility and economic benefits associated with AFR-hybrid energy system operation.« less

A net-centric system of services model for the Integrated Earth Observation System (IEOS) and the Integrated Ocean Observing System (IOOS)

NASA Astrophysics Data System (ADS)

Ardanuy, Philip; Bensman, Ed; Bergen, Bill; Chen, Bob; Griffith, Frank; Sutton, Cary; Hood, Carroll; Ritchie, Adrian; Tarro, Andre

2006-08-01

This paper considers an evolved technique for significantly enhanced enterprise-level data processing, reprocessing, archival, dissemination, and utilization. There is today a robust working paradigm established with the Advanced Weather Interactive Processing System (AWIPS)-NOAA/NWS's information integration and fusion capability. This process model extends vertically, and seamlessly, from environmental sensing through the direct delivery of societal benefit. NWS, via AWIPS, is the primary source of weather forecast and warning information in the nation. AWIPS is the tested and proven "the nerve center of operations" at all 122 NWS Weather Forecast Offices (WFOs) and 13 River Forecast Centers (RFCs). However, additional line organizations whose role in satisfying NOAA's five mission goals (ecosystems, climate, weather & water, commerce & transportation, and mission support) in multiple program areas might be facilitated through utilization of AWIPS-like functionalities, including the National Marine Fisheries Service (NMFS); National Environmental Satellite, Data, and Information Service (NESDIS); Office of Oceanic & Atmospheric Research (OAR); and the National Ocean Service (NOS). In addition to NOAA's mission goals, there are nine diverse, recommended, and important societal benefit areas in the US Integrated Earth Observation System (IEOS). This paper shows how the satisfaction of this suite of goals and benefit areas can be optimized by leveraging several key ingredients: (1) the evolution of AWIPS towards a net-centric system of services concept of operations; (2) infusion of technologies and concepts from pathfinder systems; (3) the development of new observing systems targeted at deliberate, and not just serendipitous, societal benefit; and (4) the diverse, nested local, regional, national, and international scales of the different benefits and goal areas, and their interoperability and interplay across the system of systems.

Apollo Medical Operations Project: Recommendations for EVA and Lunar Surface Operations

NASA Technical Reports Server (NTRS)

Scheuring, R. A.; Davis, J. R.; Duncan, J. M.; Polk, J. D.; Jones, J. A.; Gillis, D. B.; Novak, J.

2013-01-01

The potential risk of injury to crewmembers is inherent in aggressive surface activities, whether they be Moon-, Mars-, or asteroid-based. In December 2005, the Space Medicine Division at JSC requested a study to identify Apollo mission issues that had an impact to crew health or performance or both. This talk focused on the Apollo EVA suit and lunar surface operations concerning crew health and performance. There were roughly 20 recommendations from this study of Apollo for improving these two areas for future exploration missions, a few of which were incorporated into the Human Systems Integration Requirements (HSIR). Dr. Richard Scheuring covered these topics along with some of the analog work that has been done regarding surface operations and medical contingencies.

All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record

PubMed Central

Jensen, Roxanne E; Snyder, Claire F; Basch, Ethan; Frank, Lori; Wu, Albert W

2016-01-01

In recent years, patient-reported outcomes have become increasingly collected and integrated into electronic health records. However, there are few cross-cutting recommendations and limited guidance available in this rapidly developing research area. Our goal is to report key findings from a 2013 Patient-Centered Outcomes Research Institute workshop on this topic and a summary of actions that followed from the workshop, and present resulting recommendations that address patient, clinical and research/quality improvement barriers to regular use. These findings provide actionable guidance across research and practice settings to promote and sustain widespread adoption of patient-reported outcomes across patient populations, healthcare settings and electronic health record systems. PMID:27586855

Information filtering on coupled social networks.

PubMed

Nie, Da-Cheng; Zhang, Zi-Ke; Zhou, Jun-Lin; Fu, Yan; Zhang, Kui

2014-01-01

In this paper, based on the coupled social networks (CSN), we propose a hybrid algorithm to nonlinearly integrate both social and behavior information of online users. Filtering algorithm, based on the coupled social networks, considers the effects of both social similarity and personalized preference. Experimental results based on two real datasets, Epinions and Friendfeed, show that the hybrid pattern can not only provide more accurate recommendations, but also enlarge the recommendation coverage while adopting global metric. Further empirical analyses demonstrate that the mutual reinforcement and rich-club phenomenon can also be found in coupled social networks where the identical individuals occupy the core position of the online system. This work may shed some light on the in-depth understanding of the structure and function of coupled social networks.

Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study.

PubMed

Javan Amoli, Amir Hossein; Maserat, Elham; Safdari, Reza; Zali, Mohammad Reza

2015-01-01

Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi- structured interview. Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

Antipsychotic-induced hyperprolactinemia: synthesis of world-wide guidelines and integrated recommendations for assessment, management and future research.

PubMed

Grigg, Jasmin; Worsley, Roisin; Thew, Caroline; Gurvich, Caroline; Thomas, Natalie; Kulkarni, Jayashri

2017-11-01

Hyperprolactinemia is a highly prevalent adverse effect of many antipsychotic agents, with potentially serious health consequences. Several guidelines have been developed for the management of this condition; yet, their concordance has not been evaluated. The objectives of this paper were (1) to review current clinical guidelines; (2) to review key systematic evidence for management; and (3) based on our findings, to develop an integrated management recommendation specific to male and female patients who are otherwise clinically stabilised on antipsychotics. We performed searches of Medline and EMBASE, supplemented with guideline-specific database and general web searches, to identify clinical guidelines containing specific recommendations for antipsychotic-induced hyperprolactinemia, produced/updated 01/01/2010-15/09/2016. A separate systematic search was performed to identify emerging management approaches described in reviews and meta-analyses published ≥ 2010. There is some consensus among guidelines relating to baseline PRL screening (8/12 guidelines), screening for differential diagnosis (7/12) and discontinuing/switching PRL-raising agent (7/12). Guidelines otherwise diverge substantially regarding most aspects of screening, monitoring and management (e.g. treatment with dopamine agonists). There is an omission of clear sex-specific recommendations. Systematic literature on management approaches is promising; more research is needed. An integrated management recommendation is presented to guide sex-specific clinical response to antipsychotic-induced hyperprolactinemia. Key aspects include asymptomatic hyperprolactinemia monitoring and fertility considerations with PRL normalisation. Further empirical work is key to shaping robust guidelines for antipsychotic-induced hyperprolactinemia. The integrated management recommendation can assist clinician and patient decision-making, with the goal of balancing effective psychiatric treatment while minimising PRL-related adverse health effects in male and female patients.

Concerns and Responses for Integrating Health Systems Science Into Medical Education.

PubMed

Gonzalo, Jed D; Caverzagie, Kelly J; Hawkins, Richard E; Lawson, Luan; Wolpaw, Daniel R; Chang, Anna

2018-06-01

With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders. The authors identify several widely perceived challenges to integrating HSS into medical school curricula, respond to each concern, and provide potential strategies to address these concerns, based on their experiences designing and integrating HSS curricula. They identify two broad categories of concerns: the (1) relevance and importance of learning HSS-including the perception that there is inadequate urgency for change; HSS education is too complex and should occur in later years; early students would not be able to contribute, and the roles already exist; and the science is too nascent-and (2) logistics and practicality of teaching HSS-including limited curricular time, scarcity of faculty educators with expertise, lack of support from accreditation agencies and licensing boards, and unpreparedness of evolving health care systems to partner with schools with HSS curricula. The authors recommend the initiation and continuation of discussions between educators, clinicians, basic science faculty, health system leaders, and accrediting and regulatory bodies about the goals and priorities of medical education, as well as about the need to collaborate on new methods of education to reach these goals.

Solid state television camera

NASA Technical Reports Server (NTRS)

1976-01-01

The design, fabrication, and tests of a solid state television camera using a new charge-coupled imaging device are reported. An RCA charge-coupled device arranged in a 512 by 320 format and directly compatible with EIA format standards was the sensor selected. This is a three-phase, sealed surface-channel array that has 163,840 sensor elements, which employs a vertical frame transfer system for image readout. Included are test results of the complete camera system, circuit description and changes to such circuits as a result of integration and test, maintenance and operation section, recommendations to improve the camera system, and a complete set of electrical and mechanical drawing sketches.

Central nervous system cancers, version 2.2014. Featured updates to the NCCN Guidelines.

PubMed

Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Brem, Henry; Brown, Paul; Butowski, Nicholas; Chamberlain, Marc C; DeAngelis, Lisa M; Fenstermaker, Robert A; Friedman, Allan; Gilbert, Mark R; Hattangadi-Gluth, Jona; Hesser, Deneen; Holdhoff, Matthias; Junck, Larry; Lawson, Ronald; Loeffler, Jay S; Moots, Paul L; Mrugala, Maciej M; Newton, Herbert B; Raizer, Jeffrey J; Recht, Lawrence; Shonka, Nicole; Shrieve, Dennis C; Sills, Allen K; Swinnen, Lode J; Tran, David; Tran, Nam; Vrionis, Frank D; Wen, Patrick Yung; McMillian, Nicole R; Ho, Maria

2014-11-01

The NCCN Guidelines for Central Nervous System Cancers provide multidisciplinary recommendations for the clinical management of patients with cancers of the central nervous system. These NCCN Guidelines Insights highlight recent updates regarding the management of metastatic brain tumors using radiation therapy. Use of stereotactic radiosurgery (SRS) is no longer limited to patients with 3 or fewer lesions, because data suggest that total disease burden, rather than number of lesions, is predictive of survival benefits associated with the technique. SRS is increasingly becoming an integral part of management of patients with controlled, low-volume brain metastases. Copyright © 2014 by the National Comprehensive Cancer Network.

Telematics Framework for Federal Agencies: Lessons from the Marine Corps Fleet

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

Hodge, Cabell; Singer, Mark R.

Executive Order 13693 requires federal agencies to acquire telematics for their light- and medium-duty vehicles as appropriate. This report is intended to help agencies that are deploying telematics systems and seeking to integrate them into their fleet management process. It provides an overview of telematics capabilities, lessons learned from the deployment of telematics in the Marine Corps fleet, and recommendations for federal fleet managers to maximize value from telematics.

Conduct of the Persian Gulf Conflict: An Interim Report to Congress

DTIC Science & Technology

1991-07-01

a danger that we will assume that this war is a paradigm for the next, that subconsciously we’ll presume all future wars can be relatively pain free...CENTCOM. The experience elicited arecmmndtin o hagethe threshold for reprogram - JSTARS was an integral part of the system used to recommendation to...This Includes the realignment, reprogramming , or transfer of funds appropriated for activities unrelated to the Persian Gulf conflict. Interim Report

Perception Measurement in Clinical Trials of Schizophrenia: Promising Paradigms From CNTRICS

PubMed Central

Green, Michael F.; Butler, Pamela D.; Chen, Yue; Geyer, Mark A.; Silverstein, Steven; Wynn, Jonathan K.; Yoon, Jong H.; Zemon, Vance

2009-01-01

The third meeting of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) focused on selecting promising measures for each of the cognitive constructs selected in the first CNTRICS meeting. In the domain of perception, the 2 constructs of interest were gain control and visual integration. CNTRICS received 5 task nominations for gain control and three task nominations for visual integration. The breakout group for perception evaluated the degree to which each of these tasks met prespecified criteria. For gain control, the breakout group for perception believed that 2 of the tasks (prepulse inhibition of startle and mismatch negativity) were already mature and in the process of being incorporated into multisite clinical trials. However, the breakout group recommended that steady-state visual-evoked potentials be combined with contrast sensitivity to magnocellular vs parvocellular biased stimuli and that this combined task and the contrast-contrast effect task be recommended for translation for use in clinical trial contexts in schizophrenia research. For visual integration, the breakout group recommended the Contour Integration and Coherent Motion tasks for translation for use in clinical trials. This manuscript describes the ways in which each of these tasks met the criteria used by the breakout group to evaluate and recommend tasks for further development. PMID:19023123

Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment: Conference Key Findings and Next Steps

PubMed Central

Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen

2017-01-01

Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451

Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.

PubMed

Wilfley, Denise E; Staiano, Amanda E; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G; Dietz, William H; Cook, Stephen

2017-01-01

To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multidisciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g., >25 h) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale up training to ensure quality of care. © 2016 The Obesity Society.

Revisiting the safety of aspartame.

PubMed

Choudhary, Arbind Kumar; Pretorius, Etheresia

2017-09-01

Aspartame is a synthetic dipeptide artificial sweetener, frequently used in foods, medications, and beverages, notably carbonated and powdered soft drinks. Since 1981, when aspartame was first approved by the US Food and Drug Administration, researchers have debated both its recommended safe dosage (40 mg/kg/d) and its general safety to organ systems. This review examines papers published between 2000 and 2016 on both the safe dosage and higher-than-recommended dosages and presents a concise synthesis of current trends. Data on the safe aspartame dosage are controversial, and the literature suggests there are potential side effects associated with aspartame consumption. Since aspartame consumption is on the rise, the safety of this sweetener should be revisited. Most of the literature available on the safety of aspartame is included in this review. Safety studies are based primarily on animal models, as data from human studies are limited. The existing animal studies and the limited human studies suggest that aspartame and its metabolites, whether consumed in quantities significantly higher than the recommended safe dosage or within recommended safe levels, may disrupt the oxidant/antioxidant balance, induce oxidative stress, and damage cell membrane integrity, potentially affecting a variety of cells and tissues and causing a deregulation of cellular function, ultimately leading to systemic inflammation. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Operational integration in primary health care: patient encounters and workflows.

PubMed

Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Markaki, Adelais; Kritikos, Kyriakos; Petelos, Elena; Lionis, Christos

2017-11-29

Despite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration. The study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece. Dimensions of operational integration in PHC were selected based on the work of Kringos and colleagues. A five-point Likert-type scale, coupled with an algorithm, was used to capture and transform theoretical framework features into measurable attributes. PHC services were grouped under the main categories of chronic care, urgent/acute care, preventive care, and home care. A web-based platform was used to assess patient pathways, evaluate integration levels and propose improvement actions. Analysis relied on a comparison of actual pathways versus optimal, the latter ones having been identified through literature review. Overall integration varied among units. The majority (57%) of units corresponded to a basic level. Integration by type of PHC service ranged as follows: basic (86%) or poor (14%) for chronic care units, poor (78%) or basic (22%) for urgent/acute care units, basic (50%) for preventive care units, and partial or basic (50%) for home care units. The actual pathways across all four categories of PHC services differed from those captured in the optimum integration model. Certain similarities were observed in the operational flows between chronic care management and urgent/acute care management. Such similarities were present at the highest level of abstraction, but also in common steps along the operational flows. Existing patient care pathways were mapped and analysed, and recommendations for an optimum integration PHC model were made. The developed web platform, based on a strong theoretical framework, can serve as a robust integration evaluation tool. This could be a first step towards restructuring and improving PHC services within a financially restrained environment.

Patient and provider perspectives on adherence to and care coordination of lynch syndrome surveillance recommendations: findings from qualitative interviews.

PubMed

Schneider, Jennifer L; Goddard, Katrina A B; Muessig, Kristin R; Davis, James V; Rope, Alan F; Hunter, Jessica E; Peterson, Susan K; Acheson, Louise S; Syngal, Sapna; Wiesner, Georgia L; Reiss, Jacob A

2018-01-01

Patients with a genetic variant associated with Lynch syndrome (LS) are recommended to undergo frequent and repeated cancer surveillance activities to minimize cancer-related morbidity and mortality. Little is known about how patients and primary care providers (PCPs) track and manage these recommendations. We conducted a small exploratory study of patient and PCP experiences with recommended LS surveillance activities and communication with family members in an integrated health care system. We used in-depth interviews with patients and providers to understand how surveillance is coordinated and monitored following confirmation of LS. We recruited patients with a range of ages/gender, and providers with at least at least one patient with a molecular diagnosis of LS. All interviews were recorded, transcribed, and content analyzed by a trained qualitative methodologist. Twenty-two interviews were completed with 12 patients and 10 providers. Most patients (10) had detailed knowledge of surveillance recommendations, but were less sure of time intervals. While all patients reported receiving initial education about their surveillance recommendations from a genetic counselor, seven did not follow-up with a genetic counselor in subsequent years. A third of patients described taking sole responsibility for managing their LS surveillance care. Lack of routine communication from the health system (e.g., prompts for surveillance activities), and provider engagement were surveillance barriers. PCPs were generally aware of LS, but had limited familiarity with surveillance recommendations. Most PCPs (7) viewed LS as rare and relied on patient and specialist expertise and support. Providers typically had 1 patient with LS in a panel of 1800 patients overall. Providers felt strongly that management of LS should be coordinated by a dedicated team of specialists. Most patients (92%) had at least one family member that sought LS testing, and common barriers for family members included lack of insurance, affordability, and fear of result. The maximal benefits of screening for confirmation of LS will only be realized with adherence to recommended preventive care. Important factors to ensure patients receive recommended LS care include a comprehensive and coordinated monitoring program that includes reminder prompts, and increased PCP education of LS and associated surveillance recommendations.

Assessing and managing multiple risks in a changing world-The Roskilde recommendations.

PubMed

Selck, Henriette; Adamsen, Peter B; Backhaus, Thomas; Banta, Gary T; Bruce, Peter K H; Burton, G Allen; Butts, Michael B; Boegh, Eva; Clague, John J; Dinh, Khuong V; Doorn, Neelke; Gunnarsson, Jonas S; Hauggaard-Nielsen, Henrik; Hazlerigg, Charles; Hunka, Agnieszka D; Jensen, John; Lin, Yan; Loureiro, Susana; Miraglia, Simona; Munns, Wayne R; Nadim, Farrokh; Palmqvist, Annemette; Rämö, Robert A; Seaby, Lauren P; Syberg, Kristian; Tangaa, Stine R; Thit, Amalie; Windfeld, Ronja; Zalewski, Maciej; Chapman, Peter M

2017-01-01

Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk-Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human-modified systems; 8) assess risks and benefits to humans and the ecosystem and consider unintended consequences of management actions; 9) avoid excessive conservatism or possible underprotection resulting from sole reliance on binary, numerical benchmarks; and 10) develop adaptive risk-management and regulatory goals based on ranges of uncertainty. Environ Toxicol Chem 2017;36:7-16. © 2016 SETAC. © 2016 SETAC.

Integration of the Remote Agent for the NASA Deep Space One Autonomy Experiment

NASA Technical Reports Server (NTRS)

Dorais, Gregory A.; Bernard, Douglas E.; Gamble, Edward B., Jr.; Kanefsky, Bob; Kurien, James; Muscettola, Nicola; Nayak, P. Pandurang; Rajan, Kanna; Lau, Sonie (Technical Monitor)

1998-01-01

This paper describes the integration of the Remote Agent (RA), a spacecraft autonomy system which is scheduled to control the Deep Space 1 spacecraft during a flight experiment in 1999. The RA is a reusable, model-based autonomy system that is quite different from software typically used to control an aerospace system. We describe the integration challenges we faced, how we addressed them, and the lessons learned. We focus on those aspects of integrating the RA that were either easier or more difficult than integrating a more traditional large software application because the RA is a model-based autonomous system. A number of characteristics of the RA made integration process easier. One example is the model-based nature of RA. Since the RA is model-based, most of its behavior is not hard coded into procedural program code. Instead, engineers specify high level models of the spacecraft's components from which the Remote Agent automatically derives correct system-wide behavior on the fly. This high level, modular, and declarative software description allowed some interfaces between RA components and between RA and the flight software to be automatically generated and tested for completeness against the Remote Agent's models. In addition, the Remote Agent's model-based diagnosis system automatically diagnoses when the RA models are not consistent with the behavior of the spacecraft. In flight, this feature is used to diagnose failures in the spacecraft hardware. During integration, it proved valuable in finding problems in the spacecraft simulator or flight software. In addition, when modifications are made to the spacecraft hardware or flight software, the RA models are easily changed because they only capture a description of the spacecraft. one does not have to maintain procedural code that implements the correct behavior for every expected situation. On the other hand, several features of the RA made it more difficult to integrate than typical flight software. For example, the definition of correct behavior is more difficult to specify for a system that is expected to reason about and flexibly react to its environment than for a traditional flight software system. Consequently, whenever a change is made to the RA it is more time consuming to determine if the resulting behavior is correct. We conclude the paper with a discussion of future work on the Remote Agent as well as recommendations to ease integration of similar autonomy projects.

Recommendations for the design and the installation of large laser scanning microscopy systems

NASA Astrophysics Data System (ADS)

Helm, P. Johannes

2012-03-01

Laser Scanning Microscopy (LSM) has since the inventions of the Confocal Scanning Laser Microscope (CLSM) and the Multi Photon Laser Scanning Microscope (MPLSM) developed into an essential tool in contemporary life science and material science. The market provides an increasing number of turn-key and hands-off commercial LSM systems, un-problematic to purchase, set up and integrate even into minor research groups. However, the successful definition, financing, acquisition, installation and effective use of one or more large laser scanning microscopy systems, possibly of core facility character, often requires major efforts by senior staff members of large academic or industrial units. Here, a set of recommendations is presented, which are helpful during the process of establishing large systems for confocal or non-linear laser scanning microscopy as an effective operational resource in the scientific or industrial production process. Besides the description of technical difficulties and possible pitfalls, the article also illuminates some seemingly "less scientific" processes, i.e. the definition of specific laboratory demands, advertisement of the intention to purchase one or more large systems, evaluation of quotations, establishment of contracts and preparation of the local environment and laboratory infrastructure.

EHR based Genetic Testing Knowledge Base (iGTKB) Development

PubMed Central

2015-01-01

Background The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). Methods We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Results Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. Conclusions In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant clinical evidence, and ultimately to support development of genetic testing recommendation system, iGenetics. PMID:26606281

EHR based Genetic Testing Knowledge Base (iGTKB) Development.

PubMed

Zhu, Qian; Liu, Hongfang; Chute, Christopher G; Ferber, Matthew

2015-01-01

The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant clinical evidence, and ultimately to support development of genetic testing recommendation system, iGenetics.

From collision to collaboration - Integrating informal recyclers and re-use operators in Europe: A review.

PubMed

Scheinberg, Anne; Nesić, Jelena; Savain, Rachel; Luppi, Pietro; Sinnott, Portia; Petean, Flaviu; Pop, Flaviu

2016-09-01

The European Union hosts some of the world's most developed waste management systems and an ambitious policy commitment to the circular economy. The existence of informal recycling and re-use activities in Europe has been vigorously denied until quite recently, and remains a very challenging subject for the European solid waste management sector, as well as for European government and private institutions. In countries ranging from Malta to Macedonia and from France to Turkey, informal recyclers excluded from legal recycling niches increasingly collide with formalised and controlled European Union approaches to urban waste management, packaging recovery schemes, formal re-use enterprises, and extended producer responsibility systems.This review focuses on the period from 2004 through the first half of 2016. The 78 sources on European (and neighbouring) informal recycling and re-use are contextualised with global sources and experience. The articles focus on informal recovery in and at the borders of the European Union, document the conflicts and collisions, and elaborate some constructive approaches towards legalisation, integration, and reconciliation. The overarching recommendation, to locate the issue of informal recovery and integration in the framework of the European circular economy package, is supported by four specific pillars of an integration strategy: Documentation, legalisation, occupational and enterprise recognition, and preparation for structural integration. © The Author(s) 2016.

Overview of Intelligent Systems and Operations Development

NASA Technical Reports Server (NTRS)

Pallix, Joan; Dorais, Greg; Penix, John

2004-01-01

To achieve NASA's ambitious mission objectives for the future, aircraft and spacecraft will need intelligence to take the correct action in a variety of circumstances. Vehicle intelligence can be defined as the ability to "do the right thing" when faced with a complex decision-making situation. It will be necessary to implement integrated autonomous operations and low-level adaptive flight control technologies to direct actions that enhance the safety and success of complex missions despite component failures, degraded performance, operator errors, and environment uncertainty. This paper will describe the array of technologies required to meet these complex objectives. This includes the integration of high-level reasoning and autonomous capabilities with multiple subsystem controllers for robust performance. Future intelligent systems will use models of the system, its environment, and other intelligent agents with which it interacts. They will also require planners, reasoning engines, and adaptive controllers that can recommend or execute commands enabling the system to respond intelligently. The presentation will also address the development of highly dependable software, which is a key component to ensure the reliability of intelligent systems.

Making the CARE Comprehensive Geriatric Assessment as the Core of a Total Mobile Long Term Care Support System in China.

PubMed

Cui, Yanyan; Gong, Dongwei; Yang, Bo; Chen, Hua; Tu, Ming-Hsiang; Zhang, Chaonan; Li, Huan; Liang, Naiwen; Jiang, Liping; Chang, Polun

2018-01-01

Comprehensive Geriatric Assessments (CGAs) have been recommended to be used for better monitoring the health status of elder residents and providing quality care. This study reported how our nurses perceived the usability of CGA component of a mobile integrated-care long term care support system developed in China. We used the Continuity Assessment Record and Evaluation (CARE), developed in the US, as the core CGA component of our Android-based support system, in which apps were designed for all key stakeholders for delivering quality long term care. A convenience sample of 18 subjects from local long term care facilities in Shanghai, China were invited to assess the CGA assessment component in terms of Technology Acceptance Model for Mobile based on real field trial assessment. All (100%) were satisfied with the mobile CGA component. 88.9% perceived the system was easy to learn and use. 99.4% showed their willingness to use for their work. We concluded it is technically feasible to implement a CGA-based mobile integrated care support system in China.

SCHeMA web-based observation data information system

NASA Astrophysics Data System (ADS)

Novellino, Antonio; Benedetti, Giacomo; D'Angelo, Paolo; Confalonieri, Fabio; Massa, Francesco; Povero, Paolo; Tercier-Waeber, Marie-Louise

2016-04-01

It is well recognized that the need of sharing ocean data among non-specialized users is constantly increasing. Initiatives that are built upon international standards will contribute to simplify data processing and dissemination, improve user-accessibility also through web browsers, facilitate the sharing of information across the integrated network of ocean observing systems; and ultimately provide a better understanding of the ocean functioning. The SCHeMA (Integrated in Situ Chemical MApping probe) Project is developing an open and modular sensing solution for autonomous in situ high resolution mapping of a wide range of anthropogenic and natural chemical compounds coupled to master bio-physicochemical parameters (www.schema-ocean.eu). The SCHeMA web system is designed to ensure user-friendly data discovery, access and download as well as interoperability with other projects through a dedicated interface that implements the Global Earth Observation System of Systems - Common Infrastructure (GCI) recommendations and the international Open Geospatial Consortium - Sensor Web Enablement (OGC-SWE) standards. This approach will insure data accessibility in compliance with major European Directives and recommendations. Being modular, the system allows the plug-and-play of commercially available probes as well as new sensor probess under development within the project. The access to the network of monitoring probes is provided via a web-based system interface that, being implemented as a SOS (Sensor Observation Service), is providing standard interoperability and access tosensor observations systems through O&M standard - as well as sensor descriptions - encoded in Sensor Model Language (SensorML). The use of common vocabularies in all metadatabases and data formats, to describe data in an already harmonized and common standard is a prerequisite towards consistency and interoperability. Therefore, the SCHeMA SOS has adopted the SeaVox common vocabularies populated by SeaDataNet network of National Oceanographic Data Centres. The SCHeMA presentation layer, a fundamental part of the software architecture, offers to the user a bidirectional interaction with the integrated system allowing to manage and configure the sensor probes; view the stored observations and metadata, and handle alarms. The overall structure of the web portal developed within the SCHeMA initiative (Sensor Configuration, development of Core Profile interface for data access via OGC standard, external services such as web services, WMS, WFS; and Data download and query manager) will be presented and illustrated with examples of ongoing tests in costal and open sea.

Autonomous power expert system

NASA Technical Reports Server (NTRS)

Ringer, Mark J.; Quinn, Todd M.

1990-01-01

The goal of the Autonomous Power System (APS) program is to develop and apply intelligent problem solving and control technologies to the Space Station Freedom Electrical Power Systems (SSF/EPS). The objectives of the program are to establish artificial intelligence/expert system technology paths, to create knowledge based tools with advanced human-operator interfaces, and to integrate and interface knowledge-based and conventional control schemes. This program is being developed at the NASA-Lewis. The APS Brassboard represents a subset of a 20 KHz Space Station Power Management And Distribution (PMAD) testbed. A distributed control scheme is used to manage multiple levels of computers and switchgear. The brassboard is comprised of a set of intelligent switchgear used to effectively switch power from the sources to the loads. The Autonomous Power Expert System (APEX) portion of the APS program integrates a knowledge based fault diagnostic system, a power resource scheduler, and an interface to the APS Brassboard. The system includes knowledge bases for system diagnostics, fault detection and isolation, and recommended actions. The scheduler autonomously assigns start times to the attached loads based on temporal and power constraints. The scheduler is able to work in a near real time environment for both scheduling and dynamic replanning.

Autonomous power expert system

NASA Technical Reports Server (NTRS)

Ringer, Mark J.; Quinn, Todd M.

1990-01-01

The goal of the Autonomous Power System (APS) program is to develop and apply intelligent problem solving and control technologies to the Space Station Freedom Electrical Power Systems (SSF/EPS). The objectives of the program are to establish artificial intelligence/expert system technology paths, to create knowledge based tools with advanced human-operator interfaces, and to integrate and interface knowledge-based and conventional control schemes. This program is being developed at the NASA-Lewis. The APS Brassboard represents a subset of a 20 KHz Space Station Power Management And Distribution (PMAD) testbed. A distributed control scheme is used to manage multiple levels of computers and switchgear. The brassboard is comprised of a set of intelligent switchgear used to effectively switch power from the sources to the loads. The Autonomous Power Expert System (APEX) portion of the APS program integrates a knowledge based fault diagnostic system, a power resource scheduler, and an interface to the APS Brassboard. The system includes knowledge bases for system diagnostics, fault detection and isolation, and recommended actions. The scheduler autonomously assigns start times to the attached loads based on temporal and power constraints. The scheduler is able to work in a near real time environment for both scheduling an dynamic replanning.

The impact of informatics on nursing education: a review of the literature.

PubMed

Ainsley, Bonnie; Brown, Abbie

2009-05-01

On the basis of a study by the Institute of Medicine, the current health care system is facing several challenges that may be addressed by changes in health professions education. The study focused on integration of five core competencies into health professions education, one of which was informatics. This critical analysis investigates current use of technology and online instructional strategies in nursing education. It also explores the potential impact of integration of informatics into nursing education to increase the cognitive skills of nurses to promote evidence-based nursing. Advantages and disadvantages of using online education in the instruction of nursing students and recommendations for best online practices in nursing education are discussed.

Integrated residential photovoltaic array development

NASA Technical Reports Server (NTRS)

Shepard, N. F., Jr.

1981-01-01

Three basic module design concepts were analyzed with respect to both production and installation costs. The results of this evaluation were used to synthesize a fourth design which incorporates the best features of these initial concepts to produce a module/array design approach which offers the promise of a substantial reduction in the installed cost of a residential array. A unique waterproofing and mounting scheme was used to reduce the cost of installing an integral array while still maintaining a high probability that the installed array will be watertight for the design lifetime of the system. This recommended concept will also permit the array to be mounted as a direct or stand-off installation with no changes to the module design.

Establishing an integrated human milk banking approach to strengthen newborn care.

PubMed

DeMarchis, A; Israel-Ballard, K; Mansen, Kimberly Amundson; Engmann, C

2017-05-01

The provision of donor human milk can significantly reduce morbidity and mortality among vulnerable infants and is recommended by the World Health Organization as the next best option when a mother's own milk is unavailable. Regulated human milk banks can meet this need, however, scale-up has been hindered by the absence of an appropriate model for resource-limited settings and a lack of policy support for human milk banks and for the operational procedures supporting them. To reduce infant mortality, human milk banking systems need to be scaled up and integrated with other components of newborn care. This article draws on current guidelines and best practices from human milk banks to offer a compilation of universal requirements that provide a foundation for an integrated model of newborn care that is appropriate for low- and high-resource settings alike.

OVERVIEW OF HANFORD SINGLE SHELL TANK (SST) STRUCTURAL INTEGRITY - 12123

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

RAST RS; RINKER MW; WASHENFELDER DJ

2012-01-25

To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration. Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for the Hanfordmore » Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford SSTs. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford SSTs is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS{reg_sign} The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford SSTs has concluded that the tanks are structurally sound and meet current industry standards. Analyses of the remaining Hanford SSTs are scheduled for FY2013. Hanford SSTs are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior surface of the concrete tank domes, looking for cracks and other surface conditions that may indicate signs of structural distress. The condition of the concrete and rebar of the Hanford SSTs is currently being tested and planned for additional activities in the near future. Concrete and rebar removed from the dome of a 65-year-old tank is being tested for mechanics properties and condition. Results indicated stronger than designed concrete with additional Petrographic examination and rebar testing ongoing. Material properties determined from previous efforts combined with current testing and construction document review will help to generate a database that will provide continuing indication of Hanford SST structural integrity.« less

Overview of Hanford Single Shell Tank (SST) Structural Integrity

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

Rast, Richard S.; Washenfelder, Dennis J.; Johnson, Jeremy M.

2013-11-14

To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project (SSTIP) in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration, Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for themore » Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford Single-Shell Tanks. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS. The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford Single-Shell Tanks has concluded that the tanks are structurally sound and meet current industry standards. Analysis of the remaining Hanford Single-Shell Tanks is scheduled for FY2014. Hanford Single-Shell Tanks are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior surface of the concrete tanks, looking for cracks and other surface conditions that may indicate signs of structural distress. The condition of the concrete and rebar of the Hanford Single-Shell Tanks is currently being tested and planned for additional activities in the near future. Concrete and rebar removed from the dome of a 65 year old tank was tested for mechanics properties and condition. Results indicated stronger than designed concrete with additional Petrographic examination and rebar completed. Material properties determined from previous efforts combined with current testing and construction document review will help to generate a database that will provide indication of Hanford Single-Shell Tank structural integrity.« less