Applying ant colony optimization metaheuristic to solve forest transportation planning problems with side constraints

Treesearch

Marco A. Contreras; Woodam Chung; Greg Jones

2008-01-01

Forest transportation planning problems (FTPP) have evolved from considering only the financial aspects of timber management to more holistic problems that also consider the environmental impacts of roads. These additional requirements have introduced side constraints, making FTPP larger and more complex. Mixed-integer programming (MIP) has been used to solve FTPP, but...

7 CFR 1717.852 - Financing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and energy conservation, and on-grid and off-grid renewable energy systems; (2) The purchase..., except: (i) Certain load-management equipment (see 7 CFR 1710.251(c)); (ii) Renewable energy systems and RUS-approved programs of demand side management and energy conservation; and (iii) As determined by...

Demand-side management glossary

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Demand-side management glossary. Final report

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

PubMed

Reed, Shelby D; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L; Bowers, Margaret T; Samsa, Gregory P; Paul, Sara; Schulman, Kevin A; Whellan, David J; Riegel, Barbara J

2012-01-01

Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.

[The role of supply-side characteristics of services in AIDS mortality in Mexico].

PubMed

Bautista-Arredondo, Sergio; Serván-Mori, Edson; Silverman-Retana, Omar; Contreras-Loya, David; Romero-Martínez, Martín; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Lozano, Rafael

2015-01-01

To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

Demand-Side Management and Integrated Resource Planning: Findings from a Survey of 24 Electric Utilities

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

Schweitzer, M.

1991-01-01

Integrated resource planning differs from traditional utility planning practices primarily in its increased attention to demand-side management (DSM) programs and its integration of supply- and demand-side resources into a combined resource portfolio. This report details the findings from an Oak Ridge National Laboratory (ORNL) survey of 24 electric utilities that have well-developed integrated planning processes. These utilities account for roughly one-third of total capacity, electricity generation, and DSM-program expenditures nationwide. The ORNL survey was designed to obtain descriptive data on a national sample of utilities and to test a number of hypothesized relationships between selected utility characteristics and the mixmore » of resources selected for the integrated plan, with an emphasis on the use of DSM resources and the processes by which they are chosen. The survey solicited information on each utility's current and projected resource mix, operating environment, procedures used to screen potential DSM resources, techniques used to obtain public input and to integrate supply- and demand-side options into a unified plan, and procedures used in the final selection of resources for the plan.« less

Introduction of the TEAM-HF Costing Tool: A User-Friendly Spreadsheet Program to Estimate Costs of Providing Patient-Centered Interventions

PubMed Central

Reed, Shelby D.; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L.; Bowers, Margaret T.; Samsa, Gregory P.; Paul, Sara; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara J.

2011-01-01

Background Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Methods and Results Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers or health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. Conclusions The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions. PMID:22147884

ASPEN--A Web-Based Application for Managing Student Server Accounts

ERIC Educational Resources Information Center

Sandvig, J. Christopher

2004-01-01

The growth of the Internet has greatly increased the demand for server-side programming courses at colleges and universities. Students enrolled in such courses must be provided with server-based accounts that support the technologies that they are learning. The process of creating, managing and removing large numbers of student server accounts is…

The past, present, and future of U.S. utility demand-side management programs

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

Eto, J.

Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in responsemore » to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.« less

The impact of an empowering Internet-based Breast Cancer Patient Pathway program on breast cancer patients' clinical outcomes: a randomised controlled trial.

PubMed

Ryhänen, Anne M; Rankinen, Sirkku; Siekkinen, Mervi; Saarinen, Maiju; Korvenranta, Heikki; Leino-Kilpi, Helena

2013-04-01

To evaluate the effect of the Breast Cancer Patient Pathway program on breast cancer patient's empowerment process. The results of earlier studies indicate that the use of tailored Internet-based patient education programs increased patient's knowledge level; however, other outcome measures differed. This randomised control trial studied the effect of the Internet-based patient educational program on breast cancer patients' empowerment. In this study, we measured the quality of life, anxiety and managing with treatment-related side effects as the outcomes of breast cancer patients' empowering process. Breast cancer patients who were Internet users in one Finnish university hospital during 2008-2010 were randomised to the control group (n=43) and the intervention group (n=47). Baseline data were collected first in the hospital and the following data seven times during the treatment process, the last time one year after breast cancer diagnosis. There were no statistically significant differences in the quality of life, anxiety or side effects of treatment between the groups. The amount of treatment-related side effects was connected to both physical and psychological well-being. In this study, the Breast Cancer Patient Pathway program did not decrease anxiety level or treatment-related side effects among breast cancer patients or improve subscales of quality of life when compared with controls. There is a need to relieve the side effects caused by patients' care with the help of patient education. Internet-based patient education programs need more focus when developing new patient education methods. © 2013 Blackwell Publishing Ltd.

Communicating across the Curriculum in an Undergraduate Business Program: Management 100--Leadership and Communication in Groups

ERIC Educational Resources Information Center

Tuleja, Elizabeth A.; Greenhalgh, Anne M.

2008-01-01

Educating undergraduate business students in the 21st century requires more than addressing the quantitative side of business; rather, it calls for including the more qualitative "soft skills," such as speaking and writing. This article examines the design, delivery, and effectiveness of an undergraduate program dedicated to leadership,…

[Therapeutic education in oncology: involving patient in the management of cancer].

PubMed

Pérol, David; Toutenu, Pauline; Lefranc, Anne; Régnier, Véronique; Chvetzoff, Gisèle; Saltel, Pierre; Chauvin, Franck

2007-03-01

The notion of therapeutic education was only recently introduced in cancer. Although the term is commonly used, no standard definition exists for the concept and principles of therapeutic education and its efficacy remains to be assessed. Therapeutic education is complementary to the healthcare approach and aims to get the patients more involved in their disease and the treatment decision-making process. This discipline, placed at the interface of human and social sciences, was first developed for the management of chronic diseases (diabetes, asthma). It derives from the principle that involving patients in their own care and management can help them better adjust to life with a chronic disease. The lengthening survival time of cancer patients, which contributes to making cancer a chronic disease, as well as changes in the patient-caregiver relationship contribute to the development of therapeutic education in cancer. Pilot studies, conducted principally in the United States, evaluating the side effects of chemotherapy and the management of pain, have demonstrated that such educational programs could improve patient quality of life and decrease the side effects of treatments. The success of these programs depends on several parameters: taking into account patient's opinion in the elaboration and preparation of the programs; involving skilled multidisciplinary teams engaged in iterative educational actions; having recourse to methodological tools to evaluate the impact of implemented programs. Consistent with the World Health Organization guidelines, research should be conducted in France in order to elaborate and implement cancer-specific education programs and evaluate their potential benefit. Patient education programs on pain, fatigue, nutrition and treatment compliance are currently being developed at Saint-Etienne Regional Resource Centre for cancer information, prevention and education, within the framework of the Canceropole Lyon Auvergne Rhône-Alpes.

City of San Antonio, Texas Better Buildings Program

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

Meyer, Liza C.; Hammer, Mary C.

2014-06-30

The San Antonio Better Buildings Program is a unified single-point-of-service energy efficiency delivery mechanism targeting residential, commercial, institutional, industrial and public buildings. This comprehensive and replicable energy efficiency program is designed to be an effective demand side management initiative to provide a seamless process for program participants to have turn-key access to expert analysis, support and incentives to improve the performance of their in-place energy using systems, while reducing electrical energy use and demand.

NASA Hydrogen Research at Florida Universities, Program Year 2003

NASA Technical Reports Server (NTRS)

Block, David L.; Raissi, Ali

2006-01-01

This document presents the final report for the NASA Hydrogen Research at Florida Universities project for program year 2003. This multiyear hydrogen research program has positioned Florida to become a major player in future NASA space and space launch projects. The program is funded by grants from NASA Glenn Research Center with the objective of supporting NASA's hydrogen-related space, space launch and aeronautical research activities. The program conducts over 40 individual projects covering the areas of cryogenics, storage, production, sensors, fuel cells, power and education. At the agency side, this program is managed by NASA Glenn Research Center and at the university side, co-managed by FSEC and the University of Florida with research being conducted by FSEC and seven Florida universities: Florida International University, Florida State University, Florida A&M University, University of Central Florida, University of South Florida, University of West Florida and University of Florida. For detailed information, see the documents section of www.hydrogenresearch.org. This program has teamed these universities with the nation's premier space research center, NASA Glenn, and the nation's premier space launch facility, NASA Kennedy Space Center. It should be noted that the NASA Hydrogen Research at Florida Universities program has provided a shining example and a conduit for seven Florida universities within the SUS to work collaboratively to address a major problem of national interest, hydrogen energy and the future of energy supply in the U.S.

Sexual Assault: The Dark Side of Military Hypermasculinity

DTIC Science & Technology

2016-02-16

carter- telling-military-open-all-combat-jobs- women /76720656/. 41. DMDC Human Resources Strategic Assessment Program, “2012 Workplace and...equal opportunity education and training programs and increased more combat roles to women . To provide additional oversight and management of sexual...desire for women , a perceived existential threat or challenge to one’s manhood, and the endorsement and validation of stereotypical military

CHECKPOINT INHIBITOR IMMUNE THERAPY: Systemic Indications and Ophthalmic Side Effects.

PubMed

Dalvin, Lauren A; Shields, Carol L; Orloff, Marlana; Sato, Takami; Shields, Jerry A

2018-06-01

To review immune checkpoint inhibitor indications and ophthalmic side effects. A literature review was performed using a PubMed search for publications between 1990 and 2017. Immune checkpoint inhibitors are designed to treat system malignancies by targeting one of three ligands, leading to T-cell activation for attack against malignant cells. These ligands (and targeted drug) include cytotoxic T-lymphocyte antigen-4 (CTLA-4, ipilimumab), programmed death protein 1 (PD-1, pembrolizumab, nivolumab), and programmed death ligand-1 (PD-L1, atezolizumab, avelumab, durvalumab). These medications upregulate the immune system and cause autoimmune-like side effects. Ophthalmic side effects most frequently manifest as uveitis (1%) and dry eye (1-24%). Other side effects include myasthenia gravis (n = 19 reports), inflammatory orbitopathy (n = 11), keratitis (n = 3), cranial nerve palsy (n = 3), optic neuropathy (n = 2), serous retinal detachment (n = 2), extraocular muscle myopathy (n = 1), atypical chorioretinal lesions (n = 1), immune retinopathy (n = 1), and neuroretinitis (n = 1). Most inflammatory side effects are managed with topical or periocular corticosteroids, but advanced cases require systemic corticosteroids and cessation of checkpoint inhibitor therapy. Checkpoint inhibitors enhance the immune system by releasing inhibition on T cells, with risk of autoimmune-like side effects. Ophthalmologists should include immune-related adverse events in their differential when examining cancer patients with new ocular symptoms.

Symptom management strategies for men with early-stage prostate cancer: results from the Prostate Cancer Patient Education Program (PC PEP).

PubMed

Vij, Alok; Kowalkowski, Marc A; Hart, Tae; Goltz, Heather Honoré; Hoffman, David J; Knight, Sara J; Caroll, Peter R; Latini, David M

2013-12-01

While the literature on prostate cancer health-related quality of life has grown extensively, little is known about symptom management strategies used by men to manage treatment-related side effects and the effectiveness of those strategies. We collected 628 symptom management reports from 98 men treated for localized prostate cancer. Participants were recruited from email lists and a prostate cancer clinic in Northern California. Data were collected using the Critical Incident Technique. Symptom management reports were assigned to categories of urinary, sexual, bowel, mental health, systemic, or "other." We calculated descriptive statistics by symptom type and management strategy effectiveness. The most common symptoms were urinary (26 %) and sexual (23 %). Participants' symptom management strategies varied widely, from medical and surgical interventions (20 %) to behavioral strategies (11 %) to diet and lifestyle interventions (12 %). The effectiveness of symptom management strategies varied, with sexual symptoms being managed effectively only 47 % of the time to mental health symptom management strategies considered effective 89 % of the time. Doing nothing was a commonly reported (15 %) response to symptoms and was effective only 14 % of the time. Men report the least effectiveness in symptom management for sexual dysfunction after prostate cancer treatment. Including men's experience with managing treatment side effects may be an important way to improve survivorship programs and make them more acceptable to men. More work is needed to find out why men frequently do nothing in response to symptoms when effective solutions exist and how providers can successfully engage such men.

Symptom Management Strategies for Men with Early-Stage Prostate Cancer: Results from the Prostate Cancer Patient Education Program (PCPEP)

PubMed Central

Vij, Alok; Kowalkowski, Marc A.; Hart, Tae; Goltz, Heather Honoré; Hoffman, David J.; Knight, Sara J.; Caroll, Peter R.

2013-01-01

While the literature on prostate cancer health-related quality of life has grown extensively, little is known about symptom management strategies used by men to manage treatment-related side effects and the effectiveness of those strategies. We collected 628 symptom management reports from 98 men treated for localized prostate cancer. Participants were recruited from email lists and a prostate cancer clinic in Northern California. Data were collected using the Critical Incident Technique. Symptom management reports were assigned to categories of urinary, sexual, bowel, mental health, systemic, or “other.” We calculated descriptive statistics by symptom type and management strategy effectiveness. The most common symptoms were urinary (26 %) and sexual (23 %). Participants’ symptom management strategies varied widely, from medical and surgical interventions (20 %) to behavioral strategies (11 %) to diet and lifestyle interventions (12 %). The effectiveness of symptom management strategies varied, with sexual symptoms being managed effectively only 47 % of the time to mental health symptom management strategies considered effective 89 % of the time. Doing nothing was a commonly reported (15 %) response to symptoms and was effective only 14 % of the time. Men report the least effectiveness in symptom management for sexual dysfunction after prostate cancer treatment. Including men’s experience with managing treatment side effects may be an important way to improve survivorship programs and make them more acceptable to men. More work is needed to find out why men frequently do nothing in response to symptoms when effective solutions exist and how providers can successfully engage such men. PMID:23996206

Modeling and Analysis of Commercial Building Electrical Loads for Demand Side Management

NASA Astrophysics Data System (ADS)

Berardino, Jonathan

In recent years there has been a push in the electric power industry for more customer involvement in the electricity markets. Traditionally the end user has played a passive role in the planning and operation of the power grid. However, many energy markets have begun opening up opportunities to consumers who wish to commit a certain amount of their electrical load under various demand side management programs. The potential benefits of more demand participation include reduced operating costs and new revenue opportunities for the consumer, as well as more reliable and secure operations for the utilities. The management of these load resources creates challenges and opportunities to the end user that were not present in previous market structures. This work examines the behavior of commercial-type building electrical loads and their capacity for supporting demand side management actions. This work is motivated by the need for accurate and dynamic tools to aid in the advancement of demand side operations. A dynamic load model is proposed for capturing the response of controllable building loads. Building-specific load forecasting techniques are developed, with particular focus paid to the integration of building management system (BMS) information. These approaches are tested using Drexel University building data. The application of building-specific load forecasts and dynamic load modeling to the optimal scheduling of multi-building systems in the energy market is proposed. Sources of potential load uncertainty are introduced in the proposed energy management problem formulation in order to investigate the impact on the resulting load schedule.

Cutaneous, gastrointestinal, hepatic, endocrine, and renal side-effects of anti-PD-1 therapy.

PubMed

Hofmann, Lars; Forschner, Andrea; Loquai, Carmen; Goldinger, Simone M; Zimmer, Lisa; Ugurel, Selma; Schmidgen, Maria I; Gutzmer, Ralf; Utikal, Jochen S; Göppner, Daniela; Hassel, Jessica C; Meier, Friedegund; Tietze, Julia K; Thomas, Ioannis; Weishaupt, Carsten; Leverkus, Martin; Wahl, Renate; Dietrich, Ursula; Garbe, Claus; Kirchberger, Michael C; Eigentler, Thomas; Berking, Carola; Gesierich, Anja; Krackhardt, Angela M; Schadendorf, Dirk; Schuler, Gerold; Dummer, Reinhard; Heinzerling, Lucie M

2016-06-01

Anti-programmed cell death receptor-1 (PD-1) antibodies represent an effective treatment option for metastatic melanoma as well as for other cancer entities. They act via blockade of the PD-1 receptor, an inhibitor of the T-cell effector mechanisms that limit immune responses against tumours. As reported for ipilimumab, the anti-PD-1 antibodies pembrolizumab and nivolumab can induce immune-related adverse events (irAEs). These side-effects affect skin, gastrointestinal tract, liver, endocrine system and other organ systems. Since life-threatening and fatal irAEs have been reported, adequate diagnosis and management are essential. In total, 496 patients with metastatic melanoma from 15 skin cancer centers were treated with pembrolizumab or nivolumab; 242 side-effects were described in 138 patients. In 116 of the 138 patients, side-effects affected the skin, gastrointestinal tract, liver, endocrine, and renal system. Rare side-effects included diabetes mellitus, lichen planus, and pancreas insufficiency due to pancreatitis. Anti-PD1 antibodies can induce a plethora of irAEs. The knowledge of them will allow prompt diagnosis and improve the management resulting in decreased morbidity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Beaver Colony Density Trends on the Chequamegon-Nicolet National Forest, 1987 – 2013

PubMed Central

Ribic, Christine A.; Donner, Deahn M.; Beck, Albert J.; Reinecke, Sue; Eklund, Dan

2017-01-01

The North American beaver (Castor canadensis) is a managed species in the United States. In northern Wisconsin, as part of the state-wide beaver management program, the Chequamegon-Nicolet National Forest removes beavers from targeted trout streams on U.S. Forest Service lands. However, the success of this management program has not been evaluated. Targeted removals comprise only 3% of the annual beaver harvest, a level of effort that may not affect the beaver population. We used colony location data along Forest streams from 1987–2013 (Nicolet, northeast Wisconsin) and 1997–2013 (Chequamegon, northwest Wisconsin) to assess trends in beaver colony density on targeted trout streams compared to non-targeted streams. On the Chequamegon, colony density on non-targeted trout and non-trout streams did not change over time, while colony density on targeted trout streams declined and then stabilized. On the Nicolet, beaver colony density decreased on both non-targeted streams and targeted trout streams. However, colony density on targeted trout streams declined faster. The impact of targeted trapping was similar across the two sides of the Forest (60% reduction relative to non-targeted trout streams). Exploratory analyses of weather influences found that very dry conditions and severe winters were associated with transient reductions in beaver colony density on non-targeted streams on both sides of the Forest. Our findings may help land management agencies weigh more finely calibrated beaver control measures against continued large-scale removal programs. PMID:28081271

Beaver Colony Density Trends on the Chequamegon-Nicolet National Forest, 1987 - 2013.

PubMed

Ribic, Christine A; Donner, Deahn M; Beck, Albert J; Rugg, David J; Reinecke, Sue; Eklund, Dan

2017-01-01

The North American beaver (Castor canadensis) is a managed species in the United States. In northern Wisconsin, as part of the state-wide beaver management program, the Chequamegon-Nicolet National Forest removes beavers from targeted trout streams on U.S. Forest Service lands. However, the success of this management program has not been evaluated. Targeted removals comprise only 3% of the annual beaver harvest, a level of effort that may not affect the beaver population. We used colony location data along Forest streams from 1987-2013 (Nicolet, northeast Wisconsin) and 1997-2013 (Chequamegon, northwest Wisconsin) to assess trends in beaver colony density on targeted trout streams compared to non-targeted streams. On the Chequamegon, colony density on non-targeted trout and non-trout streams did not change over time, while colony density on targeted trout streams declined and then stabilized. On the Nicolet, beaver colony density decreased on both non-targeted streams and targeted trout streams. However, colony density on targeted trout streams declined faster. The impact of targeted trapping was similar across the two sides of the Forest (60% reduction relative to non-targeted trout streams). Exploratory analyses of weather influences found that very dry conditions and severe winters were associated with transient reductions in beaver colony density on non-targeted streams on both sides of the Forest. Our findings may help land management agencies weigh more finely calibrated beaver control measures against continued large-scale removal programs.

Beaver colony density trends on the Chequamegon-Nicolet National Forest, 1987 – 2013

USGS Publications Warehouse

Ribic, Christine; Donner, Deahn M.; Beck, Albert J.; Rugg, David J.; Reinecke, Sue; Eklund, Dan

2017-01-01

The North American beaver (Castor canadensis) is a managed species in the United States. In northern Wisconsin, as part of the state-wide beaver management program, the Chequamegon-Nicolet National Forest removes beavers from targeted trout streams on U.S. Forest Service lands. However, the success of this management program has not been evaluated. Targeted removals comprise only 3% of the annual beaver harvest, a level of effort that may not affect the beaver population. We used colony location data along Forest streams from 1987–2013 (Nicolet, northeast Wisconsin) and 1997–2013 (Chequamegon, northwest Wisconsin) to assess trends in beaver colony density on targeted trout streams compared to non-targeted streams. On the Chequamegon, colony density on non-targeted trout and non-trout streams did not change over time, while colony density on targeted trout streams declined and then stabilized. On the Nicolet, beaver colony density decreased on both non-targeted streams and targeted trout streams. However, colony density on targeted trout streams declined faster. The impact of targeted trapping was similar across the two sides of the Forest (60% reduction relative to non-targeted trout streams). Exploratory analyses of weather influences found that very dry conditions and severe winters were associated with transient reductions in beaver colony density on non-targeted streams on both sides of the Forest. Our findings may help land management agencies weigh more finely calibrated beaver control measures against continued large-scale removal programs.

Aquatic Plant Control Research Program. Large-Scale Operations Management Test (LSOMT) of Insects and Pathogens for Control of Waterhyacinth in Louisiana. Volume 1. Results for 1979-1981.

DTIC Science & Technology

1985-01-01

RD-Ai56 759 AQUATIC PLANT CONTROL RESEARCH PROGRAM LARGE-SCALE 1/2 OPERATIONS MRNAGEMENT..(U) ARMY ENGINEER WATERAYS EXPERIMENT STATION VICKSBURG MS...PO Box 631, Vicksburg, Aquatic Plant Control Mississippi 39180-0631 and University of Research Program Tennessee-Chattanooga, Chattanooga, 12...19. KEY WORDS (Continue on reverse side if necesary nd identify by block number) - Aquatic plant control Louisiana Biological control Plant

Taking Risk Assessment and Management to the Next Level: Program-Level Risk Analysis to Enable Solid Decision-Making on Priorities and Funding

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

Nelson, J. G.; Morton, R. L.; Castillo, C.

2011-02-01

A multi-level (facility and programmatic) risk assessment was conducted for the facilities in the Nevada National Security Site (NNSS) Readiness in Technical Base and Facilities (RTBF) Program and results were included in a new Risk Management Plan (RMP), which was incorporated into the fiscal year (FY) 2010 Integrated Plans. Risks, risk events, probability, consequence(s), and mitigation strategies were identified and captured, for most scope areas (i.e., risk categories) during the facilitated risk workshops. Risk mitigations (i.e., efforts in addition to existing controls) were identified during the facilitated risk workshops when the risk event was identified. Risk mitigation strategies fell intomore » two broad categories: threats or opportunities. Improvement projects were identified and linked to specific risks they mitigate, making the connection of risk reduction through investments for the annual Site Execution Plan. Due to the amount of that was collected, analysis to be performed, and reports to be generated, a Risk Assessment/ Management Tool (RAMtool) database was developed to analyze the risks in real-time, at multiple levels, which reinforced the site-level risk management process and procedures. The RAMtool database was developed and designed to assist in the capturing and analysis of the key elements of risk: probability, consequence, and impact. The RAMtool calculates the facility-level and programmatic-level risk factors to enable a side-by-side comparison to see where the facility manager and program manager should focus their risk reduction efforts and funding. This enables them to make solid decisions on priorities and funding to maximize the risk reduction. A more active risk management process was developed where risks and opportunities are actively managed, monitored, and controlled by each facility more aggressively and frequently. risk owners have the responsibility and accountability to manage their assigned risk in real-time, using the RAMtool database.« less

75 FR 32936 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

.... Applicants: New York Independent System Operator, Inc. Description: NYISO filing its Semi-Annual Reports on Demand Side Management programs and new generation projects in the New York Control Area. Filed Date: 06... Applicant. In reference to filings initiating a new proceeding, interventions or protests submitted on or...

A case series of patients using medicinal marihuana for management of chronic pain under the Canadian Marihuana Medical Access Regulations.

PubMed

Lynch, Mary E; Young, Judee; Clark, Alexander J

2006-11-01

The Canadian Marihuana Medical Access Regulations (MMAR) program allows Health Canada to grant access to marihuana for medical use to those who are suffering from grave and debilitating illnesses. This is a report on a case series of 30 patients followed at a tertiary care pain management center in Nova Scotia who have used medicinal marihuana for 1-5 years under the MMAR program. Patients completed a follow-up questionnaire containing demographic and dosing information, a series of 11-point numerical symptom relief rating scales, a side effect checklist, and a subjective measure of improvement in function. Doses of marihuana ranged from less than 1 to 5g per day via the smoked or oral route of administration. Ninety-three percent of patients reported moderate or greater pain relief. Side effects were reported by 76% of patients, the most common of which were increased appetite and a sense of well-being, weight gain, and slowed thoughts. Limitations of the study include self-selection bias, small size, and lack of a control group. The need for further study using controlled trials is discussed along with an overview of the MMAR program.

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2014 CFR

2014-01-01

... maturities for loans for the implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS... finance working capital required for the initial operation of a new system are a separate class of loans...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2012 CFR

2012-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

South Texas Maquiladora Suppliers Project.

ERIC Educational Resources Information Center

Patrick, J. Michael

This project was undertaken to assist South Texas industries in improving export to nearby Mexican maquiladoras (factories). The maquiladora program is based on co-production by two plants under a single management, one on each side of the border. Activities addressed four objectives: (1) to determine the dollar value, quantity, and source of the…

Concurrent Group Treatment for Hepatitis C: Implementation and Outcomes in a Methadone Maintenance Treatment Program

PubMed Central

Stein, Melissa R.; Soloway, Irene J.; Jefferson, Karen S.; Roose, Robert J.; Arnsten, Julia H.; Litwin, Alain H.

2012-01-01

Chronic hepatitis C virus (HCV) infection is highly prevalent among current and former drug users. However, the minority of patients enrolled in drug treatment programs have initiated HCV treatment. New models are needed to overcome barriers to care. In this retrospective study, we describe the implementation and outcomes of 42 patients treated in a Concurrent Group Treatment (CGT) program. Patients participated in weekly provider-led group treatment sessions which included review of side effects; discussion of adherence and side effect management; administration of interferon injections; brief physical exam; and ended with brief meditation. Of the first 27 patients who initiated CGT, 42% achieved a sustained viral response. Additionally, 87% (13/15) of genotype-1 infected patients treated with direct acting antiviral agent achieved an undetectable viral load at 24 weeks. The CGT model may be effective in overcoming barriers to treatment and improving adherence and outcomes among patients enrolled in drug treatment programs. PMID:23036920

Is Diversion with Ileostomy Non-inferior to Hartmann Resection for Left-sided Colorectal Anastomotic Leak?

PubMed

Stafford, Caitlin; Francone, Todd D; Marcello, Peter W; Roberts, Patricia L; Ricciardi, Rocco

2018-03-01

Treatment of left-sided colorectal anastomotic leaks often requires fecal stream diversion for prevention of further septic complications. To manage anastomotic leak, it is unclear if diverting ileostomy provides similar outcomes to Hartmann resection with colostomy. We identified all patients who developed anastomotic leak following left-sided colorectal resections from 1/2012 through 12/2014 using the American College of Surgeons National Surgical Quality Improvement Program. Then, we examined the risk of mortality and abdominal reoperation in patients treated with diverting ileostomy as compared to Hartmann resection. There were 1745 patients who experienced an anastomotic leak in a cohort of 63,748 patients (3.7%). Two hundred thirty-five patients had a reoperation for anastomotic leak involving the formation of a diverting ileostomy (n = 77) or Hartmann resection (n = 158). There was no difference in mortality or abdominal reoperation in patients treated with diverting ileostomy (3.9, 7.8%) versus Hartmann resection (3.8, 6.3%) (p = 0.8). There was no difference in the outcomes of mortality or need for second abdominal reoperation in patients treated with diverting ileostomy as compared to Hartmann resection for left-sided colorectal anastomotic leak. Thus, select patients with left-sided colorectal anastomotic leaks may be safely managed with diverting ileostomy.

Inexact nonlinear improved fuzzy chance-constrained programming model for irrigation water management under uncertainty

NASA Astrophysics Data System (ADS)

Zhang, Chenglong; Zhang, Fan; Guo, Shanshan; Liu, Xiao; Guo, Ping

2018-01-01

An inexact nonlinear mλ-measure fuzzy chance-constrained programming (INMFCCP) model is developed for irrigation water allocation under uncertainty. Techniques of inexact quadratic programming (IQP), mλ-measure, and fuzzy chance-constrained programming (FCCP) are integrated into a general optimization framework. The INMFCCP model can deal with not only nonlinearities in the objective function, but also uncertainties presented as discrete intervals in the objective function, variables and left-hand side constraints and fuzziness in the right-hand side constraints. Moreover, this model improves upon the conventional fuzzy chance-constrained programming by introducing a linear combination of possibility measure and necessity measure with varying preference parameters. To demonstrate its applicability, the model is then applied to a case study in the middle reaches of Heihe River Basin, northwest China. An interval regression analysis method is used to obtain interval crop water production functions in the whole growth period under uncertainty. Therefore, more flexible solutions can be generated for optimal irrigation water allocation. The variation of results can be examined by giving different confidence levels and preference parameters. Besides, it can reflect interrelationships among system benefits, preference parameters, confidence levels and the corresponding risk levels. Comparison between interval crop water production functions and deterministic ones based on the developed INMFCCP model indicates that the former is capable of reflecting more complexities and uncertainties in practical application. These results can provide more reliable scientific basis for supporting irrigation water management in arid areas.

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2012 CFR

2012-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2013 CFR

2013-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2011 CFR

2011-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

Three empirical essays on energy and labor economics

NASA Astrophysics Data System (ADS)

Chow, Melissa

This dissertation analyzes the differences between private and non-private firms in two contexts. Chapters 1 and 2 examine the electricity industry in the United States and the motivation behind electric utilities' usage of demand side management programs. The first chapter focuses on load management programs, which decrease electricity demand during the peak hours of the day. It looks into the impact of a plausibly exogenous decrease in natural gas prices on the utilization and capacity of these programs. The second chapter analyzes the relationship between electricity market deregulation and electric utilities' energy efficiency activity. The third chapter investigates the impact of Chinese enterprise restructuring on employment, wage bills, and productivity. All three chapters show that different objectives due to ownership type lead to differences in firm behavior.

Puerto Rico Seismic Network Operations During and After the Hurricane Maria: Response, Continuity of Operations, and Experiences

NASA Astrophysics Data System (ADS)

Vanacore, E. A.; Baez-Sanchez, G.; Huerfano, V.; Lopez, A. M.; Lugo, J.

2017-12-01

The Puerto Rico Seismic Network (PRSN) is an integral part of earthquake and tsunami monitoring in Puerto Rico and the Virgin Islands. The PRSN conducts scientific research as part of the University of Puerto Rico Mayaguez, conducts the earthquake monitoring for the region, runs extensive earthquake and tsunami education and outreach programs, and acts as a Tsunami Warning Focal Point Alternate for Puerto Rico. During and in the immediate aftermath of Hurricane Maria, the PRSN duties and responsibilities evolved from a seismic network to a major information and communications center for the western side of Puerto Rico. Hurricane Maria effectively destroyed most communications on island, critically between the eastern side of the island where Puerto Rico's Emergency Management's (PREMA) main office and the National Weather Service (NWS) is based and the western side of the island. Additionally, many local emergency management agencies on the western side of the island lost a satellite based emergency management information system called EMWIN which provides critical tsunami and weather information. PRSN's EMWIN system remained functional and consequently via this system and radio communications PRSN became the only information source for NWS warnings and bulletins, tsunami alerts, and earthquake information for western Puerto Rico. Additionally, given the functional radio and geographic location of the PRSN, the network became a critical communications relay for local emergency management. Here we will present the PRSN response in relation to Hurricane Maria including the activation of the PRSN devolution plan, adoption of duties, experiences and lessons learned for continuity of operations and adoption of responsibilities during future catastrophic events.

Optimal Multi-scale Demand-side Management for Continuous Power-Intensive Processes

NASA Astrophysics Data System (ADS)

Mitra, Sumit

With the advent of deregulation in electricity markets and an increasing share of intermittent power generation sources, the profitability of industrial consumers that operate power-intensive processes has become directly linked to the variability in energy prices. Thus, for industrial consumers that are able to adjust to the fluctuations, time-sensitive electricity prices (as part of so-called Demand-Side Management (DSM) in the smart grid) offer potential economical incentives. In this thesis, we introduce optimization models and decomposition strategies for the multi-scale Demand-Side Management of continuous power-intensive processes. On an operational level, we derive a mode formulation for scheduling under time-sensitive electricity prices. The formulation is applied to air separation plants and cement plants to minimize the operating cost. We also describe how a mode formulation can be used for industrial combined heat and power plants that are co-located at integrated chemical sites to increase operating profit by adjusting their steam and electricity production according to their inherent flexibility. Furthermore, a robust optimization formulation is developed to address the uncertainty in electricity prices by accounting for correlations and multiple ranges in the realization of the random variables. On a strategic level, we introduce a multi-scale model that provides an understanding of the value of flexibility of the current plant configuration and the value of additional flexibility in terms of retrofits for Demand-Side Management under product demand uncertainty. The integration of multiple time scales leads to large-scale two-stage stochastic programming problems, for which we need to apply decomposition strategies in order to obtain a good solution within a reasonable amount of time. Hence, we describe two decomposition schemes that can be applied to solve two-stage stochastic programming problems: First, a hybrid bi-level decomposition scheme with novel Lagrangean-type and subset-type cuts to strengthen the relaxation. Second, an enhanced cross-decomposition scheme that integrates Benders decomposition and Lagrangean decomposition on a scenario basis. To demonstrate the effectiveness of our developed methodology, we provide several industrial case studies throughout the thesis.

Windtunnel Capability Related to Test Sections, Cryogenics, and Computer-Windtunnel Integration.

DTIC Science & Technology

1982-04-01

initiate a career in one of the areas. Research and development managers are urged to act upon such conveners’ findings as: windtunnel flow quality and...mainly to those concerned with managing the various aspects of the ETW Cryogenic Technology Program. The meetings on each side of the Atlantic were not...containing 1.8 percent silver, 570-28R, did not exhibit this tendency. Therefore, 570-28R, marketed by Mirco-Measurements was selected for cryogenic balance

Summer Faculty Research Program (SFRP) (1992). Volume 1. Program Management Report.

DTIC Science & Technology

1992-12-01

the side of the 1.5 meter telescope. The receiver has two optical channels and the lidar can be configured either as a two- color system or as long...using a coordinate measuring machine (CMM) was employed. The part and mold thickness data were computed and plotted in the form of color contours for ease...using wavelets is developed based on the principle of scattering centers. The adopted target representation is based on the colored bright spots approach

A town conserves

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

Thomas, S.

1993-07-15

With encouragement from a TV personality, a Wisconsin town saves energy. This article describes how a TV program host mediated between Northern States Power, local businesses, and the people of a Wisconsin town for a demand side management program demonstration of the Wisconsin Public Service Commission. The key to acceptance and use of the program was public education of consumers, combined with making available experts who could answer questions on product availability and installation. The demonstration project is designed to show that the least expensive means to achieve energy efficiency for the customer is to foster a sense of communitymore » ownership of the program.« less

Advanced Aircraft Interfaces: The Machine Side of the Man-Machine Interface (Les Interfaces sur les Avions de Pointe: L’Aspect Machine de l’Interface Homme-Machine)

DTIC Science & Technology

1992-10-01

Manager , Advanced Transport Operating Systems Program Office Langley Research Center Mail Stop 265 Hampton, VA 23665-5225 United States Programme Committee...J.H.Lind, and C.G.Burge Advanced Cockpit - Mission and Image Management 4 by J. Struck Aircrew Acceptance of Automation in the Cockpit 5 by M. Hicks and I...DESIGN CONCEPTS AND TOOLS A Systems Approach to the Advanced Aircraft Man-Machine Interface 23 by F. Armogida Management of Avionics Data in the Cockpit

An Internal, Demand-Side Approach Toward Implementing Strategic Sourcing: Political, Legal, and Economic Considerations

DTIC Science & Technology

2013-04-01

Architecture, DASN (RDT&E)  Program Executive Officer, Littoral Combat Ships James B. Greene Jr. Keith F. Snider, PhD Rear Admiral, U.S. Navy (Ret...Personnel Management. Andreski, S. (1994). Max Weber’s insights and errors. London, UK: Routledge & Kegan Paul. Chan, T. C. T., & Chin, K. S. (2007

77 FR 34215 - Special Local Regulations for Marine Events, Swim Event; Lake Gaston, Littleton, NC

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... material to the docket, call Renee V. Wright, Program Manager, Docket Operations, telephone (202) 366-9826... along the western side of Eaton Ferry Bridge to the Waterview Restaurant. A fleet of spectator vessels... operation of any support vessel participating in the event, at any time it is deemed necessary for the...

Joint Solutions to Substance Abuse: Public Sector Employee Assistance Programs.

ERIC Educational Resources Information Center

State and Local Government Labor-Management Committee, Washington, DC.

This short booklet is a joint expression by public sector labor and management that recognizes that neither side has all the answers to the problems of employee substance abuse and that both share a common concern for a successful outcome. The booklet summarizes the dimension of substance abuse in today's workplace; and it tries to encourage…

Clinical SAS programming in India: A study of industry needs versus wants.

PubMed

Ananthakrishnan, Nithiyanandhan

2014-07-01

The clinical SAS (www.sas.com) programming industry, in India, has seen a rapid growth in the last decade and the trend seems set to continue, for the next couple of years, due to cost advantage and the availability of skilled labor. On one side the industry needs are focused on less execution time, high margins, segmented tasks and the delivery of high quality output with minimal oversight. On the other side, due to the increased demand for skilled resources, the wants of the programmers have taken a different shift toward diversifying exposure, unsustainable wage inflation due to multiple opportunities and generally high expectations around career progression. If the industry needs are not going to match with programmers want, or vice versa, then there is the possibility that the current year on year growth may start to slow or even go into decline. This paper is intended to identify the gap between wants and need and puts forwards some suggestions, for both sides, in ways to change the equation to benefit all. Questionnaire on similar themes created to survey managers and programmers working in clinical SAS programming industry and was surveyed online to collect their perspectives. Their views are compared for each theme and presented as results. Two surveys were created in www.surveymonkey.com. https://www.surveymonkey.com/s/SAS_India_managment_needvswant_survey. Programmer: https://www.surveymonkey.com/s/SAS_India_programmer_needvswant_survey. Bar chart and pie chart used on data collect to show segmentation of data. In conclusion, it seeks to highlight the future industry direction and the skillset that existing programmers need to have, in order to sustain the momentum and remain competitive, to contribute to the future pipeline and the development of the profession in India.

Side Effects (Management)

MedlinePlus

... cancer care is relieving side effects, called symptom management, palliative care, or supportive care. It is important ... treat them. To learn about the symptoms and management of the long-term side effects of cancer ...

Managing Chemotherapy Side Effects: Constipation

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Constipation Take these steps: Eat high-fiber foods ... SERVICES National Institutes of Health Managing Chemotherapy Side Effects: Constipation These foods may help if you are ...

Managing Chemotherapy Side Effects: Pain

MedlinePlus

N ational C ancer I nstitute Managing Chemotherapy Side Effects Pain It’s important to treat pain. If ... help to pay for pain medicine. Managing Chemotherapy Side Effects: Pain Keep track of the pain. Each ...

Managing Chemotherapy Side Effects: Memory Changes

MedlinePlus

... C ancer I nstitute Managing Chemotherapy Side Effects Memory Changes What is causing these changes? Your doctor ... thinking or remembering things Managing Chemotherapy Side Effects: Memory Changes Get help to remember things. Write down ...

Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data

PubMed Central

Mamykina, Lena; Heitkemper, Elizabeth M.; Smaldone, Arlene M.; Kukafka, Rita; Cole-Lewis, Heather J.; Davidson, Patricia G.; Mynatt, Elizabeth D.; Cassells, Andrea; Tobin, Jonathan N.; Hripcsak, George

2017-01-01

Objective To outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. We investigate this question in the context of chronic disease self-management with the focus on type 2 diabetes. Materials and methods We conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). Results The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals’ activities and changes in their blood glucose levels that the participants referred to as “cause and effect”. This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. We show that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, we identify opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). Discussion The study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management strategies, and that self-monitoring data can serve as a driving engine for personal discovery that may lead to sustainable behavior changes. Conclusions Enabling personal discovery is a promising new approach to enhancing chronic disease self-management with informatics interventions. PMID:28974460

Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data.

PubMed

Mamykina, Lena; Heitkemper, Elizabeth M; Smaldone, Arlene M; Kukafka, Rita; Cole-Lewis, Heather J; Davidson, Patricia G; Mynatt, Elizabeth D; Cassells, Andrea; Tobin, Jonathan N; Hripcsak, George

2017-12-01

To outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. We investigate this question in the context of chronic disease self-management with the focus on type 2 diabetes. We conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals' activities and changes in their blood glucose levels that the participants referred to as "cause and effect". This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. We show that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, we identify opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). The study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management strategies, and that self-monitoring data can serve as a driving engine for personal discovery that may lead to sustainable behavior changes. Enabling personal discovery is a promising new approach to enhancing chronic disease self-management with informatics interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical evaluation of compounds targeting PD-1/PD-L1 pathway for cancer immunotherapy.

PubMed

Lu, Jing; Lee-Gabel, Linda; Nadeau, Michelle C; Ferencz, Thomas M; Soefje, Scott A

2015-12-01

Significant enthusiasm currently exists for new immunotherapeutic strategies: blocking the interaction between programmed death-1 receptor on T-cells and programmed death-ligand 1 on tumor cells to boost immune system stimulation to fight cancer. Immunomodulation with the antiprogrammed death-1/programmed death-ligand 1 monoclonal antibodies has shown to mediate tumor shrinkage and extend overall survival from several pivotal phase I/II studies in melanoma, renal cell carcinoma, and non-small cell lung cancer. This has prompted multiple large ongoing phase III trials with the expectation for fast-track FDA approvals to satisfy unmet medical needs. Compounds targeting the programmed death-1 pathway that are in clinical trials fall into two major categories, namely antiprogrammed death-1 antibodies: Nivolumab, MK-3475, and pidilizumab; and antiprogrammed death-ligand 1 antibodies: MPDL3280A, BMS-936559, MEDI4736, and MSB0010718C. We reviewed the clinical efficacy and safety of each compound based upon major registered clinical trials and published clinical data. Overall, response rate of more than 20% is consistently seen across all these trials, with maximal response of approximately 50% achieved by certain single antiprogrammed death-1 agents or when used in combination with cytotoxic T-lymphocyte antigen-4 blockade. The responses seen are early, durable, and have continued after treatment discontinuation. Immune-related adverse events are the most common side effects seen in these clinical trials. Overall, the skin and gastrointestinal tract are the most common organ systems affected by these compounds while hepatic, endocrine, and neurologic events are less frequent. These side effects are low grade, manageable, and typically resolve within a relatively short time frame with a predictable resolution pattern given proper management. We therefore propose detailed guidelines for management of major immune-related adverse events that are anticipated with antiprogrammed death-1/programmed death-ligand 1 therapies based on general experience with other monoclonal antibodies and the established management algorithms for immune-related adverse events for cytotoxic T-lymphocyte antigen-4 blockade with ipilimumab. We anticipate that the antiprogrammed death-1 strategy will become a viable and crucial clinical strategy for cancer therapy. © The Author(s) 2014.

River bar vegetation mowing response in the Middle Rio Grande

Treesearch

Esteban Muldavin; Elizabeth Milford; Yvonne Chauvin

1999-01-01

The Bureau of Reclamation routinely mows vegetation on side bars along the Rio Grande to assist with river flow management. To address the question of how such mowing affects vegetation composition and structure, three bars in the middle Rio Grande near Albuquerque, New Mexico were selected in 1994 for an experimental mowing program. Three 50-foot-wide strips on each...

Managing Chemotherapy Side Effects: Anemia

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Anemia “I told my doctor that I was ... exercise a little every day. Managing Chemotherapy Side Effects: Anemia Eat and drink well. ● ● Talk with your ...

Managing Chemotherapy Side Effects: Skin and Nail Changes

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Skin and Nail Changes “I was glad to ... services national institutes of health Managing Chemotherapy Side Effects: Skin and Nail Changes Protect your skin from ...

Demand-side management: Why ratemaking should`nt control tax policy

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

Haney, J.D.

1995-01-01

As utilities spend money on demand-side management (DSM) programs, they usually deduct their costs currently as ordinary and necessary business expenses. However, state regulators may force deferral of DSM costs for ratemaking purposes, with possible consequences on tax returns. When regulators defer DSM costs, the Internal Revenue Service (IRS) has offered several theories to challenge current tax deductions. One theory requires capitilization instead of a current deduction if regulators include the DSM cost in rate base and provide for a rate of return on the balance. The IRS explained this theory two years ago in a White Paper on conservationmore » expenses: The direct relationship between a rate of return allowed by the Regulator for conservation expenditures allowed in rate base and future profits establishes a prima facie case for capitalization under the future benefit standard. The authors believe that IRS policy should not be linked to ratemaking decisions.« less

Innovative Soft-Sided Waste Packaging System Implementation at a Small Department of Energy Environmental Restoration/Waste Management (ER/WM) Site

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

Wolf, J.

2002-02-28

Weiss Associates (WA) performs a broad range of environmental restoration/waste management (ER/WM) activities for the U.S. Department of Energy (DOE) at the former Laboratory for Energy-Related Health Research (LEHR), University of California, Davis (UC Davis). Over the last three years, the LEHR ER/WM program transitioned from a baseline packaging system of steel, 2.7 cubic meter (3.5-cubic yard) B-25 boxes to a 7.0 cubic meter (9.1-cubic yard) soft-sided container (Lift Liner) system. The transition increased efficiencies in processing, packaging, and storage, and when combined with decreased procurement costs, achieved a $402,000 cost savings (Table I). Additional disposal costs between $128,600 andmore » $182,600 were avoided by minimizing void space. Future cost savings by the end of fiscal year 2003 are projected between $250,640 and $1,003,360.« less

Supporting patients treated for prostate cancer: a video vignette study with an email-based educational program in general practice.

PubMed

Jiwa, Moyez; Halkett, Georgia; Meng, Xingqiong; Pillai, Vinita; Berg, Melissa; Shaw, Tim

2014-02-26

Men who have been treated for prostate cancer in Australia can consult their general practitioner (GP) for advice about symptoms or side effects at any time following treatment. However, there is no evidence that such men are consistently advised by GPs and patients experience substantial unmet need for reassurance and advice. The intent of the study was to evaluate a brief, email-based educational program for GPs to manage standardized patients presenting with symptoms or side effects months or years after prostate cancer treatment. GPs viewed six pairs of video vignettes of actor-patients depicting men who had been treated for prostate cancer. The actor-patients presented problems that were attributable to the treatment of cancer. In Phase 1, GPs indicated their diagnosis and stated if they would prescribe, refer, or order tests based on that diagnosis. These responses were compared to the management decisions for those vignettes as recommended by a team of experts in prostate cancer. After Phase 1, all the GPs were invited to participate in an email-based education program (Spaced Education) focused on prostate cancer. Participants received feedback and could compare their progress and their performance with other participants in the study. In Phase 2, all GPs, regardless of whether they had completed the program, were invited to view another set of six video vignettes with men presenting similar problems to Phase 1. They again offered a diagnosis and stated if they would prescribe, refer, or order tests based on that diagnosis. In total, 64 general practitioners participated in the project, 57 GPs participated in Phase 1, and 45 in Phase 2. The Phase 1 education program was completed by 38 of the 57 (59%) participants. There were no significant differences in demographics between those who completed the program and those who did not. Factors determining whether management of cases was consistent with expert opinion were number of sessions worked per week (OR 0.78, 95% CI 0.67-0.90), site of clinical practice (remote practice, OR 2.25, 95% CI 1.01-5.03), number of patients seen per week (150 patients or more per week, OR 10.66, 95% CI 3.40-33.48), and type of case viewed. Completion of the Spaced Education did impact whether patient management was consistent with expert opinion (not completed, OR 0.88, 95% CI 0.5-1.56). The management of standardized patients by GPs was particularly unlikely to be consistent with expert opinion in the management of impotence and bony metastasis. There was no evidence from this standardized patient study that Spaced Education had an impact on the management of patients in this context. However, the program was not completed by all participants. Practitioners with a greater clinical load were more likely to manage cases as per expert opinion.

Disease management and health care reforms in Germany - does more competition lead to less solidarity?

PubMed

Stock, Stephanie Anja Katharina; Redaelli, Marcus; Lauterbach, Karl Wilhelm

2007-01-01

Up to the 1990s German health care legislation was dominated by measures regulating the supply side. Measures, such as budgets, aimed at volume control and sought to confine the increase of health care spending to the growth of the national income. To curb costs more effectively, competitive elements were introduced in the 1990s with free choice of sickness funds (open enrollment). To balance competition and solidarity, a risk compensation scheme (RCS) was implemented two years prior to open enrollment. Since then, balancing competition and solidarity has been a key feature of all consecutive health care reforms. The implementation of disease management programs in the statutory health insurance (SHI) served the dual purpose to promote quality of care and to foster competition. Preliminary experiences suggest, that the aligning of disease management programs with a RCS can greatly aid its implementation and benefit solidarity and competition.

The effect of a public health card program on the supply of health care.

PubMed

Johar, Meliyanni

2010-05-01

The supply-side responsiveness to public programs targeted to consumers is not widely studied. However, it is unlikely that supply variables remain constant, particularly when their link to the demand initiative is weak. The aim of this study is to provide such analysis, using the experience of the Indonesian health card program, which is a demand-sided program. Without an increase in staff or an appropriate salary revision, the salary payment system of the public sector may not adequately reward the existing health workers, lowering their incentives to maintain their public position. Using data from the Indonesian Family Life Surveys on public health centres, the leading providers of outpatient services in the public sector, this study found some evidence that the health card program resulted in a reduction in the number of full-time GPs working in these facilities. Other conditions not related to workers' compensation, such as infrastructure conditions and registration fees, were not adversely affected. Identification of this program's effect is achieved by variations in time and the intensity of health card distribution across communities. The findings highlight the importance of public policy management in general, and sheds light on physicians' behaviour in developing countries, about which we know very little. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Focus Group Evaluation of the LIVE Network—An Audio Music Program to Promote ART Adherence Self-Management

PubMed Central

Holstad, Marcia McDonnell; Baumann, Maya; Ofotokun, Ighovwerha; Logwood, Steven J.

2013-01-01

We present the results of 3 focus groups conducted to assess the utility, appeal, and feasibility of the LIVE Network (LN), a 70-minute audio music program developed to educate and motivate HIV-infected persons to adhere to antiretroviral therapy (ART) and self-manage medication-related side effects. Participants included 15 African American, 2 caucasian, and 1 race unknown HIV-infected persons who had been taking ART for at least 6 months. In general, the LN was well liked, relevant, educational, and motivational. It empowered and motivated participants to be responsible for their adherence self-care. One of the more surprising findings was how freely focus group participants shared the program with family and friends as a means of education and also as a means of disclosure. Moreover, the positive reception of the LN by individuals outside of the focus groups, especially children and adolescents, speaks well for the potential broad appeal of this type of program. PMID:24013689

Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

NASA Astrophysics Data System (ADS)

Gosman, Nathaniel

For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

Planning actions in robot automated operations

NASA Technical Reports Server (NTRS)

Das, A.

1988-01-01

Action planning in robot automated operations requires intelligent task level programming. Invoking intelligence necessiates a typical blackboard based architecture, where, a plan is a vector between the start frame and the goal frame. This vector is composed of partially ordered bases. A partial ordering of bases presents good and bad sides in action planning. Partial ordering demands the use of a temporal data base management system.

Bed-sediment grain-size and morphologic data from Suisun, Grizzly, and Honker Bays, CA, 1998-2002

USGS Publications Warehouse

Hampton, Margaret A.; Snyder, Noah P.; Chin, John L.; Allison, Dan W.; Rubin, David M.

2003-01-01

The USGS Place Based Studies Program for San Francisco Bay investigates this sensitive estuarine system to aid in resource management. As part of the inter-disciplinary research program, the USGS collected side-scan sonar data and bed-sediment samples from north San Francisco Bay to characterize bed-sediment texture and investigate temporal trends in sedimentation. The study area is located in central California and consists of Suisun Bay, and Grizzly and Honker Bays, sub-embayments of Suisun Bay. During the study (1998-2002), the USGS collected three side-scan sonar data sets and approximately 300 sediment samples. The side-scan data revealed predominantly fine-grained material on the bayfloor. We also mapped five different bottom types from the data set, categorized as featureless, furrows, sand waves, machine-made, and miscellaneous. We performed detailed grain-size and statistical analyses on the sediment samples. Overall, we found that grain size ranged from clay to fine sand, with the coarsest material in the channels and finer material located in the shallow bays. Grain-size analyses revealed high spatial variability in size distributions in the channel areas. In contrast, the shallow regions exhibited low spatial variability and consistent sediment size over time.

Use of New Commercial, Off-the-Shelf, High-Definition Structure Scanning Fathometer/Depth Finder For Coastal Current Survey Operations

NASA Astrophysics Data System (ADS)

Roggenstein, E. B.; Gray, G.

2013-12-01

The National Oceanic and Atmospheric Administration (NOAA) National Ocean Service (NOS) Center for Operational Oceanographic Products and Services (COOPS) manages three national observing system programs. These are the National Water level Observation Network (NWLON) (210 stations), the 23 NOAA/Physical Oceanographic Real-Time Systems (PORTS), and National Currents Observing Program (NCOP) (approximately 70 deployments/year). In support of its mission COOPS operates and maintains a number of small boats. During vessel operations, side-scan sonar data are at times needed to provide information about bottom structure for future work in the area. For example, potential hazards, obstructions, or bottom morphology features that have not been identified on localized charts for a given area could be used to inform decisions on planned installations. Side-scan sonar capability is also important when attempting to reacquire bottom mounts that fail to surface at the conclusion of a current meter survey. Structure mapping and side-scan capabilities have been added to recent consumer-level, commercial, off-the-shelf fathometers, generally intended for recreational, commercial fishing, and diving applications. We are proposing to investigate these systems' viability for meeting survey requirements. We assess their ability to provide a flexible alternative to research/commercial oceanographic level side-scan system at a significant cost savings. Such systems could provide important information to support scientific missions that require qualitative seafloor imagery.

Youpi: A Web-based Astronomical Image Processing Pipeline

NASA Astrophysics Data System (ADS)

Monnerville, M.; Sémah, G.

2010-12-01

Youpi stands for “YOUpi is your processing PIpeline”. It is a portable, easy to use web application providing high level functionalities to perform data reduction on scientific FITS images. It is built on top of open source processing tools that are released to the community by Terapix, in order to organize your data on a computer cluster, to manage your processing jobs in real time and to facilitate teamwork by allowing fine-grain sharing of results and data. On the server side, Youpi is written in the Python programming language and uses the Django web framework. On the client side, Ajax techniques are used along with the Prototype and script.aculo.us Javascript librairies.

Integrated power sector efficiency analysis: A case study of Costa Rica

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

Waddle, D.B.; MacDonald, J.M.

1990-03-01

In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 2 figs., 5 tabs.« less

U.S. utilities' experiences with the implementation of energy efficiency programs

NASA Astrophysics Data System (ADS)

Goss, Courtney

In the U.S., many electric utility companies are offering demand-side management (DSM) programs to their customers as ways to save money and energy. However, it is challenging to compare these programs between utility companies throughout the U.S. because of the variability of state energy policies. For example, some states in the U.S. have deregulated electricity markets and others do not. In addition, utility companies within a state differ depending on ownership and size. This study examines 12 utilities' experiences with DSM programs and compares the programs' annual energy savings results that the selected utilities reported to the Energy Information Administration (EIA). The 2009 EIA data suggests that DSM program effectiveness is not significantly affected by electricity market deregulation or utility ownership. However, DSM programs seem to generally be more effective when administered by utilities located in states with energy savings requirements and DSM program mandates.

Evaluating participation in water resource management: A review

NASA Astrophysics Data System (ADS)

Carr, G.; BlöSchl, G.; Loucks, D. P.

2012-11-01

Key documents such as the European Water Framework Directive and the U.S. Clean Water Act state that public and stakeholder participation in water resource management is required. Participation aims to enhance resource management and involve individuals and groups in a democratic way. Evaluation of participatory programs and projects is necessary to assess whether these objectives are being achieved and to identify how participatory programs and projects can be improved. The different methods of evaluation can be classified into three groups: (i) process evaluation assesses the quality of participation process, for example, whether it is legitimate and promotes equal power between participants, (ii) intermediary outcome evaluation assesses the achievement of mainly nontangible outcomes, such as trust and communication, as well as short- to medium-term tangible outcomes, such as agreements and institutional change, and (iii) resource management outcome evaluation assesses the achievement of changes in resource management, such as water quality improvements. Process evaluation forms a major component of the literature but can rarely indicate whether a participation program improves water resource management. Resource management outcome evaluation is challenging because resource changes often emerge beyond the typical period covered by the evaluation and because changes cannot always be clearly related to participation activities. Intermediary outcome evaluation has been given less attention than process evaluation but can identify some real achievements and side benefits that emerge through participation. This review suggests that intermediary outcome evaluation should play a more important role in evaluating participation in water resource management.

Environmental Impact Research Program. Mechanical Site Preparation Techniques. Section 5.7.1, US Army Corps of Engineers Wildlife Resources Management Manual.

DTIC Science & Technology

1986-07-01

diameter. The machine can also chop shrub thickets of Gambel’s oak (Quercus gw’nbelii) and chokecherry (Prunus virginiana ) into 4- to 6-in. pieces and...bush hog is the side-mounted hog that can be hydraulically lifted up to 15 ft for pruning tree limbs and shrubs. This implement is used primarily on

Insecticide Resistance Management

DTIC Science & Technology

2013-01-01

been a side effect of insect vector control programs since 1914, and insect disease vectors in over 45 countries are resistant to at least one...the CDC and WHO bioassays can be performed on various insects , the remainder of the guide will focus specifically on how to detect resistance in...mosquito vector populations. For a description of how to develop a bioassay for resistance testing in other groups of insects , refer to the following

Adherence to Attention-Deficit/Hyperactivity Disorder Medication During the Transition to College.

PubMed

Schaefer, Megan R; Rawlinson, Alana Resmini; Wagoner, Scott T; Shapiro, Steven K; Kavookjian, Jan; Gray, Wendy N

2017-06-01

The present study explores the medication self-management experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) during their transition to young adulthood in college. Participants were college freshmen with ADHD prescribed daily medication for their condition. Ten individual interviews were conducted using a semistructured interview script. Measures related to ADHD medication management were also completed. Qualitative data were analyzed via directed content analysis and quantitative data via descriptive statistics. Five themes emerged from interviews: (1) transitions to independence are often abrupt, and many adolescents lack critical self-management skills; (2) volitional nonadherence is high due to inaccurate disease beliefs, perceived academic demands, and medication side effects; (3) poor self-management negatively impacts school performance; (4) peer pressure to share medication affects social functioning and adherence; and (5) social support is greatly needed. Common barriers to adherence included "don't feel like taking medication" (90%) and "difficulties in sticking to a fixed medication schedule" (80%). Participants with ADHD were not prepared to manage their chronic illness independently in context of increased demands and newfound freedom, resulting in negative academic consequences. Social factors also play an influential role in ADHD self-management, particularly related to the isolation associated with sharing the medication and its side effects. Intervention programs targeting medication self-management during the transition to independence are greatly needed for young adults with ADHD as high academic performance in college is critical for future success. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Scapular-Muscle Performance: Two Training Programs in Adolescent Swimmers

PubMed Central

Van de Velde, Annemie; De Mey, Kristof; Maenhout, Annelies; Calders, Patrick; Cools, Ann M.

2011-01-01

Abstract Context: Swimming requires well-balanced scapular-muscle performance. An additional strength-training program for the shoulders is pursued by swimmers, but whether these muscle-training programs need to be generic or specific for endurance or strength is unknown. Objective: To evaluate isokinetic scapular-muscle performance in a population of adolescent swimmers and to compare the results of training programs designed for strength or muscle endurance. Design: Controlled laboratory study. Setting: University human research laboratory. Patients or Other Participants: Eighteen adolescent swimmers. Intervention(s): Each participant pursued a 12-week scapular-training program designed to improve either muscle strength or muscle endurance. Main Outcome Measure(s): Bilateral peak force, fatigue index, and protraction/retraction strength ratios before and after the scapular-training program. Results: Scapular protraction/retraction ratios were slightly higher than 1 (dominant side  =  1.08, nondominant side  =  1.25, P  =  .006). Side-to-side differences in retraction strength were apparent both before and after the training program (P  =  .03 and P  = .05, respectively). After the training program, maximal protraction (P < .05) and retraction (P < .01) strength improved on the nondominant side. Peak force and fatigue index were not different between the training groups. The fatigue indexes for protraction on both sides (P < .05) and retraction on the nondominant side (P  =  .009) were higher after the training program. Conclusions: We describe the scapular-muscle characteristics of a group of adolescent swimmers. Both muscle-strength and muscle-endurance programs improved absolute muscle strength. Neither of the strength programs had a positive effect on scapular-muscle endurance. Our results may be valuable for coaches and physiotherapists when they are designing exercise programs for swimmers. PMID:21391801

Highly Integrated Quality Assurance – An Empirical Case

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

Drake Kirkham; Amy Powell; Lucas Rich

2011-02-01

Highly Integrated Quality Assurance – An Empirical Case Drake Kirkham1, Amy Powell2, Lucas Rich3 1Quality Manager, Radioisotope Power Systems (RPS) Program, Idaho National Laboratory, P.O. Box 1625 M/S 6122, Idaho Falls, ID 83415-6122 2Quality Engineer, RPS Program, Idaho National Laboratory 3Quality Engineer, RPS Program, Idaho National Laboratory Contact: Voice: (208) 533-7550 Email: Drake.Kirkham@inl.gov Abstract. The Radioisotope Power Systems Program of the Idaho National Laboratory makes an empirical case for a highly integrated Quality Assurance function pertaining to the preparation, assembly, testing, storage and transportation of 238Pu fueled radioisotope thermoelectric generators. Case data represents multiple campaigns including the Pluto/New Horizons mission,more » the Mars Science Laboratory mission in progress, and other related projects. Traditional Quality Assurance models would attempt to reduce cost by minimizing the role of dedicated Quality Assurance personnel in favor of either functional tasking or peer-based implementations. Highly integrated Quality Assurance adds value by placing trained quality inspectors on the production floor side-by-side with nuclear facility operators to enhance team dynamics, reduce inspection wait time, and provide for immediate, independent feedback. Value is also added by maintaining dedicated Quality Engineers to provide for rapid identification and resolution of corrective action, enhanced and expedited supply chain interfaces, improved bonded storage capabilities, and technical resources for requirements management including data package development and Certificates of Inspection. A broad examination of cost-benefit indicates highly integrated Quality Assurance can reduce cost through the mitigation of risk and reducing administrative burden thereby allowing engineers to be engineers, nuclear operators to be nuclear operators, and the cross-functional team to operate more efficiently. Applicability of this case extends to any high-value, long-term project where traceability and accountability are determining factors.« less

Analysis of power sector efficiency improvements for an integrated utility planning process in Costa Rica

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

Waddle, D.B.; MacDonald, J.M.

1990-01-01

In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 4 figs., 5 tabs.« less

The National Shipbuilding Research Program, 1990 Ship Production Symposium

DTIC Science & Technology

1990-08-01

deck, sides and bottom Shear stresses which may be important for certain classes of vessels, are not accounted for in this study. The net sectional...and the superstructure. The highly pre-outfitted blocks then can be transferred to the dry dock by a gantry crane . After integrating the blocks into...manager. 2A-2-3 Examples of cost centres are: Plate Production Unit Pre-outfitting Hull Construction Ship Outfitting (Weapons Compartments) Berth Cranes

Collections: Their Development, Management, Preservation, and Sharing. Papers from the Joint Meeting of the Association of Research Libraries and the Standing Conference of National and University Libraries (York, England, September 19-22, 1988).

ERIC Educational Resources Information Center

Daval, Nicola, Ed.

Papers from the joint meeting are assembled in this document. Each of the meeting's five program sessions featured presentations by a Standing Conference of National and Universal Libraries (SCONUL) director and an Association of Research Libraries (ARL) director. The presentations highlight perspectives from both sides of the Atlantic and are…

Deterrence with China: Avoiding Nuclear Miscalculation

DTIC Science & Technology

2014-01-01

When each nation can manage these three elements in the correct way, the cost -benefit calculations of each side should favor deterrence of a...under pressure to justify the cost of its plans to replace its SSBN fleet. After a recent 2-year delay in the planned SSBN replacement program, any...of CPGS may prove advantageous in some scenarios,31 but those advantages do not come with- out a cost to nuclear deterrence stability with China—a

Management of Side Effects of Novel Therapies for Multiple Myeloma: Consensus Statements Developed by the International Myeloma Foundation’s Nurse Leadership Board

PubMed Central

Bertolotti, Page; Bilotti, Elizabeth; Colson, Kathleen; Curran, Kathleen; Doss, Deborah; Faiman, Beth; Gavino, Maria; Jenkins, Bonnie; Lilleby, Kathy; Love, Ginger; Mangan, Patricia A.; McCullagh, Emily; Miceli, Teresa; Miller, Kena; Rogers, Kathryn; Rome, Sandra; Sandifer, Stacey; Smith, Lisa C.; Tariman, Joseph D.; Westphal, Jeanne

2014-01-01

Nurses play an essential role in managing the care of patients with multiple myeloma, who require education and support to receive and adhere to optimal therapy. The International Myeloma Foundation created a Nurse Leadership Board comprised of oncology nurses from leading cancer centers and community practices. An assessment survey identified the need for specific recommendations for managing key side effects of novel antimyeloma agents. Myelosuppression, thromboembolic events, peripheral neuropathy, steroid toxicities, and gastrointestinal side effects were selected for the first consensus statements. The board developed recommendations for healthcare providers in any medical setting, including grading of side-effect toxicity and strategies for managing the side effects in general, with specific recommendations pertaining to the novel agents. PMID:18490252

Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects.

PubMed

Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

2016-06-01

Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient's lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient's effective participation in care process improved.

Obesity among those with mental disorders: a National Institute of Mental Health meeting report.

PubMed

Allison, David B; Newcomer, John W; Dunn, Andrea L; Blumenthal, James A; Fabricatore, Anthony N; Daumit, Gail L; Cope, Mark B; Riley, William T; Vreeland, Betty; Hibbeln, Joseph R; Alpert, Jonathan E

2009-04-01

The National Institute of Mental Health convened a meeting in October 2005 to review the literature on obesity, nutrition, and physical activity among those with mental disorders. The findings of this meeting and subsequent update of the literature review are summarized here. Levels of obesity are higher in those with schizophrenia and depression, as is mortality from obesity-related conditions such as coronary heart disease. Medication side effects, particularly the metabolic side effects of antipsychotic medications, contribute to the high levels of obesity in those with schizophrenia, but increased obesity and visceral adiposity have been found in some but not all samples of drug-naïve patients as well. Many of the weight-management strategies used in the general population may be applicable to those with mental disorders, but little is known about the effects of these strategies on this patient population or how these strategies may need to be adapted for the unique needs of those with mental disorders. The minimal research on weight-management programs for those with mental disorders indicates that meaningful changes in dietary intake and physical activity are possible. Physical activity is an important component of any weight-management program, particularly for those with depression, for which a substantial body of research indicates both mental and physical health benefits. Obesity among those with mental disorders has not received adequate research attention, and empirically-based interventions to address the increasing prevalence of obesity and risk of cardiovascular and metabolic diseases in this population are lacking.

Managing a patient's constipation with physical therapy.

PubMed

Harrington, Kendra L; Haskvitz, Esther M

2006-11-01

Constipation is a prevalent condition in the United States, with typical treatment consisting of diet modification, stool softeners, and laxatives. These interventions, however, are not always effective. The purpose of this case report is to describe the use of abdominal massage in physical therapist management for a patient with constipation. An 85-year-old woman with constipation was referred for physical therapy following unsuccessful treatment with stool softeners. The patient was instructed in bowel management as well as a daily, 10-minute home abdominal massage program. Upon re-examination, the patient reported a return of normal bowel frequency and function without the need to strain or use digital evacuation. Physical therapy incorporating abdominal massage appeared to be helpful in resolving this patient's constipation. Unlike medical management of constipation, no known side effects have been identified with abdominal massage.

Milwaukee County User-Side Subsidy Program : A Case Study

DOT National Transportation Integrated Search

1982-09-01

Milwaukee County, Wisconsin, instituted a user-side subsidy program in June 1978 for handicapped users of taxi and chair-car services. The program is funded entirely by county and state contributions. A distinctive feature of the program is that, unl...

User-Side Subsidy Programs for Special Needs Transportation : A Planning Handbook

DOT National Transportation Integrated Search

1983-06-01

This handbook, first of a series, provides guidance for designing and implementing a user-side subsidy program. The book is divided into two parts--Program Planning and Program Implementation. The Planning section covers six areas--Goals and Objectiv...

An interval-based possibilistic programming method for waste management with cost minimization and environmental-impact abatement under uncertainty.

PubMed

Li, Y P; Huang, G H

2010-09-15

Considerable public concerns have been raised in the past decades since a large amount of pollutant emissions from municipal solid waste (MSW) disposal of processes pose risks on surrounding environment and human health. Moreover, in MSW management, various uncertainties exist in the related costs, impact factors and objectives, which can affect the optimization processes and the decision schemes generated. In this study, an interval-based possibilistic programming (IBPP) method is developed for planning the MSW management with minimized system cost and environmental impact under uncertainty. The developed method can deal with uncertainties expressed as interval values and fuzzy sets in the left- and right-hand sides of constraints and objective function. An interactive algorithm is provided for solving the IBPP problem, which does not lead to more complicated intermediate submodels and has a relatively low computational requirement. The developed model is applied to a case study of planning a MSW management system, where mixed integer linear programming (MILP) technique is introduced into the IBPP framework to facilitate dynamic analysis for decisions of timing, sizing and siting in terms of capacity expansion for waste-management facilities. Three cases based on different waste-management policies are examined. The results obtained indicate that inclusion of environmental impacts in the optimization model can change the traditional waste-allocation pattern merely based on the economic-oriented planning approach. The results obtained can help identify desired alternatives for managing MSW, which has advantages in providing compromised schemes under an integrated consideration of economic efficiency and environmental impact under uncertainty. Copyright 2010 Elsevier B.V. All rights reserved.

What to Expect During a Mastectomy Surgery

MedlinePlus

... Managing Side Effects and Supportive Care Managing Pain Quality of Life Survival and Risk of Recurrence Breast Cancer Recurrence ... Pain Managing Side Effects and Supportive Care Support Quality of Life Survivorship Topics Survivorship Topics Medical Care After Treatment ...

Financing pharmaceuticals in transition economies.

PubMed

Kanavos, P

1999-06-01

This paper (a) provides a methodological taxonomy of pricing, financing, reimbursement, and cost containment methodologies for pharmaceuticals; (b) analyzes complex agency relationships and the health versus industrial policy tradeoff; (c) pinpoints financing measures to balance safety and effectiveness of medicines and their affordability by publicly funded systems in transition; and (d) highlights viable options for policy-makers for the financing of pharmaceuticals in transition. Three categories of measures and their implications for pharmaceutical policy cost containing are analyzed: supply-side measures, targeting manufacturers, proxy demand-side measures, targeting physicians and pharmacists, and demand-side measures, targeting patients. In pursuing supply side measures, we explore free pricing for pharmaceuticals, direct price controls, cost-plus and cost pricing, average pricing and international price comparisons, profit control, reference pricing, the introduction of a fourth hurdle, positive and negative lists, and other price control measures. The analysis of proxy-demand measures includes budgets for physicians, generic policies, practice guidelines, monitoring the authorizing behavior of physicians, and disease management schemes. Demand-side measures explore the effectiveness of patient co-payments, the impact of allowing products over-the-counter and health promotion programs. Global policies should operate simultaneously on the supply, the proxy demand, and the demand-side. Policy-making needs to have a continuous long-term planning. The importation of policies into transition economy may require extensive and expensive adaptation, and/or lead to sub-optimal policy outcomes.

Management by Trajectory Trade Study of Roles and Responsibilities Between Participants and Automation Report

NASA Technical Reports Server (NTRS)

Fernandes, Alicia D.; Kaler, Curt; Leiden, Kenneth; Atkins, Stephen; Bell, Alan; Kilbourne, Todd; Evans, Mark

2017-01-01

This report describes a trade study of roles and responsibilities associated with the Management by Trajectory (MBT) concept. The MBT concept describes roles, responsibilities, and information and automation requirements for providing air traffic controllers and managers the ability to quickly generate, evaluate and implement changes to an aircraft's trajectory. In addition, the MBT concept describes mechanisms for imposing constraints on flight operator preferred trajectories only to the extent necessary to maintain safe and efficient traffic flows, and the concept provides a method for the exchange of trajectory information between ground automation systems and the aircraft that allows for trajectory synchronization and trajectory negotiation. The participant roles considered in this trade study include: airline dispatcher, flight crew, radar controller, traffic manager, and Air Traffic Control System Command Center (ATCSCC) traffic management specialists. The proposed allocation of roles and responsibilities was based on analysis of several use cases that were developed for this purpose as well as for walking through concept elements. The resulting allocation of roles and responsibilities reflects both increased automation capability to support many aviation functions, as well as increased flexibility to assign responsibilities to different participants - in many cases afforded by the increased automation capabilities. Note that the selection of participants to consider for allocation of each function is necessarily rooted in the current environment, in that MBT is envisioned as an evolution of the National Airspace System (NAS), and not a revolution. A key feature of the MBT allocations is a vision for the traffic management specialist to take on a greater role. This is facilitated by the vision that separation management functions, in addition to traffic management functions, will be carried out as trajectory management functions. This creates an opportunity for flexibility, allowing the traffic management specialist to carry out tasks that today can only be carried out by the controller currently in contact with the aircraft. This additional tasking for the traffic management specialist comes with requirements for workload management. An increased role for the Data-side (D-side) controller relative to the Radar-side (R-side) controller is a potential approach to mitigating workload for the traffic management specialist, as the D-side controller would have similar ability to perform separation management functions in what today might be considered the "trajectory management" timeframe. This analysis did not distinguish between the D-side and R-side controllers since in many cases the R-side controller works unassisted.

The DarkSide awakens

DOE PAGES

Davini, S.; Agnes, P.; Agostino, L.; ...

2016-06-09

Here, the DarkSide program at LNGS aims to perform background-free WIMP searches using two phase liquid argon time projection chambers, with the ultimate goal of covering all parameters down to the so-called neutrino floor. One of the distinct features of the program is the use of underground argon with has a reduced content of the radioactive 39Ar compared to atmospheric argon. The DarkSide Collaboration is currently operating the DarkSide-50 experiment, the first such WIMP detector using underground argon. Operations with underground argon indicate a suppression of 39Ar by a factor (1.4 ± 0.2) × 10 3 relative to atmospheric argon.more » The new results obtained with DarkSide-50 and the plans for the next steps of the DarkSide program, the 20t fiducial mass DarkSide-20k detector and the 200 t fiducial Argo, are reviewed in this proceedings.« less

The DarkSide awakens

NASA Astrophysics Data System (ADS)

Davini, S.; Agnes, P.; Agostino, L.; Albuquerque, I. F. M.; Alexander, T.; Alton, A. K.; Arisaka, K.; Back, H. O.; Baldin, B.; Biery, K.; Bonfini, G.; Bossa, M.; Bottino, B.; Brigatti, A.; Brodsky, J.; Budano, F.; Bussino, S.; Cadeddu, M.; Cadonati, L.; Cadoni, M.; Calaprice, F.; Canci, N.; Candela, A.; Cao, H.; Cariello, M.; Carlini, M.; Catalanotti, S.; Cavalcante, P.; Chepurnov, A.; Cocco, A. G.; Covone, G.; D'Angelo, D.; D'Incecco, M.; De Cecco, S.; De Deo, M.; De Vincenzi, M.; Derbin, A.; Devoto, A.; Di Eusanio, F.; Di Pietro, G.; Edkins, E.; Empl, A.; Fan, A.; Fiorillo, G.; Fomenko, K.; Foster, G.; Franco, D.; Gabriele, F.; Galbiati, C.; Giganti, C.; Goretti, A. M.; Granato, F.; Grandi, L.; Gromov, M.; Guan, M.; Guardincerri, Y.; Hackett, B. R.; Herner, K. R.; Hungerford, E. V.; Ianni, Aldo; Ianni, Andrea; James, I.; Jollet, C.; Keeter, K.; Kendziora, C. L.; Kobychev, V.; Koh, G.; Korablev, D.; Korga, G.; Kubankin, A.; Li, X.; Lissia, M.; Lombardi, P.; Luitz, S.; Ma, Y.; Machulin, I. N.; Mandarano, A.; Mari, S. M.; Maricic, J.; Marini, L.; Martoff, C. J.; Meregaglia, A.; Meyers, P. D.; Miletic, T.; Milincic, R.; Montanari, D.; Monte, A.; Montuschi, M.; Monzani, M. E.; Mosteiro, P.; Mount, B. J.; Muratova, V. N.; Musico, P.; Napolitano, J.; Orsini, M.; Ortica, F.; Pagani, L.; Pallavicini, M.; Pantic, E.; Parmeggiano, S.; Pelczar, K.; Pelliccia, N.; Perasso, S.; Pocar, A.; Pordes, S.; Pugachev, D. A.; Qian, H.; Randle, K.; Ranucci, G.; Razeto, A.; Reinhold, B.; Renshaw, A. L.; Romani, A.; Rossi, B.; Rossi, N.; Rountree, S. D.; Sablone, D.; Saggese, P.; Saldanha, R.; Sands, W.; Sangiorgio, S.; Savarese, C.; Segreto, E.; Semenov, D. A.; Shields, E.; Singh, P. N.; Skorokhvatov, M. D.; Smirnov, O.; Sotnikov, A.; Stanford, C.; Suvorov, Y.; Tartaglia, R.; Tatarowicz, J.; Testera, G.; Tonazzo, A.; Trinchese, P.; Unzhakov, E. V.; Vishneva, A.; Vogelaar, B.; Wada, M.; Walker, S.; Wang, H.; Wang, Y.; Watson, A. W.; Westerdale, S.; Wilhelmi, J.; Wojcik, M. M.; Xiang, X.; Xu, J.; Yang, C.; Yoo, J.; Zavatarelli, S.; Zec, A.; Zhong, W.; Zhu, C.; Zuzel, G.

2016-05-01

The DarkSide program at LNGS aims to perform background-free WIMP searches using two phase liquid argon time projection chambers, with the ultimate goal of covering all parameters down to the so-called neutrino floor. One of the distinct features of the program is the use of underground argon with has a reduced content of the radioactive 39Ar compared to atmospheric argon. The DarkSide Collaboration is currently operating the DarkSide-50 experiment, the first such WIMP detector using underground argon. Operations with underground argon indicate a suppression of 39Ar by a factor (1.4 ± 0.2) × 103 relative to atmospheric argon. The new results obtained with DarkSide-50 and the plans for the next steps of the DarkSide program, the 20t fiducial mass DarkSide-20k detector and the 200 t fiducial Argo, are reviewed in this proceedings.

Side-effects of pesticides on the generalist endoparasitoid Palmistichus elaeisis (Hymenoptera: Eulophidae).

PubMed

Cruz, Ricardo Alcántara-de la; Zanuncio, José Cola; Lacerda, Mabio Chrisley; Wilcken, Carlos Frederico; Fernandes, Flávio Lemes; Tavares, Wagner de Souza; Soares, Marcus Alvarenga; Sediyama, Carlos Sigueyuki

2017-08-30

New plant protection strategies focus on minimizing chemical pesticide use and increasing their compatibility with biological control agents. The objective was to evaluate the side-effects of glyphosate, diflubenzuron, malathion, tebuconazole and triflumuron (at 720, 45, 400, 150 and 20 g ai ha -1 , respectively), pesticides authorized for soybean crops in Brazil, on the parasitoid Palmistichus elaeisis (Hymenoptera: Eulophidae) reared on Anticarsia gemmatalis (Lepidoptera: Noctuidae). The emergence and female numbers produced per P. elaeisis female were higher in A. gemmatalis pupae from caterpillars fed an artificial diet treated with glyphosate. However, emergence was lower than 50% when the caterpillars were fed on soybean leaves treated with glyphosate offered ad libitum (3-5 times). Palmistichus elaeisis died before parasiting A. gemmatalis pupae treated with malathion. Diflubenzuron reduced the P. elaesis sex ratio in the second generation. Tebuconazole and triflumuron did not cause side-effects on this parasitoid. A continuous exposure to glyphosate by the host may lead to side-effects on P. elaeisis emergence, but its moderate use is acceptable for this parasitoid. Diflubenzuron had severe transgenerational side-effects. Tebuconazole fungicide and triflumuron insecticide are compatible with P. elaeisis in sustainable integrated pest management (IPM) programs, while malathion can not be included in them.

Server-Side JavaScript Debugging: Viewing the Contents of an Object

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

Hampton, J.; Simons, R.

1999-04-21

JavaScript allows the definition and use of large, complex objects. Unlike some other object-oriented languages, it also allows run-time modifications not only of the values of object components, but also of the very structure of the object itself. This feature is powerful and sometimes very convenient, but it can be difficult to keep track of the object's structure and values throughout program execution. What's needed is a simple way to view the current state of an object at any point during execution. There is a debug function that is included in the Netscape server-side JavaScript environment. The function outputs themore » value(s) of the expression given as the argument to the function in the JavaScript Application Manager's debug window [SSJS].« less

Individual Learning Route as a Way of Highly Qualified Specialists Training for Extraction of Solid Commercial Minerals Enterprises

NASA Astrophysics Data System (ADS)

Oschepkova, Elena; Vasinskaya, Irina; Sockoluck, Irina

2017-11-01

In view of changing educational paradigm (adopting of two-tier system of higher education concept - undergraduate and graduate programs) a need of using of modern learning and information and communications technologies arises putting into practice learner-centered approaches in training of highly qualified specialists for extraction and processing of solid commercial minerals enterprises. In the unstable market demand situation and changeable institutional environment, from one side, and necessity of work balancing, supplying conditions and product quality when mining-and-geological parameters change, from the other side, mining enterprises have to introduce and develop the integrated management process of product and informative and logistic flows under united management system. One of the main limitations, which keeps down the developing process on Russian mining enterprises, is staff incompetence at all levels of logistic management. Under present-day conditions extraction and processing of solid commercial minerals enterprises need highly qualified specialists who can do self-directed researches, develop new and improve present arranging, planning and managing technologies of technical operation and commercial exploitation of transport and transportation and processing facilities based on logistics. Learner-centered approach and individualization of the learning process necessitate the designing of individual learning route (ILR), which can help the students to realize their professional facilities according to requirements for specialists for extraction and processing of solid commercial minerals enterprises.

Cyanotic Premature Babies: A Videodisc-Based Program

PubMed Central

Tinsley, L.R.; Ashton, G.C.; Boychuk, R.B.; Easa, D.J.

1989-01-01

This program for the IBM InfoWindow system is designed to assist medical students and pediatric residents with diagnosis and management of premature infants exhibiting cyanosis. The program consists of six diverse case simulations, with additional information available on diagnosis, procedures, and relevant drugs. Respiratory difficulties accompanied by cyanosis are a common problem in premature infants at or just after birth, but the full diversity of causes is rarely seen in a short training period. The purpose of the program is to assist the student or resident with diagnosis and management of a variety of conditions which they may or may not see during their training. The opening menu permits selection from six cases, covering (1) respiratory distress syndrome proceeding through patent ductus arteriosus to pneumothorax, (2) a congenital heart disorder, (3) sepsis/pneumonia, (4) persistent fetal circulation, (5) diaphragmatic hernia, and (6) tracheo-esophageal fistula. In each case the student is provided with relevant introductory information and must then proceed with diagnosis and management. At each decision point the student may view information about relevant procedures, obtain assistance with diagnosis, or see information about useful drugs. Segments between decision points may be repeated if required. Provision is made for backtracking and review of instructional segments. The program is written in IBM's InfoWindow Presentation System authoring language and the video segments are contained on one side of a standard 12″ laserdisc. The program runs on IBM's InfoWindow System, with the touch screen used to initiate all student actions. The extensive graphics in the program were developed with Storyboard Plus, using the 640×350 resolution mode. This program is one of a number being developed for the Health Sciences Interactive Videodisc Consortium, and was funded in part by IBM Corporation.

The PhEDEx next-gen website

NASA Astrophysics Data System (ADS)

Egeland, R.; Huang, C.-H.; Rossman, P.; Sundarrajan, P.; Wildish, T.

2012-12-01

PhEDEx is the data-transfer management solution written by CMS. It consists of agents running at each site, a website for presentation of information, and a web-based data-service for scripted access to information. The website allows users to monitor the progress of data-transfers, the status of site agents and links between sites, and the overall status and behaviour of everything about PhEDEx. It also allows users to make and approve requests for data-transfers and for deletion of data. It is the main point-of-entry for all users wishing to interact with PhEDEx. For several years, the website has consisted of a single perl program with about 10K SLOC. This program has limited capabilities for exploring the data, with only coarse filtering capabilities and no context-sensitive awareness. Graphical information is presented as static images, generated on the server, with no interactivity. It is also not well connected to the rest of the PhEDEx codebase, since much of it was written before the data-service was developed. All this makes it hard to maintain and extend. We are re-implementing the website to address these issues. The UI is being rewritten in Javascript, replacing most of the server-side code. We are using the YUI toolkit to provide advanced features and context-sensitive interaction, and will adopt a Javascript charting library for generating graphical representations client-side. This relieves the server of much of its load, and automatically improves server-side security. The Javascript components can be re-used in many ways, allowing custom pages to be developed for specific uses. In particular, standalone test-cases using small numbers of components make it easier to debug the Javascript than it is to debug a large server program. Information about PhEDEx is accessed through the PhEDEx data-service, since direct SQL is not available from the clients’ browser. This provides consistent semantics with other, externally written monitoring tools, which already use the data-service. It also reduces redundancy in the code, yielding a simpler, consolidated codebase. In this talk we describe our experience of re-factoring this monolithic server-side program into a lighter client-side framework. We describe some of the techniques that worked well for us, and some of the mistakes we made along the way. We present the current state of the project, and its future direction.

YRE Program Guide.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Div. of School Facilities Planning.

This report examines single- and multi-track educational programs as found in California's public school system, explores the pros and cons of using year-round education (YRE) programs, and how to implement these programs. Each year-round tracking system is detailed using each of their calendars in a side-by-side comparison along with the…

Building heating and cooling applications thermal energy storage program overview

NASA Technical Reports Server (NTRS)

Eissenberg, D. M.

1980-01-01

Thermal energy storage technology and development of building heating and cooling applications in the residential and commercial sectors is outlined. Three elements are identified to undergo an applications assessment, technology development, and demonstration. Emphasis is given to utility load management thermal energy system application where the stress is on the 'customer side of the meter'. Thermal storage subsystems for space conditioning and conservation means of increased thermal mass within the building envelope and by means of low-grade waste heat recovery are covered.

Simulators Sustainment Management: Advanced Planning Information

DTIC Science & Technology

2006-05-23

1M per year Competition Type: TSA II Small Business Set-A-Side, FFP Program Mgr : James H. Burks,507 ACSS/GFLC, (801) 586-1859; jim.burks...ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12 . DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13...BEST O G D E N A I R L O G I S T I C S C E N T E R Training Systems Business Opportunities FY06-07 HC-130P Weapon System Trainer T-38C Aircrew

Defense AT&L (Volume 34, Number 6, November-December 2005)

DTIC Science & Technology

2005-12-01

practices are consid- ered to be the best offers real-world program managers some food for thought. 27 Lending a Helping Hand Owen Gadeken Effective ...mentoring is rewarding for both sides of the equation. The author gives pointers for being a more effective mentor whose protégés will eventually pass on...maintain the uniforms because they put the patches on with Velcro ®. It’s got pockets in the right places, based on the needs of the soldier in the field

Research for assessment, not deployment, of Climate Engineering: The German Research Foundation's Priority Program SPP 1689

NASA Astrophysics Data System (ADS)

Oschlies, Andreas; Klepper, Gernot

2017-01-01

The historical developments are reviewed that have led from a bottom-up responsibility initiative of concerned scientists to the emergence of a nationwide interdisciplinary Priority Program on the assessment of Climate Engineering (CE) funded by the German Research Foundation (DFG). Given the perceived lack of comprehensive and comparative appraisals of different CE methods, the Priority Program was designed to encompass both solar radiation management (SRM) and carbon dioxide removal (CDR) ideas and to cover the atmospheric, terrestrial, and oceanic realm. First, key findings obtained by the ongoing Priority Program are summarized and reveal that, compared to earlier assessments such as the 2009 Royal Society report, more detailed investigations tend to indicate less efficiency, lower effectiveness, and often lower safety. Emerging research trends are discussed in the context of the recent Paris agreement to limit global warming to less than two degrees and the associated increasing reliance on negative emission technologies. Our results show then when deployed at scales large enough to have a significant impact on atmospheric CO2, even CDR methods such as afforestation—often perceived as "benign"—can have substantial side effects and may raise severe ethical, legal, and governance issues. We suppose that before being deployed at climatically relevant scales, any negative emission or CE method will require careful analysis of efficiency, effectiveness, and undesired side effects.

F-15B ACTIVE - First supersonic yaw vectoring flight

NASA Technical Reports Server (NTRS)

1996-01-01

On Wednesday, April 24, 1996, the F-15 Advanced Control Technology for Integrated Vehicles (ACTIVE) aircraft achieved its first supersonic yaw vectoring flight at Dryden Flight Research Center, Edwards, California. ACTIVE is a joint NASA, U.S. Air Force, McDonnell Douglas Aerospace (MDA) and Pratt & Whitney (P&W) program. The team will assess performance and technology benefits during flight test operations. Current plans call for approximately 60 flights totaling 100 hours. 'Reaching this milestone is very rewarding. We hope to set some more records before we're through,' stated Roger W. Bursey, P&W's pitch-yaw balance beam nozzle (PYBBN) program manager. A pair of P&W PYBBNs vectored (horizontally side-to-side, pitch is up and down) the thrust for the MDA manufactured F-15 research aircraft. Power to reach supersonic speeds was provided by two high-performance F100-PW-229 engines that were modified with the multi-directional thrust vectoring nozzles. The new concept should lead to significant increases in performance of both civil and military aircraft flying at subsonic and supersonic speeds.

Interactive two-stage stochastic fuzzy programming for water resources management.

PubMed

Wang, S; Huang, G H

2011-08-01

In this study, an interactive two-stage stochastic fuzzy programming (ITSFP) approach has been developed through incorporating an interactive fuzzy resolution (IFR) method within an inexact two-stage stochastic programming (ITSP) framework. ITSFP can not only tackle dual uncertainties presented as fuzzy boundary intervals that exist in the objective function and the left- and right-hand sides of constraints, but also permit in-depth analyses of various policy scenarios that are associated with different levels of economic penalties when the promised policy targets are violated. A management problem in terms of water resources allocation has been studied to illustrate applicability of the proposed approach. The results indicate that a set of solutions under different feasibility degrees has been generated for planning the water resources allocation. They can help the decision makers (DMs) to conduct in-depth analyses of tradeoffs between economic efficiency and constraint-violation risk, as well as enable them to identify, in an interactive way, a desired compromise between satisfaction degree of the goal and feasibility of the constraints (i.e., risk of constraint violation). Copyright © 2011 Elsevier Ltd. All rights reserved.

One-on-one care management and procurement of Naloxone for ambulatory use.

PubMed

Whittington, Richard; Whittington, Kathleen; Whittington, John; Porter, Joel; Zimmermann, Karla; Case, Holly; Berg, Stacey

2018-02-16

Morbidity and mortality from prescription opioids has reached unprecedented levels. Opioids remain part of chronic pain treatment in primary care. This study was designed to determine whether one-on-one care management increases procurement of Naloxone, an opioid antagonist shown to reduce morbidity and mortality in opioid overdoses. Participants included all patients ≥18 years enrolled in a primary care-based chronic pain management program and who were prescribed a daily dose of opioids for treatment of chronic pain. In total, 153 patients chose to participate. Each had a 1 h one-on-one education meeting with a registered nurse. Among the enrolled, eight patients (5.2%) had procured Naloxone prior to intervention. Overall, 31 additional patients (20.2%) procured Naloxone after intervention, a 288% relative improvement in the attainment of Naloxone (P < 0.0001) (χ2 = 29.032 with 1 degree freedom). Of the 114 participants who never procured Naloxone, 69.3% believed it was unnecessary, 20% forgot about Naloxone, 8% said it was cost prohibitive, 3.5% had access concerns and 0.9% had concerns about side effects. Direct one-on-one nurse care management sessions were associated with an increased procurement of Naloxone in a primary care-based pain management program. A significant number of patients believed Naloxone was unnecessary after the intervention.

Air pollution effects due to deregulation of the electric industry

NASA Astrophysics Data System (ADS)

Davoodi, Khojasteh Riaz

The Energy Policy Act of 1992 introduced the concept of open-access into the electric utility industry which allows privately-owned utilities to transmit power produced by non-utility generators and independent power producers (IPPs). In April 1996, the Federal Energy Regulatory Commission (FERC) laid down the final rules (Orders No. 888 & No. 889), which required utilities to open their transmission lines to any power producer and charge them no more than what they pay for the use of their own lines. These rules set the stage for the retail sale of electricity to industrial, commercial and residential utility customers; non-utility generators (Nugs); and power marketers. These statutory, regulatory and administrative changes create for the electric utility industry two different forces that contradict each other. The first is the concept of competition among utility companies; this places a greater emphasis on electric power generation cost control and affects generation/fuel mix selection and demand side management (DSM) activities. The second force, which is converse to the first, is that utilities are major contributors to the air pollution burden in the United States and environmental concerns are forcing them to reduce emissions of air pollutants by using more environmentally friendly fuels and implementing energy saving programs. This study evaluates the impact of deregulation within the investor owned electric utilities and how this deregulation effects air quality by investigating the trend in demand side management programs and generation/fuel mix. A survey was conducted of investor owned utilities and independent power producers. The results of the survey were analyzed by analysis of variance and regression analysis to determine the impact to Air Pollution. An air Quality Impact model was also developed in this study. This model consists of six modules: (1) demand side management and (2) consumption of coal, (3) gas, (4) renewable, (5) oil and (6) nuclear sources until the year 2005. Each module was analyzed separately and the result from each module was transferred into the Air Quality Impact model. The model assesses the changes in electricity generation within each module due to deregulation and these changes can then be correlated to the emission of air pollutants in the United States.

Development and Usability Testing of a Web-based Self-management Intervention for Oral Cancer Survivors and their Family Caregivers

PubMed Central

Badr, Hoda; Lipnick, Daniella; Diefenbach, Michael A; Posner, Marshall; Kotz, Tamar; Miles, Brett; Genden, Eric

2016-01-01

Oral cancer (OC) survivors experience debilitating side effects that affect their quality of life (QOL) and that of their caregivers. This study aimed to develop and evaluate a dyadic, web-based intervention to improve survivor self-management and survivor/caregiver QOL. A qualitative needs assessment (semi-structured interviews) with 13 OC survivors and 12 caregivers was conducted to discern information and support needs as well as preferences regarding website features and tools. Results using Grounded Theory analysis showed that OC survivors and caregivers: 1) want and need practical advice about managing side effects; 2) want to reach out to other survivors/caregivers for information and support; and, 3) have both overlapping and unique needs and preferences regarding website features. Usability testing (N=6 survivors; 5 caregivers) uncovered problems with the intuitiveness, navigation, and design of the website that were subsequently addressed. Users rated the website favorably on the dimensions of attractiveness, controllability, efficiency, intuitiveness, and learnability, and gave it a total usability score of 80/100. Overall, this study demonstrates that OC survivors and caregivers are interested in using an online program to improve QOL, and that providing tailored website content and features based on the person’s role as survivor or caregiver is important in this population. PMID:26507369

[Wellness-activities to prevent metabolic syndrome among patients with schizophrenia].

PubMed

Brönner, Monika; Betz, Christine; Christ, Sarah; Froböse, Teresa; Pitschel-Walz, Gabi; Bäuml, Josef

2010-01-01

Weight gain and metabolic disturbances are growing side effects of a modern antipsychotic therapy. Different programs were developed to reduce them. This article gives an overview of existing and evaluated programs. A literature research was made through PubMed. Relevant reviews and intervention studies were identified. Studies with the main outcome variable of weight reductions are numerous, even randomised controlled trials. Short-term weight loss under antipsychotic treatment is possible, but there is still a lack of long-term studies. Life style interventions, which include e. g. physical exercise, are not that common. Also, interventions such as wellness-activities, which contribute by means of adequate motivation strategies to an enhancement of the general well-being, are still missing. Present results turned out to be positive. Further programs which exceed weight management are required. There is necessity for more studies with consistent outcome variables and methods, especially long-term programs. Georg Thieme Verlag KG Stuttgart, New York.

Selection of Server-Side Technologies for an E-Business Curriculum

ERIC Educational Resources Information Center

Sandvig, J. Christopher

2007-01-01

The rapid growth of e-business and e-commerce has made server-side programming an increasingly important topic in information systems (IS) and computer science (CS) curricula. This article presents an overview of the major features of several popular server-side programming technologies and discusses the factors that influence the selection of…

Science to support adaptive habitat management: Overton Bottoms North Unit, Big Muddy National Fish and Wildlife Refuge, Missouri [Volumes 1-6

USGS Publications Warehouse

Jacobson, Robert B.

2006-01-01

Extensive efforts are underway along the Lower Missouri River to rehabilitate ecosystem functions in the channel and flood plain. Considerable uncertainty inevitably accompanies ecosystem restoration efforts, indicating the benefits of an adaptive management approach in which management actions are treated as experiments, and results provide information to feed back into the management process. The Overton Bottoms North Unit of the Big Muddy National Fish and Wildlife Refuge is a part of the Missouri River Fish and Wildlife Habitat Mitigation Project. The dominant management action at the Overton Bottoms North Unit has been excavation of a side-channel chute to increase hydrologic connectivity and to enhance shallow, slow current-velocity habitat. The side-channel chute also promises to increase hydrologic gradients, and may serve to alter patterns of wetland inundation and vegetation community growth in undesired ways. The U.S. Geological Survey's Central Region Integrated Studies Program (CRISP) undertook interdisciplinary research at the Overton Bottoms North Unit in 2003 to address key areas of scientific uncertainty that were highly relevant to ongoing adaptive management of the site, and to the design of similar rehabilitation projects on the Lower Missouri River. This volume presents chapters documenting the surficial geologic, topographic, surface-water, and ground-water framework of the Overton Bottoms North Unit. Retrospective analysis of vegetation community trends over the last 10 years is used to evaluate vegetation responses to reconnection of the Overton Bottoms North Unit to the river channel. Quasi-experimental analysis of cottonwood growth rate variation along hydrologic gradients is used to evaluate sensitivity of terrestrial vegetation to development of aquatic habitats. The integrated, landscape-specific understanding derived from these studies illustrates the value of scientific information in design and management of rehabilitation projects.

The Office of Inspector General (OIG)

NASA Technical Reports Server (NTRS)

Macisco, Christopher A.

2004-01-01

The NASA Office of Inspector General is the Federal Law Enforcement Agency at NASA which conducts criminal and regulatory investigations in which NASA is a victim. The OIG prevents and detects crime, fiaud, waste and abuse and assists NASA management in promoting economy, efficiency, and effectiveness in its programs and operations. Investigations (OI) and the Office of Audits (OA). The investigations side deals with criminal Investigations, administrative investigations, and civil investigations. The Audits side deals with inspections and assessments as well as the Auditing of NASA Programs and Activities. Our mission at the OIG is to conduct and supervise independent and objective audits and investigations relating to agency programs and operations; to promote economy, effectiveness and efficiency within the agency; to prevent and detect crime, fraud, waste and abuse in agency programs and operations; to review and make recommendations regarding existing and proposed legislation and regulations relating to agency programs and operations. We are also responsible for keeping the agency head and the Congress fully and currently informed of problems in agency programs and operations. deal with False Claims, False Statements, Conspiracy, Theft, Computer Crime, Mail Fraud, the Procurement Integrity Act, the Anti-Kickback Act, as well as noncompliance with NASA Management Instructions, the Federal Acquisition Regulations (FAR), and the Code of Federal Regulations (CFR). Most of the casework that is dealt with in our office is generated through gum shoe work or cases that we generate on our own. These cases can come from Law Enforcement Referrals, GIDEP Reports, EPlMS (NASA Quality System), Defense Contract Audit Agency, Newspaper Articles, and Confidential Information. In many cases, confidentiality is the biggest factor to informants coming forward. We are able to maintain confidentiality because the 01 is independent of NASA Management and doesn t report to the Center Directors, therefore the informant s mangers and supervisors are unaware of the informants actions. The only time when an informant s confidentiality may be compromised is when it is needed in a Court of Law and is released through a Judicial Court Order. During my tenure here at the NASA OIG/OI at Glenn Research Center, I have been involved in many different tasks. They have ranged from updating Suspected Unapproved Parts case files to independently interviewing NASA employees to turn up general background information. The 01 has the duty of informing NASA aeronautical safety managers of potential Nonconforming products. My mission is to compile a database of Nonconformance reports for distribution. The background information that I turn up from my interviews is then used to determine NASA s susceptibility to acceptance of unapproved parts. The IG organization is divided up into two separate disciplines, the Office of 01 investigations primarily focus on violations of Federal laws. Some of these violations

Managing Chemotherapy Side Effects: Bleeding Problems

MedlinePlus

... C ancer I nstitute Managing Chemotherapy Side Effects Bleeding Problems “My nurse said that chemotherapy could make ... with a clean cloth. Keep pressing until the bleeding stops. If you bruise: Put ice on the ...

Managing Chemotherapy Side Effects: Swelling (Fluid Retention)

MedlinePlus

N ational C ancer I nstitute Managing Chemotherapy Side Effects Swelling (Fluid retention) “My hands and feet were swollen and puffy. My nurse helped me understand why I had to stop eating salty ...

X-Windows Information Sharing Protocol Widget Class

NASA Technical Reports Server (NTRS)

Barry, Matthew R.

2006-01-01

The X-Windows Information Sharing Protocol (ISP) Widget Class ("Class") is used here in the object-oriented-programming sense of the word) was devised to simplify the task of implementing ISP graphical-user-interface (GUI) computer programs. ISP programming tasks require many method calls to identify, query, and interpret the connections and messages exchanged between a client and an ISP server. Most X-Windows GUI programs use widget sets or toolkits to facilitate management of complex objects. The widget standards facilitate construction of toolkits and application programs. The X-Windows Information Sharing Protocol (ISP) Widget Class encapsulates the client side of the ISP programming libraries within the framework of an X-Windows widget. Using the widget framework, X-Windows GUI programs can interact with ISP services in an abstract way and in the same manner as that of other graphical widgets, making it easier to write ISP GUI client programs. Wrapping ISP client services inside a widget framework enables a programmer to treat an ISP server interface as though it were a GUI. Moreover, an alternate subclass could implement another communication protocol in the same sort of widget.

An exploratory qualitative study of the meaning and value of a running/walking program for women after a diagnosis of breast cancer.

PubMed

Brunet, Jennifer; Saunders, Stephanie; Gifford, Wendy; Thomas, Roanne; Hamilton, Ryan

2018-05-01

To generate insights into the personal meaning and value of a running/walking program for women after a diagnosis of breast cancer. After completing a 12-week running/walking program with a 5-km training goal, eight women were interviewed and seven participated in a focus group. The interviews and focus group were audio-recorded and transcribed verbatim. Data were thematically analyzed. Data portrayed the personal benefits and value of the clinic. Four themes were identified: (1) receiving practical information and addressing targeted concerns, (2) pushing personal limits, (3) enabling a committed mindset, and (4) seeing benefits and challenges of running/walking with a group. Findings provide initial understanding of how women experience a running/walking program after a diagnosis of breast cancer and what they find to be important about their experiences. The range of positive benefits experienced by women suggests a running/walking program can help fill a gap in care for women diagnosed with breast cancer, and thus be part of cancer rehabilitation. However, because some women felt isolated at times, future research should seek to examine how running/walking programs can be modified and tailored so that all women find it socially beneficial. Implications for Rehabilitation The diagnosis and treatment of breast cancer can result in side effects and increase the risk of long-term disability. Physical activity can help women manage the side effects and lessen the risk of long-term disability. In a relatively small sample, this study shows that participation in a running/walking program can be an important part of breast cancer recovery.

DSM and electric utility competitiveness: An Illinois perspective

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

Jackson, P.W.

1994-12-31

A predominant theme in the current electric utility industry literature is that competitive forces have emerged and may become more prominent. The wholesale bulk power market is alreadly competitive, as non-utility energy service providers already have had a significant impact on that market; this trend was accelerated by the Energy Policy Act of 1992. Although competition at the retail level is much less pervasive, electric utility customers increasingly have greater choice in selecting energy services. These choices may include, depending on the customer, the ability to self-generate, switch fuels, move to a new location, or rely more heavily on demand-sidemore » management as a means of controlling electric energy use. This paper explores the subject of how demand-side management (DSM) programs, which are often developed by a utility to satisfy resource requirements as a part of its least-cost planning process, can affect the utility`s ability to compete in the energy services marketplace. In this context, the term `DSM` is used in this paper to refer to those demand-side services and programs which provide resources to the utility`s system. Depending on one`s perspective, DSM programs (so defined) can be viewed either as an enhancement to the competitive position of a utility by enabling it to provide its customers with a broader menu of energy services, simultaneously satisfying the objectives of the utility as well as those of the customers, or as a detractor to a utility`s ability to compete. In the latter case, the concern is with respect to the potential for adverse rate impacts on customers who are not participants in DSM programs. The paper consists of an identification of the pros and cons of DSM as a competitive strategy, the tradeoff which can occur between the cost impacts and rate impacts of DSM, and an examination of alternative strategies for maximizing the utilization of DSM both as a resource and as a competitive strategy.« less

Understanding Grief and Loss

MedlinePlus

... Cancer Coping With Uncertainty Managing Stress Coping with Anger Anxiety Depression Fear of Treatment-Related Side Effects Coping with ... Cancer Coping With Uncertainty Managing Stress Coping with Anger Anxiety Depression Fear of Treatment-Related Side Effects Coping with ...

A Technology Program that Rescues Spacecraft

NASA Astrophysics Data System (ADS)

Deutsch, Leslie J.; Lesh, J. R.

2004-03-01

There has never been a long-duration deep space mission that did not have unexpected problems during operations. JPL's Interplanetary Network Directorate (IND) Technology Program was created to develop new and improved methods of communication, navigation, and operations. A side benefit of the program is that it maintains a cadre of human talent and experimental systems that can be brought to bear on unexpected problems that may occur during mission operations. Solutions fall into four categories: applying new technology during operations to enhance science performance, developing new operational strategies, providing domain experts to help find solutions, and providing special facilities to trouble-shoot problems. These are illustrated here using five specific examples of spacecraft anomalies that have been solved using, at least in part, expertise or facilities from the IND Technology Program: Mariner 10, Voyager, Galileo, SOHO, and Cassini/Huygens. In this era of careful cost management, and emphasis on returns-on-investment, it is important to recognize this crucial additional benefit from such technology program investments.

Grieving the Loss of a Sibling

MedlinePlus

... Cancer Coping With Uncertainty Managing Stress Coping with Anger Anxiety Depression Fear of Treatment-Related Side Effects Coping with ... Cancer Coping With Uncertainty Managing Stress Coping with Anger Anxiety Depression Fear of Treatment-Related Side Effects Coping with ...

The Ed.D. Program at the University of Illinois at Chicago: Using Continuous Improvement to Promote School Leadership Preparation

ERIC Educational Resources Information Center

Cosner, Shelby; Tozer, Steve; Smylie, Mark

2012-01-01

This article describes the process of replacing a modest Master's level school leader preparation program with an innovative Ed.D. program at the University of Illinois at Chicago (UIC). The new doctoral program is intensive, highly selective, intellectually rigorous, and field-based. The authors provide side-by-side comparisons of the difference…

AN OBSERVATIONAL STUDY OF SOCIAL CONTROL, MOOD, AND SELF-EFFICACY IN COUPLES DURING TREATMENT FOR HEAD AND NECK CANCER

PubMed Central

BADR, HODA; YEUNG, CHI; LEWIS, MEGAN A.; MILBURY, KATHRIN; REDD, WILLIAM H.

2014-01-01

OBJECTIVE Head and neck cancer (HNC) patients experience debilitating side effects, including abnormally reduced salivation and difficulty swallowing. Intensive self-care protocols are prescribed to control side effects and minimize discomfort, but non-adherence rates are high. Although spouses are in a prime position to encourage adherence, studies have yet to examine how spouse social control (i.e., attempts to influence patient behavior to support adherence) affects HNC patient mood and self-efficacy for engaging in these self-care routines. METHODS One-hundred twenty-five HNC couples where the patient (86% male) was undergoing radiotherapy were recorded in the laboratory as they discussed a cancer-related issue that the patient identified as being a topic of concern. RESULTS Sixty-eight couples discussed side-effects and spouses engaged in social control in 61 of these discussions. Although oral complications and pain were frequently identified by patients as being topics of concern, dental/oral care and pain management were some of the least likely self-care behaviors to be targeted by spouses, who focused primarily on encouraging patients to maintain their weight and hydration. Although spouses engaged in an almost equal number of positive and negative control attempts, only positive control was significantly (p<.05) associated with patient positive mood and self-efficacy. CONCLUSION HNC couples may benefit from programs that emphasize the regular practice of self-care routines to control oral side effects, pain, and nutrition/hydration problems. Likewise, programs that encourage spouses to maximize their use of positive social control may also boost patients’ mood during treatment and empower them to engage in recommended self-care behaviors. PMID:25471820

Attitudes of Italian general practitioners in the treatment of cancer pain. The Committee of the Associazione Italiana di Oncologia Medica (AIOM).

PubMed

Minotti, V; Betti, M

1997-01-01

The attitude of Italian general practitioners in prescribing practices for patients with cancer pain was assessed by means of a questionnaire. The results indicated that among most of the doctors who completed the questionnaire the basic principles of pain treatment in cancer patients are largely understood. Oral morphine emerged as the most commonly used opioid (60%) and controlled-release morphine as the preferred preparation. Non-steroidal anti-inflammatory drugs were the most commonly used minor analgesics. Fear of side effects and restrictive prescribing regulations emerged as the most important barrier against adequate pain management. The survey emphasised the need for continued efforts in implementing specific educational programming for improvement in cancer pain management.

[Nursing in the movies: its image during the Spanish Civil War].

PubMed

Siles González, J; García Hernández, E; Cibanal Juan, L; Gallardo Frías, Y; Lillo Crespo, M

1998-12-01

The cinema had carried out a determining role in the development of stereotypes and in a wide gamut of models related to real life situations. The objective of this analysis is to determine the influence cinema had on the image of nurses during the Spanish Civil War from 1936-1939. These are the initial hypotheses: the role of Spanish nurses during the civil war was reflected by both sides in their respective movie productions; and the image of nurses shown in these films, on both sides, presents a conflicting role concept for women in society. Following strategies developed by specialists in film analysis (Bondwell 1995, Uneso 1995, Carmona 1991) a total of 453 movie productions, 360 on the republican side and 93 on the national side, were reviewed. These films were listed in the Spanish National Films Library records. After analyzing the Spanish cinema productions during the Spanish Civil War, data relating to 453 films were identified. The genre included documents, news programs and fiction movies. 77 were produced in 1936, 235 in 1937, 102 in 1938 and 39 in 1939. A tremendous difference exists between the republican productions, 79% of the total, and the national productions. By genres, the types produced on the republican side were: in 1936, 53 documentals, 4 news programs and 9 fiction films; in 1937, 186 documentals, 5 news programs and 19 fiction films; in 1938, 72 documentals, 1 news programs and 2 fiction films; in 1939, 2 documentals and 2 fiction films. On the national side, their productions were: in 1936, 10 documentals and 1 fiction film; in 1937, 22 documentals, 2 news programs and 1 fiction film; in 1938, 19 documentals and 3 news programs; in 1939, 29 documentals and 6 fiction films. During the Spanish Civil War, movies produced by both sides made an effort to reflect their ideal woman as a stereotypical ideal nurse. This ideal nurse showed the values, ideas, aesthetics and prejudices each side held in the war.

A Novel Location-Centric IoT-Cloud Based On-Street Car Parking Violation Management System in Smart Cities.

PubMed

Dinh, Thanh; Kim, Younghan

2016-06-02

Nowadays, in big cities, parking management is a critical issue from both the driver's side and the city government's side. From the driver's side, how to find an available parking lot in a city is a considerable concern. As a result, smart parking systems recently have received great interest, both in academia and industry. From the city government's side, how to manage and distribute such a limited public parking resource efficiently to give every visitor a fair chance of finding an on-street parking lot is also a considerable concern. However, existing studies of smart parking management focus only on assisting the driver's side to find available parking spaces. This study aims to raise a new perspective on such smart parking management and to propose a novel location-centric IoT-cloud-based parking violation management system. The system is designed to assist authoritative officers in finding parking violations easily and recommends the least cost path for officers so that officers can achieve their highest productivity in finding parking violations and issuing parking tickets. Experimental results show that the system not only improves the productivity of officers in finding parking violations and issuing tickets, but also helps reduce the traveling cost of officers and to reduce the average violation period of violating cars considerably.

A Novel Location-Centric IoT-Cloud Based On-Street Car Parking Violation Management System in Smart Cities

PubMed Central

Dinh, Thanh; Kim, Younghan

2016-01-01

Nowadays, in big cities, parking management is a critical issue from both the driver’s side and the city government’s side. From the driver’s side, how to find an available parking lot in a city is a considerable concern. As a result, smart parking systems recently have received great interest, both in academia and industry. From the city government’s side, how to manage and distribute such a limited public parking resource efficiently to give every visitor a fair chance of finding an on-street parking lot is also a considerable concern. However, existing studies of smart parking management focus only on assisting the driver’s side to find available parking spaces. This study aims to raise a new perspective on such smart parking management and to propose a novel location-centric IoT-cloud-based parking violation management system. The system is designed to assist authoritative officers in finding parking violations easily and recommends the least cost path for officers so that officers can achieve their highest productivity in finding parking violations and issuing parking tickets. Experimental results show that the system not only improves the productivity of officers in finding parking violations and issuing tickets, but also helps reduce the traveling cost of officers and to reduce the average violation period of violating cars considerably. PMID:27271620

Computer program determines exact two-sided tolerance limits for normal distributions

NASA Technical Reports Server (NTRS)

Friedman, H. A.; Webb, S. R.

1968-01-01

Computer program determines by numerical integration the exact statistical two-sided tolerance limits, when the proportion between the limits is at least a specified number. The program is limited to situations in which the underlying probability distribution for the population sampled is the normal distribution with unknown mean and variance.

Managing Chemotherapy Side Effects: Urination Changes

MedlinePlus

... how important it was to drink lots of water. She told me what changes to call about, such as a fever or ... when you urinate Managing Chemotherapy Side Effects: Urination ... Drink liquids such as water, soup, milkshakes, and cranberry juice. Add extra water ...

Managing Chemotherapy Side Effects: Hair Loss (Alopecia)

MedlinePlus

... C ancer I nstitute Managing Chemotherapy Side Effects Hair Loss (Alopecia) “Losing my hair was hard at first. Then I got used ... uncovered.” Questions other people have asked: Why does hair fall out? Chemotherapy can harm the cells that ...

The PhEDEx next-gen website

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

Egeland, R.; Huang, C. H.; Rossman, P.

PhEDEx is the data-transfer management solution written by CMS. It consists of agents running at each site, a website for presentation of information, and a web-based data-service for scripted access to information. The website allows users to monitor the progress of data-transfers, the status of site agents and links between sites, and the overall status and behaviour of everything about PhEDEx. It also allows users to make and approve requests for data-transfers and for deletion of data. It is the main point-of-entry for all users wishing to interact with PhEDEx. For several years, the website has consisted of a singlemore » perl program with about 10K SLOC. This program has limited capabilities for exploring the data, with only coarse filtering capabilities and no context-sensitive awareness. Graphical information is presented as static images, generated on the server, with no interactivity. It is also not well connected to the rest of the PhEDEx codebase, since much of it was written before the data-service was developed. All this makes it hard to maintain and extend. We are re-implementing the website to address these issues. The UI is being rewritten in Javascript, replacing most of the server-side code. We are using the YUI toolkit to provide advanced features and context-sensitive interaction, and will adopt a Javascript charting library for generating graphical representations client-side. This relieves the server of much of its load, and automatically improves server-side security. The Javascript components can be re-used in many ways, allowing custom pages to be developed for specific uses. In particular, standalone test-cases using small numbers of components make it easier to debug the Javascript than it is to debug a large server program. Information about PhEDEx is accessed through the PhEDEx data-service, since direct SQL is not available from the clients browser. This provides consistent semantics with other, externally written monitoring tools, which already use the data-service. It also reduces redundancy in the code, yielding a simpler, consolidated codebase. In this talk we describe our experience of re-factoring this monolithic server-side program into a lighter client-side framework. We describe some of the techniques that worked well for us, and some of the mistakes we made along the way. We present the current state of the project, and its future direction.« less

Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients.

PubMed

Shah, Surbhi; Young, Henry N; Cobran, Ewan K

2018-06-01

The high frequency of treatment-related side effects for men with localized prostate cancer creates uncertainty for treatment outcomes. This study assessed the comparative effectiveness of treatment-related side effects associated with conservative management and cryotherapy in patients with localized prostate cancer. A retrospective longitudinal cohort study was conducted, using the linked data of the Surveillance, Epidemiology, and End Results and Medicare, which included patients diagnosed from 2000 through year 2013, and their Medicare claims information from 2000 through 2014. To compare the differences in baseline characteristics and treatment-related side effects between the study cohorts, χ 2 tests were conducted. Multivariate logistic regression was used to assess the association between treatment selection and side effects. There were 7,998 and 3,051 patients in the conservative management and cryotherapy cohort, respectively. The likelihood of erectile dysfunction, lower urinary tract obstruction, urinary fistula, urinary incontinence, and hydronephrosis was reported to be significantly lower (53%, 35%, 69%, 65%, and 36%, respectively) in the conservative management cohort. Conservative management had a lower likelihood of treatment-related side effects compared to cryotherapy. However, further research is needed to compare other significant long-term outcomes such as costs associated with these treatment choices and quality of life.

Java-based browsing, visualization and processing of heterogeneous medical data from remote repositories.

PubMed

Masseroli, M; Bonacina, S; Pinciroli, F

2004-01-01

The actual development of distributed information technologies and Java programming enables employing them also in the medical arena to support the retrieval, integration and evaluation of heterogeneous data and multimodal images in a web browser environment. With this aim, we used them to implement a client-server architecture based on software agents. The client side is a Java applet running in a web browser and providing a friendly medical user interface to browse and visualize different patient and medical test data, integrating them properly. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. Based on the Java Advanced Imaging API, processing and analysis tools were developed to support the evaluation of remotely retrieved bioimages through the quantification of their features in different regions of interest. The Java platform-independence allows the centralized management of the implemented prototype and its deployment to each site where an intranet or internet connection is available. Giving healthcare providers effective support for comprehensively browsing, visualizing and evaluating medical images and records located in different remote repositories, the developed prototype can represent an important aid in providing more efficient diagnoses and medical treatments.

Identifying and managing the adverse effects of immune checkpoint blockade

PubMed Central

Winer, Arthur; Bodor, J. Nicholas

2018-01-01

Immunotherapy has revolutionized the field of oncology. By inhibiting the cytotoxic T-lymphocyte-associated protein (CTLA-4) and programmed death-1 (PD-1) immune checkpoint pathways, multiple studies have demonstrated greatly improved survival in locally advanced and metastatic cancers including melanoma, renal, lung, gastric, and hepatocellular carcinoma. Trials in other malignancies are ongoing, and undoubtedly the number of drugs in this space will grow beyond the six currently approved by the Food and Drug Administration. However, by altering the immune response to fight cancer, a new class of side effects has emerged known as immune-related adverse events (irAEs). These adverse events are due to overactivation of the immune system in almost any organ of the body, and can occur at any point along a patient’s treatment course. irAEs such as endocrinopathies (thyroiditis), colitis, and pneumonitis may occur more commonly. However, other organs such as the liver, heart, or brain may also be affected by immune overactivation and any of these side effects may become life threatening. This review presents an approach to promptly recognize and manage these toxicities, to hopefully minimize morbidity and mortality from irAEs. PMID:29593893

Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review.

PubMed

Augestad, Knut Magne; Rose, Johnie; Crawshaw, Benjamin; Cooper, Gregory; Delaney, Conor

2014-05-15

Most patients treated with curative intent for colorectal cancer (CRC) are included in a follow-up program involving periodic evaluations. The survival benefits of a follow-up program are well delineated, and previous meta-analyses have suggested an overall survival improvement of 5%-10% by intensive follow-up. However, in a recent randomized trial, there was no survival benefit when a minimal vs an intensive follow-up program was compared. Less is known about the potential side effects of follow-up. Well-known side effects of preventive programs are those of somatic complications caused by testing, negative psychological consequences of follow-up itself, and the downstream impact of false positive or false negative tests. Accordingly, the potential survival benefits of CRC follow-up must be weighed against these potential negatives. The present review compares the benefits and side effects of CRC follow-up, and we propose future areas for research.

Microgravity

NASA Image and Video Library

2001-06-01

The schematic depicts the major elements and flow patterns inside the NASA Bioreactor system. Waste and fresh medium are contained in plastic bags placed side-by-side so the waste bag fills as the fresh medium bag is depleted. The compliance vessel contains a bladder to accommodate pressure transients that might damage the system. A peristolic pump moves fluid by squeezing the plastic tubing, thus avoiding potential contamination. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

How hepatitis C patients manage the treatment process of pegylated interferon and ribavirin therapy: a qualitative study.

PubMed

Tsai, Shu-Mei; Kao, Jung-Ta; Tsai, Yun-Fang

2016-07-11

Hepatitis C virus (HCV) infection is a global public health issue. Adequate treatment for hepatitis C patients is important, but anticipated side effects make patients fearful of receiving treatment. Little is known about the experiences of hepatitis C patients who have completed treatment with pegylated interferon and ribavirin. The purpose of this study was to explore the experiences of hepatitis C patients who had undergone therapy with pegylated interferon and ribavirin and gain an understanding of what factors contributed to completion of treatment. This was a qualitative study with 21 adult hepatitis C patients purposively sampled from outpatient liver clinics of a medical university hospital in Taichung City, Taiwan. Participants had completed 6-12 months of therapy with pegylated interferon and ribavirin. Data were collected through individual, face-to-face, in-depth interviews conducted in the participants' homes from June-October 2013. Data were analysed using conventional content analysis. Data analysis revealed three themes that described the strategies employed to alleviate and ease symptoms and manage the processes involved: restructuring their lifestyle, adopting a positive attitude, and seeking support. Hepatitis C patients face many challenges during treatment with pegylated interferon and ribavirin. These findings provide knowledge that can be used in designing effective programs to help other Hepatitis C patients manage the side effects of pegylated interferon and ribavirin therapy, complete treatment and improve quality of life.

An evaluation of two large scale demand side financing programs for maternal health in India: the MATIND study protocol.

PubMed

Sidney, Kristi; de Costa, Ayesha; Diwan, Vishal; Mavalankar, Dileep V; Smith, Helen

2012-08-27

High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSY)and Chiranjeevi Yojana (CY), were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making among policy makers and program managers who currently work with or are planning similar programs in different contexts.

Advances in Pharmacotherapeutics of Space Motion Sickness

NASA Technical Reports Server (NTRS)

Putcha, Lakshmi

2006-01-01

Space Motion Sickness (SMS) is common occurrence in the U.S. manned space flight program and nearly 2/3 of Shuttle crewmembers experience SMS. Several drugs have been prescribed for therapeutic management of SMS. Typically, orally-administered SMS medications (scopolamine, promethazine) have poor bioavailability and often have detrimental neurocognitive side effects at recommended doses. Intramuscularly administered promethazine (PMZ) is perceived to have optimal efficacy with minimal side effects in space. However, intramuscular injections are painful and the sedating neurocognitive side effects of promethazine, significant in controlled ground testing, may be masked in orbit because injections are usually given prior to crew sleep. Currently, EVAs cannot be performed by symptomatic crew or prior to flight day three due to the lack of a consistently efficacious drug, concern about neurocognitive side effects, and because an in-suit vomiting episode is potentially fatal. NASA has long sought a fast acting, consistently effective anti-motion sickness medication which has only minor neurocognitive side effects. Development of intranasal formulations of scopolamine and promethazine, the two commonly used SMS drugs at NASA for both space and reduced gravity environment medical operations, appears to be a logical alternative to current treatment modalities for SMS. The advantages are expected to be fast absorption, reliable and high bioavailability, and probably reduced neurocognitive side effects owing to dose reduction. Results from clinical trials with intranasal scopolamine gel formulation and pre-clinical testing of a prototype microcapsule intranasal gel dosage form of PMZ (INPMZ) will be discussed. These formulations are expected to offer a dependable and effective noninvasive treatment option for SMS.

EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT COST-SHARED DEMONSTRATIONS

EPA Science Inventory

The paper discusses an investigation of how photovoltaics (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utilit...

U.S. EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT PROJECT

EPA Science Inventory

The paper discusses an investigation of how photovoltaic (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utiliti...

Family Wellness, Not HIV Prevention

PubMed Central

Swendeman, Dallas; Flannery, Diane

2010-01-01

HIV exceptionalism (and disease-specific programs generally) garner both unbalanced funding and the most talented personnel, distorting local health priorities. In support of HIV exceptionalism, the successful mobilization of significant global health sector resources was not possible prior to HIV. Both sides of the debate have merits; rather than perpetuating polarization, we suggest that sustained improvements in global health require creating a prevention infrastructure to meet multiple health challenges experienced by local communities. We propose four fundamental shifts in HIV and disease prevention: (1) horizontally integrating prevention at one site locally, with priorities tailored to local health challenges and managed by local community leaders; (2) using a family wellness metaphor for services, not disease prevention; (3) implementing evidence-based prevention programs (EBPP) based on common principles, factors, and processes, rather than replication of specific programs; and (4) utilizing the expertise of private enterprise to re-design EBPP into highly attractive, engaging, and accessible experiences. PMID:19148744

Positive Side Effects of a Job-Related Training Program for Older Adults in South Korea

ERIC Educational Resources Information Center

Lee, Minhong; Choi, Jae-Sung

2012-01-01

The objective of the current study was to evaluate empirically positive side effects of a job-related training program on older adults' self-esteem, depression, and social networks. A total of 70 older adults participated in the study after completing the Older Paraprofessional Training Program developed and provided by the Continuing Education…

Rehabilitation and transition after lung transplantation in children.

PubMed

Burton, J H; Marshall, J M; Munro, P; Moule, W; Snell, G I; Westall, G P

2009-01-01

We describe the key components of an outpatient pediatric recovery and rehabilitation program set up within the adult lung transplant service at the Alfred Hospital, Melbourne. Following discharge, pediatric lung transplant recipients and their families participated in an intensive 3-month outpatient rehabilitation program. Weekly sessions included education regarding transplant issues, physiotherapy, and occupational therapy sessions. The overall aim of the program was to comprehensively address physical rehabilitation and psychosocial and educational needs. Sessions tailored to meet the individual needs of the child were presented at an appropriate cognitive level. Education sessions for both the children and parents focused on medications, identification of infection and rejection, nutrition, physiotherapy/rehabilitation, occupational roles and stress management, donor issues, psychosocial readjustment, and transition issues. Physiotherapy included a progressive aerobic and strength training program, postural reeducation, and core stability. We incorporate Age-appropriate play activities: running, dancing, jumping, ball skills, and so on. Occupational therapy sessions addressed the primary roles of patient, students, and player. Transitions such as returning to school, friends, and the community were explored. Issues discussed included adjustment to new health status, strategies to manage side effects of medications, and altered body image issues. Weekly multidisciplinary team meetings were used to discuss and plan the rehabilitation progress. School liaison and visits occurred prior to school commencement with follow-up offered to review the ongoing transition process. Both patients and parents have reported a high level of satisfaction with the rehabilitation program. We plan to formally evaluate the program in the future.

Dual and parallel postdoctoral training programs: implications for the osteopathic medical profession.

PubMed

Burkhart, Diane N; Lischka, Terri A

2011-04-01

Students in colleges of osteopathic medicine have several options when considering postdoctoral training programs. In addition to training programs approved solely by the American Osteopathic Association or accredited solely by the Accreditation Council for Graduate Medical Education (ACGME), students can pursue programs accredited by both organizations (ie, dually accredited programs) or osteopathic programs that occur side-by-side with ACGME programs (ie, parallel programs). In the present article, we report on the availability and growth of these 2 training options and describe their benefits and drawbacks for trainees and the osteopathic medical profession as a whole.

Cover crop water quality benefits in intensive production

USDA-ARS?s Scientific Manuscript database

Fresh market tomatoes are typically grown in in raised beds covered in polyethylene mulch with bare-soil furrows between the beds. Field experiments were conducted over five years to examine two alternative management strategies. In side-by-side comparison with the traditional management practice, t...

Impact of the Urban Reproductive Health Initiative on family planning uptake at facilities in Kenya, Nigeria, and Senegal.

PubMed

Winston, Jennifer; Calhoun, Lisa M; Corroon, Meghan; Guilkey, David; Speizer, Ilene

2018-01-05

The 2012 London Summit on Family Planning set ambitious goals to enable 120 million more women and adolescent girls to use modern contraceptives by 2020. The Urban Reproductive Health Initiative (URHI) was a Bill & Melinda Gates Foundation funded program designed to help contribute to these goals in urban areas in India, Kenya, Nigeria, and Senegal. URHI implemented a range of country-specific demand and supply side interventions, with supply interventions generally focused on improved service quality, provider training, outreach to patients, and commodity stock management. This study uses data collected by the Measurement, Learning & Evaluation (MLE) Project to examine the effectiveness of these supply-side interventions by considering URHI's influence on the number of family planning clients at health facilities over a four-year period in Kenya, Nigeria, and Senegal. The analysis used facility audits and provider surveys. Principal-components analysis was used to create country-specific program exposure variables for health facilities. Fixed-effects regression was used to determine whether family planning uptake increased at facilities with higher exposure. Outcomes of interest were the number of new family planning acceptors and the total number of family planning clients per reproductive health care provider in the last year. Higher program component scores were associated with an increase in new family planning acceptors per provider in Kenya (β = 18, 95% CI = 7-29), Nigeria (β = 14, 95% CI = 8-20), and Senegal (β = 7, 95% CI = 3-12). Higher scores were also associated with more family planning clients per provider in Kenya (β = 31, 95% CI = 7-56) and Nigeria (β = 26, 95% CI = 15-38), but not in Senegal. Supply-side interventions have increased the number of new family planning acceptors at facilities in urban Nigeria, Kenya, and Senegal and the overall number of clients in urban Nigeria and Kenya. While tailoring to the local environment, programs seeking to increase family planning use should include components to improve availability and quality of family planning services, which are part of a rights-based approach to family planning programming.

Randomized Controlled Trial of a Home‐Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor‐Associated Arthralgia in Breast Cancer Survivors

PubMed Central

Callahan, Leigh F.; Cleveland, Rebecca J.; Arbeeva, Liubov L.; Hackney, Betsy S.; Muss, Hyman B.

2017-01-01

Abstract Background. In postmenopausal women diagnosed with breast cancer (BC), most BC tumors are hormone receptor positive and guidelines recommend adjuvant endocrine therapy that includes an aromatase inhibitor (AI). This study investigates the impact of a 6‐week, home‐based, self‐directed walking program on the commonly reported side effect of AI‐associated arthralgia (AIAA). Materials and Methods. In this phase II trial, consented BC patients were randomized to walking Intervention (n = 31) or Wait List Control (WLC; n = 31). Eligibility criteria included: stage 0–III BC, on AI for at least 4 weeks, ≥3 on a 5‐point scale inquiring about joint symptom intensity “at its worst,” and exercising ≤150 minutes per week. Outcomes were self‐reported joint symptoms and psychosocial measures. Analyses comparing Intervention and WLC groups were conducted on an intention‐to‐treat basis to assess intervention impact at 6 weeks (postintervention) and at 6‐months follow‐up. Adjusted means were calculated to assess differences in two groups. Results. In our final sample (n = 62), mean age was 64 years, 74% were white, and 63% had a body mass index of 30 or higher. At postintervention, Intervention group participants reported significantly increased walking minutes per week, reduced stiffness, less difficulty with activities of daily living (ADL), and less perceived helplessness in managing joint symptoms. At 6‐months follow‐up (postwalking period in both Intervention and WLC), walking minutes per week had decreased significantly; however, improvements in stiffness and difficulty with ADLs were maintained. Conclusion. This study adds to the growing evidence base suggesting exercise as a safe alternative or adjunct to medications for the management of AIAA. Implications for Practice. Breast cancer survivors whose adjuvant endocrine treatment includes an aromatase inhibitor (AI) often experience the side effect of AI‐associated arthralgia (AIAA). This study investigates the impact of a 6‐week, home‐based, self‐directed walking program in the management of AIAA. Compared with Wait List Control, women in the Intervention group reported significantly increased walking minutes per week, reduced stiffness, less difficulty with activities of daily living, and less perceived helplessness in managing joint symptoms. This study adds to the growing evidence base suggesting exercise as a safe alternative or adjunct to medications for the management of AIAA. PMID:28698390

Single-step simultaneous side-by-side placement of a self-expandable metallic stent with a 6-Fr delivery system for unresectable malignant hilar biliary obstruction: a feasibility study.

PubMed

Kawakubo, Kazumichi; Kawakami, Hiroshi; Kuwatani, Masaki; Kudo, Taiki; Abe, Yoko; Kawahata, Shuhei; Kubo, Kimitoshi; Kubota, Yoshimasa; Sakamoto, Naoya

2015-02-01

Bilateral self-expandable metallic stent (SEMS) placement for the management of unresectable malignant hilar biliary obstruction (UMHBO) is technically challenging to perform using the existing metallic stents with thick delivery systems. The recently developed 6-Fr delivery systems could facilitate a single-step simultaneous side-by-side placement through the accessory channel of the duodenoscope. The aim of this study was to evaluate the feasibility of this procedure. Between May and September 2013, 13 consecutive patients with UMHBO underwent a single-step simultaneous side-by-side placement of SEMS with the 6-Fr delivery system. The technical success rate, stent patency, and rate of complications were evaluated from the prospectively collected database. Technical success was achieved in 11 (84.6%, 95% confidence interval [CI]: 57.8-95.8) patients. The median procedure time was 25 min. Early and late complications were observed in 23% (one segmental cholangitis and two liver abscesses) and 15% (one segmental cholangitis and one cholecystitis) patients, respectively. Median dysfunction free patency was 263 days (95% CI: 37-263). Five patients (38%) experienced stent occlusion that was successfully managed by endoscopic stent placement. A single-step simultaneous side-by-side placement of SEMS with a 6-Fr delivery system was feasible for the management of UMHBO. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Using NetCloak to develop server-side Web-based experiments without writing CGI programs.

PubMed

Wolfe, Christopher R; Reyna, Valerie F

2002-05-01

Server-side experiments use the Web server, rather than the participant's browser, to handle tasks such as random assignment, eliminating inconsistencies with JAVA and other client-side applications. Heretofore, experimenters wishing to create server-side experiments have had to write programs to create common gateway interface (CGI) scripts in programming languages such as Perl and C++. NetCloak uses simple, HTML-like commands to create CGIs. We used NetCloak to implement an experiment on probability estimation. Measurements of time on task and participants' IP addresses assisted quality control. Without prior training, in less than 1 month, we were able to use NetCloak to design and create a Web-based experiment and to help graduate students create three Web-based experiments of their own.

A novel microgrid demand-side management system for manufacturing facilities

NASA Astrophysics Data System (ADS)

Harper, Terance J.

Thirty-one percent of annual energy consumption in the United States occurs within the industrial sector, where manufacturing processes account for the largest amount of energy consumption and carbon emissions. For this reason, energy efficiency in manufacturing facilities is increasingly important for reducing operating costs and improving profits. Using microgrids to generate local sustainable power should reduce energy consumption from the main utility grid along with energy costs and carbon emissions. Also, microgrids have the potential to serve as reliable energy generators in international locations where the utility grid is often unstable. For this research, a manufacturing process that had approximately 20 kW of peak demand was matched with a solar photovoltaic array that had a peak output of approximately 3 KW. An innovative Demand-Side Management (DSM) strategy was developed to manage the process loads as part of this smart microgrid system. The DSM algorithm managed the intermittent nature of the microgrid and the instantaneous demand of the manufacturing process. The control algorithm required three input signals; one from the microgrid indicating the availability of renewable energy, another from the manufacturing process indicating energy use as a percent of peak production, and historical data for renewable sources and facility demand. Based on these inputs the algorithm had three modes of operation: normal (business as usual), curtailment (shutting off non-critical loads), and energy storage. The results show that a real-time management of a manufacturing process with a microgrid will reduce electrical consumption and peak demand. The renewable energy system for this research was rated to provide up to 13% of the total manufacturing capacity. With actively managing the process loads with the DSM program alone, electrical consumption from the utility grid was reduced by 17% on average. An additional 24% reduction was accomplished when the microgrid and DSM program was enabled together, resulting in a total reduction of 37%. On average, peak demand was reduced by 6%, but due to the intermittency of the renewable source and the billing structure for peak demand, only a 1% reduction was obtained. During a billing period, it only takes one day when solar irradiance is poor to affect the demand reduction capabilities. To achieve further demand reduction, energy storage should be introduced and integrated.

Sociological survey in a municipality with a high level separate collection programme in an area of historic unpopularity

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

De Feo, Giovanni, E-mail: g.defeo@unisa.it

2014-08-15

Highlights: • Behaviours, opinions and knowledge of citizens on MSW management were investigated. • The knowledge level was better than that of nearby university students and citizens. • The higher the education level, the greater the level of knowledge was. • The local authority showed a leading role in terms of waste management. • Trust is the key to any social program success including waste management programs. - Abstract: Behaviours, opinions and knowledge of citizens on MSW and separate collection were investigated in the city of Mercato San Severino (about 22,000 people), in the Campania region of Southern Italy thatmore » is an area suffering from a serious solid waste emergency that has lasted over 17 years due to the absence of treatment facilities. The image of heaps of rubbish in the streets of Naples and other nearby cities is only one side of the coin. Mercato San Severino has adopted an effective kerbside collection system since 2001 and a pay-as-you-throw program during 2005, guaranteeing more than the minimum level of recycling required by the Italian legislation. Structured questionnaires were administered to a sample of 500 people in 2010. Chi-square tests of independence were applied to state whether the differences were statistically significant (5%). About 90% of the sample stated that the success of the separate collection program was due to either the citizens and local authority or only the local authority, highlighting the leading role of the local authority and confirming that trust is the key to any social program success. The registered level of knowledge was better than that of nearby university students and citizens. The higher the education level, the greater the level of knowledge was.« less

Waste management under multiple complexities: inexact piecewise-linearization-based fuzzy flexible programming.

PubMed

Sun, Wei; Huang, Guo H; Lv, Ying; Li, Gongchen

2012-06-01

To tackle nonlinear economies-of-scale (EOS) effects in interval-parameter constraints for a representative waste management problem, an inexact piecewise-linearization-based fuzzy flexible programming (IPFP) model is developed. In IPFP, interval parameters for waste amounts and transportation/operation costs can be quantified; aspiration levels for net system costs, as well as tolerance intervals for both capacities of waste treatment facilities and waste generation rates can be reflected; and the nonlinear EOS effects transformed from objective function to constraints can be approximated. An interactive algorithm is proposed for solving the IPFP model, which in nature is an interval-parameter mixed-integer quadratically constrained programming model. To demonstrate the IPFP's advantages, two alternative models are developed to compare their performances. One is a conventional linear-regression-based inexact fuzzy programming model (IPFP2) and the other is an IPFP model with all right-hand-sides of fussy constraints being the corresponding interval numbers (IPFP3). The comparison results between IPFP and IPFP2 indicate that the optimized waste amounts would have the similar patterns in both models. However, when dealing with EOS effects in constraints, the IPFP2 may underestimate the net system costs while the IPFP can estimate the costs more accurately. The comparison results between IPFP and IPFP3 indicate that their solutions would be significantly different. The decreased system uncertainties in IPFP's solutions demonstrate its effectiveness for providing more satisfactory interval solutions than IPFP3. Following its first application to waste management, the IPFP can be potentially applied to other environmental problems under multiple complexities. Copyright © 2012 Elsevier Ltd. All rights reserved.

DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS

EPA Science Inventory

This study investigated the pollutant emission reduction and demand-side management potential of 16 photovoltaic (PV) systems installed across the U.S. in 1993 and 1994. The project was sponsored by the U.S. Environmental Protection Agency (EPA) and 11 electric utilities. This ar...

Comparison and Assessment of Mechanical and Herbicide-Chemical Side-Trimming Methods of Managing Roadside Vegetation by the Texas Department of Transportation (TxDOT)

DOT National Transportation Integrated Search

2012-09-01

The project compared and assessed the mechanical and herbicide-chemical side-trimming methods : that TxDOT uses to manage roadside vegetation. This report discusses safety, effectiveness, and economic : costs of these methods. It also shares industry...

Counseling issues and management of side effects for women using depot medroxyprogesterone acetate contraception.

PubMed

Nelson, A L

1996-05-01

Patients satisfaction is crucial to maximizing long-term utilization and efficacy of any contraceptive method. Satisfaction is enhanced when appropriate preutilization counseling is offered and when side effects are successfully managed. This article provides a conceptual model for patient counseling, highlights the significant points that should be included in counseling patients about depot medroxyprogesterone acetate (DMPA) and offers clinical suggestions to help evaluate and treat the more common side effects associated with DMPA use.

Protein side chain conformation predictions with an MMGBSA energy function.

PubMed

Gaillard, Thomas; Panel, Nicolas; Simonson, Thomas

2016-06-01

The prediction of protein side chain conformations from backbone coordinates is an important task in structural biology, with applications in structure prediction and protein design. It is a difficult problem due to its combinatorial nature. We study the performance of an "MMGBSA" energy function, implemented in our protein design program Proteus, which combines molecular mechanics terms, a Generalized Born and Surface Area (GBSA) solvent model, with approximations that make the model pairwise additive. Proteus is not a competitor to specialized side chain prediction programs due to its cost, but it allows protein design applications, where side chain prediction is an important step and MMGBSA an effective energy model. We predict the side chain conformations for 18 proteins. The side chains are first predicted individually, with the rest of the protein in its crystallographic conformation. Next, all side chains are predicted together. The contributions of individual energy terms are evaluated and various parameterizations are compared. We find that the GB and SA terms, with an appropriate choice of the dielectric constant and surface energy coefficients, are beneficial for single side chain predictions. For the prediction of all side chains, however, errors due to the pairwise additive approximation overcome the improvement brought by these terms. We also show the crucial contribution of side chain minimization to alleviate the rigid rotamer approximation. Even without GB and SA terms, we obtain accuracies comparable to SCWRL4, a specialized side chain prediction program. In particular, we obtain a better RMSD than SCWRL4 for core residues (at a higher cost), despite our simpler rotamer library. Proteins 2016; 84:803-819. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Managing side effects of JAK inhibitors for myelofibrosis in clinical practice.

PubMed

Saeed, Iram; McLornan, Donal; Harrison, Claire N

2017-07-01

Myelofibrosis (MF) is characterized by bone marrow fibrosis, abnormalities in peripheral counts, extramedullary hematopoiesis, splenomegaly and an increased risk of transformation to acute myeloid leukaemia. The disease course is often heterogeneous and management can range from observation alone through to allogeneic stem cell transplantation. As of 2017, the only approved medication for MF remains the JAK Inhibitor (JAKi), ruxolitinib (Novartis Pharmaceuticals, Basel, Switzerland; Incyte, Wilmington, Detroit, USA) although several others have reached advanced stages of clinical trials. Areas covered: In this review, we focus on the management of both common and uncommon side effects arising from the use of currently approved and clinical trial JAKi. Most of the discussion concerns ruxolitinib although we also cover both pacritinib (CTI BioPharma) and momelotinib (Gilead Sciences, Foster City, California) which have been in recent large, multinational phase III trials. The various approaches to management of JAKi-related side effects are discussed - with particular emphasis to anaemia, thrombocytopaenia and infection risk. Expert commentary: JAK inhibitors are effective in many individuals with MF and have revolutionized the current treatment paradigm. The side effect profile, in the most, is predictable and manageable with high degrees of clinical surveillance and dose modifications.

EIA model documentation: World oil refining logistics demand model,``WORLD`` reference manual. Version 1.1

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

Not Available

1994-04-11

This manual is intended primarily for use as a reference by analysts applying the WORLD model to regional studies. It also provides overview information on WORLD features of potential interest to managers and analysts. Broadly, the manual covers WORLD model features in progressively increasing detail. Section 2 provides an overview of the WORLD model, how it has evolved, what its design goals are, what it produces, and where it can be taken with further enhancements. Section 3 reviews model management covering data sources, managing over-optimization, calibration and seasonality, check-points for case construction and common errors. Section 4 describes in detailmore » the WORLD system, including: data and program systems in overview; details of mainframe and PC program control and files;model generation, size management, debugging and error analysis; use with different optimizers; and reporting and results analysis. Section 5 provides a detailed description of every WORLD model data table, covering model controls, case and technology data. Section 6 goes into the details of WORLD matrix structure. It provides an overview, describes how regional definitions are controlled and defines the naming conventions for-all model rows, columns, right-hand sides, and bounds. It also includes a discussion of the formulation of product blending and specifications in WORLD. Several Appendices supplement the main sections.« less

Department of Defense Natural Resources Program: American Woodcock (Scolopax minor). Section 4.1.2. US Army Corps of Engineers Wildlife Resources Management Manual

DTIC Science & Technology

1989-04-01

size of a bob- white. The breast is a light cinnamon color, and the back and sides are washed with black. The head is gray and brown with a series of 3...are a pinkish buff to cinnamon color and are covered with light brown spots or blotches overlaid with darkeL warkings. The shell is smooth and oval...Louisi- ana bottomlands ranged from pastures to fallow fields to agricultural fields planted in corn, cotton, and sugar cane (Glasgow 1958). Two

The assessment and management of chemotherapy-induced nausea and vomiting among cancer patients in a chemotherapy ward: a best practice implementation project.

PubMed

Gu, Lingli; Li, Jing

2016-03-01

Chemotherapy-induced nausea and vomiting (CINV) are considered to be two of the most distressing side-effects of chemotherapy. They have a negative impact on a patient's quality of life and can influence the continuance of treatment. Owing to the lack of effective management of CINV, regular assessment and management of CINV is recommended for patients undergoing chemotherapy. The aim of this project was to integrate the available evidence on the assessment and management of CINV into practice, and implement strategies to improve compliance with evidence-based practice. The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the best available evidence on the assessment and management of CINV. The program was divided into three phases and conducted over four months in the chemotherapy ward, Fudan University Shanghai Cancer Center, Shanghai, China. Sixty patients and 14 oncology nurses were involved in this project. The results of the follow-up cycle showed that the compliance rates regarding patient education, risk factors evaluation and non-pharmacologic managements were 100%, 100% and 80%, respectively. The rate of validated tools being used by patients and nurses improved by 93% and 97%, respectively. This project demonstrated that the use of pre- and post-best practice audits is an effective method for incorporating evidence into practice in a chemotherapy ward. The practice of assessing and managing CINV was significantly improved. The next step is to develop strategies for sustaining the new procedures of CINV assessment and management.

Computer program for calculating supersonic flow on the windward side conical delta wings by the method of lines

NASA Technical Reports Server (NTRS)

Klunker, E. B.; South, J. C., Jr.; Davis, R. M.

1972-01-01

A user's manual is presented for a program that calculates the supersonic flow on the windward side of conical delta wings with shock attached at the sharp leading edge by the method of lines. The program also has a limited capability for computing the flow about circular and elliptic cones at incidence. It provides information including the shock shape, flow field, isentropic surface-flow properties, and force coefficients. A description of the program operation, a sample computation, and a FORTRAN 4 program listing are included.

DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS SITED ON MILITARY BASES

EPA Science Inventory

The report gives results of an investigation into the pollutant emission reduction and demand-side management potential of three photovoltaic (PV) systems installed at Ft. Huachuca, AZ, Ft. Dix, NJ, and Hickam Air Force Base, HI, which began operation between January and July 199...

DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS

EPA Science Inventory

The report gives results of an investigation of the pollutant emission reduction and demand-side management potential of 16 photovoltaic (PV) systems installed across the U.S. in 1993 and 1994. The investigation was sponsored by the U.S. EPA and 11 electric utilities. The report ...

The Human Side of Knowledge Management: An Annotated Bibliography.

ERIC Educational Resources Information Center

Mayer, Pamela S.

This annotated bibliography lists books and articles that have direct application to managing the human side of knowledge acquisition, transfer, and application. What is meant by the human dimension of knowledge is how motivation and learning affect the acquisition and transfer of knowledge and how group dynamics mediate the role of knowledge in…

An analysis of the factors influencing demand-side management activity in the electric utility industry

NASA Astrophysics Data System (ADS)

Bock, Mark Joseph

Demand-side management (DSM), defined as the "planning, implementation, and monitoring of utility activities designed to encourage consumers to modify their pattern of electricity usage, including the timing and level of electricity demand," is a relatively new concept in the U.S. electric power industry. Nevertheless, in twenty years since it was first introduced, utility expenditures on DSM programs, as well as the number of such programs, have grown rapidly. At first glance, it may seem peculiar that a firm would actively attempt to reduce demand for its primary product. There are two primary explanations as to why a utility might pursue DSM: regulatory mandate, and self-interest. The purpose of this dissertation is to determine the impact these influences have on the amount of DSM undertaken by utilities. This research is important for two reasons. First, it provides insight into whether DSM will continue to exist as competition becomes more prevalent in the industry. Secondly, it is important because no one has taken a comprehensive look at firm-level DSM activity on an industry-wide basis. The primary data set used in this dissertation is the U.S. Department of Energy's Annual Electric Utility Report, Form EIA-861, which represents the most comprehensive data set available for analyzing DSM activity in the U.S. There are four measures of DSM activity in this data set: (1) utility expenditures on DSM programs; (2) energy savings by DSM program participants; and (3) the actual and (4) the potential reductions in peak load resulting from utility DSM measures. Each is used as the dependent variable in an econometric analysis where independent variables include various utility characteristics, regulatory characteristics, and service territory and customer characteristics. In general, the results from the econometric analysis suggest that in 1993, DSM activity was primarily the result of regulatory pressure. All of the evidence suggests that if DSM continues to exist in a deregulated environment, it will be at a greatly reduced level. This conclusion holds unless utilities see advantages to DSM as a marketing tool to increase customer satisfaction and loyalty.

Archeology as Family Recreation: The Passport in Time Program.

ERIC Educational Resources Information Center

Geiger, Brian F.

Passport in Time (PIT), a volunteer program of the United States Department of Agriculture Forest Service, is an excellent recreational learning experience. Families work side-by-side with professional archaeologists and historians to excavate, record, and restore historic and prehistoric sites across the United States. In addition, families…

Sunny Side Up in Mathematics.

ERIC Educational Resources Information Center

LaHart, David, Ed.

Energy is a problem affecting all individuals. To help today's students understand the problem and become realistic decision-makers, materials have been developed by the Sunny Side Up (in Mathematics) program to introduce energy concepts into the mathematics curriculum. Objectives of the program are to: (1) provide highly effective practice in…

Feasibility of a Symptom Management Intervention for Adolescents Recovering from a Hematopoietic Stem Cell Transplant

PubMed Central

Rodgers, Cheryl C.; Krance, Robert; Street, Richard L.; Hockenberry, Marilyn J.

2015-01-01

Background Adolescents undergoing a hematopoietic stem cell transplant (HSCT) experience a variety of side effects and eating difficulties. Few interventions exist to assist patients with self-care after HSCT hospitalization. The Eating After Transplant (EAT!) program is a mobile phone application developed to assist adolescents with self-management of common eating related issues during HSCT recovery. Objective This study examined the acceptability and usability of the EAT! program among adolescents and assessed the competency of the participants using the program after hospital discharge through the first 100 days post HSCT. Methods A repeated measures design was used to evaluate the EAT! application with 16 adolescent patients recovering from an allogeneic HSCT. Participants provided verbal feedback and used a Likert-scale to rate acceptability and usability of the application. Additionally, a tracking device monitored use of the application. Competency was measured with orientation time and independent demonstration of use of the application. Results Acceptability remained high throughout the study, but use significantly decreased over time. Patients reported familiarity with the program’s content as the reason for the declining use. Competency was excellent with a short orientation period and independent demonstration throughout the study. Conclusions A mobile phone application is a feasible intervention to educate adolescents with symptom management strategies. Future research needs to examine factors affecting sustainability of use over time. Implications for Practice Healthcare providers need to continue to develop and evaluate innovative methods to educate adolescents on effective self-care strategies throughout HSCT recovery. PMID:23842522

Genome Maps, a new generation genome browser.

PubMed

Medina, Ignacio; Salavert, Francisco; Sanchez, Rubén; de Maria, Alejandro; Alonso, Roberto; Escobar, Pablo; Bleda, Marta; Dopazo, Joaquín

2013-07-01

Genome browsers have gained importance as more genomes and related genomic information become available. However, the increase of information brought about by new generation sequencing technologies is, at the same time, causing a subtle but continuous decrease in the efficiency of conventional genome browsers. Here, we present Genome Maps, a genome browser that implements an innovative model of data transfer and management. The program uses highly efficient technologies from the new HTML5 standard, such as scalable vector graphics, that optimize workloads at both server and client sides and ensure future scalability. Thus, data management and representation are entirely carried out by the browser, without the need of any Java Applet, Flash or other plug-in technology installation. Relevant biological data on genes, transcripts, exons, regulatory features, single-nucleotide polymorphisms, karyotype and so forth, are imported from web services and are available as tracks. In addition, several DAS servers are already included in Genome Maps. As a novelty, this web-based genome browser allows the local upload of huge genomic data files (e.g. VCF or BAM) that can be dynamically visualized in real time at the client side, thus facilitating the management of medical data affected by privacy restrictions. Finally, Genome Maps can easily be integrated in any web application by including only a few lines of code. Genome Maps is an open source collaborative initiative available in the GitHub repository (https://github.com/compbio-bigdata-viz/genome-maps). Genome Maps is available at: http://www.genomemaps.org.

Genome Maps, a new generation genome browser

PubMed Central

Medina, Ignacio; Salavert, Francisco; Sanchez, Rubén; de Maria, Alejandro; Alonso, Roberto; Escobar, Pablo; Bleda, Marta; Dopazo, Joaquín

2013-01-01

Genome browsers have gained importance as more genomes and related genomic information become available. However, the increase of information brought about by new generation sequencing technologies is, at the same time, causing a subtle but continuous decrease in the efficiency of conventional genome browsers. Here, we present Genome Maps, a genome browser that implements an innovative model of data transfer and management. The program uses highly efficient technologies from the new HTML5 standard, such as scalable vector graphics, that optimize workloads at both server and client sides and ensure future scalability. Thus, data management and representation are entirely carried out by the browser, without the need of any Java Applet, Flash or other plug-in technology installation. Relevant biological data on genes, transcripts, exons, regulatory features, single-nucleotide polymorphisms, karyotype and so forth, are imported from web services and are available as tracks. In addition, several DAS servers are already included in Genome Maps. As a novelty, this web-based genome browser allows the local upload of huge genomic data files (e.g. VCF or BAM) that can be dynamically visualized in real time at the client side, thus facilitating the management of medical data affected by privacy restrictions. Finally, Genome Maps can easily be integrated in any web application by including only a few lines of code. Genome Maps is an open source collaborative initiative available in the GitHub repository (https://github.com/compbio-bigdata-viz/genome-maps). Genome Maps is available at: http://www.genomemaps.org. PMID:23748955

Drug and Nondrug Treatment in Tension-type Headache

PubMed Central

2009-01-01

Tension-type headache (TTH) is a common primary headache with tremendous socioeconomic impact. Establishment of an accurate diagnosis is important before initiation of any treatment. Nondrug management is crucial. Information, reassurance and identification of trigger factors may be rewarding. Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH. Combination analgesics, triptans, muscle relaxants and opioids should not be used, and it is crucial to avoid frequent and excessive use of simple analgesics to prevent the development of medication-overuse headache. The tricyclic antidepressant amitriptyline is drug of first choice for the prophylactic treatment of chronic TTH. The efficacy is modest and treatment is often hampered by side effects. Thus, treatment of frequent TTH is often difficult and multidisciplinary treatment strategies can be useful. The development of specific nonpharmacological and pharmacological managements for TTH with higher efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient. PMID:21179525

Web tools for effective retrieval, visualization, and evaluation of cardiology medical images and records

NASA Astrophysics Data System (ADS)

Masseroli, Marco; Pinciroli, Francesco

2000-12-01

To provide easy retrieval, integration and evaluation of multimodal cardiology images and data in a web browser environment, distributed application technologies and java programming were used to implement a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test dat and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved cardiology images, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for querying, visualizing and evaluating comprehensively cardiology medical images and records in all locations where they can need them- i.e. emergency, operating theaters, ward, or even outpatient clinics- the developed prototype represents an important aid in providing more efficient diagnoses and medical treatments.

Using Interdisciplinary research to enrich teachers and classrooms

NASA Astrophysics Data System (ADS)

Warburton, J.; Timm, K.; Huffman, L. T.; Peart, L. W.; Hammond, J.; McMahon, E.

2011-12-01

Imagine being on the stern of a ship in the Atlantic Ocean off the coast of New England as the crew dumps thousands of scallops on the deck, searching the Greenland ice sheet for a remote weather station, or uncovering secrets to past climates as you join an ocean sediment drilling team in Antarctica. So you ask yourself, what would you be doing in all of these places? What you would be doing is what hundreds of educators from around the world have done for over 20 years, participating in field-based Teacher Research Experience (TRE) programs. Teacher Research Experiences involve educators from varying grade levels and backgrounds in hands-on research as a member of a scientific research team. The teacher works side by side with actual research scientists, often on tasks similar to a field assistant or graduate student. As an important member of the research team teachers learn more about science content and the process of science. Subsequently, the educators play a key role in digesting and communicating the science to their students and the general public. TRE programs vary in many ways. Programs take place in a variety of settings-from laboratories to field camps, and from university campuses to aircraft or ships. The primary commonality of the TRE programs in this presentation-PolarTREC (Teachers and Researchers Exploring and Collaborating), ANDRILL (ANtarctic geological DRILLing) Research Immersion for Science Educators (ARISE); Integrated Ocean Drilling Program (IODP) School of Rock (SOR); and the National Oceanic and Atmospheric Administration Teacher at Sea (TAS) program-is that these programs provide an authentic field-based research experience for teachers outside of a laboratory setting, frequently in harsh, remote, or unusual settings. In addition, each of these programs is federally funded, possess dedicated program management staff, leverage existing scientific and programmatic resources, and are usually national, and sometimes international, in scope. Sharing their unique lessons learned and program results, authors will describe how TRE's improve and enrich interdisciplinary science education by connecting teachers, researchers, students, and the public around the globe for involvement in scientific research and global issues.

Choreatic Side Effects of Deep Brain Stimulation of the Anteromedial Subthalamic Nucleus for Treatment-Resistant Obsessive-Compulsive disorder.

PubMed

Mulders, Anne E P; Leentjens, Albert F G; Schruers, Koen; Duits, Annelien; Ackermans, Linda; Temel, Yasin

2017-08-01

Patients with treatment-resistant obsessive-compulsive disorder (OCD) are potential candidates for deep brain stimulation (DBS). The anteromedial subthalamic nucleus (STN) is among the most commonly used targets for DBS in OCD. We present a patient with a 30-year history of treatment-resistant OCD who underwent anteromedial STN-DBS. Despite a clear mood-enhancing effect, stimulation caused motor side effects, including bilateral hyperkinesia, dyskinesias, and sudden large amplitude choreatic movements of arms and legs when stimulating at voltages greater than approximately 1.5 V. DBS at lower amplitudes and at other contact points failed to result in a significant reduction of obsessions and compulsions without inducing motor side effects. Because of this limitation in programming options, we decided to reoperate and target the ventral capsule/ventral striatum (VC/VS), which resulted in a substantial reduction in key obsessive and compulsive symptoms without serious side effects. Choreatic movements and hemiballismus have previously been linked to STN dysfunction and have been incidentally reported as side effects of DBS of the dorsolateral STN in Parkinson disease (PD). However, in PD, these side effects were usually transient, and they rarely interfered with DBS programming. In our patient, the motor side effects were persistent, and they made optimal DBS programming impossible. To our knowledge, such severe and persistent motor side effects have not been described previously for anteromedial STN-DBS. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of oncology pharmacist-managed oral anticancer therapy in patients with chronic myelogenous leukemia.

PubMed

Lam, Masha Sh; Cheung, Nathan

2016-12-01

Studies have identified non-adherence as one of the major contributing factors to treatment failure in chronic myelogenous leukemia (CML) patients receiving imatinib. Published literature has demonstrated a unique role of oncology pharmacists, as part of a multidisciplinary team, in contributing to overall positive outcomes for patients. To evaluate the impact of an oncology pharmacist-managed oral anticancer therapy program on oral medication adherence in CML patients versus usual care. Electronic refill history and medical records of patients diagnosed with CML treated with oral tyrosine kinase inhibitors (TKIs) managed by oncology pharmacists during a 6-year period, were retrospectively reviewed. Imatinib adherence rate, as the primary endpoint, was compared with the rate for those in the usual care group within the same organization. The secondary endpoints were descriptive to characterize pharmacist interventions for all TKIs. A total of 56 patients including 45 who were treated with imatinib, were evaluated. The group managed by oncology pharmacists resulted in a higher percentage of imatinib adherence rate compared to usual care (88.6% vs 65.8%, p = 0.0046). A total of 3432 pharmacist encounters were reviewed, and 567 interventions of six categories including side effect monitoring/management (n = 95; 16.8%); drug interaction detection (n = 109; 19.2%); TKI dose adjustment (n = 82; 14.5%); laboratory monitoring (n = 200; 35.3%); non-CML related drug choice (n = 74; 13.1%); and copay assistance (n = 7; 1.2%), were documented. This resulted in a mean of 10.1 interventions per patient. Our oncology pharmacist-managed oral anticancer therapy program significantly improved TKI adherence rates in CML patients. We attribute the success of our program to consistent follow-up by utilizing routine phone, and secure email follow-ups, that allowed our oncology pharmacists to build a close and trustworthy relationship with patients and families. © The Author(s) 2015.

An integrated study of earth resources in the state of California based on ERTS-1 and supporting aircraft data

NASA Technical Reports Server (NTRS)

Colwell, R. N.; Thorley, G. A.; Burgy, R. H.; Schubert, G.; Estes, J. E.; Bowden, L. W.; Algazi, V. R.; Wildman, W. E.; Huntington, G. L. (Principal Investigator)

1972-01-01

There are no author-identified significant results in this report. Results of an integrated study of earth resources in the state of California using ERTS-1 and supporting aircraft data are presented. Areas of investigation cover (1) regional agricultural surveys; (2) solving water resource management problems; (3) resource management in Northern California using ERTS-1 data; (4) analysis of river meanders; (5) assessment and monitoring change in west side of the San Joaquin Valley and central coastal zone of state; (6) assessment and monitoring of changes in Southern California environment; (7) digital handling and processing of ERTS-1 data; (8) use of ERTS-1 data in educational and applied research programs of the Agricultural Extension Service; and (9) identification, classification, and mapping of salt affected soils.

Improving medication adherence with a targeted, technology-driven disease management intervention.

PubMed

Lawrence, David B; Allison, Wanda; Chen, Joyce C; Demand, Michael

2008-06-01

Treatment adherence is critical in managing chronic disease, but achieving it remains an elusive goal across many prevalent conditions. As part of its care management strategy, BlueCross BlueShield of South Carolina (BCBSSC) implemented the Longitudinal Adherence Treatment Evaluation program, a behavioral intervention to improve medication adherence among members with cardiovascular disease and/or diabetes. The objectives of this study were to 1) assess the effectiveness of telephonic intervention in influencing reinitiation of medication therapy, and 2) evaluate the rate and timing of medication reinitiation. BCBSSC applied algorithms against pharmacy claims data to identify patients prescribed targeted medications who were 60 or more days overdue for refills. This information was provided to care managers to address during their next patient contact. Care managers received focused training on techniques for medication behavior change, readiness to change, motivational interviewing, and active listening. Training also addressed common barriers to adherence and available resources, including side effect management, mail order benefits, drug assistance programs, medication organizers, and reminder systems. Overdue refills were tracked for 12 months, with medication reinitiation followed for an additional 3 months. In the intervention group, 94 patients were identified with 123 instances of late medication refills. In the age- and gender-matched comparison group, 61 patients were identified with 76 late refills. The intervention group had a significantly higher rate of medication reinitiation (59.3%) than the control group (42.1%; P < 0.05). Time to reinitiation was significantly shorter in the intervention group, 59.5 (+/- 69.0) days vs. 107.4 (+/- 109) days for the control group (P < 0.05). This initiative demonstrated that a targeted disease management intervention promoting patient behavior change increased the number of patients who reinitiated therapy after a period of nonadherence and decreased the time from nonadherence to adherence.

Time Savers: Make Sure Time Is on Your Side with These Practices

ERIC Educational Resources Information Center

Burrall, Bill

2006-01-01

Time is the proverbial black hole that educators must constantly manage as they juggle multiple jobs in a typical workday. Whether it be managing staff, dealing with parents and community, or implementing new technologies, time is usually not on our side. Although technology cannot solve all problems, it can assist educators on all fronts in…

SU-E-T-317: The Development of a DIBH Technique for Left Sided Breast Patients Undergoing Radiation Therapy Utilizing Varians RPM System in a Community Hospital

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

Hasson, B; Young, M; Workie, D

2014-06-01

Purpose: To develop and implement a Deep Inhalation Breath Hold program (DIBH) for treatment of patients with Left-sided breast cancer in a community hospital. Methods: All patients with left sided breast cancer underwent a screening free breathing CT. Evaluation of the conventional tangent treatment fields and the heart was conducted. If the heart would not be excluded using tangents, the patient then received DIBH breathe coaching. The patients returned for a 4D CT simulation. The patients breathing cycle was monitored using the Varian Real-Time position ManagementTM (RPM) system to assess duration of DIBH, amplitude, phase and recovery time to normalmore » breathing. Then a DIBH CT was obtained at the desired amplitude. Duplicate plans were developed for both free breathing and DIBH on the Eclipse planning system and comparison DVH's were created. The plan that provided the prescribed treatment coverage and the least doses to the OAR (heart, Lt. Lung) was determined. Those patients selected to receive treatment with DIBH were set up for treatment, and breathing was monitored using the RPM system. Practice trials were used to confirm that the amplitude, phase and recovery were consistent with findings from simulation. Results: 10 patients have been treated using the DIBH procedure in our clinic. The DIBH patients had an average increase of 80% lung volume on DIBH, decreased lung volume receiving 50% of the dose, and decreases in the V20 dose. Significant reduction in the maximum and mean dose to the heart, as well as the dose to 1CC of the volume for the DIBH plans. Conclusion: Using the RPM system already available in the clinic, staff training, and patient coaching a simple DIBH program was setup. The use of DIBH has shown promise in reducing doses to the critical organs while maintaining PTV coverage for left sided breast treatments.« less

[Wellness holidays--wholesome wish or one-sided reality].

PubMed

Müller, H; Kaufmann, E L

2001-04-01

The term wellness is widely used in European tourism. The principal observations regarding the wellness industry concern an expanding supply of and an insufficiently researched demand for wellness programs. The quality dimension of wellness services is increasingly becoming the decisive competitive factor. For this reason quality management plays an important role. Market research shows that average 3- to 5-star hotels provide fairly comprehensive wellness facilities. Wellness hotels should therefore specialize in health information, individual care and a wide range of cultural and relaxation programs. Although the same hotel can host cure and wellness guests at the same time, these two segments have to be considered separately when deciding on the marketing strategy. We therefore assume that wellness is pursued solely by 'healthy' people, the prime aim being prevention. 'Normal cure guests' aim to heal their illness.

Epidemiologic, socioeconomic and psychosocial aspects in lupus erythematosus.

PubMed

Aberer, E

2010-08-01

Epidemiologic, socioeconomic, and psychosocial factors play an important role in health care and handling of patients with the various clinical forms of lupus erythematosus (LE). Patients with LE are mostly young women; adolescents and some ethnic groups are especially prone to a severe course of disease. The unpredictable and fluctuating flares of disease, the need for longterm treatment, and the side effects and damage caused by the disease itself severely reduce quality of life. Problems arise, involving family members, adherence to medical advice and therapy, communication and self management. Socioeconomically, patients are often unable to take regular employment and to pay for health insurance. Stress factors that arise have a negative impact on the course of disease, increasing both fatigue and the basic burden of illness. Healthcare professionals must pay careful attention to all these items, as they attempt to treat flares, minimize drug side effects, provide pain relief, arrange communication and exercise programs along with behavioral and psychosocial interventions in multidisciplinary cooperation, and also involve and support family members.

Pre-Dawn Martian Sky

NASA Technical Reports Server (NTRS)

1997-01-01

On Sol 39 there were wispy blue clouds in the pre-dawn sky of Mars, as seen by the Imager for Mars Pathfinder (IMP). The color image was made by taking blue, green, and red images and then combining them into a single color image. The clouds appear to have a bluish side and a greenish side because they moved (in the wind from the northeast) between images. This picture was made an hour and twenty minutes before sunrise -- the sun is not shining directly on the water ice clouds, but they are illuminated by the dawn twilight.

Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and manages the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. JPL is a division of the California Institute of Technology (Caltech). The Imager for Mars Pathfinder (IMP) was developed by the University of Arizona Lunar and Planetary Laboratory under contract to JPL. Peter Smith is the Principal Investigator.

NASA Bioreactor Schematic

NASA Technical Reports Server (NTRS)

2001-01-01

The schematic depicts the major elements and flow patterns inside the NASA Bioreactor system. Waste and fresh medium are contained in plastic bags placed side-by-side so the waste bag fills as the fresh medium bag is depleted. The compliance vessel contains a bladder to accommodate pressure transients that might damage the system. A peristolic pump moves fluid by squeezing the plastic tubing, thus avoiding potential contamination. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

Deconstructing Decisions to Initiate, Maintain, or Discontinue Adjuvant Endocrine Therapy in Breast Cancer Survivors: A Mixed-Methods Study

PubMed Central

Bluethmann, Shirley M.; Murphy, Caitlin C.; Tiro, Jasmin A.; Mollica, Michelle A.; Vernon, Sally W.; Bartholomew, Leona Kay

2017-01-01

Purpose/Objectives Adjuvant endocrine therapy (AET) has been shown to improve survival in hormone receptor–positive breast cancer survivors, but as many as half do not complete recommended treatment. Management of medication-related side effects and engagement with providers are two potentially modifiable factors, but their associations with adherence are not well understood. The aims were to build on survey results to qualitatively explore survivors’ experiences with prescribed AET to (a) describe appraisal and management of AET side effects and (b) deconstruct decisions to initiate, discontinue, or maintain AET. Research Approach The authors used a mixed-methods explanatory sequence research design with a qualitative emphasis. Setting Survivors were recruited from a clinical cancer registry maintained at the University of Texas Southwestern Medical Center, which includes the Harold C. Simmons Comprehensive Cancer Center (National Cancer Institute–designated), in Dallas. Participants 452 survivors completed a survey, and 30 took part in telephone interviews. Methodologic Approach Qualitative methods were used in which the authors recorded and transcribed interviews for analysis and used open coding to reduce data into themes. Findings Among adherent survivors, the themes of tolerance of side effects and perseverance were strong. Nonadherent survivors expressed more difficulty managing side effects and perceived fewer benefits when side effects were bothersome. The most common side effects mentioned by all survivors were menopausal symptoms and joint pain; less common side effects were cognitive decline and cardiac distress. Some sought advice from their oncology team. Nonadherent survivors appeared initially motivated to maintain AET but identified a tolerance limit for side effects after which a provider’s recommendation was less influential in their decision to maintain or discontinue AET. Interpretation This study elucidated adherence as a complex continuum of behaviors, appraisals, and decision points. These insights may be particularly useful in counseling survivors taking AET and promoting timely delivery of clinical interventions to enhance adherence. Implications for Nursing Nurses should be involved in the planning and implementation of clinical interventions to manage side effects and other barriers to AET adherence. PMID:28635973

NOAA seeks healthy budget

NASA Astrophysics Data System (ADS)

Bush, Susan

The small, crowded room of the House side of the U.S. Capitol building belied the large budget of $1,611,991,000 requested for Fiscal Year 1992 by the National Oceanic and Atmospheric Administration. John A. Knauss, Undersecretary for Oceans and Atmosphere, U.S. Department of Commerce, delivered his testimony on February 28 before the House Appropriations Subcommittee on Commerce, Justice, and State, the Judiciary and Related Agencies. He told the subcommittee that the budget “attempts to balance the two goals of maintaining NOAA's position as an important science agency and addressing the serious budget problems that the government continues to face.”Climate and global change, modernization of the National Weather Service, and the Coastal Ocean Science program are NOAA's three ongoing, high-priority initiatives that the budget addresses. Also, three additional initiatives—a NOAA-wide program to improve environmental data management, President Bush's multiagency Coastal America initiative, and a seafood safety program administered jointly by NOAA and the Food and Drug Administration—are addressed.

Ground-source heat pump case studies and utility programs

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

Lienau, P.J.; Boyd, T.L.; Rogers, R.L.

1995-04-01

Ground-source heat pump systems are one of the promising new energy technologies that has shown rapid increase in usage over the past ten years in the United States. These systems offer substantial benefits to consumers and utilities in energy (kWh) and demand (kW) savings. The purpose of this study was to determine what existing monitored data was available mainly from electric utilities on heat pump performance, energy savings and demand reduction for residential, school and commercial building applications. In order to verify the performance, information was collected for 253 case studies from mainly utilities throughout the United States. The casemore » studies were compiled into a database. The database was organized into general information, system information, ground system information, system performance, and additional information. Information was developed on the status of demand-side management of ground-source heat pump programs for about 60 electric utility and rural electric cooperatives on marketing, incentive programs, barriers to market penetration, number units installed in service area, and benefits.« less

Interleaving subthalamic nucleus deep brain stimulation to avoid side effects while achieving satisfactory motor benefits in Parkinson disease: A report of 12 cases.

PubMed

Zhang, Shizhen; Zhou, Peizhi; Jiang, Shu; Wang, Wei; Li, Peng

2016-12-01

Deep brain stimulation (DBS) of the subthalamic nucleus is an effective treatment for advanced Parkinson disease (PD). However, achieving ideal outcomes by conventional programming can be difficult in some patients, resulting in suboptimal control of PD symptoms and stimulation-induced adverse effects. Interleaving stimulation (ILS) is a newer programming technique that can individually optimize the stimulation area, thereby improving control of PD symptoms while alleviating stimulation-induced side effects after conventional programming fails to achieve the desired results. We retrospectively reviewed PD patients who received DBS programming during the previous 4 years in our hospital. We collected clinical and demographic data from 12 patients who received ILS because of incomplete alleviation of PD symptoms or stimulation-induced adverse effects after conventional programming had proven ineffective or intolerable. Appropriate lead location was confirmed with postoperative reconstruction images. The rationale and clinical efficacy of ILS was analyzed. We divided our patients into 4 groups based on the following symptoms: stimulation-induced dysarthria and choreoathetoid dyskinesias, gait disturbance, and incomplete control of parkinsonism. After treatment with ILS, patients showed satisfactory improvement in PD symptoms and alleviation of stimulation-induced side effects, with a mean improvement in Unified PD Rating Scale motor scores of 26.9%. ILS is a newer choice and effective programming strategy to maximize symptom control in PD while decreasing stimulation-induced adverse effects when conventional programming fails to achieve satisfactory outcome. However, we should keep in mind that most DBS patients are routinely treated with conventional stimulation and that not all patients benefit from ILS. ILS is not recommended as the first choice of programming, and it is recommended only when patients have unsatisfactory control of PD symptoms or stimulation-induced side effects after multiple treatments with conventional stimulation. A return to conventional stimulation may be required if ILS induces new side effects or the needs of the patient change.

Interleaving subthalamic nucleus deep brain stimulation to avoid side effects while achieving satisfactory motor benefits in Parkinson disease

PubMed Central

Zhang, Shizhen; Zhou, Peizhi; Jiang, Shu; Wang, Wei; Li, Peng

2016-01-01

Abstract Background: Deep brain stimulation (DBS) of the subthalamic nucleus is an effective treatment for advanced Parkinson disease (PD). However, achieving ideal outcomes by conventional programming can be difficult in some patients, resulting in suboptimal control of PD symptoms and stimulation-induced adverse effects. Interleaving stimulation (ILS) is a newer programming technique that can individually optimize the stimulation area, thereby improving control of PD symptoms while alleviating stimulation-induced side effects after conventional programming fails to achieve the desired results. Methods: We retrospectively reviewed PD patients who received DBS programming during the previous 4 years in our hospital. We collected clinical and demographic data from 12 patients who received ILS because of incomplete alleviation of PD symptoms or stimulation-induced adverse effects after conventional programming had proven ineffective or intolerable. Appropriate lead location was confirmed with postoperative reconstruction images. The rationale and clinical efficacy of ILS was analyzed. Results: We divided our patients into 4 groups based on the following symptoms: stimulation-induced dysarthria and choreoathetoid dyskinesias, gait disturbance, and incomplete control of parkinsonism. After treatment with ILS, patients showed satisfactory improvement in PD symptoms and alleviation of stimulation-induced side effects, with a mean improvement in Unified PD Rating Scale motor scores of 26.9%. Conclusions: ILS is a newer choice and effective programming strategy to maximize symptom control in PD while decreasing stimulation-induced adverse effects when conventional programming fails to achieve satisfactory outcome. However, we should keep in mind that most DBS patients are routinely treated with conventional stimulation and that not all patients benefit from ILS. ILS is not recommended as the first choice of programming, and it is recommended only when patients have unsatisfactory control of PD symptoms or stimulation-induced side effects after multiple treatments with conventional stimulation. A return to conventional stimulation may be required if ILS induces new side effects or the needs of the patient change. PMID:27930569

Successful management of airway hemangioma with propranolol.

PubMed

Mendiratta, Vibhu; Varghese, Bincy; Chander, Ram; Parakh, Ankit; Solanki, Ravi S

2013-06-01

Airway hemangiomas can be difficult to manage and cause anxiety in both the parents and the treating physician. Propranolol, a nonselective beta-blocker, has recently been used for treating proliferating infantile hemangiomas. We report successful management of a proliferating, large, mixed infantile hemangioma with subglottic extension in an Indian infant using oral propranolol in a dose of 2mg/kg/day without any side effects. Induction of early involution and freedom from the side effects of steroid therapy seem encouraging for using propranolol as a first line treatment modality in the management of troublesome hemangiomas. © 2013 The International Society of Dermatology.

Quantifying acromiohumeral distance in overhead athletes with glenohumeral internal rotation loss and the influence of a stretching program.

PubMed

Maenhout, Annelies; Van Eessel, Valerie; Van Dyck, Lieselot; Vanraes, Aagje; Cools, Ann

2012-09-01

Loss of internal rotation range of motion (ROM) on the dominant side is well documented in athletes performing overhead sports activity. This altered motion pattern has been shown to change glenohumeral and scapular kinematics. This could compromise the subacromial space and explain the association between glenohumeral internal rotation deficit (GIRD) and subacromial impingement. First, to quantify acromiohumeral distance (AHD) and compare between the dominant and nondominant side in overhead athletes with GIRD of more than 15°. Second, to investigate the effect of a sleeper stretch program on ROM and AHD. Controlled laboratory study. Range of motion was measured with a digital inclinometer and AHD was measured with ultrasound in 62 overhead athletes with GIRD (>15°) at baseline. Differences between sides were analyzed. Athletes were randomly allocated to the stretch (n = 30) or control group (n = 32). The stretch group performed a 6-week sleeper stretch program on the dominant side. Change of range of motion and AHD were measured and analyzed in both groups after 6 weeks. The dominant side showed a significant internal rotation deficit (-24.7° ± 6.3°) and horizontal adduction deficit (-11.8° ± 7.4°) and the dominant side AHD was significantly smaller with the arm at neutral (-0.4 ± 0.6 mm) and at 45° (-0.5 ± 0.8 mm) and 60° (-0.6 ± 0.7 mm) of active abduction compared with the nondominant side. After stretching, significant increase of internal rotation (+13.5° ± 0.8°), horizontal adduction (+10.6° ± 0.9°) ROM and AHD (+0.5 to +0.6mm) was observed at the dominant side of the stretch group compared with prestretching measurements. No significant change of AHD was seen in the nondominant side of the stretch group and in both sides of the control group. The AHD, a 2-dimensional measure for subacromial space, was found to be smaller on the dominant side in athletes with GIRD and was found to increase after a 6-week sleeper stretch program. These findings might provide insight into the relation between GIRD and subacromial impingement but future studies are needed to determine clinical implications.

Women with breast cancer report substantially more disease- and treatment-related side or late effects than registered by clinical oncologists: a cross-sectional study of a standard follow-up program in an oncological department.

PubMed

Ellegaard, Mai-Britt Bjørklund; Grau, Cai; Zachariae, Robert; Jensen, Anders Bonde

2017-08-01

Follow-up after breast cancer treatment is standard due to the risk of development of new primary cancers and recurrent disease. The aim of the present study was to evaluate a standard follow-up program in an oncological department by assessing: (1) Symptoms or signs of new primary cancer or recurrent disease, (2) Disease- and treatment-related physical and psychosocial side or late effects, and (3) relevant actions by oncology staff. In a cross-sectional study, 194 women who came for follow-up visit after treatment for primary surgery were included. The clinical oncologists registered symptoms and signs of recurrent disease or new primary cancer. Side or late effects were both assessed by patient and the clinical oncologists. Loco-regional or distant signs of recurrent disease were suspected in eight (5%) patients. Further examinations revealed no disease recurrence. Most patients (93%) reported some degree of side or late effects. Statistically significant more side or late effects were reported by the women (average: 6.9) than registered by the clinical oncologists (average: 2.4), p < 0.001. The three most often patient-reported side or late effects were hot flushes (35%), fatigue (32%), and sleep disturbance (31%). None of the scheduled or additional visits resulted in detection of recurrent disease. Furthermore, the majority of patients reported side or late effects. Statistically significant more women reported side or late effects than registered by the clinical oncologists. This suggests the need for rethinking of the follow-up programs with more emphasis upon side or late effects of the treatment.

Modeling and managing urban water demand through smart meters: Benefits and challenges from current research and emerging trends

NASA Astrophysics Data System (ADS)

Cominola, A.; Giuliani, M.; Castelletti, A.; Piga, D.; Rizzoli, A. E.

2015-12-01

Urban population growth, climate and land use change are expected to boost residential water demand in urban contexts in the next decades. In such a context, developing suitable demand-side management strategies is essential to meet future water demands, pursue water savings, and reduce the costs for water utilities. Yet, the effectiveness of water demand management strategies (WDMS) relies on our understanding of water consumers' behavior, their consumption habits, and the water use drivers. While low spatial and temporal resolution water consumption data, as traditionally gathered for billing purposes, hardly support this understanding, the advent of high-resolution, smart metering technologies allowed for quasi real-time monitoring water consumption at the single household level. This, in turn, is advancing our ability in characterizing consumers' behavior, modeling, and designing user-oriented residential water demand management strategies. Several water smart metering programs have been rolled-out in the last two decades worldwide, addressing one or more of the following water demand management phases: (i) data gathering, (ii) water end-uses characterization, (iii) user modeling, (iv) design and implementation of personalized WDMS. Moreover, the number of research studies in this domain is quickly increasing and big economic investments are currently being devoted worldwide to smart metering programs. With this work, we contribute the first comprehensive review of more than 100 experiences in the field of residential water demand modeling and management, and we propose a general framework for their classification. We revise consolidated practices, identify emerging trends and highlight the challenges and opportunities for future developments given by the use of smart meters advancing residential water demand management. Our analysis of the status quo of smart urban water demand management research and market constitutes a structured collection of information supporting the development of integrated procedures in the field of urban water management, as well as common actions aiding the collaboration with other sectors, as the nexus with energy demand management.

Commonwealth of the Northern Mariana Islands Energy Action Plan

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

Conrad, M. D.; Ness, J. E.

2013-07-01

This document describes the three near-term energy strategies selected by the CNMI Energy Task Force during action planning workshops conducted in March 2013, and outlines the steps being taken to implement those strategies. The three energy strategies selected by the task force are (1) designing a demand-side management program focusing on utility, residential and commercial sectors, (2) developing an outreach and education plan focused on energy conservation in government agencies and businesses, including workplace rules, and (3) exploring waste-to-energy options. The task force also discussed several other medium- and long-term energy strategies that could be explored at a future date.

The darkside multiton detector for the direct dark matter search

DOE PAGES

Aalseth, C. E.; Agnes, P.; Alton, A.; ...

2015-01-01

Although the existence of dark matter is supported by many evidences, based on astrophysical measurements, its nature is still completely unknown. One major candidate is represented by weakly interacting massive particles (WIMPs), which could in principle be detected through their collisions with ordinary nuclei in a sensitive target, producing observable low-energy (<100 keV) nuclear recoils. The DarkSide program aims at the WIPMs detection using a liquid argon time projection chamber (LAr-TPC). In this paper we quickly review the DarkSide program focusing in particular on the next generation experiment DarkSide-G2, a 3.6-ton LAr-TPC. The different detector components are described as wellmore » as the improvements needed to scale the detector from DarkSide-50 (50 kg LAr-TPC) up to DarkSide-G2. Finally, the preliminary results on background suppression and expected sensitivity are presented.« less

The psychopharmacology algorithm project at the Harvard South Shore Program: an algorithm for acute mania.

PubMed

Mohammad, Othman; Osser, David N

2014-01-01

This new algorithm for the pharmacotherapy of acute mania was developed by the Psychopharmacology Algorithm Project at the Harvard South Shore Program. The authors conducted a literature search in PubMed and reviewed key studies, other algorithms and guidelines, and their references. Treatments were prioritized considering three main considerations: (1) effectiveness in treating the current episode, (2) preventing potential relapses to depression, and (3) minimizing side effects over the short and long term. The algorithm presupposes that clinicians have made an accurate diagnosis, decided how to manage contributing medical causes (including substance misuse), discontinued antidepressants, and considered the patient's childbearing potential. We propose different algorithms for mixed and nonmixed mania. Patients with mixed mania may be treated first with a second-generation antipsychotic, of which the first choice is quetiapine because of its greater efficacy for depressive symptoms and episodes in bipolar disorder. Valproate and then either lithium or carbamazepine may be added. For nonmixed mania, lithium is the first-line recommendation. A second-generation antipsychotic can be added. Again, quetiapine is favored, but if quetiapine is unacceptable, risperidone is the next choice. Olanzapine is not considered a first-line treatment due to its long-term side effects, but it could be second-line. If the patient, whether mixed or nonmixed, is still refractory to the above medications, then depending on what has already been tried, consider carbamazepine, haloperidol, olanzapine, risperidone, and valproate first tier; aripiprazole, asenapine, and ziprasidone second tier; and clozapine third tier (because of its weaker evidence base and greater side effects). Electroconvulsive therapy may be considered at any point in the algorithm if the patient has a history of positive response or is intolerant of medications.

A framework for improving the cost-effectiveness of DSM program evaluations

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

Sonnenblick, R.; Eto, J.

The prudence of utility demand-side management (DSM) investments hinges on their performance, yet evaluating performance is complicated because the energy saved by DSM programs can never be observed directly but only inferred. This study frames and begins to answer the following questions: (1) how well do current evaluation methods perform in improving confidence in the measurement of energy savings produced by DSM programs; (2) in view of this performance, how can limited evaluation resources be best allocated to maximize the value of the information they provide? The authors review three major classes of methods for estimating annual energy savings: trackingmore » database (sometimes called engineering estimates), end-use metering, and billing analysis and examine them in light of the uncertainties in current estimates of DSM program measure lifetimes. The authors assess the accuracy and precision of each method and construct trade-off curves to examine the costs of increases in accuracy or precision. Several approaches for improving evaluations for the purpose of assessing program cost effectiveness are demonstrated. The methods can be easily generalized to other evaluation objectives, such as shared savings incentive payments.« less

Side Effects: Fatigue

Cancer.gov

Fatigue is a common side effect of many cancer treatments such as chemotherapy, radiation therapy, immunotherapy, and surgery. Anemia and pain can also cause fatigue. Learn about symptoms and way to manage fatigue.

Side Effects: Sleep Problems

Cancer.gov

Sleep problems are a common side effect during cancer treatment. Learn how a polysomnogram can assess sleep problems. Learn about the benefits of managing sleep disorders in men and women with cancer.

A mixed methods inquiry: How dairy farmers perceive the value(s) of their involvement in an intensive dairy herd health management program.

PubMed

Kristensen, Erling; Enevoldsen, Carsten

2008-12-18

Research has been scarce when it comes to the motivational and behavioral sides of farmers' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers' expectations related to participation in a health management program by: 1) identifying important ambitions, goals and subjective well-being among farmers, 2) submitting those data to a quantitative analysis thereby characterizing perspective(s) of value added by health management programs among farmers; and 3) to characterize perceptions of farmers' goals among veterinarians. The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse) of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians' competences as experienced by the farmers and time constraints in the farmers' everyday life. Farmers' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers' primary focus was on production and profit, however, farmers' valued teamwork and animal welfare more. The veterinarians in this study appear to focus too much on financial performance and increased production when compared to most of the participating farmers' expectations. On the other hand veterinarians did not focus enough on the major products, which farmers really wanted to buy, i.e. teamwork and animal welfare. Consequently, disciplines like sociology, economics and marketing may offer new methodological approaches to veterinarians as these disciplines have understood that accounting for individual differences is central to motivate change, i.e. 'know thy customer'.

Balancing opioid-induced gastrointestinal side effects with pain management: Insights from the online community.

PubMed

Whitman, Cynthia B; Reid, Mark W; Arnold, Corey; Patel, Haridarshan; Ursos, Lyann; Sa'adon, Roee; Pourmorady, Jonathan; Spiegel, Brennan M R

2015-01-01

Opioids cause gastrointestinal (GI) symptoms such as nausea, vomiting, pain, and (in 40 percent) constipation that diminish patients' quality of life. Outside traditional surveys, little is known about the opioid-induced constipation (OIC) patient experience and its impact on pain management. The purpose of this study was to use data from social media platforms to qualitatively examine patient beliefs about OIC and other prominent GI side effects, their impact on effective pain management and doctor-patient interaction. The authors collected Tweets from March 25 to July 31, 2014, and e-forum posts from health-related social networking sites regardless of timestamp. The authors identified specific keywords related to opioids and GI side effects to locate relevant content in the dataset, which was then manually coded using ATLAS.ti software. The authors examined 2,519,868 Tweets and more than 1.8 billion e-forum posts, of which, 88,586 Tweets and 9,767 posts satisfied the search criteria. Three thousand three individuals experienced opioidinduced GI side effects, mostly related to phenanthrenes (n = 1,589), and 1,274 (42.4 percent) individuals described constipation. Over-the-counter medications and nonevidence-based natural approaches were most commonly used to alleviate constipation. Many individuals questioned, rotated, reduced, or stopped their opioid treatments as a result of their GI side effects. Investigation of social media reveals a struggle to balance pain management with opioid-induced GI side effects, especially constipation. Individuals are often unprepared to treat OIC, to modify opioid regiments without medical advice, and to resort to using natural remedies and treatments lacking scientific evidence of effectiveness. These results identify opportunities to improve physician-patient communication and explore effective treatment alternatives.

Measuring financial performance: an overview of financial statements.

PubMed

Dalsted, N L

1995-07-01

Financial management has emerged as a critical component in the long-term viability of today's ranches and farms. Proper and timely financial reporting and analysis of financial statements are valuable tools that agricultural producers can use to monitor, coordinate, and plan their operational production and marketing schemes and strategies. A side note to preparation of financial statements. With the concerns over lender liability issues associated with statements either assisted with or prepared by a lending officer, agricultural producers will be responsible for preparing their own statements. The lending institutions may prepare their own statements in their assessment of the financial condition of a business and or individual, but, ultimately, the responsibility of financial statements is the borrower's. Some of the material presented in this article provides important input for use in such analytical programs as the National Cattlemen's Association, Integrated Resource Committees, and Standard Performance Analysis (SPA). SPA techniques and associated software have been or currently are under development for cow-calf, stocker, seedstock, and sheep enterprises. Critical to the analysis is having complete and correct financial statements. These analytical programs build on the financial statements. These analytical programs build on the financial statements as recommended by the FFSTF. Proper financial reporting is critical not only to a SPA assessment but also to the overall financial management of today's farms and ranches. Recognizing the importance of financial management in production agriculture is not enough, taking a proactive stance in one's financial plan is paramount to success. Failure to do so will only enhance the exit rates of producers from production agriculture.

Concepts for Life Cycle Cost Control Required to Achieve Space Transportation Affordability and Sustainability

NASA Technical Reports Server (NTRS)

Rhodes, Russel E.; Zapata, Edgar; Levack, Daniel J. H.; Robinson, John W.; Donahue, Benjamin B.

2009-01-01

Cost control must be implemented through the establishment of requirements and controlled continually by managing to these requirements. Cost control of the non-recurring side of life cycle cost has traditionally been implemented in both commercial and government programs. The government uses the budget process to implement this control. The commercial approach is to use a similar process of allocating the non-recurring cost to major elements of the program. This type of control generally manages through a work breakdown structure (WBS) by defining the major elements of the program. If the cost control is to be applied across the entire program life cycle cost (LCC), the approach must be addressed very differently. A functional breakdown structure (FBS) is defined and recommended. Use of a FBS provides the visibifity to allow the choice of an integrated solution reducing the cost of providing many different elements of like function. The different functional solutions that drive the hardware logistics, quantity of documentation, operational labor, reliability and maintainability balance, and total integration of the entire system from DDT&E through the life of the program must be fully defined, compared, and final decisions made among these competing solutions. The major drivers of recurring cost have been identified and are presented and discussed. The LCC requirements must be established and flowed down to provide control of LCC. This LCC control will require a structured rigid process similar to the one traditionally used to control weight/performance for space transportation systems throughout the entire program. It has been demonstrated over the last 30 years that without a firm requirement and methodically structured cost control, it is unlikely that affordable and sustainable space transportation system LCC will be achieved.

Waste management under multiple complexities: Inexact piecewise-linearization-based fuzzy flexible programming

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

Sun Wei; Huang, Guo H., E-mail: huang@iseis.org; Institute for Energy, Environment and Sustainable Communities, University of Regina, Regina, Saskatchewan, S4S 0A2

2012-06-15

Highlights: Black-Right-Pointing-Pointer Inexact piecewise-linearization-based fuzzy flexible programming is proposed. Black-Right-Pointing-Pointer It's the first application to waste management under multiple complexities. Black-Right-Pointing-Pointer It tackles nonlinear economies-of-scale effects in interval-parameter constraints. Black-Right-Pointing-Pointer It estimates costs more accurately than the linear-regression-based model. Black-Right-Pointing-Pointer Uncertainties are decreased and more satisfactory interval solutions are obtained. - Abstract: To tackle nonlinear economies-of-scale (EOS) effects in interval-parameter constraints for a representative waste management problem, an inexact piecewise-linearization-based fuzzy flexible programming (IPFP) model is developed. In IPFP, interval parameters for waste amounts and transportation/operation costs can be quantified; aspiration levels for net system costs, as well as tolerancemore » intervals for both capacities of waste treatment facilities and waste generation rates can be reflected; and the nonlinear EOS effects transformed from objective function to constraints can be approximated. An interactive algorithm is proposed for solving the IPFP model, which in nature is an interval-parameter mixed-integer quadratically constrained programming model. To demonstrate the IPFP's advantages, two alternative models are developed to compare their performances. One is a conventional linear-regression-based inexact fuzzy programming model (IPFP2) and the other is an IPFP model with all right-hand-sides of fussy constraints being the corresponding interval numbers (IPFP3). The comparison results between IPFP and IPFP2 indicate that the optimized waste amounts would have the similar patterns in both models. However, when dealing with EOS effects in constraints, the IPFP2 may underestimate the net system costs while the IPFP can estimate the costs more accurately. The comparison results between IPFP and IPFP3 indicate that their solutions would be significantly different. The decreased system uncertainties in IPFP's solutions demonstrate its effectiveness for providing more satisfactory interval solutions than IPFP3. Following its first application to waste management, the IPFP can be potentially applied to other environmental problems under multiple complexities.« less

Ketamine for Pain Management-Side Effects & Potential Adverse Events.

PubMed

Allen, Cheryl A; Ivester, Julius R

2017-12-01

An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. The doses used for analgesic purposes are much lower than those used for anesthesia purposes. A literature review was performed to ascertain potential side effects and/or adverse events when using ketamine for analgesia purposes. The search included CINAHL, PubMed, and Ovid using the search terms "ketamine," "ketamine infusion," "pain," "adverse events," "practice guideline," and "randomized controlled trial." Searches were limited to full-text, peer-reviewed articles and systematic reviews. Initially 1,068 articles were retrieved. The search was then narrowed by using the Boolean connector AND with various search term combinations. After adjusting for duplication, article titles and abstracts were reviewed, leaving 25 articles for an in-depth analysis. Specific exclusion criteria were then applied. The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Managing Adrenal Insufficiency

MedlinePlus

... replace cortisol; they are called glucocorticoids. At NIH, hydrocortisone, dexamethasone, or prednisone are usually recommended. If you ... side effects of these drugs? Replacement doses of hydrocortisone rarely cause side effects. Sometimes, an upset stomach ...

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

NONE

Britannia Operator Ltd. (BOL), a UK joint venture of Chevron UK Ltd. and Conoco (UK) Ltd., expects to begin gas and condensate production in August from Britannia field, likely to be last of the UK giant platform developments. Britannia has estimated reserves of 3 tcf of gas and an anticipated 145 million bbl of condensate and natural gas liquids. Peak production is expected to be 740 MMcfd of gas and 70,000 b/d of condensate. While the technical side of Britannia may not have been revolutionary, the way the project was managed probably reflects more than any other UK development themore » principles of Crine--the Cost Reduction Initiative for a New Era instigated by UK offshore operators. One of the key aims of the Crine program was to reduce typical field development costs by 30%. The means of achieving this aim was seen as smarter management rather than smarter technology.« less

CERA: 1996 To be watershed year for electric power industry

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

O'Driscoll, M.

1994-05-03

How broadly regulators define open access transmission tops the list of six crucial events that Cambridge Energy Research Associates says will converge in 1996 and create a [open quotes]watershed[close quotes] period that will determine the electric power industry's direction for the next century. Those events likely will involve state regulators and lawmakers, and will be driven by a combination of lower fuel costs and surprising technological advances that make gas turbines more efficient, environmental imperatives and the growing support for competition over regulation. And while some see conventional utilities inevitably weakened because of these changes, it is possible they mightmore » emerge stronger. Besides open access transmission, the other events are: A second generation of independent power producers; A transformation of demand side management programs; Air pollution restrictions; Premature closure of nuclear plants; and Management of risks in long-term natural gas contracting.« less

Energy Sustainability and the Green Campus.

ERIC Educational Resources Information Center

Simpson, Walter

2003-01-01

Discusses the importance of campus energy sustainability, explaining that both demand- and supply-side strategies are required. Suggests that on the demand side, an aggressive campus energy conservation program can reduce campus energy consumption by 30 percent or more. Asserts that addressing the supply side of the energy equation means shifting…

Adjuvant endocrine therapy after breast cancer: a qualitative study of factors associated with adherence

PubMed Central

Boulton, Mary; Fenlon, Debbie; Hulbert-Williams, Nick J; Walter, Fiona M; Donnelly, Peter; Lavery, Bernadette A; Morgan, Adrienne; Morris, Carolyn; Watson, Eila K

2018-01-01

Introduction Despite evidence of the efficacy of adjuvant endocrine therapy (AET) in reducing the risk of recurrence and mortality after treatment for primary breast cancer, adherence to AET is suboptimal. This study aimed to explore factors that influence adherence and nonadherence to AET following breast cancer to inform the development of supportive interventions. Methods Interviews were conducted with 32 women who had been prescribed AET, 2–4 years following their diagnosis of breast cancer. Both adherers (n=19) and nonadherers (n=13) were recruited. The analysis was conducted using the Framework approach. Results Factors associated with adherence were as follows: managing side effects including information and advice on side effects and taking control of side effects, supportive relationships, and personal influences. Factors associated with nonadherence were as follows: burden of side effects, feeling unsupported, concerns about long-term AET use, regaining normality, including valuing the quality of life over length of life, and risk perception. Conclusion Provision of timely information to prepare women for the potential side effects of AET and education on medication management strategies are needed, including provision of timely and accurate information on the efficacy of AET in reducing breast cancer recurrence and on potential side effects and ways to manage these should they arise. Trust in the doctor–patient relationship and clear patient pathways for bothersome side effects and concerns with AET are important. Training and education on AET for GPs should be considered alongside novel care pathways such as primary care nurse cancer care review and community pharmacist follow-up. PMID:29497284

Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature.

PubMed

Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

2017-09-03

Antiarrhythmic drugs are commonly prescribed cardiac drugs. Due to their receptor mimicry with several of the gastrointestinal tract receptors, they can frequently lead to gastrointestinal side effects. These side effects are the most common reasons for discontinuation of these drugs by the patients. Knowledge of these side effects is important for clinicians that manage antiarrhythmic drugs. This review focuses on the gastrointestinal side effects of these drugs and provides a detailed up-to-date literature review of the side effects of these drugs. The review provides case reports reported in the literature as well as possible mechanisms that lead to gastrointestinal side effects.

Improvement and modification of the routing system for the health-care waste collection and transportation in Istanbul.

PubMed

Alagöz, Aylin Zeren; Kocasoy, Günay

2008-01-01

Handling of health-care wastes is among the most important environmental problems in Turkey as it is in the whole world. Approximately 25-30tons of health-care wastes, in addition to the domestic and recyclable wastes, are generated from hospitals, clinics and other small health-care institutions daily on the European and the Asian sides of Istanbul [Kocasoy, G., Topkaya, B., Zeren, B.A., Kiliç, M., et al., 2004. Integrated Health-care Waste Management in Istanbul, Final Report of the LIFE00 TCY/TR/054 Project, Turkish National Committee on Solid Wastes, Istanbul, Turkey; Zeren, B.A., 2004. The Health-care Waste Management of the Hospitals in the European Side of Istanbul, M.S. Thesis, Boğaziçi University, Istanbul, Turkey; Kiliç, M., 2004. Determination of the Health-care Waste Handling and Final Disposal of the Infected Waste of Hospital-Medical Centers in the Anatolian Side of Istanbul. M.S. Thesis, Boğaziçi University, Istanbul, Turkey]. Unfortunately, these wastes are not handled, collected or temporarily stored at the institutions properly according to the published Turkish Medical Waste Control Regulation [Ministry of Environment and Forestry, 2005. Medical Waste Control Regulation. Official Gazette No. 25883, Ankara, Turkey]. Besides the inappropriate handling at the institutions, there is no systematic program for the transportation of the health-care wastes to the final disposal sites. The transportation of these wastes is realized by the vehicles of the municipalities in an uncontrolled, very primitive way. As a consequence, these improperly managed health-care wastes cause many risks to the public health and people who handle them. This study has been conducted to develop a health-care waste collection and transportation system for the city of Istanbul, Turkey. Within the scope of the study, the collection of health-care wastes from the temporary storage rooms of the health-care institutions, transportation of these wastes to the final disposal areas and the cost-benefit analyses of the existing and the proposed optimum transportation routes are investigated and the most feasible routes from the point of view of efficiency and economy have been determined. In order to solve the scheduling and route optimization problem, special software programs called MapInfo and Roadnet were used. For the program, the geocodes of hospital locations, data about the amount of the health-care wastes generated, the loading and unloading process times, and the capacity of the collecting vehicles were taken into account. The new systems developed aim at the daily collection of the health-care wastes from the institutions and their transportation directly to the final disposal area/facility by using the shortest and the most efficient routes to resolve the routing and scheduling problem and to reduce the cost arising from the transportation.

Community-based asthma care: trial of a "credit card" asthma self-management plan.

PubMed

D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K

1994-07-01

Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

Staff Knowledge of the Side Effects of Anti-Psychotic Medication

ERIC Educational Resources Information Center

Fretwell, Christine; Felce, David

2007-01-01

Background: Anti-psychotic medications are widely prescribed to people with intellectual disabilities and have a range of negative side effects. The aim was to identify the level of knowledge of anti-psychotic medications and their side effects among key carers or home managers of adults with intellectual disabilities living in residential group…

Influence of trap placement and design on capture of the emerald ash borer (Coleoptera: Buprestidae).

PubMed

Francese, Joseph A; Oliver, Jason B; Fraser, Ivich; Lance, David R; Youssef, Nadeer; Sawyer, Alan J; Mastro, Victor C

2008-12-01

The key to an effective pest management program for the emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera Buprestidae), is a survey program equipped with tools for detecting and delimiting populations. We studied the effects of trap design, color, and placement on the efficacy of sticky traps for capturing the emerald ash borer. There were significant differences in trap catch along a transect gradient from wooded to open field conditions, with most beetles being caught along the edge, or in open fields, 15-25 m outside an ash (Fraxinus spp. L.) (Oleaceae) woodlot. Greater emerald ash borer catch occurred on purple traps than on red or white traps. Traps placed in the mid-canopy of ash trees (13 m) caught significantly more beetles than those placed at ground level. We also describe a new trap design, a three-sided prism trap, which is relatively easy to assemble and deploy.

Blockchain Based Decentralized Management of Demand Response Programs in Smart Energy Grids.

PubMed

Pop, Claudia; Cioara, Tudor; Antal, Marcel; Anghel, Ionut; Salomie, Ioan; Bertoncini, Massimo

2018-01-09

In this paper, we investigate the use of decentralized blockchain mechanisms for delivering transparent, secure, reliable, and timely energy flexibility, under the form of adaptation of energy demand profiles of Distributed Energy Prosumers, to all the stakeholders involved in the flexibility markets (Distribution System Operators primarily, retailers, aggregators, etc.). In our approach, a blockchain based distributed ledger stores in a tamper proof manner the energy prosumption information collected from Internet of Things smart metering devices, while self-enforcing smart contracts programmatically define the expected energy flexibility at the level of each prosumer, the associated rewards or penalties, and the rules for balancing the energy demand with the energy production at grid level. Consensus based validation will be used for demand response programs validation and to activate the appropriate financial settlement for the flexibility providers. The approach was validated using a prototype implemented in an Ethereum platform using energy consumption and production traces of several buildings from literature data sets. The results show that our blockchain based distributed demand side management can be used for matching energy demand and production at smart grid level, the demand response signal being followed with high accuracy, while the amount of energy flexibility needed for convergence is reduced.

Use of Hematopoietic Growth Factor in the Management of Hematological Side Effects Associated to Antiviral Treatment for Hcv Hepatitis

PubMed Central

Mancino, Paola; Falasca, Katia; Ucciferri, Claudio; Pizzigallo, Eligio; Vecchiet, Jacopo

2010-01-01

Haematological abnormalities are common during combination antiviral therapy for chronic hepatitis C. Although dose reduction or discontinuation can easily treat these side effects, they can adversely affect the efficacy of combination antiviral therapy reducing the likelihood of a sustained viral response (SVR). To avoid potentially diminishing a patient’s chance of response, many physicians have begun using growth factors off-label to manage anaemia and neutropenia in hepatitis C. Haematopoietic growth factors are generally well tolerated and they may be useful for managing haematological side effects of anti-HCV therapy improving patients’ quality of life. To date, the role and benefit of these agents during anti-HCV therapy and their positive impact on SVR have not conclusively determined in the published studies. However, the possibility of a benefit to individual outpatients remains, and an individualized approach is recommended. This review explores the incidence, clinical significance, and management of anaemia, neutropenia and thrombocytopenia associated with combination therapy for HCV infection. PMID:21415945

A novel approach in managing right-sided haemothorax in neurofibromatosis type 1.

PubMed

Mydin, Muhammad Izanee Mohamed; Sharma, Amit; Zia, Zergham; Hawari, Mohammad; Jadoon, Mehmood; Majewski, Andrzej

2015-06-01

Spontaneous haemothorax due to vasculopathy in patients with neurofibromatosis type 1 is rare but life-threatening. A 56-year-old lady with neurofibromatosis type 1 presented with right-sided chest pain, dyspnoea, and collapse. Computed tomography showed a right-sided hemothorax. Urgent angiography showed contrast leakage from a right subclavian artery pseudoaneurysm. A Gore Viabahn endovascular stent graft was deployed. Completion angiography revealed satisfactory haemostasis. She underwent video-assisted thoracoscopic evacuation of the hemothorax, with good results. This case highlights a novel approach to managing a rare emergency, using combined procedures. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Side Effects: Diarrhea

Cancer.gov

Diarrhea, a side effect of cancer treatment, may cause symptoms such as loose, watery stools. Diarrhea can lead to dehydration and malnutrition in cancer patients. Learn about ways to treat and manage diarrhea during cancer treatment.

Bortezomib, a newly approved proteasome inhibitor for the treatment of multiple myeloma: nursing implications.

PubMed

Colson, Kathleen; Doss, Deborah S; Swift, Regina; Tariman, Joseph; Thomas, Teri E

2004-10-01

Multiple myeloma (MM), a malignancy of the plasma cells, accounts for an estimated 14% of all newly diagnosed hematologic malignancies. Advances in chemotherapy and stem cell transplantation have improved survival rates, but MM remains incurable. Bortezomib (Velcade, Millennium Pharmaceuticals, Inc., Cambridge, MA), a first-in-class proteasome inhibitor, has been approved for patients with MM who have received at least two prior treatments and have demonstrated disease progression on the most recent one. During clinical trials, most side effects were manageable with standard interventions. The most common toxicities were asthenic conditions (fatigue, malaise, and weakness), gastrointestinal disturbances (nausea, vomiting, diarrhea, and constipation), thrombocytopenia, peripheral neuropathy, pyrexia, and anemia. Supportive therapies and strategies for side-effect management can prevent worsening of these symptoms, thereby avoiding dose reductions and treatment delays. Oncology nurses play a key role in ensuring the proper and safe administration of bortezomib and often are the first to identify the signs of side effects. Patient education about anticipated side effects and close monitoring of patients can lead to symptom management interventions that are essential to patient comfort and safety.

An Analysis of the Organizational Structures Supporting PPBE within the Military Departments

DTIC Science & Technology

2008-06-01

correlation between the offices on the military side and offices on the civilian side. The top portion of the figure, the green part, is the...Management) (DASA( FIM )); Chief, Congressional Budget Liaison; Chief, Comptroller Proponency. The Military Deputy for Budget, although not directly...fall under the cognizance of the Military Deputy for Budget. The DASA( FIM ) oversees the financial management systems and processes within the Army to

Side Effects: Anemia

Cancer.gov

Anemia is a side effect of cancer treatments, including chemotherapy and radiation therapy. It can make women and men feel fatigued, dizzy, and short of breath. Learn how to manage fatigue caused by anemia during cancer treatment.

Overview and Experiences of a Nursing e-Mentorship Program

PubMed Central

Faiman, Beth

2012-01-01

Little is known regarding the feasibility and efficacy of an online continuing education program for oncology nurses. The Multiple Myeloma Mentorship Program, a quality improvement project for the Institute for Medical Education and Research, was designed to meet the educational needs of oncology nurses caring for patients with multiple myeloma. Twenty-five expert nurses with expertise in multiple myeloma from 23 cancer centers in the United States partnered with 50 oncology nurses in an electronic format from July 2009 to January 2010. The purpose of the program was to educate oncology nurses about the latest treatments and strategies for optimal side-effect management for patients with multiple myeloma. Nurse mentees selected their preferred form of learning—webcast, in-person speaker, or monograph. Two live webcasts allowed for didactic discussion between mentors and mentees. During and after the program, mentors conducted informal, unscripted interviews with nurse participants to determine preferred learning format, challenges, and implications for practice. Twelve nurses preferred Web-based learning to in-person presentations, citing flexibility and convenience as reasons for that choice. Time constraints with Web-based and in-person learning were a barrier to nurse mentees completing assigned modules. Several nurses implemented practice changes as a result of the program. Nurses who participated in the mentorship program were satisfied with the content. Learning styles and format should be considered in future mentorship programs. PMID:21810575

Surgical management of colonic diverticular disease: discrepancy between right- and left-sided diseases.

PubMed

Oh, Heung-Kwon; Han, Eon Chul; Ha, Heon-Kyun; Choe, Eun Kyung; Moon, Sang Hui; Ryoo, Seung-Bum; Jeong, Seung-Yong; Park, Kyu Joo

2014-08-07

To compare the outcome of the surgical management of left-sided and right-sided diverticular disease. The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients. The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P < 0.05). Moreover, no differences in gender, body mass index, multiplicity of the diverticula, fever, or leukocytosis were noted between patients with right-sided and left-sided disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P < 0.01). Furthermore, left-sided disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P < 0.01), combined resection due to extensive inflammation (21.6% vs 5.0%, P < 0.05), operative complications (51.4% vs 27.5%, P < 0.05), and in-hospital mortality (10.8% vs 0%, P < 0.05), along with longer post-operative hospitalization duration (21.3 ± 10.2 d vs 10.6 ± 8.1 d, P < 0.05). Compared with right-sided diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes.

Surgical management of colonic diverticular disease: Discrepancy between right- and left-sided diseases

PubMed Central

Oh, Heung-Kwon; Han, Eon Chul; Ha, Heon-Kyun; Choe, Eun Kyung; Moon, Sang Hui; Ryoo, Seung-Bum; Jeong, Seung-Yong; Park, Kyu Joo

2014-01-01

AIM: To compare the outcome of the surgical management of left-sided and right-sided diverticular disease. METHODS: The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients. RESULTS: The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P < 0.05). Moreover, no differences in gender, body mass index, multiplicity of the diverticula, fever, or leukocytosis were noted between patients with right-sided and left-sided disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P < 0.01). Furthermore, left-sided disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P < 0.01), combined resection due to extensive inflammation (21.6% vs 5.0%, P < 0.05), operative complications (51.4% vs 27.5%, P < 0.05), and in-hospital mortality (10.8% vs 0%, P < 0.05), along with longer post-operative hospitalization duration (21.3 ± 10.2 d vs 10.6 ± 8.1 d, P < 0.05). CONCLUSION: Compared with right-sided diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes. PMID:25110438

Integrative relational machine-learning for understanding drug side-effect profiles

PubMed Central

2013-01-01

Background Drug side effects represent a common reason for stopping drug development during clinical trials. Improving our ability to understand drug side effects is necessary to reduce attrition rates during drug development as well as the risk of discovering novel side effects in available drugs. Today, most investigations deal with isolated side effects and overlook possible redundancy and their frequent co-occurrence. Results In this work, drug annotations are collected from SIDER and DrugBank databases. Terms describing individual side effects reported in SIDER are clustered with a semantic similarity measure into term clusters (TCs). Maximal frequent itemsets are extracted from the resulting drug x TC binary table, leading to the identification of what we call side-effect profiles (SEPs). A SEP is defined as the longest combination of TCs which are shared by a significant number of drugs. Frequent SEPs are explored on the basis of integrated drug and target descriptors using two machine learning methods: decision-trees and inductive-logic programming. Although both methods yield explicit models, inductive-logic programming method performs relational learning and is able to exploit not only drug properties but also background knowledge. Learning efficiency is evaluated by cross-validation and direct testing with new molecules. Comparison of the two machine-learning methods shows that the inductive-logic-programming method displays a greater sensitivity than decision trees and successfully exploit background knowledge such as functional annotations and pathways of drug targets, thereby producing rich and expressive rules. All models and theories are available on a dedicated web site. Conclusions Side effect profiles covering significant number of drugs have been extracted from a drug ×side-effect association table. Integration of background knowledge concerning both chemical and biological spaces has been combined with a relational learning method for discovering rules which explicitly characterize drug-SEP associations. These rules are successfully used for predicting SEPs associated with new drugs. PMID:23802887

Integrative relational machine-learning for understanding drug side-effect profiles.

PubMed

Bresso, Emmanuel; Grisoni, Renaud; Marchetti, Gino; Karaboga, Arnaud Sinan; Souchet, Michel; Devignes, Marie-Dominique; Smaïl-Tabbone, Malika

2013-06-26

Drug side effects represent a common reason for stopping drug development during clinical trials. Improving our ability to understand drug side effects is necessary to reduce attrition rates during drug development as well as the risk of discovering novel side effects in available drugs. Today, most investigations deal with isolated side effects and overlook possible redundancy and their frequent co-occurrence. In this work, drug annotations are collected from SIDER and DrugBank databases. Terms describing individual side effects reported in SIDER are clustered with a semantic similarity measure into term clusters (TCs). Maximal frequent itemsets are extracted from the resulting drug x TC binary table, leading to the identification of what we call side-effect profiles (SEPs). A SEP is defined as the longest combination of TCs which are shared by a significant number of drugs. Frequent SEPs are explored on the basis of integrated drug and target descriptors using two machine learning methods: decision-trees and inductive-logic programming. Although both methods yield explicit models, inductive-logic programming method performs relational learning and is able to exploit not only drug properties but also background knowledge. Learning efficiency is evaluated by cross-validation and direct testing with new molecules. Comparison of the two machine-learning methods shows that the inductive-logic-programming method displays a greater sensitivity than decision trees and successfully exploit background knowledge such as functional annotations and pathways of drug targets, thereby producing rich and expressive rules. All models and theories are available on a dedicated web site. Side effect profiles covering significant number of drugs have been extracted from a drug ×side-effect association table. Integration of background knowledge concerning both chemical and biological spaces has been combined with a relational learning method for discovering rules which explicitly characterize drug-SEP associations. These rules are successfully used for predicting SEPs associated with new drugs.

Parameter study for child injury mitigation in near-side impacts through FE simulations.

PubMed

Andersson, Marianne; Pipkorn, Bengt; Lövsund, Per

2012-01-01

The objective of this study is to investigate the effects of crash-related car parameters on head and chest injury measures for 3- and 12-year-old children in near-side impacts. The evaluation was made using a model of a complete passenger car that was impacted laterally by a barrier. The car model was validated in 2 crash conditions: the Insurance Institute for Highway Safety (IIHS) and the US New Car Assessment Program (NCAP) side impact tests. The Small Side Impact Dummy (SID-IIs) and the human body model 3 (HBM3) (Total HUman Model for Safety [THUMS] 3-year-old) finite element models were used for the parametric investigation (HBM3 on a booster). The car parameters were as follows: vehicle mass, side impact structure stiffness, a head air bag, a thorax-pelvis air bag, and a seat belt with pretensioner. The studied dependent variables were as follows: resultant head linear acceleration, resultant head rotational acceleration, chest viscous criterion, rib deflection, and relative velocity at head impact. The chest measurements were only considered for the SID-IIs. The head air bag had the greatest effect on the head measurements for both of the occupant models. On average, it reduced the peak head linear acceleration by 54 g for the HBM3 and 78 g for the SID-IIs. The seat belt had the second greatest effect on the head measurements; the peak head linear accelerations were reduced on average by 39 g (HBM3) and 44 g (SID-IIs). The high stiffness side structure increased the SID-IIs' head acceleration, whereas it had marginal effect on the HBM3. The vehicle mass had a marginal effect on SID-IIs' head accelerations, whereas the lower vehicle mass caused 18 g higher head acceleration for HBM3 and the greatest rotational acceleration. The thorax-pelvis air bag, vehicle mass, and seat belt pretensioner affected the chest measurements the most. The presence of a thorax-pelvis air bag, high vehicle mass, and a seat belt pretensioner all reduced the chest viscous criterion (VC) and peak rib deflection in the SID-IIs. The head and thorax-pelvis air bags have the potential to reduce injury measurements for both the SID-IIs and the HBM3, provided that the air bag properties are designed to consider these occupant sizes also. The seat belt pretensioner is also effective, provided that the lateral translation of the torso is managed by other features. The importance of lateral movement management is greater the smaller the occupant is. Light vehicles require interior restraint systems of higher performance than heavy vehicles do to achieve the same level of injury measures for a given side structure. Copyright © 2012 Taylor & Francis Group, LLC

Side Effects: Hair Loss (Alopecia)

Cancer.gov

Hair loss, also called alopecia, is a side effect of cancer treatments, such as chemotherapy and radiation therapy. Learn how to cope with and manage hair loss. Listen to tips from others who have experienced hair loss.

Exploring Tradeoffs in Demand-side and Supply-side Management of Urban Water Resources using Agent-based Modeling and Evolutionary Computation

NASA Astrophysics Data System (ADS)

Kanta, L.; Berglund, E. Z.

2015-12-01

Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS) framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger (1) increases in the volume of water pumped through inter-basin transfers from an external reservoir and (2) drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

The Role of Pain Management in Recovery Following Trauma and Orthopaedic Surgery

DTIC Science & Technology

2012-01-01

effective , it has significant side effects that can complicate recovery and rehabilitation following injury. These side effects (eg, sedation, nausea and...managed pain has a negative effect on nearly every aspect of patient recovery and rehabilitation.4 Opioid Use and Related Complications Morphine... effects associ- ated with the use of morphine and COL Chester C. Buckenmaier III, MD, MC, USA From the Walter Reed Army Medical Center, Washington, DC

Supply and demand: negotiating the prescription drug labyrinth to reduce costs.

PubMed

DeStefino, Kevin

2003-01-01

Prescription drug costs are increasing at a rate of 15% to 17% a year and a look into the future does not bring much better news. Employers can expect to see more numbers like these as doctors more aggressively treat diseases using drug therapy, the population continues to age and pharmaceutical companies continue to spend billions of dollars on direct-to-consumer advertising aimed at consumers who are desensitized to the true costs of their prescriptions. In this environment, it is unlikely that companies can realistically expect to reverse costs of even to avoid cost increases. However, this article provides employers with a prudent approach to managing both the supply and demand sides of the prescription drug equation in order to reduce their level of increase. Supply-side management focuses on negotiations with vendors, while the demand side focuses on managing employee utilization.

1996 Coolant Flow Management Workshop

NASA Technical Reports Server (NTRS)

Hippensteele, Steven A. (Editor)

1997-01-01

The following compilation of documents includes a list of the 66 attendees, a copy of the viewgraphs presented, and a summary of the discussions held after each session at the 1996 Coolant Flow Management Workshop held at the Ohio Aerospace Institute, adjacent to the NASA Lewis Research Center, Cleveland, Ohio on December 12-13, 1996. The workshop was organized by H. Joseph Gladden and Steven A. Hippensteele of NASA Lewis Research Center. Participants in this workshop included Coolant Flow Management team members from NASA Lewis, their support service contractors, the turbine engine companies, and the universities. The participants were involved with research projects, contracts and grants relating to: (1) details of turbine internal passages, (2) computational film cooling capabilities, and (3) the effects of heat transfer on both sides. The purpose of the workshop was to assemble the team members, along with others who work in gas turbine cooling research, to discuss needed research and recommend approaches that can be incorporated into the Center's Coolant Flow Management program. The workshop was divided into three sessions: (1) Internal Coolant Passage Presentations, (2) Film Cooling Presentations, and (3) Coolant Flow Integration and Optimization. Following each session there was a group discussion period.

The College Opportunity Grant Program of the California State Scholarship and Loan Commission; A Report on and Evaluation of the 1969 and 1970 COG Selection Procedures.

ERIC Educational Resources Information Center

Klingelhofer, Edwin L.

The College Opportunity Grant (COG) program was established by the California legislature in 1968 and was intended to provide monetary grants to financially needy students, primarily from ethnic minorities, to assist them while attending college. This paper contains: (1) a side-by-side description of the characteristics of the 1969 and 1970…

Side-to-Side Tracheobronchoplasty to Reconstruct Complex Congenital Tracheobronchial Stenosis.

PubMed

Ragalie, William S; Chun, Robert H; Martin, Timothy; Ghanayem, Nancy S; Berens, Richard J; Beste, David J; Mitchell, Michael E

2017-08-01

Long segment tracheobronchial stenosis is a rare congenital anomaly that can also occur in combination with abnormal bronchial arborization. Long segment tracheal reconstruction in the setting of a supernumerary bridging bronchus has been reported; however, these repairs can be particularly complex. We present our experience using the bridging bronchus to augment long segment tracheal stenosis with a side-to-side tracheobronchoplasty. Four patients with complex long segment tracheobronchial stenosis involving a bronchus suis (right upper lobe bronchus) and a bridging bronchus presented with refractory respiratory distress requiring urgent tracheal reconstruction. Patient 1 was initially managed with modified slide tracheoplasty and tracheostomy. Patients 2, 3, and 4 were managed with single-stage procedures. All patients underwent definitive long segment tracheobronchoplasty consisting of a side-to-side anastomosis between the bridging bronchus and the right upper lobe bronchus. Age at surgery was 569, 69, 24, and 142 days, respectively. Weight at surgery was 9.3, 4.3, 2.7, and 5.9 kg. All patients were weaned from mechanical ventilation at 84, 13, 47, and 8 days after side-to-side tracheobronchoplasty. All patients were alive and free from tracheostomy at follow-up of 6.7, 3.8, 2.7, and 0.5 years. Side-to-side tracheal reconstruction is feasible in severe cases of long segment tracheal stenosis with a right upper lobe bronchus and a bridging bronchus. This technique can be successfully applied in high-risk patients and in the neonatal period and can provide excellent midterm results. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Azithromycin

MedlinePlus

... taking azithromycin unless you experience the severe side effects described in the SIDE EFFECTS section. If you stop taking azithromycin too soon ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

Flight Systems Integration and Test

NASA Technical Reports Server (NTRS)

Wright, Michael R.

2011-01-01

Topics to be Covered in this presentation are: (1) Integration and Test (I&T) Planning (2) Integration and Test Flows (3) Overview of Typical Mission I&T (4) Supporting Elements (5) Lessons-Learned and Helpful Hints (6) I&T Mishaps and Failures (7) The Lighter Side of I&T and (8) Small-Group Activity. This presentation highlights a typical NASA "in-house" I&T program (1) For flight systems that are developed by NASA at a space flight center (like GSFC) (2) Requirements well-defined: qualification/acceptance, documentation, configuration management. (3) Factors: precedents, human flight, risk-aversion ("failure-phobia"), taxpayer dollars, jobs and (4) Some differences among NASA centers, but generally a resource-intensive process

Dust Wind Tails Around Rocks

NASA Technical Reports Server (NTRS)

1997-01-01

This image was taken by the Sojourner rover's left front camera on Sol 32. The Pathfinder lander is at right and is about 9 meters away. Wind tails of dust are clearly seen extending from the left side of many of the small rocks in the foreground. The large rocks on the horizon at left center are the next goal of Sojourner as it continues our exploration of Mars.

Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and managed the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. JPL is a division of the California Institute of Technology (Caltech).

Spacecraft Status Report: 2001 Mars Odyssey

NASA Technical Reports Server (NTRS)

Boyles, Carole

2012-01-01

Fourth extension of Odyssey mission continues, with orbital science investigations and relay services for landed assets. Mitigation of aging IMU and UHF transceiver. ODY has responded to Program Office/board recommendations. All Stellar mode has been certified for flight operations and is now standard for nadir point operations on the A-side. Investigating options to mitigate aging Battery. Gradual transfer to a later LMST orbit node to shorten eclipse durations. Reduce spacecraft loads during the longer eclipses. Optimize battery performance. ODY is preparing for E5 Proposal and Planetary Science Division FY12 Senior Review activities. ODY is on track to support MSL EDL and surface operations. ODY is managing consumables in order to remain in operations until 2020.

Effects of a dynamic core stability program on the biomechanics of cutting maneuvers: A randomized controlled trial.

PubMed

Whyte, E F; Richter, C; O'Connor, S; Moran, K A

2018-02-01

Deficits in trunk control predict ACL injuries which frequently occur during high-risk activities such as cutting. However, no existing trunk control/core stability program has been found to positively affect trunk kinematics during cutting activities. This study investigated the effectiveness of a 6-week dynamic core stability program (DCS) on the biomechanics of anticipated and unanticipated side and crossover cutting maneuvers. Thirty-one male, varsity footballers participated in this randomized controlled trial. Three-dimensional trunk and lower limb biomechanics were captured in a motion analysis laboratory during the weight acceptance phase of anticipated and unanticipated side and crossover cutting maneuvers at baseline and 6-week follow-up. The DCS group performed a DCS program three times weekly for 6 weeks in a university rehabilitation room. Both the DCS and control groups concurrently completed their regular practice and match play. Statistical parametric mapping and repeated measures analysis of variance were used to determine any group (DCS vs control) by time (pre vs post) interactions. The DCS resulted in greater internal hip extensor (P=.017, η 2 =0.079), smaller internal knee valgus (P=.026, η 2 =0.076), and smaller internal knee external rotator moments (P=.041, η 2 =0.066) during anticipated side cutting compared with the control group. It also led to reduced posterior ground reaction forces for all cutting activities (P=.015-.030, η 2 =0.074-0.105). A 6-week DCS program did not affect trunk kinematics, but it did reduce a small number of biomechanical risk factors for ACL injury, predominantly during anticipated side cutting. A DCS program could play a role in multimodal ACL injury prevention programs. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Design and Delivery of Multiple Server-Side Computer Languages Course

ERIC Educational Resources Information Center

Wang, Shouhong; Wang, Hai

2011-01-01

Given the emergence of service-oriented architecture, IS students need to be knowledgeable of multiple server-side computer programming languages to be able to meet the needs of the job market. This paper outlines the pedagogy of an innovative course of multiple server-side computer languages for the undergraduate IS majors. The paper discusses…

Landsat's TIRS Instrument

NASA Image and Video Library

2017-12-08

The Thermal Infrared Sensor (TIRS) will fly on the next Landsat satellite, the Landsat Data Continuity Mission (LDCM). The right side of the instrument is what's called the 'nadir side,' that's the side that points toward Earth when the instrument is in space. The black circle visible on the right side is where the optics for the instrument are located. In that area are the lens and the detectors. The white area is a radiator that radiates heat to keep the telescope and the detector cool. The black hole on the white area on the left is what the satellite operators point to deep space when they calibrate the instrument to the cold temperatures of space. TIRS was built on an accelerated schedule at NASA's Goddard Space Flight Center, Greenbelt, Md. and will now be integrated into the LDCM spacecraft at Orbital Science Corp. in Gilbert, Ariz. The Landsat Program is a series of Earth observing satellite missions jointly managed by NASA and the U.S. Geological Survey. Landsat satellites have been consistently gathering data about our planet since 1972. They continue to improve and expand this unparalleled record of Earth's changing landscapes for the benefit of all. For more information on Landsat, visit: www.nasa.gov/landsat Credit: NASA/GSFC/Rebecca Roth NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Managing the oral side-effects of medications used to treat multiple sclerosis.

PubMed

Cockburn, N; Pateman, K; Taing, M W; Pradhan, A; Ford, P J

2017-09-01

Many medications used to manage multiple sclerosis (MS) affect oral health. This review aimed to identify the oral side-effects of the current drugs recommended in Australia to treat MS and make dental practitioners aware of the range of symptoms. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat MS. For each medication, the generic name, class, route of administration, dosage and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (MIMs) database. Meyler's Side-effect of Drugs Encyclopaedia was used to identify any additional oral adverse reactions to medications used to treat MS. Fourteen drugs were identified for the treatment of MS progression and 13 drugs for the treatment of MS symptoms. For these medications, 18 oral side-effects were documented: xerostomia was the most common, followed by dysgeusia, dysphagia, mouth ulceration and sinusitis. Anticholinergic drugs caused xerostomia while immunosuppressants resulted in more infection-related side-effects. Dental practitioners should be aware of the range of symptoms likely to be reported by this population. Clinicians are encouraged to continue providing dental care for their patients who develop MS and refer complex cases to specialists. © 2017 Australian Dental Association.

Wind Drifts at Viking 1 Landing Site

NASA Technical Reports Server (NTRS)

1997-01-01

This image is of so-called wind drifts seen at the Viking 1 landing site. These are somewhat different from the features seen at the Pathfinder site in two important ways. 1) These landforms have no apparent slip-or avalanche-face as do both terrestrial dunes and the Pathfinder features, and may represent deposits of sediment falling from the air, as opposed to dune sand, which 'hops' or saltates along the ground; 2) these features may indicate erosion on one side, because of the layering and apparent scouring on their right sides. They may, therefore have been deposited by a wind moving left to right, partly or weakly cemented or solidified by surface processes at some later time, then eroded by a second wind (right to left), exposing their internal structure.

Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and manages the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. JPL is a division of the California Institute of Technology (Caltech).

Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Men

MedlinePlus

... Chemotherapy Side Effects Sexual and Fertility Changes in Men “I talked with my doctor before treatment. I ... other health issues are also important. Questions from men about sexual problems: What sexual problems might I ...

46 CFR 162.060-30 - Testing requirements for ballast water management system (BWMS) components.

Code of Federal Regulations, 2013 CFR

2013-10-01

... production configuration: (1) A resonance search vertically up and down, horizontally from side to side, and...) Components that may be installed in enclosed spaces that are environmentally controlled, including an engine...

46 CFR 162.060-30 - Testing requirements for ballast water management system (BWMS) components.

Code of Federal Regulations, 2014 CFR

2014-10-01

... production configuration: (1) A resonance search vertically up and down, horizontally from side to side, and...) Components that may be installed in enclosed spaces that are environmentally controlled, including an engine...

3. VIEW OF EAST SIDE AND NORTH FRONT OF BUILDING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. VIEW OF EAST SIDE AND NORTH FRONT OF BUILDING #2205 (AREA CONTAINING VEHICLE REPAIR SHOP AND VEHICLE MANAGEMENT OFFICE), FACING SOUTHWEST. - Medford Service Center, Warehouse, 1319 McAndrews Road, Medford, Jackson County, OR

Side Effects - Memory or Concentration Problems

Cancer.gov

Cancer treatments, such as chemo, may cause difficulty thinking, concentrating, or other cognitive problems. Learn about steps people with cancer can take to manage these side effects. See a list of helpful questions for families to ask the doctor.

Bulk electric system reliability evaluation incorporating wind power and demand side management

NASA Astrophysics Data System (ADS)

Huang, Dange

Electric power systems are experiencing dramatic changes with respect to structure, operation and regulation and are facing increasing pressure due to environmental and societal constraints. Bulk electric system reliability is an important consideration in power system planning, design and operation particularly in the new competitive environment. A wide range of methods have been developed to perform bulk electric system reliability evaluation. Theoretically, sequential Monte Carlo simulation can include all aspects and contingencies in a power system and can be used to produce an informative set of reliability indices. It has become a practical and viable tool for large system reliability assessment technique due to the development of computing power and is used in the studies described in this thesis. The well-being approach used in this research provides the opportunity to integrate an accepted deterministic criterion into a probabilistic framework. This research work includes the investigation of important factors that impact bulk electric system adequacy evaluation and security constrained adequacy assessment using the well-being analysis framework. Load forecast uncertainty is an important consideration in an electrical power system. This research includes load forecast uncertainty considerations in bulk electric system reliability assessment and the effects on system, load point and well-being indices and reliability index probability distributions are examined. There has been increasing worldwide interest in the utilization of wind power as a renewable energy source over the last two decades due to enhanced public awareness of the environment. Increasing penetration of wind power has significant impacts on power system reliability, and security analyses become more uncertain due to the unpredictable nature of wind power. The effects of wind power additions in generating and bulk electric system reliability assessment considering site wind speed correlations and the interactive effects of wind power and load forecast uncertainty on system reliability are examined. The concept of the security cost associated with operating in the marginal state in the well-being framework is incorporated in the economic analyses associated with system expansion planning including wind power and load forecast uncertainty. Overall reliability cost/worth analyses including security cost concepts are applied to select an optimal wind power injection strategy in a bulk electric system. The effects of the various demand side management measures on system reliability are illustrated using the system, load point, and well-being indices, and the reliability index probability distributions. The reliability effects of demand side management procedures in a bulk electric system including wind power and load forecast uncertainty considerations are also investigated. The system reliability effects due to specific demand side management programs are quantified and examined in terms of their reliability benefits.

Smart Grid Risk Management

NASA Astrophysics Data System (ADS)

Abad Lopez, Carlos Adrian

Current electricity infrastructure is being stressed from several directions -- high demand, unreliable supply, extreme weather conditions, accidents, among others. Infrastructure planners have, traditionally, focused on only the cost of the system; today, resilience and sustainability are increasingly becoming more important. In this dissertation, we develop computational tools for efficiently managing electricity resources to help create a more reliable and sustainable electrical grid. The tools we present in this work will help electric utilities coordinate demand to allow the smooth and large scale integration of renewable sources of energy into traditional grids, as well as provide infrastructure planners and operators in developing countries a framework for making informed planning and control decisions in the presence of uncertainty. Demand-side management is considered as the most viable solution for maintaining grid stability as generation from intermittent renewable sources increases. Demand-side management, particularly demand response (DR) programs that attempt to alter the energy consumption of customers either by using price-based incentives or up-front power interruption contracts, is more cost-effective and sustainable in addressing short-term supply-demand imbalances when compared with the alternative that involves increasing fossil fuel-based fast spinning reserves. An essential step in compensating participating customers and benchmarking the effectiveness of DR programs is to be able to independently detect the load reduction from observed meter data. Electric utilities implementing automated DR programs through direct load control switches are also interested in detecting the reduction in demand to efficiently pinpoint non-functioning devices to reduce maintenance costs. We develop sparse optimization methods for detecting a small change in the demand for electricity of a customer in response to a price change or signal from the utility, dynamic learning methods for scheduling the maintenance of direct load control switches whose operating state is not directly observable and can only be inferred from the metered electricity consumption, and machine learning methods for accurately forecasting the load of hundreds of thousands of residential, commercial and industrial customers. These algorithms have been implemented in the software system provided by AutoGrid, Inc., and this system has helped several utilities in the Pacific Northwest, Oklahoma, California and Texas, provide more reliable power to their customers at significantly reduced prices. Providing power to widely spread out communities in developing countries using the conventional power grid is not economically feasible. The most attractive alternative source of affordable energy for these communities is solar micro-grids. We discuss risk-aware robust methods to optimally size and operate solar micro-grids in the presence of uncertain demand and uncertain renewable generation. These algorithms help system operators to increase their revenue while making their systems more resilient to inclement weather conditions.

Physical, social, and psychological consequences of treatment for hepatitis C : a community-based evaluation of patient-reported outcomes.

PubMed

Manos, M Michele; Ho, Chanda K; Murphy, Rosemary C; Shvachko, Valentina A

2013-01-01

Hepatitis C virus (HCV) antiviral therapy entails a long treatment course, as well as significant side effects that can lead to medication non-adherence and premature termination of treatment. Few large studies have comprehensively examined patient perspectives on the treatment experience, particularly the social and personal effects. We sought to understand how a diverse group of patients' lives were affected during HCV treatment, and to obtain suggestions about how to better support patients during treatment. On average, 13 months after therapy we interviewed by telephone a consecutive sample of 200 patients treated for hepatitis C with ribavirin and pegylated interferon in a comprehensive, integrated health plan in the years 2008-2010. Mixed (quantitative and qualitative) survey methods were used. The response rate was 68.9 %. Mean age at treatment was 51 years; 63.0 % were men; and Black, Hispanic, Asian, and White non-Hispanic racial/ethnic groups were similarly represented. Patients whose treatment was managed by nurses or clinical pharmacists (vs. physicians) were more likely to report their providers as being part of their support system (83.5 % vs. 58.9 %; p < 0.001). Most patients reported flu-like symptoms (93.5 %) and psychiatric problems (84.5 %), and 42.5 % reported side effects lasted up to 6 months after treatment. Black patients reported discontinuing treatment prematurely due to side effects more often than non-Blacks (29.4 % vs. 12.1 %; p < 0.001). Physical side effects (69.5 % of patients), psychiatric issues (43.5 %), and employment (27.4 %) were ranked among the three most difficult challenges. Patients desired help in anticipating and arranging work modifications during treatment. Most patients rated peer support, nutritional guidance, and weekly provider contact by telephone as potentially helpful resources for future patients undergoing HCV treatment. Patient perspectives can help formulate and refine HCV treatment support programs. Effective support programs for diverse populations are crucial as the complexities and costs of HCV treatment increase. The call for greater support from peers, providers, and employers demands new systems such as patient-centered care teams.

Yoga-Based Rehabilitation Program in Reducing Physical and Emotional Side Effects in Patients With Cancer

ClinicalTrials.gov

2017-01-23

Alopecia; Anxiety; Breast Carcinoma; Cognitive Side Effects of Cancer Therapy; Colorectal Carcinoma; Depression; Fatigue; Lung Carcinoma; Nausea and Vomiting; Pain; Psychological Impact of Cancer; Sleep Disorder; Weight Change

Combining Distributed and Shared Memory Models: Approach and Evolution of the Global Arrays Toolkit

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

Nieplocha, Jarek; Harrison, Robert J.; Kumar, Mukul

2002-07-29

Both shared memory and distributed memory models have advantages and shortcomings. Shared memory model is much easier to use but it ignores data locality/placement. Given the hierarchical nature of the memory subsystems in the modern computers this characteristic might have a negative impact on performance and scalability. Various techniques, such as code restructuring to increase data reuse and introducing blocking in data accesses, can address the problem and yield performance competitive with message passing[Singh], however at the cost of compromising the ease of use feature. Distributed memory models such as message passing or one-sided communication offer performance and scalability butmore » they compromise the ease-of-use. In this context, the message-passing model is sometimes referred to as?assembly programming for the scientific computing?. The Global Arrays toolkit[GA1, GA2] attempts to offer the best features of both models. It implements a shared-memory programming model in which data locality is managed explicitly by the programmer. This management is achieved by explicit calls to functions that transfer data between a global address space (a distributed array) and local storage. In this respect, the GA model has similarities to the distributed shared-memory models that provide an explicit acquire/release protocol. However, the GA model acknowledges that remote data is slower to access than local data and allows data locality to be explicitly specified and hence managed. The GA model exposes to the programmer the hierarchical memory of modern high-performance computer systems, and by recognizing the communication overhead for remote data transfer, it promotes data reuse and locality of reference. This paper describes the characteristics of the Global Arrays programming model, capabilities of the toolkit, and discusses its evolution.« less

Future therapeutic directions for factor Xa inhibition in the prophylaxis and treatment of thrombotic disorders.

PubMed

Turpie, Alexander G G

2003-11-15

The targeted mechanism of factor Xa inhibition has been studied extensively, initially as prophylaxis for venous thromboembolism (VTE) in the orthopedic surgical setting. Future therapeutic directions for selective factor Xa inhibition in the management of other thrombotic diseases are discussed. Thromboembolic diseases can occur in the venous or arterial sides of the circulatory system. Factor Xa inhibition is a targeted approach to anticoagulation that resulted from significant advances in our understanding of the coagulation cascade. The factor Xa inhibitor fondaparinux has been studied extensively in the orthopedic surgical setting for the prophylaxis of VTE. Current investigations that are under way or completed evaluate the efficacy and safety of fondaparinux for the management of various thrombotic diseases. The future development of fondaparinux resides primarily in three therapeutic areas: prevention of VTE, treatment of VTE, and treatment of acute coronary syndromes. For the prevention of VTE, fondaparinux has been studied as extended prophylaxis following hip fracture surgery (PENTHIFRA Plus), for use in high-risk abdominal surgical patients (PEGASUS and APOLLO), and for use in medical patients (ARTEMIS). Studies evaluating fondaparinux for the treatment of VTE are part of the large MATISSE clinical program (MATISSE DVT and MATISSE PE). Fondaparinux was investigated in phase 2 studies for the treatment of acute coronary syndromes, including acute ST-segment myocardial infarction (PENTALYSE) and unstable angina (PENTUA). Encouraging data from these trials are the basis for phase 3 programs in this area (MICHELANGELO). The orthopedic prophylactic and nonorthopedic clinical programs for fondaparinux in the management of thrombosis support the concept that targeted inhibition of coagulation is an effective advance in antithrombotic therapy.

Research Strategy for Modeling the Complexities of Turbine Heat Transfer

NASA Technical Reports Server (NTRS)

Simoneau, Robert J.

1996-01-01

The subject of this paper is a NASA research program, known as the Coolant Flow Management Program, which focuses on the interaction between the internal coolant channel and the external film cooling of a turbine blade and/or vane in an aircraft gas turbine engine. The turbine gas path is really a very complex flow field. The combination of strong pressure gradients, abrupt geometry changes and intersecting surfaces, viscous forces, rotation, and unsteady blade/vane interactions all combine to offer a formidable challenge. To this, in the high pressure turbine, we add the necessity of film cooling. The ultimate goal of the turbine designer is to maintain or increase the high level of turbine performance and at the same time reduce the amount of coolant flow needed to achieve this end. Simply stated, coolant flow is a penalty on the cycle and reduces engine thermal efficiency. Accordingly, understanding the flow field and heat transfer associated with the coolant flow is a priority goal. It is important to understand both the film cooling and the internal coolant flow, particularly their interaction. Thus, the motivation for the Coolant Flow Management Program. The paper will begin with a brief discussion of the management and research strategy, will then proceed to discuss the current attack from the internal coolant side, and will conclude by looking at the film cooling effort - at all times keeping sight of the primary goal the interaction between the two. One of the themes of this paper is that complex heat transfer problems of this nature cannot be attacked by single researchers or even groups of researchers, each working alone. It truly needs the combined efforts of a well-coordinated team to make an impact. It is important to note that this is a government/industry/university team effort.

The relationship between patient activation, confidence to self-manage side effects, and adherence to oral oncolytics: a pilot study with Michigan oncology practices.

PubMed

Salgado, Teresa M; Mackler, Emily; Severson, Jane A; Lindsay, Jamie; Batra, Peter; Petersen, Laura; Farris, Karen B

2017-06-01

The Michigan Oncology Quality Consortium (MOQC) is a continuous quality improvement collaborative seeking to improve oncology care in Michigan, including for patients taking oral chemotherapy. The aim of this study was to assess the relationship between patient activation, confidence to self-manage side effects, and adherence to oral oncolytics to inform future oncology care. A multicenter cross-sectional observational study was conducted using an online survey to examine patient activation (patient activation measure, PAM), health literacy, symptom burden (Edmonton Symptom Assessment System, ESAS), confidence to self-manage side effects (fatigue, nausea, and diarrhea), and adherence to oral oncolytics. Inclusion criteria were patients taking an oral oncolytic for at least 1 month. Bivariate analyses and logistic regression were performed to evaluate relationships between the variables. A total of 125 respondents, mean (SD) age 66.2 (13.6), 57.7% female, and 95.1% Caucasian completed the survey. The mean (SD) PAM score was 65.0 (18.0). Confidence to manage fatigue, nausea, and diarrhea was associated with higher activation, and confidence to self-manage fatigue and diarrhea were associated with higher health literacy. About 30% of participants reported some level of non-adherence to oral oncolytics, and those who experienced side effects (Fisher's exact test p = 0.033) and with shorter length of therapy (t test p = 0.027) were significantly more likely to be non-adherent. These findings show that there is room for improvement across practices involved with MOQC with regard to supporting patients taking oral oncolytics. Patients will need to improve their activation levels, and oncology clinics will need to create new workflows in order to enhance self-care management ability for patients taking oral oncolytics.

A security-awareness virtual machine management scheme based on Chinese wall policy in cloud computing.

PubMed

Yu, Si; Gui, Xiaolin; Lin, Jiancai; Tian, Feng; Zhao, Jianqiang; Dai, Min

2014-01-01

Cloud computing gets increasing attention for its capacity to leverage developers from infrastructure management tasks. However, recent works reveal that side channel attacks can lead to privacy leakage in the cloud. Enhancing isolation between users is an effective solution to eliminate the attack. In this paper, to eliminate side channel attacks, we investigate the isolation enhancement scheme from the aspect of virtual machine (VM) management. The security-awareness VMs management scheme (SVMS), a VMs isolation enhancement scheme to defend against side channel attacks, is proposed. First, we use the aggressive conflict of interest relation (ACIR) and aggressive in ally with relation (AIAR) to describe user constraint relations. Second, based on the Chinese wall policy, we put forward four isolation rules. Third, the VMs placement and migration algorithms are designed to enforce VMs isolation between the conflict users. Finally, based on the normal distribution, we conduct a series of experiments to evaluate SVMS. The experimental results show that SVMS is efficient in guaranteeing isolation between VMs owned by conflict users, while the resource utilization rate decreases but not by much.

A Security-Awareness Virtual Machine Management Scheme Based on Chinese Wall Policy in Cloud Computing

PubMed Central

Gui, Xiaolin; Lin, Jiancai; Tian, Feng; Zhao, Jianqiang; Dai, Min

2014-01-01

Cloud computing gets increasing attention for its capacity to leverage developers from infrastructure management tasks. However, recent works reveal that side channel attacks can lead to privacy leakage in the cloud. Enhancing isolation between users is an effective solution to eliminate the attack. In this paper, to eliminate side channel attacks, we investigate the isolation enhancement scheme from the aspect of virtual machine (VM) management. The security-awareness VMs management scheme (SVMS), a VMs isolation enhancement scheme to defend against side channel attacks, is proposed. First, we use the aggressive conflict of interest relation (ACIR) and aggressive in ally with relation (AIAR) to describe user constraint relations. Second, based on the Chinese wall policy, we put forward four isolation rules. Third, the VMs placement and migration algorithms are designed to enforce VMs isolation between the conflict users. Finally, based on the normal distribution, we conduct a series of experiments to evaluate SVMS. The experimental results show that SVMS is efficient in guaranteeing isolation between VMs owned by conflict users, while the resource utilization rate decreases but not by much. PMID:24688434

Practice Patterns Compared with Evidence-based Strategies for the Management of Androgen Deprivation Therapy-Induced Side Effects in Prostate Cancer Patients: Results of a European Web-based Survey.

PubMed

Bultijnck, Renée; Surcel, Cristian; Ploussard, Guillaume; Briganti, Alberto; De Visschere, Pieter; Fütterer, Jurgen; Ghadjar, Pirus; Giannarini, Gianluca; Isbarn, Hendrik; Massard, Christophe; Sooriakumaran, Prasanna; Valerio, Massimo; van den Bergh, Roderick; Ost, Piet

2016-12-01

Evidence-based recommendations are available for the management of androgen deprivation therapy (ADT)-induced side effects; however, there are no data on the implementation of the recommendations into daily practice patterns. To compare practice patterns in the management of ADT-induced side effects with evidence-based strategies. A European Web-based survey was conducted from January 16, 2015, to June 24, 2015. The 25-item questionnaire was designed with the aid of expert opinion and covered general respondent information, ADT preference per disease stage, patient communication on ADT-induced side effects, and strategies to mitigate side effects. All questions referred to patients with long-term ADT use. Reported practice patterns were compared with available evidence-based strategies. Following data collection, descriptive statistics were used for analysis. Frequency distributions were compiled and compared using a generalised chi-square test. In total, 489 eligible respondents completed the survey. Luteinising hormone-releasing hormone-agonist with or without an antiandrogen was the preferred method of ADT in different settings. Patients were well informed about loss of libido (90%), hot flushes (85%), fatigue (67%), and osteoporosis (63%). An osteoporotic and metabolic risk assessment prior to commencing ADT was done by one-quarter of physicians. The majority (85%) took preventive measures and applied at least one evidence-based strategy. Exercise was recommended by three-quarters of physicians who advocate its positive effects; however, only 25% of physicians had access to exercise programmes. Although the minimum sample size was set at 400 participants, the current survey remains susceptible to volunteer and nonresponder bias. Patients were well informed about several ADT-induced complications but uncommonly underwent an osteoporotic and metabolic risk assessment. Nevertheless, physicians partially provided evidence-based strategies for the management of the complications. Physicians often advised exercise to reduce ADT-induced side effects, but programmes were not widely available. Implementation of evidence-based strategies for androgen deprivation therapy-induced side effects in real-life practice patterns should be improved. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Payments for Environmental Services in a Policymix: Spatial and Temporal Articulation in Mexico.

PubMed

Ezzine-de-Blas, Driss; Dutilly, Céline; Lara-Pulido, José-Alberto; Le Velly, Gwenolé; Guevara-Sanginés, Alejando

2016-01-01

Government based Payments for Ecosystem Services (PES) have been criticized for not maximizing environmental effectiveness through appropriate targeting, while instead prioritizing social side-objectives. In Mexico, existing literature on how the Payments for Ecosystem Services-Hydrological program (PSA-H) has targeted deforestation and forest degradation shows that both the process of identifying the eligible areas and the choice of the selection criteria for enrolling forest parcels have been under the influence of competing agendas. In the present paper we study the influence of the PSA-H multi-level governance on the environmental effectiveness of the program-the degree to which forest at high risk of deforestation is enrolled- building from a "policyscape" framework. In particular, we combine governance analysis with two distinct applications of the policyscape framework: First, at national level we assess the functional overlap between the PSA-H and other environmental and rural programs with regard to the risk of deforestation. Second, at regional level in the states of Chiapas and Yucatan, we describe the changing policy agenda and the role of technical intermediaries in defining the temporal spatialization of the PSA-H eligible and enrolled areas with regard to key socio-economic criteria. We find that, although at national level the PSA-H program has been described as coping with both social and environmental indicators thanks to successful adaptive management, our analysis show that PSA-H is mainly found in communities where deforestation risk is low and in combination with other environmental programs (protected areas and forest management programs). Such inertia is reinforced at regional level as a result of the eligible areas' characteristics and the behaviour of technical intermediaries, which seek to minimise transaction costs and sources of uncertainty. Our project-specific analysis shows the importance of integrating the governance of a program in the policyscape framework as a way to better systematize complex interactions at different spatial and institutional scales between policies and landscape characteristics.

Quantifying side-chain conformational variations in protein structure

PubMed Central

Miao, Zhichao; Cao, Yang

2016-01-01

Protein side-chain conformation is closely related to their biological functions. The side-chain prediction is a key step in protein design, protein docking and structure optimization. However, side-chain polymorphism comprehensively exists in protein as various types and has been long overlooked by side-chain prediction. But such conformational variations have not been quantitatively studied and the correlations between these variations and residue features are vague. Here, we performed statistical analyses on large scale data sets and found that the side-chain conformational flexibility is closely related to the exposure to solvent, degree of freedom and hydrophilicity. These analyses allowed us to quantify different types of side-chain variabilities in PDB. The results underscore that protein side-chain conformation prediction is not a single-answer problem, leading us to reconsider the assessment approaches of side-chain prediction programs. PMID:27845406

Quantifying side-chain conformational variations in protein structure

NASA Astrophysics Data System (ADS)

Miao, Zhichao; Cao, Yang

2016-11-01

Protein side-chain conformation is closely related to their biological functions. The side-chain prediction is a key step in protein design, protein docking and structure optimization. However, side-chain polymorphism comprehensively exists in protein as various types and has been long overlooked by side-chain prediction. But such conformational variations have not been quantitatively studied and the correlations between these variations and residue features are vague. Here, we performed statistical analyses on large scale data sets and found that the side-chain conformational flexibility is closely related to the exposure to solvent, degree of freedom and hydrophilicity. These analyses allowed us to quantify different types of side-chain variabilities in PDB. The results underscore that protein side-chain conformation prediction is not a single-answer problem, leading us to reconsider the assessment approaches of side-chain prediction programs.

Quantifying side-chain conformational variations in protein structure.

PubMed

Miao, Zhichao; Cao, Yang

2016-11-15

Protein side-chain conformation is closely related to their biological functions. The side-chain prediction is a key step in protein design, protein docking and structure optimization. However, side-chain polymorphism comprehensively exists in protein as various types and has been long overlooked by side-chain prediction. But such conformational variations have not been quantitatively studied and the correlations between these variations and residue features are vague. Here, we performed statistical analyses on large scale data sets and found that the side-chain conformational flexibility is closely related to the exposure to solvent, degree of freedom and hydrophilicity. These analyses allowed us to quantify different types of side-chain variabilities in PDB. The results underscore that protein side-chain conformation prediction is not a single-answer problem, leading us to reconsider the assessment approaches of side-chain prediction programs.

Crossing 138: two approaches to churn under the Affordable Care Act.

PubMed

Ravel, Gabriel; DeSantis, J Angelo

2014-01-01

A predicted side effect of the Medicaid expansion and state-based Exchanges under the Affordable Care Act is churn. Churn is the shifting into and out of eligibility for insurance affordability programs due to income changes. Because the line between Medicaid and Exchange eligibility is fine -138% of the federal poverty level -millions of Americans are expected to gain and lose eligibility. Frequently, this churning undermines continuity of care, raises costs, and frustrates those affected. This article explores two proposed programs to mitigate the effects of churn: the Basic Health Program and the Bridge Program. This article evaluates both programs' ability to mitigate the effects of churn, the likely side effects to states' implementing them, and legal and practical obstacles to their implementation. It concludes that the Bridge Program is the better approach.

The influence of easy-to-read pamphlets about self-care management of radiation side effects on patients' knowledge.

PubMed

Wilson, Feleta L; Mood, Darlene; Nordstrom, Cheryl K

2010-11-01

To test patients' knowledge of side effects after they review six easy-to-read pamphlets on radiation side effects. Nonexperimental. Urban radiation oncology clinic. 47 patients receiving radiation treatment. The Knowledge of Radiation Side Effects Test was administered. Patient literacy and knowledge level. The self-report of highest grade completed in school was 10th grade; however, the actual reading level was 4th-6th grade. Scores for each knowledge test increased with literacy level, with statistically significant correlations for pamphlets on fatigue, skin problems for women, and skin problems for men. Participants who read at the 4th-6th-grade level scored higher than expected. Although the pamphlets were deemed easy to read, patients who had the lowest reading levels still had difficulty understanding them. In addition to written patient information, oncology nurses should use innovative teaching strategies to improve patient understanding and self-care behaviors. A need exists for continued nursing inquiry that will focus on self-care behaviors to manage radiation side effects, particularly for patients with low literacy.

Tetrabenazine

MedlinePlus

... the medication works for you and the side effects you experience. Be sure to tell your doctor ... your condition with the lowest risk of side effects. ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics

PubMed Central

Nwosu, Benjamin U.; Meltzer, Bruce; Maranda, Louise; Ciccarelli, Carol; Reynolds, Daniel; Curtis, Laura; King, Jean; Frazier, Jean A.; Lee, Mary M.

2014-01-01

Second-generation antipsychotic (SGA) medications introduced about 20 years ago are increasingly used to treat psychiatric illnesses in children and adolescents. There has been a five-fold increase in the use of these medications in U.S. children and adolescents in the past decade. However, there has also been a parallel rise in the incidence of side effects associated with these medications, such as obesity, dyslipidemia, insulin resistance, and diabetes mellitus. Despite the severity of these complications and their financial impact on the national healthcare budget, there is neither a clear understanding of the mechanisms contributing to these side effects nor the best ways to address them. Studies that examined lifestyle modification and pharmaceutical agents have yielded mixed results. Therefore, clinical studies using agents, such as vitamin D, which are inexpensive, readily available, with low side effects profile, and have mechanisms to counteract the metabolic side effects of SGA agents, are warranted. Vitamin D is a prohormone with skeletal and extraskeletal properties that could potentially reduce the severity of these metabolic side effects. Its role as an adjunctive therapy for the management of metabolic side effects of SGA agents has not been adequately studied. Effective strategies to curb these side effects will improve the overall health of youths with psychiatric illnesses who receive SGAs. Herein we present a pilot study on the use of vitamin D in patients on treatment with SGAs. PMID:22145446

Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) as a Target for Concurrent Management of Diabetes and Obesity-Related Cancer.

PubMed

Wang, Qingqing; Imam, Mustapha Umar; Yida, Zhang; Wang, Fudi

2017-01-01

Peroxisome proliferator-activated receptor gamma (PPARγ) is a member of the nuclear receptor superfamily of ligand-inducible transcription factors that regulate adipogenesis, lipid metabolism, cell proliferation, inflammation and insulin sensitization. Abnormalities in PPARγ signaling have been associated with obesity, diabetes and cancer. The use of agonists to manage these diseases has been limited by their side effects. Accordingly, dual or pan agonists targeting the PPARα or PPARα and PPARδ, respectively, in addition to the PPARγ have been developed to overcome these side effects. This review details the shared PPARγ-dependent mechanisms between obesity-related cancers and diabetes and their potential therapeutic values. We performed a systematic literature search through pubmed, Scopus and google scholar for articles on PPARγ-dependent signaling in diabetes or cancer. There is growing co-occurrence of obesity-related cancers and diabetes, necessitating the use of effective therapies with the least amount of side effects for concurrent management of these diseases, by targeting potentially shared PPARγ-dependent mechanisms including abnormalities of the wnt/β-catenin, lysosomal acid lipase, inflammatory and cell cycle pathways, and the plasminogen activator system. Taking advantage of the multiple docking sites of the PPARγ and the pleiotropic nature of its signaling, structure-activity relationship and molecular docking studies have provided insights into designer PPARγ agonists or dual PPARα/γ agonists that modulate PPARγ signaling and negate side effects of full PPARγ agonists. Effective therapies, possibly devoid of side effects, for concurrent management of obesity-related cancers and diabetes can be developed through diligent structure-activity and molecular docking studies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Side effects associated with anti-HIV drugs.

PubMed

Highleyman, L

1998-04-01

Many side effects are associated with the use of anti-HIV drugs, impacting the development of drug resistance and the quality of life for HIV-patients. Concern about side effects is a primary factor in deterring people from beginning HIV therapy. Frequency and severity of side effects vary greatly, but they are frequently more common and severe in people who are taking a new drug or who have advanced HIV disease. Information on side effects comes largely from clinical trials; however, many side effects are not discovered until the drug has been approved and used by larger numbers of people. Side effects vary from serious toxicities that require stopping treatment to uncomfortable or annoying side effects that interfere with daily life. A table categorizes the four major side effects (nausea, fever, skin rash, and fatigue) and divides them into grades that describe their intensity. A chart lists the side effects associated with specific anti-HIV drugs. Suggestions for managing side effects are included.

Side Effects of Immunosuppressant Medications as They Affect Physical Fitness: A Physical Therapist's Point of View

MedlinePlus

... Another side effect of immunosuppressant medications is hyperglycemia (high blood sugar) and secondary diabetes because they may alter the way your body manages glucose (sugar). It is important to routinely check your ...

Molecular targeted therapies for solid tumors: management of side effects.

PubMed

Grünwald, Viktor; Soltau, Jens; Ivanyi, Philipp; Rentschler, Jochen; Reuter, Christoph; Drevs, Joachim

2009-03-01

This review will provide physicians and oncologists with an overview of side effects related to targeted agents that inhibit vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and mammalian target of rapamycin (mTOR) signaling in the treatment of solid tumors. Such targeted agents can be divided into monoclonal antibodies, tyrosine kinase inhibitors, multitargeted tyrosine kinase inhibitors and serine/threonine kinase inhibitors. Molecular targeted therapies are generally well tolerated, but inhibitory effects on the biological function of the targets in healthy tissue can result in specific treatment-related side effects, particularly with multitargeted agents. We offer some guidance on how to manage adverse events in cancer patients based on the range of options currently available. Copyright 2009 S. Karger AG, Basel.

A 26-year-old man with dyspnea and chest pain.

PubMed

Mittal, Saurabh; Jain, Akanksha; Arava, Sudheer; Hadda, Vijay; Mohan, Anant; Guleria, Randeep; Madan, Karan

2017-01-01

A 26-year-old smoker male presented with a history of sudden onset dyspnea and right-sided chest pain. Chest radiograph revealed large right-sided pneumothorax which was managed with tube thoracostomy. High-resolution computed tomography thorax revealed multiple lung cysts, and for a definite diagnosis, a video-assisted thoracoscopic surgery-guided lung biopsy was performed followed by pleurodesis. This clinicopathologic conference discusses the clinical and radiological differential diagnoses, utility of lung biopsy, and management options for patients with such a clinical presentation.

A 26-year-old man with dyspnea and chest pain

PubMed Central

Mittal, Saurabh; Jain, Akanksha; Arava, Sudheer; Hadda, Vijay; Mohan, Anant; Guleria, Randeep; Madan, Karan

2017-01-01

A 26-year-old smoker male presented with a history of sudden onset dyspnea and right-sided chest pain. Chest radiograph revealed large right-sided pneumothorax which was managed with tube thoracostomy. High-resolution computed tomography thorax revealed multiple lung cysts, and for a definite diagnosis, a video-assisted thoracoscopic surgery-guided lung biopsy was performed followed by pleurodesis. This clinicopathologic conference discusses the clinical and radiological differential diagnoses, utility of lung biopsy, and management options for patients with such a clinical presentation. PMID:29099006

[Rare side effects in management of hyperthyroidism. Case report].

PubMed

Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta

2016-05-29

The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism.

KSC-2009-6507

NASA Image and Video Library

2009-11-20

CAPE CANAVERAL, Fla. – In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, Michael Suffredini, program manager, International Space Station, NASA, addresses the invited guests at a ceremony transferring the ownership of node 3 for the International Space Station, looming in the background, from the European Space Agency, or ESA, to NASA. Seated, from left, are Michael Suffredini, program manager, International Space Station, NASA; William Dowdell, deputy for Operations, International Space Station and Spacecraft Processing, Kennedy; and Bernardo Patti, head of International Space Station, Program Department, ESA. Node 3 is named "Tranquility" after the Sea of Tranquility, the lunar landing site of Apollo 11. The payload for the STS-130 mission, Tranquility is a pressurized module that will provide room for many of the International Space Station's life support systems. The module was built for ESA by Thales Alenia Space in Turin, Italy. Attached to one end of Tranquility is a cupola, a unique work station with six windows on its sides and one on top. The cupola resembles a circular bay window and will provide a vastly improved view of the station's exterior. Just under 10 feet in diameter, the module will accommodate two crew members and portable workstations that can control station and robotic activities. The multi-directional view will allow the crew to monitor spacewalks and docking operations, as well as provide a spectacular view of Earth and other celestial objects. Space shuttle Endeavour's STS-130 mission is targeted to launch Feb. 4, 2010. Photo credit: NASA/Kim Shiflett

Planning of water resources management and pollution control for Heshui River watershed, China: A full credibility-constrained programming approach.

PubMed

Zhang, Y M; Huang, G; Lu, H W; He, Li

2015-08-15

A key issue facing integrated water resources management and water pollution control is to address the vague parametric information. A full credibility-based chance-constrained programming (FCCP) method is thus developed by introducing the new concept of credibility into the modeling framework. FCCP can deal with fuzzy parameters appearing concurrently in the objective and both sides of the constraints of the model, but also provide a credibility level indicating how much confidence one can believe the optimal modeling solutions. The method is applied to Heshui River watershed in the south-central China for demonstration. Results from the case study showed that groundwater would make up for the water shortage in terms of the shrinking surface water and rising water demand, and the optimized total pumpage of groundwater from both alluvial and karst aquifers would exceed 90% of its maximum allowable levels when credibility level is higher than or equal to 0.9. It is also indicated that an increase in credibility level would induce a reduction in cost for surface water acquisition, a rise in cost from groundwater withdrawal, and negligible variation in cost for water pollution control. Copyright © 2015 Elsevier B.V. All rights reserved.

Blockchain Based Decentralized Management of Demand Response Programs in Smart Energy Grids

PubMed Central

Pop, Claudia; Cioara, Tudor; Antal, Marcel; Anghel, Ionut; Salomie, Ioan; Bertoncini, Massimo

2018-01-01

In this paper, we investigate the use of decentralized blockchain mechanisms for delivering transparent, secure, reliable, and timely energy flexibility, under the form of adaptation of energy demand profiles of Distributed Energy Prosumers, to all the stakeholders involved in the flexibility markets (Distribution System Operators primarily, retailers, aggregators, etc.). In our approach, a blockchain based distributed ledger stores in a tamper proof manner the energy prosumption information collected from Internet of Things smart metering devices, while self-enforcing smart contracts programmatically define the expected energy flexibility at the level of each prosumer, the associated rewards or penalties, and the rules for balancing the energy demand with the energy production at grid level. Consensus based validation will be used for demand response programs validation and to activate the appropriate financial settlement for the flexibility providers. The approach was validated using a prototype implemented in an Ethereum platform using energy consumption and production traces of several buildings from literature data sets. The results show that our blockchain based distributed demand side management can be used for matching energy demand and production at smart grid level, the demand response signal being followed with high accuracy, while the amount of energy flexibility needed for convergence is reduced. PMID:29315250

A mixed methods inquiry: How dairy farmers perceive the value(s) of their involvement in an intensive dairy herd health management program

PubMed Central

Kristensen, Erling; Enevoldsen, Carsten

2008-01-01

Background Research has been scarce when it comes to the motivational and behavioral sides of farmers' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers' expectations related to participation in a health management program by: 1) identifying important ambitions, goals and subjective well-being among farmers, 2) submitting those data to a quantitative analysis thereby characterizing perspective(s) of value added by health management programs among farmers; and 3) to characterize perceptions of farmers' goals among veterinarians. Methods The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse) of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians' competences as experienced by the farmers and time constraints in the farmers' everyday life. Results Farmers' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers' primary focus was on production and profit, however, farmers' valued teamwork and animal welfare more. Conclusion The veterinarians in this study appear to focus too much on financial performance and increased production when compared to most of the participating farmers' expectations. On the other hand veterinarians did not focus enough on the major products, which farmers really wanted to buy, i.e. teamwork and animal welfare. Consequently, disciplines like sociology, economics and marketing may offer new methodological approaches to veterinarians as these disciplines have understood that accounting for individual differences is central to motivate change, i.e. 'know thy customer'. PMID:19091134

How family caregivers of cancer patients manage symptoms at home: A systematic review.

PubMed

Ullgren, Helena; Tsitsi, Theologia; Papastavrou, Evridiki; Charalambous, Andreas

2018-05-29

Cancer affects not only the patient, but also the whole family, especially when a member of the family assumes the role of the family caregiver. This puts an additional emotional, social and financial strain on the family caregivers. Family caregivers of cancer patients are actively involved in the care provided at the home setting through various ways including practical tasks, symptom management and care coordination. The focus of preceding studies on family caregivers and symptom management was either on pain or the patients' and family caregivers' experience of symptom management and coping. The aim of this review was to provide evidence on how family caregivers manage symptoms and side effects at home, in adult cancer patients throughout the disease trajectory. A systematic literature review was performed in PubMed, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials with a combination of keywords and MeSH terms for family caregivers, cancer, symptoms, side effects and management. Based on predetermined inclusion and exclusion criteria, a total of 1270 articles were screened and 20 studies were included in the analysis. A descriptive analysis was performed due to the heterogeneity of the findings. The results showed that only a limited number of studies (3/20) explored how and what family caregivers do in symptom management as a primary outcome. Family caregivers provided psychosocial support, such as supporting and motivating the patient and maintaining social engagement. Caregivers provided physical support such as with the administration of medicine and tube feeding. As an integral part of managing the symptoms, family caregivers actively monitored and assessed symptoms to timely recognize any treatment related side effects, assess the response to therapeutic interventions and recognize possible deterioration in physical status. Furthermore, family caregivers were often the decision maker - being alert, watching and waiting and decided when to act and when not to act. Family caregivers are doing work similar to healthcare professionals, when managing symptoms and side effects at home in patients with cancer. Advanced tasks such as assessing, monitoring and deciding when and how to act are included in the daily routine of family caregivers. Copyright © 2018 Elsevier Ltd. All rights reserved.

Monitoring Potential Transport of Radioactive Contaminants in Shallow Ephemeral Channels: FY2017

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

Mizell, Steve A.; Campbell, Scott A.; McCurdy, Greg

The Desert Research Institute (DRI) is conducting a field assessment of the potential for contaminated soil to be transported from the Smoky Site Contamination Area (CA) as a result of storm runoff. This activity supports U.S. Department of Energy (DOE) Environmental Management Nevada Program (EM-NV) efforts to establish post-closure monitoring plans for the Smoky Site Soils Corrective Action Unit (CAU) 550. The work is intended to confirm the likely mechanism of transport and determine the meteorological conditions that might cause the movement of contaminated soils, as well as determine the particle size fraction that is most closely associated with transportedmore » radionuclide-contaminated soils. These data will facilitate the design of the appropriate post-closure monitoring program. In 2011, DRI installed a meteorological monitoring station on the west side of the Smoky Site CA and a hydrologic (runoff) monitoring station within the CA, near the east side. Air temperature, wind speed, wind direction, relative humidity, precipitation, solar radiation, barometric pressure, soil temperature, and soil water content are collected at the meteorological station. The maximum, minimum, and average or total values (as appropriate) for each of these parameters are recorded for each 10-minute interval. The maximum, minimum, and average water depth in the flume installed at the hydrology station are also recorded for every 10-minute interval. This report presents data collected from these stations during fiscal year (FY) 2017.« less

Stomach position in prediction of survival in left-sided congenital diaphragmatic hernia with or without fetoscopic endoluminal tracheal occlusion.

PubMed

Cordier, A-G; Jani, J C; Cannie, M M; Rodó, C; Fabietti, I; Persico, N; Saada, J; Carreras, E; Senat, M-V; Benachi, A

2015-08-01

To investigate the value of fetal stomach position in predicting postnatal outcome in left-sided congenital diaphragmatic hernia (CDH) with and without fetoscopic endoluminal tracheal occlusion (FETO). This was a retrospective review of CDH cases that were expectantly managed or treated with FETO, assessed from May 2008 to October 2013, in which we graded, on a scale of 1-4, stomach position on the four-chamber view of the heart with respect to thoracic structures. Logistic regression analysis was used to investigate the effect of management center (Paris, Brussels, Barcelona, Milan), stomach grading, observed-to-expected lung area-to-head circumference ratio (O/E-LHR), gestational age at delivery, birth weight in expectantly managed CDH, gestational ages at FETO and at removal and period of tracheal occlusion, on postnatal survival in CDH cases treated with FETO. We identified 67 expectantly managed CDH cases and 47 CDH cases that were treated with FETO. In expectantly managed CDH, stomach position and O/E-LHR predicted postnatal survival independently. In CDH treated with FETO, stomach position and gestational age at delivery predicted postnatal survival independently. In left-sided CDH with or without FETO, stomach position is predictive of postnatal survival. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Understanding the side effects of emission trading: implications for waste management.

PubMed

Braschel, Nina; Posch, Alfred; Pierer, Magdalena

2014-01-01

The trading of emission allowances is an important market instrument in climate policy. However, the inclusion of certain branches of industry in the trading system not only provides incentives for emission reduction, it also entails unwanted side effects. Thus, the objective of the present study is to identify such side effects-positive and negative-by examining the potential impact of waste management inclusion in the European Union Emissions Trading Scheme (EU ETS). Desk research was supplemented with qualitative and quantitative empirical analysis (based on expert interviews and a questionnaire) in order to analyse the related perceptions and expectations of actors and stakeholders. The impact of waste management inclusion in the EU ETS is analysed in terms of the following three areas: (i) costs and cost pass-through, (ii), competitiveness and market position, and (iii) carbon leakage. Concerning expectations in the area of costs, both the interviewed experts and the practitioners surveyed thought that costs were likely to increase or that they could be passed on to customers. However, experts and practitioners differed with respect to the possibility of carbon leakage. Clearly, increased knowledge of the possible impact arising from inclusion of the waste sector in the EU ETS would enable managers to become more proactive and to manage waste streams and treatment options more economically.

D-Side: A Facility and Workforce Planning Group Multi-criteria Decision Support System for Johnson Space Center

NASA Technical Reports Server (NTRS)

Tavana, Madjid

2005-01-01

"To understand and protect our home planet, to explore the universe and search for life, and to inspire the next generation of explorers" is NASA's mission. The Systems Management Office at Johnson Space Center (JSC) is searching for methods to effectively manage the Center's resources to meet NASA's mission. D-Side is a group multi-criteria decision support system (GMDSS) developed to support facility decisions at JSC. D-Side uses a series of sequential and structured processes to plot facilities in a three-dimensional (3-D) graph on the basis of each facility alignment with NASA's mission and goals, the extent to which other facilities are dependent on the facility, and the dollar value of capital investments that have been postponed at the facility relative to the facility replacement value. A similarity factor rank orders facilities based on their Euclidean distance from Ideal and Nadir points. These similarity factors are then used to allocate capital improvement resources across facilities. We also present a parallel model that can be used to support decisions concerning allocation of human resources investments across workforce units. Finally, we present results from a pilot study where 12 experienced facility managers from NASA used D-Side and the organization's current approach to rank order and allocate funds for capital improvement across 20 facilities. Users evaluated D-Side favorably in terms of ease of use, the quality of the decision-making process, decision quality, and overall value-added. Their evaluations of D-Side were significantly more favorable than their evaluations of the current approach. Keywords: NASA, Multi-Criteria Decision Making, Decision Support System, AHP, Euclidean Distance, 3-D Modeling, Facility Planning, Workforce Planning.

Oncology providers' perspectives on endocrine therapy prescribing and management.

PubMed

Wheeler, Stephanie B; Roberts, Megan C; Bloom, Diane; Reeder-Hayes, Katherine E; Espada, Maya; Peppercorn, Jeffrey; Golin, Carol E; Earp, Jo Anne

2016-01-01

Adjuvant endocrine therapy (ET) can reduce the risk of recurrence among females with hormone receptor-positive breast cancer. Overall, initiation and adherence to ET are suboptimal, though reasons are not well described. The study's objective was to better understand ET decision making, prescribing, and patient management from oncology providers' perspectives. Using purposive sampling, we recruited oncology providers who saw five or more breast cancer patients per week (n=20). We conducted 30-45-minute telephone interviews, using a semistructured guide to elicit perspectives on ET use. We used thematic content analysis to systematically identify categories of meaning and double-coded transcripts using Atlas.ti. Providers recommend ET to all eligible patients except those with contraindications or other risk factors. Providers base their ET prescribing decisions on the patient's menopausal status, side effects, and comorbidities. ET is typically discussed multiple times: at the onset of breast cancer treatment and in more detail after other treatment completion. Providers felt that the associated recurrence risk reduction is the most compelling argument for patients during ET decision making. While providers rarely perceived noninitiation as a problem, nonadherence was prevalent, often due to unresolvable side effects. From the clinicians' perspectives, side effects from ET are the dominant factor in nonadherence. Efforts to improve adherence should focus on strategies to minimize side effects and ensure clinicians and patients are well informed regarding optimal side effect management. This finding has important implications for novel endocrine regimens that offer improved outcomes through longer duration or more intensive therapy.

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom.

PubMed

Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

2014-02-01

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment.

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom

PubMed Central

Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

2014-01-01

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment. PMID:24678503

Advances in Data Management in Remote Sensing and Climate Modeling

NASA Astrophysics Data System (ADS)

Brown, P. G.

2014-12-01

Recent commercial interest in "Big Data" information systems has yielded little more than a sense of deja vu among scientists whose work has always required getting their arms around extremely large databases, and writing programs to explore and analyze it. On the flip side, there are some commercial DBMS startups building "Big Data" platform using techniques taken from earth science, astronomy, high energy physics and high performance computing. In this talk, we will introduce one such platform; Paradigm4's SciDB, the first DBMS designed from the ground up to combine the kinds of quality-of-service guarantees made by SQL DBMS platforms—high level data model, query languages, extensibility, transactions—with the kinds of functionality familiar to scientific users—arrays as structural building blocks, integrated linear algebra, and client language interfaces that minimize the learning curve. We will review how SciDB is used to manage and analyze earth science data by several teams of scientific users.

Specific application for Oak Ridge National Laboratory dismantlement of Building 3004. Appendix A -- Quality assurance plan; Appendix B -- Records management plan

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

NONE

This quality assurance (QA) plan defines the QA requirements for the dismantlement and removal of Building 3004 at Oak Ridge National Laboratory (ORNL). The building is a four-story wooden trained structure with wooden siding, which resides approximately 150 ft west of the Bulk Shielding Reactor, and only several feet away from the visitors entrance to the Graphite Reactor museum. Complete descriptions and sketches are in the Performance Specification document for this project. This project is being conducted as a non-CERCLA maintenance action. This plan is an appendix to the QA plan for the ORNL Environmental Restoration (ER) Program. ORNL/ER-225, whichmore » is the source of the project QA requirements, tailors those QA requirements to the specific needs of this project as defined in ORNL/ER-225. Project-specific description and organization are also provided in this plan. Appendix B, Records Management Plan, is included.« less

Concrete box-beam deterioration, phase II : appendices.

DOT National Transportation Integrated Search

2009-04-13

Side-by-side box-beam bridge constitutes approximately 17 percent of bridges built or replaced annually on public roads and there is a renewed thrust to use this bridge type for rapid construction under the Highway for LIFE program. Further, failure ...

Ionizable side chains at catalytic active sites of enzymes.

PubMed

Jimenez-Morales, David; Liang, Jie; Eisenberg, Bob

2012-05-01

Catalytic active sites of enzymes of known structure can be well defined by a modern program of computational geometry. The CASTp program was used to define and measure the volume of the catalytic active sites of 573 enzymes in the Catalytic Site Atlas database. The active sites are identified as catalytic because the amino acids they contain are known to participate in the chemical reaction catalyzed by the enzyme. Acid and base side chains are reliable markers of catalytic active sites. The catalytic active sites have 4 acid and 5 base side chains, in an average volume of 1,072 Å(3). The number density of acid side chains is 8.3 M (in chemical units); the number density of basic side chains is 10.6 M. The catalytic active site of these enzymes is an unusual electrostatic and steric environment in which side chains and reactants are crowded together in a mixture more like an ionic liquid than an ideal infinitely dilute solution. The electrostatics and crowding of reactants and side chains seems likely to be important for catalytic function. In three types of analogous ion channels, simulation of crowded charges accounts for the main properties of selectivity measured in a wide range of solutions and concentrations. It seems wise to use mathematics designed to study interacting complex fluids when making models of the catalytic active sites of enzymes.

Ionizable Side Chains at Catalytic Active Sites of Enzymes

PubMed Central

Jimenez-Morales, David; Liang, Jie

2012-01-01

Catalytic active sites of enzymes of known structure can be well defined by a modern program of computational geometry. The CASTp program was used to define and measure the volume of the catalytic active sites of 573 enzymes in the Catalytic Site Atlas database. The active sites are identified as catalytic because the amino acids they contain are known to participate in the chemical reaction catalyzed by the enzyme. Acid and base side chains are reliable markers of catalytic active sites. The catalytic active sites have 4 acid and 5 base side chains, in an average volume of 1072 Å3. The number density of acid side chains is 8.3 M (in chemical units); the number density of basic side chains is 10.6 M. The catalytic active site of these enzymes is an unusual electrostatic and steric environment in which side chains and reactants are crowded together in a mixture more like an ionic liquid than an ideal infinitely dilute solution. The electrostatics and crowding of reactants and side chains seems likely to be important for catalytic function. In three types of analogous ion channels, simulation of crowded charges accounts for the main properties of selectivity measured in a wide range of solutions and concentrations. It seems wise to use mathematics designed to study interacting complex fluids when making models of the catalytic active sites of enzymes. PMID:22484856

Integrating fire management into land management planning for west-side forests

Treesearch

Peter D. Teensma

1996-01-01

Fire management's integration into land management planning is critical to the successful management of nearly all wildland ecosystems, including westside forests, which lie west of the Cascade crest in Oregon and the northern coastal ranges in California. Restoration and maintenance of fire as an ecosystem process is critical to retention of biological diversity...

Riparian adaptive management symposium: a conversation between scientists and management

Treesearch

Douglas F. Ryan; John M. Calhoun

2010-01-01

Scientists, land managers and policy makers discussed whether riparian (stream side) forest management and policy for state, federal and private lands in western Washington are consistent with current science. Answers were mixed: some aspects of riparian policy and management have a strong basis in current science, while other aspects may not. Participants agreed that...

Impact of Standardized New Medication Education Program on Postdischarge Patients' Knowledge and Satisfaction.

PubMed

Jones, Tammie R; Coke, Lola

2016-10-01

This study, implemented on 2 medical-surgical units, evaluated the impact of a standardized, evidence-based new medication education program. Outcomes evaluated included patient postdischarge knowledge of new medication purpose and side effects, patient satisfaction with new medication, and Medicare reimbursement earn-back potential. As a result, knowledge scores for new medication purpose and side effects were high post intervention. Patient satisfaction with new medication education increased. Value-based purchasing reimbursement earn-back potential improved.

Advertising, marketing and purchase behavior for energy-related products

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

Tiedemann, K.; Nelson, D.

Energy conservation programs have relied heavily on incentives and regulatory standards to reduce residential energy consumption. However, in the changing market environment characterized by competitive pressures, alternative mechanisms such as marketing and promotions may increase substantially in importance compared to the demand-side management programs which have been the focus of most research. This paper describes the role of marketing and promotions in encouraging energy efficiency at the household level in British Columbia. The paper examines three related issues: first, the purchase process for energy-related products; second, the criteria used by customers in making purchase decisions; and third, the impact andmore » effectiveness of alternative marketing tools. A key finding is the energy-related purchases do not fall into the impulse purchase category. There are two reasons for this: first, most of these products require installation and this requires a high level of commitment on the part of the purchaser; second, many energy-related products require a significant outlay of funds and this reduces impulse buying.« less

Distributed utility technology cost, performance, and environmental characteristics

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

Wan, Y; Adelman, S

1995-06-01

Distributed Utility (DU) is an emerging concept in which modular generation and storage technologies sited near customer loads in distribution systems and specifically targeted demand-side management programs are used to supplement conventional central station generation plants to meet customer energy service needs. Research has shown that implementation of the DU concept could provide substantial benefits to utilities. This report summarizes the cost, performance, and environmental and siting characteristics of existing and emerging modular generation and storage technologies that are applicable under the DU concept. It is intended to be a practical reference guide for utility planners and engineers seeking informationmore » on DU technology options. This work was funded by the Office of Utility Technologies of the US Department of Energy.« less

Taxi Scrip Program in Seattle, Washington

DOT National Transportation Integrated Search

1982-09-01

The Municipality of Metropolitan Seattle (Metro) took over a taxi user-side subsidy program from the City of Seattle in December 1978, which was based on the sale of discounted taxicab scrip. Metro expanded the program, raised the discount, and condu...

Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

PubMed Central

Trompetas, Vasileios

2008-01-01

INTRODUCTION The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. METHODS A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. DISCUSSION Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure. PMID:18430330

Oral health impacts of medications used to treat mental illness.

PubMed

Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

2017-12-01

Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

Novel therapies in advanced renal cell carcinoma: management of adverse events from sorafenib and sunitinib.

PubMed

Ivanyi, Philipp; Winkler, Thomas; Ganser, Arnold; Reuter, Christoph; Grünwald, Viktor

2008-03-01

Sorafenib and Sunitinib are the first tyrosine kinase inhibitors licensed for the treatment of advanced renal cell carcinoma. In contrast to conventional chemotherapy, targeted therapies have distinct and specific side effects. Selective review in Medline and the data base of the American Society of Clinical Oncology on the treatment and side effects of tyrosine kinase inhibitors in renal cell carcinoma, drawing on the authors' own experience. Tyrosine kinase inhibitors are characterized by a variety of uncommon side effects, such as lassitude, mucosal inflammation and skin changes. The detection and treatment of adverse events are critical for interdisciplinary cancer treatment in order to ensure patients' safety. This article offers an overview of the unwanted effects of drug therapy in the management of renal cell carcinoma.

Managing imperfect competition by pay for performance and reference pricing.

PubMed

Mak, Henry Y

2018-01-01

I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics. However, pay for performance may not outperform prospective payment when consumers are rational and providers are profit maximizing, or when one of the service qualities is not contractible. Copyright © 2017 Elsevier B.V. All rights reserved.

Diagnosing the Causes and Severity of One-sided Message Contention

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

Tallent, Nathan R.; Vishnu, Abhinav; van Dam, Hubertus

Two trends suggest network contention for one-sided messages is poised to become a performance problem that concerns application developers: an increased interest in one-sided programming models and a rising ratio of hardware threads to network injection bandwidth. Unfortunately, it is difficult to reason about network contention and one-sided messages because one-sided tasks can either decrease or increase contention. We present effective and portable techniques for diagnosing the causes and severity of one-sided message contention. To detect that a message is affected by contention, we maintain statistics representing instantaneous (non-local) network resource demand. Using lightweight measurement and modeling, we identify themore » portion of a message's latency that is due to contention and whether contention occurs at the initiator or target. We attribute these metrics to program statements in their full static and dynamic context. We characterize contention for an important computational chemistry benchmark on InfiniBand, Cray Aries, and IBM Blue Gene/Q interconnects. We pinpoint the sources of contention, estimate their severity, and show that when message delivery time deviates from an ideal model, there are other messages contending for the same network links. With a small change to the benchmark, we reduce contention up to 50% and improve total runtime as much as 20%.« less

Efficient Windows Collaborative

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

Nils Petermann

2010-02-28

The project goals covered both the residential and commercial windows markets and involved a range of audiences such as window manufacturers, builders, homeowners, design professionals, utilities, and public agencies. Essential goals included: (1) Creation of 'Master Toolkits' of information that integrate diverse tools, rating systems, and incentive programs, customized for key audiences such as window manufacturers, design professionals, and utility programs. (2) Delivery of education and outreach programs to multiple audiences through conference presentations, publication of articles for builders and other industry professionals, and targeted dissemination of efficient window curricula to professionals and students. (3) Design and implementation of mechanismsmore » to encourage and track sales of more efficient products through the existing Window Products Database as an incentive for manufacturers to improve products and participate in programs such as NFRC and ENERGY STAR. (4) Development of utility incentive programs to promote more efficient residential and commercial windows. Partnership with regional and local entities on the development of programs and customized information to move the market toward the highest performing products. An overarching project goal was to ensure that different audiences adopt and use the developed information, design and promotion tools and thus increase the market penetration of energy efficient fenestration products. In particular, a crucial success criterion was to move gas and electric utilities to increase the promotion of energy efficient windows through demand side management programs as an important step toward increasing the market share of energy efficient windows.« less

Managing inherent complexity for sustainable walleye fisheries in Lake Erie

USGS Publications Warehouse

Roseman, Edward F.; Drouin, Richard; Gaden, Marc; Knight, Roger; Tyson, Jeff; Zhao, Yingming; Taylor, William W.; Lynch, Abigail J.; Léonard, Nancy J.

2012-01-01

In Lake Erie, Walleye (Sander vitreus vitreus) is king. The naturally occurring species is the foundation of commercial fishing operations on the Canadian side of the lake and is a much-prized sport fish on the American side. Management of Lake Erie walleye fisheries is complex and takes place in an inter-jurisdictional setting composed of resource agencies from the states of Michigan (MDNR), Ohio (ODNR), Pennsylvania (PFBC), and New York (NYDEC) and the province of Ontario (OMNR). The complexity of walleye management is exacerbated by interactions among environmental and ecological changes in Lake Erie, complex life-history characteristics of the species, public demand for walleye, and cultural/governance differences among managing groups and their respective constituents. Success of future management strategies will largely hinge upon our ability to understand these inherent complexities and to employ tactics that successfully accommodate stock productivity and human demand in a highly dynamic environment. In this report, we review the history of Lake Erie walleye management, outline the multi-jurisdictional process for international management of walleye, and discuss strategies to address challenges facing managers.

Managing Radiation Therapy Side Effects: What to Do about Feeling Sick to Your Stomach and Throwing Up (Nausea and ...

MedlinePlus

... because it makes them feel sick. ■ ■ Listen to music or an audiobook before treatment, to help relax. ... livehelp NCI has a series of 9 Radiation Therapy Side Effects Sheets at: www.cancer.gov/radiation- ...

EFFECTS OF GREEN MACROALGAE ON CLASSIFICATION OF SEAGRASS IN SIDE SCAN SONAR IMAGERY

EPA Science Inventory

High resolution maps of seagrass beds are useful for monitoring estuarine condition, managing fish habitats, and modeling estuarine processes. Side scan sonar (SSS) is one method for producing spatially accurate seagrass maps, although it has not been used widely. Our team rece...

Peace making/peace keeping missions: role of the U.S. Army nurse.

PubMed

Yoder, Linda H; Brunken, Sandra L

2003-06-01

Somewhere in the world every month expert military critical care/trauma providers are working side-by-side with host nations to help them develop their trauma and disaster management systems. This article discusses the Air Force Medical System's (AFMS) mission to provide humanitarian and civic assistance, disaster response, and care of wartime injured. Within the context of this tripartite mission, the article introduces the AFMS's flagship international course, "Leadership Course in Regional Disaster Response and Trauma System Management," and highlights the that military critical care nurses play in this international effort.

"Side effects affected my daily activities a lot": a qualitative exploration of the impact of contraceptive side effects in Bangladesh.

PubMed

Jain, Aparna; Reichenbach, Laura; Ehsan, Iqbal; Rob, Ubaidur

2017-01-01

In a country like Bangladesh that has made great progress in contraceptive use with one of the lowest levels of fertility and highest levels of contraceptive use, understanding what factors influence women's decisions to discontinue a contraceptive method and not switch to a new method is critical in designing interventions and programs that will help enable Bangladesh to reach its FP2020 goals. Research on side effects has focused on physical manifestations like headaches, moodiness, abdominal pain, and menstrual irregularities. While physical effects alone may stop women from continuing a contraceptive method, less is known about how side effects influence women's daily activities and lives. The purpose of this study is to understand the ways that side effects affect Bangladeshi women's participation in different social settings. Thirty-five in-depth interviews with married women who recently discontinued or switched to a different contraceptive method were conducted in Sylhet and Khulna Divisions. Interviews explored reasons for discontinuation including experience of side effects and impact of side effects on women's lives. Key themes emerged including that side effects are not only experienced physically but are barriers to women's participation in many aspects of their lives. The spheres of life that most commonly appeared to be influenced by side effects include religion, household, and sexual intimacy irrespective of method used or residence. Family planning providers need to be aware of these additional consequences associated with contraceptive side effects to provide tailored counseling that recognizes these issues and helps women to mitigate them. For Bangladesh to achieve its FP2020 goals, understanding the broader context in which family planning decisions are made vis-à-vis side effects is critical to design programs and interventions that meet all the needs of women beyond just their fertility intentions.

Development of Educational Support System for Learning Image Processing Enabling Client-Side Programming Aided by Java Servlet Technology

NASA Astrophysics Data System (ADS)

Furukawa, Tatsuya; Aoki, Noriyuki; Ohchi, Masashi; Nakao, Masaki

The image proccessing has become a useful and important technology in various reserch and development fields. According to such demands for engineering problems, we have designed and implemented the educational support system for that using a Java Applet technology. However in the conventional system, it required the tedious procedure for the end user to code his own programs. Therefore, in this study, we have improved the defect in the previous system by using a Java Servlet technology. The new system will make it possible for novice user to experience a practical digital image proccessing and an advanced programming with ease. We will describe the architecture of the proposed system function, that has been introduced to facilitate the client-side programming.

Russian Space Agency research and development program for Aerospace Plane combined propulsion systems ('OREL-2-1' R&D)

NASA Astrophysics Data System (ADS)

Lanshin, A.; Sosounov, V.

The 'OREL-2-1' R&D program - 'Development of Combined Propulsion Systems for Advanced Reusable Space Transportation Systems (RSTS) Using Atmospheric Air as an Oxidizer' is being conducted in 1993-1995 according to the order of the Russian Space Agency (RSA). This work is part of the complex 'OREL' R&D program - 'Complex Investigations for RSTS Development preferable Directions Basis and Making of the Scientific and Technical Experience for the RSTS Creation' at which the TsNIIMash, TsAGI and NIITP side by side the Central Institute of Aviation Motors (CIAM) are the lead organizations of the four work parts. The 'OREL-2-1' R&D program and some of its results of 1993 are described briefly in this paper.

Structuring learning environments: Lessons from the organization of post-literacy programs

NASA Astrophysics Data System (ADS)

Easton, Peter A.

1989-12-01

New conceptual and historical work on the nature of literacy and information on several bellwether post-literacy efforts in developing countries furnish a basis for diagnosing some of the deficiencies in current approaches to post-literacy programming. The key issue is the design of a `literate environment'. Heretofore attention has been concentrated too exclusively on the reading materials and continuing education side of the problem, and insufficient attention has been given to the more critical and difficult aspect: ensuring adequate opportunities for the application of new literate skills. The availability of these functional opportunities is closely related to the possibilities for accumulation and reinvestment of economic surplus in the environment, and to the way in which the related activities are organized. Literacy programs can unite skills relevant to management of local resources with strategies of cultural, political or religious revitalization that mobilize people to use their human resources. They therefore continue to offer an attractive means of initiating a reinvestment spiral from limited initial capital. To realize these potentials at the post-literacy stage, however, requires planning post-literacy before literacy, broadening programs to address primary school leavers as well, and paying greatly increased attention to the economic and social structure of the learning environment.

Using Targeting Outcomes of Programs as a Framework to Target Photographic Events in Nonformal Educational Programs

ERIC Educational Resources Information Center

Rockwell, S. Kay; Albrecht, Julie A.; Nugent, Gwen C.; Kunz, Gina M.

2012-01-01

Targeting Outcomes of Programs (TOP) is a seven-step hierarchical programming model in which the program development and performance sides are mirror images of each other. It served as a framework to identify a simple method for targeting photographic events in nonformal education programs, indicating why, when, and how photographs would be useful…

The use of lorcaserin in the management of obesity: a critical appraisal

PubMed Central

Bai, Bo; Wang, Yu

2011-01-01

Obesity is a chronic disease with a high prevalence in both developed and developing countries. Effective management of this worldwide epidemic will have a significant impact on the health care system globally. Lifestyle interventions, such as restricting calorie consumption and increasing physical activity, remain a major component of weight-reduction programs. The development of pharmacotherapy for the management of obesity is still at the infancy stage. Side effects have been the key issue for anti-obesity drugs previously withdrawn from the market. The focus of this review, lorcaserin, is a selective serotonin receptor agonist that is currently undergoing Phase III evaluations. The efficacy of this drug in reducing body weight and improving metabolic parameters of obese patients has been demonstrated in two recent clinical trials. The available evidence indicates that this drug does not show unwanted effects on heart valves or pulmonary artery pressure, and the treatment improves the risk factors for type 2 diabetes and cardiovascular diseases. Despite these promising results, additional experimental and clinical studies are critical for the approval of lorcaserin as a new anti-obesity monodrug therapy by the US Food and Drug Administration. PMID:21267355

The use of lorcaserin in the management of obesity: a critical appraisal.

PubMed

Bai, Bo; Wang, Yu

2010-12-20

Obesity is a chronic disease with a high prevalence in both developed and developing countries. Effective management of this worldwide epidemic will have a significant impact on the health care system globally. Lifestyle interventions, such as restricting calorie consumption and increasing physical activity, remain a major component of weight-reduction programs. The development of pharmacotherapy for the management of obesity is still at the infancy stage. Side effects have been the key issue for anti-obesity drugs previously withdrawn from the market. The focus of this review, lorcaserin, is a selective serotonin receptor agonist that is currently undergoing Phase III evaluations. The efficacy of this drug in reducing body weight and improving metabolic parameters of obese patients has been demonstrated in two recent clinical trials. The available evidence indicates that this drug does not show unwanted effects on heart valves or pulmonary artery pressure, and the treatment improves the risk factors for type 2 diabetes and cardiovascular diseases. Despite these promising results, additional experimental and clinical studies are critical for the approval of lorcaserin as a new anti-obesity monodrug therapy by the US Food and Drug Administration.

TAC management in North Sea flatfish fisheries

NASA Astrophysics Data System (ADS)

Daan, Niels

1997-11-01

The Common Fisheries Policy of the European Union adopted in 1983 is primarily focused on a science-based TAC management system with fixed national quota shares. The quality of the assessments of plaice and sole, the consistency of the scientific advice, the congruency of the management decisions, and the enforcement of the regulations are reviewed over a 15-year period. The conclusion is that there have been problems at each level, with the ultimate effect that the policy has not been able to restrict fishing mortality and that the level of overexploitation has only increased. It is argued that the present TAC system has created more problems than it has resolved. Attention is drawn to the autonomic economic developments within the fishery and to the potential for managing the fishery more effectively from the cost side rather than the profit side.

Schools' Responses to Voucher Policy: Participation Decisions and Early Implementation Experiences in the Indiana Choice Scholarship Program

ERIC Educational Resources Information Center

Austin, Megan J.

2015-01-01

Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…

SIRIUS. An automated method for the analysis of the preferred packing arrangements between protein groups.

PubMed

Singh, J; Thornton, J M

1990-02-05

Automated methods have been developed to determine the preferred packing arrangement between interacting protein groups. A suite of FORTRAN programs, SIRIUS, is described for calculating and analysing the geometries of interacting protein groups using crystallographically derived atomic co-ordinates. The programs involved in calculating the geometries search for interacting pairs of protein groups using a distance criterion, and then calculate the spatial disposition and orientation of the pair. The second set of programs is devoted to analysis. This involves calculating the observed and expected distributions of the angles and assessing the statistical significance of the difference between the two. A database of the geometries of the 400 combinations of side-chain to side-chain interaction has been created. The approach used in analysing the geometrical information is illustrated here with specific examples of interactions between side-chains, peptide groups and particular types of atom. At the side-chain level, an analysis of aromatic-amino interactions, and the interactions of peptide carbonyl groups with arginine residues is presented. At the atomic level the analyses include the spatial disposition of oxygen atoms around tyrosine residues, and the frequency and type of contact between carbon, nitrogen and oxygen atoms. This information is currently being applied to the modelling of protein interactions.

The DarkSide physics program and its recent results

DOE PAGES

D'Angelo, D.

2017-01-12

Here, DarkSide (DS) at Gran Sasso underground laboratory is a direct Dark Matter search program based on Time Projection Chambers (TPC) with liquid Argon from underground sources. The DarkSide-50 (DS-50) TPC, with 150 kg of Argon is installed inside active neutron and muon detectors. DS-50 has been taking data since November 2013 with Atmospheric Argon (AAr) and since April 2015 with Underground Argon (UAr), depleted in radioactive 39Ar by a factor ~1400. The exposure of 1422 kg d of AAr has demonstrated that the operation of DS-50 for three years in a background free condition is a solid reality, thanksmore » to the superb performance of the Pulse Shape Analysis. The first release of results from an exposure of 2616 kg d of UAr has shown no candidate Dark Matter events. We have set the best limit for Spin-Independent elastic nuclear scattering of WIMPs obtained by Argon-based detectors, corresponding to a cross-section of 2 10 –44 cm 2 at a WIMP mass of 100 GeV. We present the detector design and performance, the results from the AAr run and the first results from the UAr run and we briefly introduce the future of the DarkSide program.« less

The DarkSide physics program and its recent results

NASA Astrophysics Data System (ADS)

D'Angelo, D.; Agnes, P.; Agostino, L.; F. M. Albuquerque, I.; Alexander, T.; K. Alton, A.; Arisaka, K.; Back, H. O.; Baldin, B.; Biery, K.; Bonfini, G.; Bossa, M.; Bottino, B.; Brigatti, A.; Brodsky, J.; Budano, F.; Bussino, S.; Cadeddu, M.; Cadonati, L.; Cadoni, M.; Calaprice, F.; Canci, N.; Candela, A.; Cao, H.; Cariello, M.; Carlini, M.; Catalanotti, S.; Cavalcante, P.; Chepurnov, A.; Cocco, A. G.; Covone, G.; Crippa, L.; D'Incecco, M.; Davini, S.; De Cecco, S.; De Deo, M.; De Vincenzi, M.; Derbin, A.; Devoto, A.; Di Eusanio, F.; Di Pietro, G.; Edkins, E.; Empl, A.; Fan, A.; Fiorillo, G.; Fomenko, K.; Forster, G.; Franco, D.; Gabriele, F.; Galbiati, C.; Giganti, C.; M. Goretti, A.; Granato, F.; Grandi, L.; Gromov, M.; Guan, M.; Guardincerri, Y.; R. Hackett, B.; Herner, K.; V. Hungerford, E.; Ianni, Al.; Ianni, An.; James, I.; Jollet, C.; Keeter, K.; L. Kendziora, C.; Kobychev, V.; Koh, G.; Korablev, D.; Korga, G.; Kubankin, A.; Lissia, M.; Li, X.; Lombardi, P.; Luitz, S.; N. Machulin, I.; Mandarano, A.; Maricic, J.; Marini, L.; M. Mari, S.; J. Martoff, C.; Ma, Y.; Meregaglia, A.; D. Meyers, P.; Miletic, T.; Milincic, R.; Montanari, D.; Monte, A.; Montuschi, M.; Monzani, M.; Mosteiro, P.; J. Mount, B.; N. Muratova, V.; Musico, P.; Napolitano, J.; Nelson, A.; Odrowski, S.; Orsini, M.; Ortica, F.; Pagani, L.; Pallavicini, M.; Pantic, E.; Parmeggiano, S.; Pelczar, K.; Pelliccia, N.; Perasso, S.; Pocar, A.; Pordes, S.; A. Pugachev, D.; Qian, H.; Randle, K.; Ranucci, G.; Razeto, A.; Reinhold, B.; L. Renshaw, A.; Romani, A.; Rossi, B.; Rossi, N.; Rountree, D.; Sablone, D.; Saggese, P.; Saldanha, R.; Sands, W.; Sangiorgio, S.; Savarese, C.; Segreto, E.; A. Semenov, D.; Shields, E.; N. Singh, P.; D. Skorokhvatov, M.; Smirnov, O.; Sotnikov, A.; Stanford, C.; Suvorov, Y.; Tartaglia, R.; Tatarowicz, J.; Testera, G.; Tonazzo, A.; Trinchese, P.; V. Unzhakov, E.; Vishneva, A.; Vogelaar, B.; Wada, M.; Walker, S.; Wang, H.; Wang, Y.; W. Watson, A.; Westerdale, S.; Wilhelmi, J.; M. Wojcik, M.; Xiang, X.; Xu, J.; Yang, C.; Yoo, J.; Zavatarelli, S.; Zec, A.; Zhong, W.; Zhu, C.; Zuzel, G.

2017-07-01

DarkSide (DS) at Gran Sasso underground laboratory is a direct Dark Matter search program based on Time Projection Chambers (TPC) with liquid Argon from underground sources. The DarkSide-50 (DS-50) TPC, with 150kg of Argon is installed inside active neutron and muon detectors. DS-50 has been taking data since November 2013 with Atmospheric Argon (AAr) and since April 2015 with Underground Argon (UAr), depleted in radioactive ^{39} Ar by a factor {˜}1400 . The exposure of 1422kg d of AAr has demonstrated that the operation of DS-50 for three years in a background free condition is a solid reality, thanks to the superb performance of the Pulse Shape Analysis. The first release of results from an exposure of 2616kg d of UAr has shown no candidate Dark Matter events. We have set the best limit for Spin-Independent elastic nuclear scattering of WIMPs obtained by Argon-based detectors, corresponding to a cross-section of 2 10^{-44}{ cm2} at a WIMP mass of 100GeV. We present the detector design and performance, the results from the AAr run and the first results from the UAr run and we briefly introduce the future of the DarkSide program.

Strengthening Teacher Evaluation: What District Leaders Can Do

ERIC Educational Resources Information Center

Donaldson, Morgaen L.; Donaldson, Gordon A., Jr.

2012-01-01

School districts have typically not done a good job of managing the human side of teacher evaluation. In general, neither supervisors nor teachers find performance assessment a constructive, interpersonally respectful experience. District leaders can cultivate high-quality teaching--and attend to the human side of assessment--by taking five…

Supply-Side Interventions and Student Learning in Guatemala

ERIC Educational Resources Information Center

Vasquez, William F.

2012-01-01

This paper presents estimates of production functions of reading and mathematics test scores to assess the effects of supply-side interventions, such as the provision of a community-based school management programme, bilingual education and multigrade teaching, on student learning in Guatemala. The efficiency and consistency of the estimates is…

The design of a wireless batteryless biflash installation with high power LEDs

NASA Astrophysics Data System (ADS)

Cappelle, J.; De Geest, W.; Hanselaer, P.

2011-05-01

Adding flashlights at crosswalks may make these weak traffic points safer. Unfortunately plugging in traffic lights into the electrical grid is expensive and complex. This paper reports about the energetic, the electronic and the optical design and building of a wireless and batteryless biflash installation in the framework of a flemish SME supporting program. The energy is supplied by a small solar panel and is buffered by supercapacitors instead of batteries. This has the advantage of being maintenance free: the number of charge-discharge cycles is almost unlimited because there is no chemical reaction involved in the storage mechanism. On the other hand the limited energy storage capacity of supercapacitors requires a new approach for the system design. Based on the EN-12352 standard for warning light devices, all design choices were filled in to be as energy efficient as possible. The duty cycle and the light output of the high power led flashlights are minimized. The components for the electronic circuits for the led driver, the control and the RF communication are selected based on their energy consumption and power management techniques are implemented. A lot of energy is saved by making the biflash system active. The leds are only flashing on demand or at preprogrammed moments. A biflash installation is typically installed at both sides of a crosswalk. A call at one of the sides should result in flashing at both sides. To maintain the drag and drop principle, a wireless RF communication system is designed.

Autism and Obesity: Co-Occurring Conditions or Drug Side Effects

DTIC Science & Technology

2015-10-01

Antipsychotic-Induced Weight Gain ASD: Autism Spectrum Disorder BMI: Body Mass Index SSC: Simons Simplex Collection SNP: Single Nucleotide Polymorphism...AWARD NUMBER: W81XWH-14-1-0374 TITLE: Autism and Obesity: Co-Occurring Conditions or Drug Side Effects? PRINCIPAL INVESTIGATOR: Zohreh...SUBTITLE Autism and Obesity: Co-Occurring Conditions or Drug Side Effects? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0374 5c. PROGRAM ELEMENT

Nonnarcotic analgesics and tricyclic antidepressants for the treatment of chronic nonmalignant pain.

PubMed

Richlin, D M

1991-05-01

Chronic nonmalignant pain is often characterized by multiple treatment failures, a pattern of maladaptive behavior, and depression. Often there is a history of inappropriate and excessive use of medications for pain. Prior and ongoing use of narcotics and sedatives acts to compound and aggravate the chronic pain syndrome. A first step in treatment is controlled withdrawal of these agents. Nonnarcotic analgesics, NSAIDs, and tricyclic antidepressants are commonly employed in patients with chronic pain. Effective use of these agents requires understanding of their pharmacokinetic and pharmacodynamic properties. Use of a fixed-time schedule is necessary to achieve an effective, sustained therapeutic response. Careful patient education and monitoring for side effects and toxicity are necessary, particularly in the elderly and patients with coexisting medical disorders. Incidence of side effects and toxicity may be reduced by choice of drug and modification of dosing regimen. Nonnarcotic analgesics, TCAs, and NSAIDs are seldom effective by themselves in resolving the pain and distress of patients with chronic nonmalignant pain. This is particularly true when maladaptive behavior coexists. A comprehensive multimodal pain management program encompassing additional pain-relieving strategies and behavior-modifying techniques should be considered and utilized in conjunction with medication.

Pharmacogenomic and clinical data link non-pharmacokinetic metabolic dysregulation to drug side effect pathogenesis

PubMed Central

Zielinski, Daniel C.; Filipp, Fabian V.; Bordbar, Aarash; Jensen, Kasper; Smith, Jeffrey W.; Herrgard, Markus J.; Mo, Monica L.; Palsson, Bernhard O.

2015-01-01

Drug side effects cause a significant clinical and economic burden. However, mechanisms of drug action underlying side effect pathogenesis remain largely unknown. Here, we integrate pharmacogenomic and clinical data with a human metabolic network and find that non-pharmacokinetic metabolic pathways dysregulated by drugs are linked to the development of side effects. We show such dysregulated metabolic pathways contain genes with sequence variants affecting side effect incidence, play established roles in pathophysiology, have significantly altered activity in corresponding diseases, are susceptible to metabolic inhibitors and are effective targets for therapeutic nutrient supplementation. Our results indicate that metabolic dysregulation represents a common mechanism underlying side effect pathogenesis that is distinct from the role of metabolism in drug clearance. We suggest that elucidating the relationships between the cellular response to drugs, genetic variation of patients and cell metabolism may help managing side effects by personalizing drug prescriptions and nutritional intervention strategies. PMID:26055627

Forest Fertilization Symposium Proceedings

Treesearch

Albert L. Leaf; Raymond E. Leonard

1973-01-01

Forest fertilization is a cultural practice becoming available to forest land managers for use in meeting management objectives. Like other cultural practices, it involves an investment in the site, it may result in an array of side effects in the ecosystem, and it must fit logically into long-range management plans.

Teaching clinical opioid pharmacology with the Human Patient Simulator.

PubMed

Hassan, Zaki; DiLorenzo, Amy; Sloan, Paul

2010-01-01

Postoperative pain should be aggressively treated to decrease the development of chronic postsurgical pain. There has been an increase in the use of Human Patient Simulator (HPS) for teaching advanced courses in pharmacology to medical students, residents, and nurses. The aim of this educational investigation was to pilot the HPS for the training of medical students and surgical recovery room staff nurses in the pharmacology of opioids for the management of postoperative pain. The computerized HPS mannequin is fully monitored with appropriate displays and includes a voice speaker mounted in the head. Medical students and Postanesthesia care unit nurses, led by faculty in the Department of Anesthesiology in small groups of 4-6, participated in a 2- to 3-hour HPS course on the use of opioids for the management of acute postoperative pain. Trainees were asked to treat the acute and severe postoperative pain of a simulated patient. Opioid effects and side effects (such as respiratory depression) were presented on the mannequin in real time to the participants. Side effects of naloxone to reverse opioid depression were presented as a crisis in real time to the participants. Participants completed a 10-item course evaluation using a 5-point Likert scale (1 = strongly disagree; 5 = strongly agree). Twenty-two nurses and nine medical students completed the HPS opioid pharmacology scenario. Almost all participants rated the HPS course very highly and rated every item as either agree or strongly agree. Most participants agreed that the simulator session improved their understanding of opioid pharmacology including opioid side effects and management of opioid complications. Course participants felt most strongly (median, interquartile range) that the simulator session improved their understanding of naloxone pharmacology (5, 0), simulators serve as a useful teaching tool (5, 0), and that they would be pleased to participate in any additional HPS teaching sessions (5, 0). The HPS provides a novel educational format to teach essential information regarding opioid pharmacology for the management of acute postoperative pain. The HPS provides a realistic format to teach the pharmacology of acute opioid side effects and the management of acute and life-threatening side effects of naloxone therapy.

Side impact test and analysis of a DOT-112 tank car.

DOT National Transportation Integrated Search

2016-12-01

As part of a program to improve transportation safety for tank cars, Transportation Technology Center, Inc. (TTCI) has conducted a side impact test on a DOT-112 tank car to evaluate the performance of the DOT-112 under dynamic impact conditions and t...

An integrated eVoucher mechanism for flexible loads in real-time retail electricity market

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

Chen, Tao; Pourbabak, Hajir; Liang, Zheming

This study proposes an innovative economic and engineering coupled framework to encourage typical flexible loads or load aggregators, such as parking lots with high penetration of electric vehicles, to participate directly in the real-time retail electricity market based on an integrated eVoucher program. The integrated eVoucher program entails demand side management, either in the positive or negative direction, following a popular customer-centric design principle. It provides the extra economic benefit to end-users and reduces the risk associated with the wholesale electricity market for electric distribution companies (EDCs), meanwhile improving the potential resilience of the distribution networks with consideration for frequencymore » deviations. When implemented, the eVoucher program allows typical flexible loads, such as electric vehicle parking lots, to adjust their demand and consumption behavior according to financial incentives from an EDC. A distribution system operator (DSO) works as a third party to hasten negotiations between such parking lots and EDCs, as well as the price clearing process. Eventually, both electricity retailers and power system operators will benefit from the active participation of the flexible loads and energy customers.« less

An integrated eVoucher mechanism for flexible loads in real-time retail electricity market

DOE PAGES

Chen, Tao; Pourbabak, Hajir; Liang, Zheming; ...

2017-01-26

This study proposes an innovative economic and engineering coupled framework to encourage typical flexible loads or load aggregators, such as parking lots with high penetration of electric vehicles, to participate directly in the real-time retail electricity market based on an integrated eVoucher program. The integrated eVoucher program entails demand side management, either in the positive or negative direction, following a popular customer-centric design principle. It provides the extra economic benefit to end-users and reduces the risk associated with the wholesale electricity market for electric distribution companies (EDCs), meanwhile improving the potential resilience of the distribution networks with consideration for frequencymore » deviations. When implemented, the eVoucher program allows typical flexible loads, such as electric vehicle parking lots, to adjust their demand and consumption behavior according to financial incentives from an EDC. A distribution system operator (DSO) works as a third party to hasten negotiations between such parking lots and EDCs, as well as the price clearing process. Eventually, both electricity retailers and power system operators will benefit from the active participation of the flexible loads and energy customers.« less

Reirradiation on recurrent cervical cancer case: Treatment response and side effects

NASA Astrophysics Data System (ADS)

Siregar, M. F.; Supriana, N.; Nuranna, L.; Prihartono, J.

2017-08-01

Management of recurrent cervical cancer by reirradiation after radiation treatment remains controversial. In Indonesia, there is currently no data about reirradiation tumor response and side effects. This study aims to assess the tumor response to and side effects of reirradiation, the effect of time interval between first radiation treatment and cancer recurrence on the tumor response and side effects, and the effect of tumor size on tumor response. A cohort retrospective study with no comparison was done with the Radiotherapy Department at Cipto Mangunkusumo General Hospital, Jakarta. Participants were recurrent cervical cancer patients undergoing reirradiation. Data was collected from patients’ medical records and follow-up phone calls. Twenty-two patients participated in this study. Nine patients (40.9%) had complete responses, 10 patients (45.5%) had partial responses, 1 patient (4.5%) had a stable response, and 2 patients (9.1%) had tumor progressions. In general, 15 patients (68.2%) had no to light side effects (grade 0-2 RTOG) and 7 patients (31.8%) had severe side effects (grade 3-4 RTOG). Four patients (18.1%) had severe gastrointestinal acute side effects, 6 patients (27.3%) had severe gastrointestinal late side effects, 2 patients (9.1%) had severe urogenital side effects, and there were no patients had severe urogenital late side effects. There was no significant difference in tumor response between patients with time interval between first radiation treatment and recurrence of <12 months vs. ≥12 months. There was no significant difference in tumor response between patients with tumor size ≤4 cm vs. >4 cm. Reirradiation can be considered as a modality in recurrent cervical cancer management since good tumor response was achieved and the majority of patients had no to light side effects (grade 0-2 RTOG). This study found no correlation between tumor response, side effects, and time gap between first radiation treatment and recurrence of <12 months vs. ≥12 months. There was also no correlation between tumor response and tumor size of ≤4 cm vs. > 4 cm.

Challenges in Fibromyalgia Management: A Study of Anxiety, Depression, and Motivation Using Distance Learning and Social Networking

ERIC Educational Resources Information Center

Caines, Matthew J.

2010-01-01

Patients with fibromyalgia have difficulty managing symptoms (e.g., fatigue, chronic pain). The challenges in fibromyalgia management may vary from patient to patient, from painful physical exercise to pharmaceutical side-effects. Since the management of fibromyalgia greatly varies, there seems to be an individualist or personal component to…

NPS pollution related to forest management activities in southern states

Treesearch

Johnny M. Grace

2004-01-01

Road systems on the nation’s public lands are vital links; providing access to perform management prescriptions, fire management, and recreation opportunities. Sediment movement downslope of forest road systems is a concern because these sediments have the potential to reach stream systems. Filter strips and stream side management zones (SMZs) are recommended and...

Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis.

PubMed

Kumar, Amandeep; Suri, Ashish; Sharma, Bhawani S

2014-07-01

Valproic acid (VPA) is a commonly used drug for epilepsy, psychiatric disorders and migraine and is frequently used in neurosurgical intensive care units. Though most of its side-effects are mild and transient, certain idiosyncratic side-effects have been attributed to VPA. Valproate induced hyperammonemia (VIH) is one such side-effect. VIH can produce symptoms of encephalopathy known as valproate induced hyperammonemic encephalopathy (VHE). VIH and VHE usually respond to withdrawal of VPA. However, in some cases VHE can be unresponsive to supportive measures and severe enough to be life-threatening. In such cases, dialysis can be used to rapidly reverse hyperammonemia and VHE and can prove to be a lifesaving measure. We report such a case of VIH and life-threatening VHE in a postoperative neurosurgical patient that was managed successfully with peritoneal dialysis.

6 CFR 29.5 - Requirements for protection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PCII Program Manager or the PCII Program Manager's designee; (2) The information is submitted for... information initially provided received by the PCII Program Manager or the PCII Program Manager's designee... provided, to be received by the PCII Program Manager or the PCII Program Manager's designee within a...

Systemic bias in the medical literature on androgen deprivation therapy and its implication to clinical practice.

PubMed

Phillips, J L; Wassersug, R J; McLeod, D L

2012-12-01

LHRH agonists are used for androgen deprivation therapy (ADT) to treat prostate cancer, but have many side effects that reduce of the quality of life of prostate cancer patients and their partners. Patients are poorly informed about the side effects of these drugs and how to manage them. To test the hypothesis that there is bias in the peer-reviewed literature on ADT that correlates with an association between authors and the luteinising hormone-releasing hormone (LHRH) agonists pharmaceutical industry. We assessed 155 articles on ADT published in English-language peer-reviewed journals in terms of how comprehensive they were in acknowledging LHRH agonists' side effects. Although the literature regarding ADT is substantial, the vast majority of articles failed to acknowledge many of the more stressful side effects of ADT for patients and their partners. Articles most likely to acknowledge the psychosocial impact of ADT were significantly less likely to have had industrial support than those articles that did not mention those side effects. Alternative treatments to the LHRH agonists were rarely mentioned. Authors who indicated some association with a pharmaceutical company tended to minimise the side effects of LHRH agonists and not acknowledge alternatives to the LHRH agonists for ADT. Industrial support is associated with a proliferation of articles published in the peer-reviewed literature directed at practising physicians. Such flooding of the literature may, in part, limit physicians' knowledge of the side effects of these drugs and, in turn, account for the poor knowledge that patients on LHRH agonists have about the drugs they are taking and ways to manage their side effects. © 2012 Blackwell Publishing Ltd.

Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effects.

PubMed

Boettger, Soenke; Jenewein, Josef; Breitbart, William

2015-08-01

The aim of this study was to compare the efficacy and side-effect profile of the typical antipsychotic haloperidol with that of the atypical antipsychotics risperidone, olanzapine, and aripiprazole in the management of delirium. The Memorial Delirium Assessment Scale (MDAS), the Karnofsky Performance Status (KPS) scale, and a side-effect rating were recorded at baseline (T1), after 2-3 days (T2), and after 4-7 days (T3). Some 21 cases were case-matched by age, preexisting dementia, and baseline MDAS scores, and subsequently analyzed. The baseline characteristics of the medication groups were not different: The mean age of the patients ranged from 64.0 to 69.6 years, dementia was present in between 23.8 and 28.6%, and baseline MDAS scores were 19.9 (haloperidol), 18.6 (risperidone), 19.4 (olanzapine), and 18.0 (aripiprazole). The doses of medication at T3 were 5.5 mg haloperidol, 1.3 mg risperidone, 7.1 mg olanzapine, and 18.3 mg aripiprazole. Over one week, the decline in MDAS scores between medications was equal, and no differences between individual MDAS scores existed at T2 or T3. After one week, the MDAS scores were 6.8 (haloperidol), 7.1 (risperidone), 11.7 (olanzapine), and 8.3 (aripiprazole). At T2, delirium resolution occurred in 42.9-52.4% of cases and at T3 in 61.9-85.7%; no differences in assessments between medications existed. Recorded side effects were extrapyramidal symptoms (EPSs) in haloperidol- and risperidone-managed patients (19 and 4.8%, respectively) and sedation with olanzapine (28.6%). Haloperidol, risperidone, aripiprazole, and olanzapine were equally effective in the management of delirium; however, they differed in terms of their side-effect profile. Extrapyramidal symptoms were most frequently recorded with haloperidol, and sedation occurred most frequently with olanzapine.

Implementing an Applied Science Program

NASA Technical Reports Server (NTRS)

Rickman, Doug; Presson, Joan

2007-01-01

The work implied in the NASA Applied Science Program requires a delicate balancing act for the those doing it. At the implementation level there are multiple tensions intrinsic to the program. For example each application of an existing product to a decision support process requires deep knowledge about the data and deep knowledge about the decision making process. It is highly probable no one person has this range of knowledge. Otherwise the decision making process would already be using the data. Therefore, a team is required. But building a team usually requires time, especially across agencies. Yet the program mandates efforts of relatively short duration. Further, those who know the data are scientists, which makes them essential to the program. But scientists are evaluated on their publication record. Anything which diverts a scientist from the research for his next publication is an anathema to him and potential death to their career. Trying to get another agency to use NASA data does not strike most scientists as material inherently suitable for publication. Also, NASA wishes to rapidly implement often substantial changes to another agency's process. For many reasons, such as budget and program constraints, speed is important. But the owner of a decision making process is tightly constrained, usually by law, regulation, organization and custom. Changes when made are slow, cautious, even hesitant, and always done according a process specific to the situation. To manage this work MSFC must balance these and other tensions. Some things we have relatively little control over, such as budget. These we try to handle by structural techniques. For example by insisting all of our people work on multiple projects simultaneously we inherently have diversification of funding for all of our people. In many cases we explicitly use some elements of tension to be productive. For example the need for the scientists to constantly publish is motivation to keep tasks short and to the immediate point. As another example, the DSS agency and it personnel are treated as integral to the effort at every step. Thus, their ways of doing things, their problems and their assets become part of the solution. MSFC also manages the Applied Science work' within a strategic framework.' First, the scientists are necessarily at the core of all of this work as well as all of the work within the larger' organization. We therefore strive to keep a roughly 50-50 balance between the work done on tasks funded directly by the research side of NASA's Science Mission Directorate and funding from the applied side. Done at both the organization level and the level of the individual, this keeps the scientist both happy and productive over the long term. We also try diligently to remove as much burden from the scientist as practical by employing people such as the authors and others to do tasks not requiring; scientific knowledge. We also have designed our effort to take full use of external partners. We actively seek and support, including fund, people from multiple organizations to join us as committed collaborators. In this we use today's money and today's problem to help us diversify and strengthen for tomorrow. MSFC also considers the Applied Science work holistically. Each element is viewed as a step in a larger process. At a management level we can chose to emphasize or encourage certain areas which service long term goals. Thus, if we think work in a particular area should be developed, we can start with the smaller, less costly elements and grow.

Use of Biologics in Private Practice: Nine Years of Lessons and Learning.

PubMed

Correa-Selm, Lilia M; Alamgir, Mahin; Rao, Babar K

2017-03-01

Over a decade ago, the FDA approved biologics for psoriasis, which changed how the disease is treated and, in most cases, has a significant positive impact on the lives of patients. Side effects primarily identified during the investigational and research phase led to the development of specific guidelines for treatment. The treatment guidelines have been amended to incorporate better understandings of side-effects over the years that the disease has been treated. In this study, we focused on a chart review that included assessing the current guidelines and their alignment with modern patient management and the recent side effects presented. This life-cycle evaluation included over 100 patients, management of their treatment, laboratory abnormalities, criteria for choosing or changing to a different biologic, and the effects of the treatments management throughout the years. The review identified some recommended changes in the application and treatment of psoriasis with biologics. To further evidence our findings, we hope to expand this study to a larger scale with more patients.

J Drugs Dermatol. 2017;16(3):215-217.

Landscape assessment of side channel plugs and associated cumulative side channel attrition across a large river floodplain.

PubMed

Reinhold, Ann Marie; Poole, Geoffrey C; Bramblett, Robert G; Zale, Alexander V; Roberts, David W

2018-04-24

Determining the influences of anthropogenic perturbations on side channel dynamics in large rivers is important from both assessment and monitoring perspectives because side channels provide critical habitat to numerous aquatic species. Side channel extents are decreasing in large rivers worldwide. Although riprap and other linear structures have been shown to reduce side channel extents in large rivers, we hypothesized that small "anthropogenic plugs" (flow obstructions such as dikes or berms) across side channels modify whole-river geomorphology via accelerating side channel senescence. To test this hypothesis, we conducted a geospatial assessment, comparing digitized side channel areas from aerial photographs taken during the 1950s and 2001 along 512 km of the Yellowstone River floodplain. We identified longitudinal patterns of side channel recruitment (created/enlarged side channels) and side channel attrition (destroyed/senesced side channels) across n = 17 river sections within which channels were actively migrating. We related areal measures of recruitment and attrition to the density of anthropogenic side channel plugs across river sections. Consistent with our hypothesis, a positive spatial relationship existed between the density of anthropogenic plugs and side channel attrition, but no relationship existed between plug density and side channel recruitment. Our work highlights important linkages among side channel plugs and the persistence and restoration of side channels across floodplain landscapes. Specifically, management of small plugs represents a low-cost, high-benefit restoration opportunity to facilitate scouring flows in side channels to enable the persistence of these habitats over time.

TACT 1: A computer program for the transient thermal analysis of a cooled turbine blade or vane equipped with a coolant insert. 2. Programmers manual

NASA Technical Reports Server (NTRS)

Gaugler, R. E.

1979-01-01

A computer program to calculate transient and steady state temperatures, pressures, and coolant flows in a cooled axial flow turbine blade or vane with an impingement insert is described. Coolant-side heat transfer coefficients are calculated internally in the program, with the user specifying either impingement or convection heat transfer at each internal flow station. Spent impingement air flows in a chordwise direction and is discharged through the trailing edge and through film cooling holes. The ability of the program to handle film cooling is limited by the internal flow model. Input to the program includes a description of the blade geometry, coolant-supply conditions, outside thermal boundary conditions, and wheel speed. The blade wall can have two layers of different materials, such as a ceramic thermal barrier coating over a metallic substrate. Program output includes the temperature at each node, the coolant pressures and flow rates, and the coolant-side heat transfer coefficients.

What Works May Hurt--Side Effects in Education

ERIC Educational Resources Information Center

Zhao, Yong

2018-01-01

Medical products are required to disclose both their intended outcomes and known side effects. Educational policy and practice, however, carries no such labels. Thus, teachers, school leaders, and the public are not told, for example, that "this program helps improve your students' reading scores, but it may make them hate reading…

Condition assessment and methods of abatement of prestressed concrete box-beam deterioration, phase II : volume 1.

DOT National Transportation Integrated Search

2009-04-13

Side-by-side box-beam bridge constitutes approximately 17 percent of bridges built or replaced annually on : public roads and there is a renewed thrust to use this bridge type for rapid construction under the Highway for : LIFE program. Further, fail...

COMPARATIVE U.S./USSR TESTS OF A HOT-SIDE ELECTROSTATIC PRECIPITATOR

EPA Science Inventory

The report describes a U.S./USSR cooperative test program to quantify and characterize particulate emissions from a U.S. coal-burning power plant boiler, equipped with a hot-side electrostatic precipitator, at Duke Power Co.'s Allen Steam Station in March 1976. U.S. and Soviet eq...

The DarkSide Program

NASA Astrophysics Data System (ADS)

Rossi, B.; Agnes, P.; Alexander, T.; Alton, A.; Arisaka, K.; Back, H. O.; Baldin, B.; Biery, K.; Bonfini, G.; Bossa, M.; Brigatti, A.; Brodsky, J.; Budano, F.; Calaprice, F.; Canci, N.; Candela, A.; Cariello, M.; Cavalcante, P.; Catalanotti, S.; Chavarria, A.; Chepurnov, A.; Cocco, A. G.; Covone, G.; D'Angelo, D.; D'Incecco, M.; De Deo, M.; Derbin, A.; Devoto, A.; Di Eusanio, F.; Edkins, E.; Empl, A.; Fan, A.; Fiorillo, G.; Fomenko, K.; Franco, D.; Gabriele, F.; Galbiati, C.; Goretti, A.; Grandi, L.; Guan, M. Y.; Guardincerri, Y.; Hackett, B.; Herner, K.; Hungerford, E. V.; Ianni, Al.; Ianni, An.; Kendziora, C.; Koh, G.; Korablev, D.; Korga, G.; Kurlej, A.; Li, P. X.; Lombardi, P.; Luitz, S.; Machulin, I.; Mandarano, A.; Mari, S.; Maricic, J.; Marini, L.; Martoff, C. J.; Meyers, P. D.; Montanari, D.; Montuschi, M.; Monzani, M. E.; Musico, P.; Odrowski, S.; Orsini, M.; Ortica, F.; Pagani, L.; Pallavicini, M.; Pantic, E.; Papp, L.; Parmeggiano, S.; Pelliccia, N.; Perasso, S.; Pocar, A.; Pordes, S.; Qian, H.; Randle, K.; Ranucci, G.; Razeto, A.; Reinhold, B.; Renshaw, A.; Romani, A.; Rossi, N.; Rountree, S. D.; Sablone, D.; Saldanha, R.; Sands, W.; Segreto, E.; Shields, E.; Smirnov, O.; Sotnikov, A.; Stanford, C.; Suvorov, Y.; Tartaglia, R.; Tatarowicz, J.; Testera, G.; Tonazzo, A.; Unzhakov, E.; Vogelaar, R. B.; Wada, M.; Walker, S.; Wang, H.; Watson, A.; Westerdale, S.; Wojcik, M.; Xiang, X.; Xu, J.; Yang, C. G.; Yoo, J.; Zavatarelli, S.; Zec, A.; Zhu, C.; Zuzel, G.

2016-07-01

DarkSide-50 at Gran Sasso underground laboratory (LNGS), Italy, is a direct dark matter search experiment based on a liquid argon TPC. DS-50 has completed its first dark matter run using atmospheric argon as target. The detector performances and the results of the first physics run are presented in this proceeding.

Condition assessment and methods of abatement of prestressed concrete box-beam deterioration, phase II : volume 2.

DOT National Transportation Integrated Search

2009-04-13

Side-by-side box-beam bridge constitutes approximately 17 percent of bridges built or replaced annually on public roads and there is a renewed thrust to use this bridge type for rapid construction under the Highway for LIFE program. Further, failure ...

An assessment of the impact of the JSY cash transfer program on maternal mortality reduction in Madhya Pradesh, India

PubMed Central

Ng, Marie; Misra, Archana; Diwan, Vishal; Agnani, Manohar; Levin-Rector, Alison; De Costa, Ayesha

2014-01-01

Background The Indian Janani Suraksha Yojana (JSY) program is a demand-side program in which the state pays women a cash incentive to deliver in an institution, with the aim of reducing maternal mortality. The JSY has had 54 million beneficiaries since inception 7 years ago. Although a number of studies have demonstrated the effect of JSY on coverage, few have examined the direct impact of the program on maternal mortality. Objective To study the impact of JSY on maternal mortality in Madhya Pradesh (MP), one of India's largest provinces. Design By synthesizing data from various sources, district-level maternal mortality ratios (MMR) from 2005 to 2010 were estimated using a Bayesian spatio-temporal model. Based on these, a mixed effects multilevel regression model was applied to assess the impact of JSY. Specifically, the association between JSY intensity, as reflected by 1) proportion of JSY-supported institutional deliveries, 2) total annual JSY expenditure, and 3) MMR, was examined. Results The proportion of all institutional deliveries increased from 23.9% in 2005 to 55.9% in 2010 province-wide. The proportion of JSY-supported institutional deliveries rose from 14% (2005) to 80% (2010). MMR declines in the districts varied from 2 to 35% over this period. Despite the marked increase in JSY-supported delivery, our multilevel models did not detect a significant association between JSY-supported delivery proportions and changes in MMR in the districts. The results from the analysis examining the association between MMR and JSY expenditure are similar. Conclusions Our analysis was unable to detect an association between maternal mortality reduction and the JSY in MP. The high proportion of institutional delivery under the program does not seem to have converted to lower mortality outcomes. The lack of significant impact could be related to supply-side constraints. Demand-side programs like JSY will have a limited effect if the supply side is unable to deliver care of adequate quality. PMID:25476929

A Handbook for Alcohol and Drug Control Officers. Volume II. Appendices.

DTIC Science & Technology

1975-02-01

informed respondent is regarding drug/alcohol side - effects , what respondent has learned from a given program or experience, etc.). There are a number...appearance, can list side effects of each and can score Z% on a multiple-choice test concerning federal and state laws and Armed Services Regulations...at least X% on a multiple- choice test regarding the major side effects of substance abuse. * The number of enlisted men found unfit for duty because

Connecting Hydrologic Research and Management in American Samoa through Collaboration and Capacity Building

NASA Astrophysics Data System (ADS)

Shuler, C. K.; El-Kadi, A. I.; Dulai, H.; Glenn, C. R.; Mariner, M. K. E.; DeWees, R.; Schmaedick, M.; Gurr, I.; Comeros, M.; Bodell, T.

2017-12-01

In small-island developing communities, effective communication and collaboration with local stakeholders is imperative for successful implementation of hydrologic or other socially pertinent research. American Samoa's isolated location highlights the need for water resource sustainability, and effective scientific research is a key component to addressing critical challenges in water storage and management. Currently, aquifer degradation from salt-water-intrusion or surface-water contaminated groundwater adversely affects much of the islands' municipal water supply, necessitating an almost decade long Boil-Water-Advisory. This presentation will share the approach our research group, based at the University of Hawaii Water Resources Research Center, has taken for successfully implementing a collaboration-focused water research program in American Samoa. Instead of viewing research as a one-sided activity, our program seeks opportunities to build local capacity, develop relationships with key on-island stakeholders, and involve local community through forward-looking projects. This presentation will highlight three applications of collaborative research with water policy and management, water supply and sustainability, and science education stakeholders. Projects include: 1) working with the island's water utility to establish a long-term hydrological monitoring network, motivated by a need for data to parameterize numerical groundwater models, 2) collaboration with the American Samoa Environmental Protection Agency to better understand groundwater discharge and watershed scale land-use impacts for management of nearshore coral reef ecosystems, and 3) participation of local community college and high school students as research interns to increase involvement in, and exposure to socially pertinent water focused research. Through these innovative collaborative approaches we have utilized resources more effectively, and focused research efforts on more pertinent locally-driven research questions. Additionally, this approach has enhanced our ability to provide technical support and knowledge transfer for on-island scientific needs, and helped overcome data availability barriers faced by water managers, planners, and future investigators.

Implementation of Bluetooth technology in processing aspheric mirrors

NASA Astrophysics Data System (ADS)

Chen, Dong-yun; Li, Xiao-jin

2010-10-01

This paper adopts the Bluetooth wireless transmission to replace the conducting rings currently using in the active lap process to overcome the cost and abrasion problems brought by the conducting rings, which has great significance for reducing the costs of processing large aspheric mirrors. Based on the actual application requirements, Article proposes the overall program of using Bluetooth technology as data transmission, including the active lap-side and machine tool-side: In the machine tool-side, the MCU separately connects with Bluetooth module and the sensor via UART0 and UART1 serial port, and when the MCU receives the signals sending from the sensor, the MCU packs and then sends them through the Bluetooth module; while in the active lap side, the CCAL reads-out the position signals of sensor detecting in dual-port memory via one-side ports, and the other side ports connect with the MCU's high ports P4-P7, so the MCU can unpacks and stores the position signals receiving via Bluetooth module. This paper designs and implements the system's hardware circuit, and mainly introduces the ways of serial and parallel. Based upon the realized system, design the test program for the Bluetooth wireless transmission and the experiment results, in the condition of the active lap processing large aspheric mirrors, showed that Bluetooth technology can meet the requirements of practical applications.

Lateralized swim positions are conserved across environments for beluga (Delphinapterus leucas) mother-calf pairs.

PubMed

Hill, Heather M; Guarino, Sara; Calvillo, Amber; Gonzalez, Antonio; Zuniga, Kristy; Bellows, Chris; Polasek, Lori; Sims, Christy

2017-05-01

Research with wild belugas has indicated that, during mother-calf swims, calves spend more time on their mothers' right side, which enables the calves to maintain visual contact with their mothers using their left eye. This bias may facilitate processing of social information by the right hemisphere, much like human and non-human primates and other animals. The current study explored the social laterality of the Cook Inlet, AK beluga population in comparison to a beluga population in managed care. As expected, the results indicated that the calves spent more time on the mothers' right side than the left for both populations. We also examined the developmental trend for the belugas in managed care and found that the calves generally preferred to swim on their mother's right side across most months, although there was an inversion during the third quarter when a left-side preference appeared. Individual differences were present. The results corroborate previous research conducted with two wild beluga populations from the White Sea and from the Sea of Okhotsk in which a left-eye bias was displayed by calves when swimming with their mothers. In conclusion, a preference for a lateralized swim position appears to be conserved across wild and managed care settings, and this lateralized swim position may facilitate the processing of social information or familiar stimuli for the calves. Copyright © 2017 Elsevier B.V. All rights reserved.

T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

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

Chen, Yong, E-mail: cheny102@163.com; Ye, Peng, E-mail: thomas19871223@163.com; Jiang, Wen-jin, E-mail: 18653501187@163.com

Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

A life scientist's gateway to distributed data management and computing: the PathPort/ToolBus framework.

PubMed

Eckart, J Dana; Sobral, Bruno W S

2003-01-01

The emergent needs of the bioinformatics community challenge current information systems. The pace of biological data generation far outstrips Moore's Law. Therefore, a gap continues to widen between the capabilities to produce biological (molecular and cell) data sets and the capability to manage and analyze these data sets. As a result, Federal investments in large data set generation produces diminishing returns in terms of the community's capabilities of understanding biology and leveraging that understanding to make scientific and technological advances that improve society. We are building an open framework to address various data management issues including data and tool interoperability, nomenclature and data communication standardization, and database integration. PathPort, short for Pathogen Portal, employs a generic, web-services based framework to deal with some of the problems identified by the bioinformatics community. The motivating research goal of a scalable system to provide data management and analysis for key pathosystems, especially relating to molecular data, has resulted in a generic framework using two major components. On the server-side, we employ web-services. On the client-side, a Java application called ToolBus acts as a client-side "bus" for contacting data and tools and viewing results through a single, consistent user interface.

Ginger augmented chemotherapy: A novel multitarget nontoxic approach for cancer management.

PubMed

Saxena, Roopali; Rida, Padmashree C G; Kucuk, Omer; Aneja, Ritu

2016-06-01

Cancer, referred to as the 'disease of civilization', continues to haunt humanity due to its dreadful manifestations and limited success of therapeutic interventions such as chemotherapy in curing the disease. Although effective, chemotherapy has repeatedly demonstrated inadequacy in disease management due to its debilitating side effects arising from its deleterious nonspecific effects on normal healthy cells. In addition, development of chemoresistance due to mono-targeting often results in cessation of chemotherapy. This urgently demands development and implementation of multitargeted alternative therapies with mild or no side effects. One extremely promising strategy that yet remains untapped in the clinic is augmenting chemotherapy with dietary phytochemicals or extracts. Ginger, depository of numerous bioactive molecules, not only targets cancer cells but can also mitigate chemotherapy-associated side effects. Consequently, combination therapy involving ginger extract and chemotherapeutic agents may offer the advantage of being efficacious with reduced toxicity. Here we discuss the remarkable and often overlooked potential of ginger extract to manage cancer, the possibility of developing ginger-based combinational therapies, and the major roadblocks along with strategies to overcome them in clinical translation of such inventions. We are optimistic that clinical implementation of such combination regimens would be a much sought after modality in cancer management. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation.

PubMed

Leijendekkers, Ruud A; van Hinte, Gerben; Nijhuis-van der Sanden, Maria Wg; Staal, J Bart

2017-02-01

In patients with a transfemoral amputation socket-related problems are associated with reduced prosthetic use, activity, and quality of life. Furthermore, gait asymmetries are present that may explain secondary complaints. Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are available, screw and press-fit implants. Rehabilitation following surgery for a press-fit BAP is poorly described. To describe a rehabilitation program designed to minimize compensation strategies and increase activity using a case-report of an active, 70-year-old man with a traumatic transfemoral amputation who had used a socket prosthesis for 52 years and received a press-fit BAP [Endo-Exo Femoral Prosthesis - EEFP]. A 13-week physiotherapy program. Outcomes were assessed before surgery, at the end of rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait had improved, the patient had more arm movement, more pelvic shift, less hip rotation during swing phase on the prosthetic side, and absence of vaulting on the sound side. Isometric hip abductor strength was 15% higher on the sound side and 16% higher on the prosthetic side, and walking distance increased from 200 m to 1500 m. At the six-month follow-up, the patient had lower back complications and reduced hip abductor strength and walking distance. At one-year follow-up, walking distance had recovered to 1000 m and gait pattern had improved again, with yielding and absence of terminal impact on the prosthetic side. The described rehabilitation program may be an effective method of improving gait in patients with an EEFP even after long-term socket usage.

STS-44 MS Musgrave looks out OV-104's side hatch viewport on middeck

NASA Technical Reports Server (NTRS)

1991-01-01

STS-44 Mission Specialist (MS) F. Story Musgrave, wearing communications kit assembly lightweight headset (HDST), looks out side hatch viewport on Atlantis', Orbiter Vehicle (OV) 104's, middeck. Just behind him is the waste management compartment (WMC). The stainless steel cylinder is the temporary wet trash can.

9. DETAIL VIEW OF BRIDGE CRANE ON WEST SIDE OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. DETAIL VIEW OF BRIDGE CRANE ON WEST SIDE OF BUILDING. CAMERA FACING NORTHEAST. CONTAMINATED AIR FILTERS LOADED IN TRANSPORT CASKS WERE TRANSFERRED TO VEHICLES AND SENT TO RADIOACTIVE WASTE MANAGEMENT COMPLEX FOR STORAGE. INEEL PROOF NUMBER HD-17-1. - Idaho National Engineering Laboratory, Old Waste Calcining Facility, Scoville, Butte County, ID

Efficacy of proximal colectomy for surgical management of right-sided first colorectal cancer in Lynch Syndrome mutation carriers.

PubMed

Hiatt, Molly J; Casey, Murray Joseph; Lynch, Henry T; Snyder, Carrie L; Stacey, Mark; Walters, Ryan W

2018-07-01

This study analyzes the occurrence of colorectal cancer (CRC) in Lynch syndrome (LS) mutation carriers, interval until diagnosis of metachronous CRC, and survival after proximal colectomy (PC) compared with total (TC) and subtotal colectomy (STC) for right-sided first CRC in LS mutation carriers. Sixty-four LS mutation carriers with right-sided first CRC treated with PC or TC + STC were confirmed by clinical records. Bivariate analyses were examined for significance and life tables were generated for risk of metachronous CRC and survival estimates following surgery. One of 16 (6.3%) mutation carriers treated with TC + STC developed subsequent CRC compared with 13/48 (27%) treated by PC. There was no significant difference in survival estimates between PC compared with TC + STC through 25 years after surgery. Risk of subsequent CRC and survival estimates following PC and TC + STC should be considered in surgical management of right-sided first CRC in LS mutation carriers. Copyright © 2017 Elsevier Inc. All rights reserved.

Management issues with exogenous steroid therapy

PubMed Central

Patt, Hiren; Bandgar, Tushar; Lila, Anurag; Shah, Nalini

2013-01-01

Glucocorticoids (GCs) are extensively used for various inflammatory and autoimmune disorders, but long term use of these agents is not without complications. Almost every GC formulations (e.g. oral, topical, inhaled, etc.) can cause systemic side effects. It can range from minor side effects (e.g. weight gain) to life-threatening effects (e.g. adrenal suppression, sepsis, etc.), which may require immediate intervention. Therefore, the decision to institute steroid therapy always requires careful consideration of the relative risk and benefit in each patient. The objectives of this study are to discuss monitoring of patients on GCs and management of the complications of GCs. PMID:24910822

Detecting and Managing Adverse Effects of Antipsychotic Medications: Current State of Play.

PubMed

Ames, Donna; Carr-Lopez, Sian M; Gutierrez, Mary A; Pierre, Joseph M; Rosen, Jennifer A; Shakib, Susan; Yudofsky, Lynn M

2016-06-01

Antipsychotics are some of the most frequently prescribed medications not only for psychotic disorders and symptoms but also for a wide range of on-label and off-label indications. Because second-generation antipsychotics have largely replaced first-generation antipsychotics as first-line options due to their substantially decreased risk of extrapyramidal side effects, attention has shifted to other clinically concerning adverse events associated with antipsychotic therapy. The focus of this article is to update the nonextrapyramidal side effects associated with second-generation antipsychotics. Issues surrounding diagnosis and monitoring as well as clinical management are addressed. Published by Elsevier Inc.

The Effects of Medicaid Policy Changes on Adults' Service Use Patterns in Kentucky and Idaho

PubMed Central

Marton, James; Kenney, Genevieve M.; Pelletier, Jennifer E.; Talbert, Jeffery; Klein, Ariel

2013-01-01

Background In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Methods Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. Results While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. Conclusions We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions. PMID:24800159

The effects of Medicaid policy changes on adults' service use patterns in Kentucky and Idaho.

PubMed

Marton, James; Kenney, Genevieve M; Pelletier, Jennifer E; Talbert, Jeffery; Klein, Ariel

2012-01-01

In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions.

14 CFR 91.1017 - Amending program manager's management specifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

14 CFR 91.1017 - Amending program manager's management specifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

Dual-opioid therapy: changing the paradigm. Introduction.

PubMed

Nicholson, Bruce D

2012-03-01

Morphine sulfate and oxycodone hydrochloride are commonly used for pain management because of their pharmacologic profile, pharmacokinetics, and analgesic potency. However, opioids are associated with a significant adverse event (AE) burden that limits their use in both the acute and the chronic pain settings. Co-administration of opioids demonstrated synergistic analgesia and reduced side effects. Thus, dual-opioid therapy has the potential to enhance the positive analgesic benefits of opioids, while limiting the burden of opioid-related AEs. This symposium proceedings was based on presentations at the 13th World Congress on Pain in August 2010. This program will review the rationale for dual-opioid therapy based on preclinical findings and data from clinical studies showing the efficacy and tolerability profile of a dual-opioid formulation when used to treat acute postoperative pain. Wiley Periodicals, Inc.

ARC-1969-A78-0077-5

NASA Image and Video Library

1978-01-27

Pioneer 10 and 11 Missions Jupiter encounters - Activities at Ames Research Center December 1973 and December 1974 - As a memento of the highly successful Pioneer 10 and 11 missions to Jupiter, this collection of photographs represents a sampling of those taken at Ames Research Center during the Jupiter encounter periods in December 1973 and December 1974. The captions for these photographs are meant to suggest the lighter side of the intense activities that took place during these periods. I would like to express my gratitude to all participants in the Pioneer 10/11 program for their teamwork in accomplishing the scientific and technical objectives of the Pioneer 10 and 11 missions to Jupiter. (signed) Charles F. Hall - Manager, Pioneer Project L-R: Dr. John H Wolfe, Robert R Nunamaker, Alfred M. Worden

SEAFLOOR EXPLORATION AND CHARACTERIZATION: PREREQUISITE TO OCEAN SPACE UTILIZATION.

USGS Publications Warehouse

Hill, Gary; Lockwood, Millington

1987-01-01

A historical survey of US bathymetric mapping is presented up through the major mapping project begun in response to the 1983, establishment of an Exclusive Economic Zone (EEZ), 200 nautical miles seaward. The EEZ extends sovereign rights for the purposes of exploring, exploiting, conserving, and managing natural resources in the coastal ocean. This new area is approximately 3. 4 million square nautical miles or about 1. 3 times the total US land area. To characterize the resources within it, the US National Oceanic and Atmospheric Administration (NOAA) and the US Geological Survey (USGS) are undertaking systematic mapping programs of the EEZ. NOAA's effort includes detailed bathymetric mapping of the seabed. The USGS is using a wide-swath side-scan sonar system to map the EEZ seafloor on a reconaissance scale.

Home Energy Management System - VOLTTRON Integration

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

Zandi, Helia

In most Home Energy Management Systems (HEMS) available in the market, different devices running different communication protocols cannot interact with each other and exchange information. As a result of this integration, the information about different devices running different communication protocol can be accessible by other agents and devices running on VOLTTRON platform. The integration process can be used by any HEMS available in the market regardless of the programming language they use. If the existing HEMS provides an Application Programming Interface (API) based on the RESTFul architecture, that API can be used for integration. Our candidate HEMS in this projectmore » is home-assistant (Hass). An agent is implemented which can communicate with the Hass API and receives information about the devices loaded on the API. The agent publishes the information it receives on the VOLTTRON message bus so other agents can have access to this information. On the other side, for each type of devices, an agent is implemented such as Climate Agent, Lock Agent, Switch Agent, Light Agent, etc. Each of these agents is subscribed to the messages published on the message bus about their associated devices. These agents can also change the status of the devices by sending appropriate service calls to the API. Other agents and services on the platform can also access this information and coordinate their decision-making process based on this information.« less

The role of the case manager in a disease management program.

PubMed

Huston, Carol J

2002-01-01

Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

The role of the case manager in a disease management program.

PubMed

Huston, C J

2001-01-01

Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

What are the career planning and development practices for nurses in hospitals? Is there a difference between private and public hospitals?

PubMed

Sonmez, Betul; Yildirim, Aytolan

2009-12-01

The aim was to determine the opinions of nurse managers about career planning and development for nurses in hospitals. Career planning and development are defined as an important and necessary tool in the development of nurses as professionals and in retaining nurses in a facility. A descriptive survey. The research population comprised nurse managers in 200+ bed hospitals on the European side of Istanbul province (n = 668). The entire population was targeted and 373 nurse managers were included in the study (55.8% return rate). Data were collected with a 32-item survey form that had three sections to determine the nurse managers' demographic characteristics, the career development practices at the facility where they worked, the nurse managers' responsibilities for career development and their expected competencies and recommendations. The findings of this study suggest that the most common technique used for nurses for career development was education programs, the career development practices of private hospitals were more developed than public hospitals and the nurse managers' perceptions about career development were different according to their management level, age group and educational level (p < 0.05). Although different practices were found in public and private hospitals in Turkey there were no effective career development practices identified and the nurse managers did not have agreement on the subject of career development. Hospitals which provide opportunity for horizontal and vertical promotion and have clear development policies will be successful hospitals which are preferred by high quality nurses. This study draws attention to the importance of career planning in nursing and the need for nurse managers to take an active role in career planning and development.

From Process Models to Decision Making: The Use of Data Mining Techniques for Developing Effect Decision Support Systems

NASA Astrophysics Data System (ADS)

Conrads, P. A.; Roehl, E. A.

2010-12-01

Natural-resource managers face the difficult problem of controlling the interactions between hydrologic and man-made systems in ways that preserve resources while optimally meeting the needs of disparate stakeholders. Finding success depends on obtaining and employing detailed scientific knowledge about the cause-effect relations that govern the physics of these hydrologic systems. This knowledge is most credible when derived from large field-based datasets that encompass the wide range of variability in the parameters of interest. The means of converting data into knowledge of the hydrologic system often involves developing computer models that predict the consequences of alternative management practices to guide resource managers towards the best path forward. Complex hydrologic systems are typically modeled using computer programs that implement traditional, generalized, physical equations, which are calibrated to match the field data as closely as possible. This type of model commonly is limited in terms of demonstrable predictive accuracy, development time, and cost. The science of data mining presents a powerful complement to physics-based models. Data mining is a relatively new science that assists in converting large databases into knowledge and is uniquely able to leverage the real-time, multivariate data now being collected for hydrologic systems. In side-by-side comparisons with state-of-the-art physics-based hydrologic models, the authors have found data-mining solutions have been substantially more accurate, less time consuming to develop, and embeddable into spreadsheets and sophisticated decision support systems (DSS), making them easy to use by regulators and stakeholders. Three data-mining applications will be presented that demonstrate how data-mining techniques can be applied to existing environmental databases to address regional concerns of long-term consequences. In each case, data were transformed into information, and ultimately, into knowledge. In each case, DSSs were developed that facilitated the use of simulation models and analysis of model output to a broad range of end users with various technical abilities. When compared to other modeling projects of comparable scope and complexity, these DSSs were able to pass through needed technical reviews much more quickly. Unlike programs such as finite-element flow models, DSSs are by design open systems that are easy to use and readily disseminated directly to decision makers. The DSSs provide direct coupling of predictive models with the real-time databases that drive them, graphical user interfaces for point-and-click program control, and streaming displays of numerical and graphical results so that users can monitor the progress of long-term simulations. Customizations for specific problems include numerical optimization loops that invert predictive models; integrations with a three-dimensional finite-element flow model, GIS packages, and a plant ecology model; and color contouring of simulation output data.

Managing orthopedics and neurosciences costs through standard treatment protocols.

PubMed

McGinnity, E S; Pluth, T E

1994-06-01

High-cost, high-volume specialty programs such as orthopedics and neurosciences find themselves in a position of evaluating the costs and in some cases the appropriateness of medical practices in response to payer scrutiny and provider selection processes. Orthopedics and neurosciences programs are at a stage of development analogous to that of cardiovascular care several years ago. Many of the same trends have come into play, such as payer "carve-outs" for orthopedic services, payer selection of centers of excellence based on cost and quality, reduction of Medicare reimbursement, greater use of high-cost technology, the decline of profitability due to "older, sicker, and tougher" patients, and the recent emergence of national orthopedic specialty networks oriented to national contracts for care. In an era in which payers demand value on both sides of the cost-plus-quality equation, programs are challenged to maximize the return on a patient population rife with "no-win" situations. In the orthopedic service line these include a high proportion of Medicare patients and chronic conditions such as workers' compensation medical back cases or repetitive motion injuries, which can be elusive to diagnose and expensive to treat. Many hospitals continue to lose money on joint replacement surgeries, the largest-volume orthopedic inpatient service, primarily because of the high Medicare population and the cost of implants. Neuroservices, while still relatively well reimbursed, face a rising proportion of Medicare payments as patients live longer and develop chronic, degenerative conditions. Inpatient days are decreasing due to payer pressures to limit hospital stays and to shift inpatient care to outpatient services. Some hospitals "have lost interest in (the orthopedic) service line during the last five years because of recent trends in orthopedic-related inpatient volume and payment." But by managing costs strategically, both the neurosciences and orthopedics service lines can provide substantial revenue as well as the opportunity to achieve a "center of excellence" competitive position in a managed care environment. This Special Report outlines the process and advantages of managing costs and quality of care strategically, that is, in a manner which helps these programs meet internal cost and clinical goals while responding to market situations. The hospital, physicians, and patients all benefit as costs are reduced, quality is enhanced, and the service line's competitive position is strengthened.

14 CFR 91.1411 - Continuous airworthiness maintenance program use by fractional ownership program manager.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program use by fractional ownership program manager. 91.1411 Section 91.1411 Aeronautics and Space FEDERAL... airworthiness maintenance program use by fractional ownership program manager. Fractional ownership program... through 91.1443. Any program manager who elects to maintain the program aircraft using a continuous...

The Future of Utility Customer-Funded Energy Efficiency Programs in the United States: Projected Spending and Savings to 2025

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

Barbose, Galen; Goldman, Charles; Hoffman, Ian

2012-09-11

We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the United States, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double frommore » 2010 levels to $9.5 billion in the medium case, compared to $15.6 billion in the high case and $6.5 billion in the low case. Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning. Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70% of total U.S. spending in 2010 to slightly more than 50% in 2025, with the South and Midwest splitting the remainder roughly evenly. Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the U.S. (which is about 0.5% of electric utility retail sales) to 28.8 TWh in 2025 (0.8% of retail sales). These savings would offset the majority of load growth in the Energy Information Administration’s most recent reference case forecast, given specific assumptions about the extent to which future energy efficiency program savings are captured in that forecast. However, the pathway that customer-funded efficiency programs ultimately take will depend on a series of key challenges and uncertainties associated both with the broader market and policy context and with the implementation and regulatory oversight of the energy efficiency programs themselves.« less

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda

PubMed Central

2013-01-01

Background Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Methods Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. Results The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher program with other services is likely to address some of the barriers. The public sector facilities were also seen as being well positioned to provide voucher services because of their countrywide reach, enhanced infrastructure, and referral networks. The voucher program also has the potential to address public sector constraints such as understaffing and supply shortages. Conclusions Accrediting public facilities has the potential to increase voucher program coverage by reaching a wider pool of poor mothers, shortening distance to service, strengthening linkages between public and private sectors through public-private partnerships and referral systems as well as ensuring the awareness and buy-in of policy makers, which is crucial for mobilization of resources to support the sustainability of the programs. Specifically, identifying policy champions and consulting with key policy sectors is key to the successful inclusion of the public sector into the voucher program. PMID:24139603

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda.

PubMed

Okal, Jerry; Kanya, Lucy; Obare, Francis; Njuki, Rebecca; Abuya, Timothy; Bange, Teresah; Warren, Charlotte; Askew, Ian; Bellows, Ben

2013-10-18

Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher program with other services is likely to address some of the barriers. The public sector facilities were also seen as being well positioned to provide voucher services because of their countrywide reach, enhanced infrastructure, and referral networks. The voucher program also has the potential to address public sector constraints such as understaffing and supply shortages. Accrediting public facilities has the potential to increase voucher program coverage by reaching a wider pool of poor mothers, shortening distance to service, strengthening linkages between public and private sectors through public-private partnerships and referral systems as well as ensuring the awareness and buy-in of policy makers, which is crucial for mobilization of resources to support the sustainability of the programs. Specifically, identifying policy champions and consulting with key policy sectors is key to the successful inclusion of the public sector into the voucher program.

Pulse Power Hybrid Energy Storage Module Development Program

DTIC Science & Technology

2015-05-01

consumed by the PFN. The energy stored in the HESM is displayed 12 as flywheel speed (RPM) against the right-side vertical axis . The flywheel speed...energy consumed by the PFN. The energy stored in the HESM is shown in Joules on the left-side vertical axis and in terms of flywheel speed (RPM) on the...right-side vertical axis . A noticeable difference in the charging variants is seen in the energy transfer through the HESM. Referring to Fig. 8, the

Cardiac side effects of bruton tyrosine kinase (BTK) inhibitors.

PubMed

Tang, Chloe Pek Sang; McMullen, Julie; Tam, Constantine

2017-09-13

The development of bruton tyrosine kinase inhibitors (BTKi) has been a significant advancement in the treatment of chronic lymphocytic leukemia and related B-cell malignancies. As experience in using ibrutinib increased, the first drug to be licensed in its class, atrial fibrillation (AF) emerged as an important side effect. The intersection between BTKi therapy for B-cell malignancies and AF represents a complex area of management with scant evidence for guidance. Consideration needs to be taken regarding the interplay of increased bleeding risk versus thromboembolic complications of AF, drug interactions between ibrutinib and anticoagulants and antiarrhythmic agents, and the potential for other, as yet seldom reported cardiac side effects. This review describes the current knowledge regarding BTKi and potential pathophysiologic mechanisms of AF and discusses the management of BTKi-associated AF. Finally, a review of the second generation BTKi is provided and gaps in knowledge in this evolving field are highlighted.

A Virtual World Versus Face-to-Face Intervention Format to Promote Diabetes Self-Management Among African American Women: A Pilot Randomized Clinical Trial

PubMed Central

Heyden, Robin; Mejilla, Roanne; Capelson, Roberta; Chalmers, Karen A; Rizzo DePaoli, Maria; Veerappa, Chetty; Wiecha, John M

2014-01-01

Background Virtual world environments have the potential to increase access to diabetes self-management interventions and may lower cost. Objective We tested the feasibility and comparative effectiveness of a virtual world versus a face-to-face diabetes self-management group intervention. Methods We recruited African American women with type 2 diabetes to participate in an 8-week diabetes self-management program adapted from Power to Prevent, a behavior-change in-person group program for African Americans with diabetes or pre-diabetes. The program is social cognitive theory–guided, evidence-based, and culturally tailored. Participants were randomized to participate in the program via virtual world (Second Life) or face-to-face, both delivered by a single intervention team. Blinded assessors conducted in-person clinical (HbA1c), behavioral, and psychosocial measurements at baseline and 4-month follow-up. Pre-post differences within and between intervention groups were assessed using t tests and chi-square tests (two-sided and intention-to-treat analyses for all comparisons). Results Participants (N=89) were an average of 52 years old (SD 10), 60% had ≤high school, 82% had household incomes

People and Process: Managing the Human Side of Information Technology Application. Professional Paper Series, #7.

ERIC Educational Resources Information Center

Baltzer, Jan A.

Recognizing that the hard part of making the application of technology successful is the development of appropriate management structures and approaches, this paper reviews the research and writings of several top management and communications professionals and correlates these theories to the information technology environment on campus. Six…

Preparing the Host Country Workforce for Expatriate Managers: The Neglected Other Side of the Coin.

ERIC Educational Resources Information Center

Vance, Charles M.; Ring, Peter Smith

1994-01-01

Using an instructional systems development approach, ways to prepare the host country workforce for the assignment of an expatriate manager are discussed. The model is based on a number of perspectives: exchange theory, participatory management, corporate social responsibility, communication theory, and strategic human resource planning. (SK)

Indigenous Specializations: Dreams, Developments, Delivery and Vision

ERIC Educational Resources Information Center

Richardson, Cathy; Thomas, Robina; Green, Jacquie; Ormiston, Todd

2012-01-01

This article documents the establishment of the Indigenous Specializations program in the School of Social Work at the University of Victoria. In the absence of funding for Indigenous programs, First Nations professors Robina Thomas and Jacquie Green developed the Indigenous Specializations program "off the side of their desk". This…

Landscape assessment of side channel plugs and associated cumulative side channel attrition across a large river floodplain

USGS Publications Warehouse

Reinhold, Ann Marie; Poole, Geoffrey C.; Bramblett, Robert G.; Zale, Alexander V.; Roberts, David W.

2018-01-01

Determining the influences of anthropogenic perturbations on side channel dynamics in large rivers is important from both assessment and monitoring perspectives because side channels provide critical habitat to numerous aquatic species. Side channel extents are decreasing in large rivers worldwide. Although riprap and other linear structures have been shown to reduce side channel extents in large rivers, we hypothesized that small “anthropogenic plugs” (flow obstructions such as dikes or berms) across side channels modify whole-river geomorphology via accelerating side channel senescence. To test this hypothesis, we conducted a geospatial assessment, comparing digitized side channel areas from aerial photographs taken during the 1950s and 2001 along 512 km of the Yellowstone River floodplain. We identified longitudinal patterns of side channel recruitment (created/enlarged side channels) and side channel attrition (destroyed/senesced side channels) across n = 17 river sections within which channels were actively migrating. We related areal measures of recruitment and attrition to the density of anthropogenic side channel plugs across river sections. Consistent with our hypothesis, a positive spatial relationship existed between the density of anthropogenic plugs and side channel attrition, but no relationship existed between plug density and side channel recruitment. Our work highlights important linkages among side channel plugs and the persistence and restoration of side channels across floodplain landscapes. Specifically, management of small plugs represents a low-cost, high-benefit restoration opportunity to facilitate scouring flows in side channels to enable the persistence of these habitats over time.

Handbook of evaluation of utility DSM programs. [Demand-Side Management (DSM)

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

Hirst, E.; Reed, J.; Bronfman, B.

Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility's portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough tomore » highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to triangulate'' an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.« less

An investigation of constraint-based component-modeling for knowledge representation in computer-aided conceptual design

NASA Technical Reports Server (NTRS)

Kolb, Mark A.

1990-01-01

Originally, computer programs for engineering design focused on detailed geometric design. Later, computer programs for algorithmically performing the preliminary design of specific well-defined classes of objects became commonplace. However, due to the need for extreme flexibility, it appears unlikely that conventional programming techniques will prove fruitful in developing computer aids for engineering conceptual design. The use of symbolic processing techniques, such as object-oriented programming and constraint propagation, facilitate such flexibility. Object-oriented programming allows programs to be organized around the objects and behavior to be simulated, rather than around fixed sequences of function- and subroutine-calls. Constraint propagation allows declarative statements to be understood as designating multi-directional mathematical relationships among all the variables of an equation, rather than as unidirectional assignments to the variable on the left-hand side of the equation, as in conventional computer programs. The research has concentrated on applying these two techniques to the development of a general-purpose computer aid for engineering conceptual design. Object-oriented programming techniques are utilized to implement a user-extensible database of design components. The mathematical relationships which model both geometry and physics of these components are managed via constraint propagation. In addition, to this component-based hierarchy, special-purpose data structures are provided for describing component interactions and supporting state-dependent parameters. In order to investigate the utility of this approach, a number of sample design problems from the field of aerospace engineering were implemented using the prototype design tool, Rubber Airplane. The additional level of organizational structure obtained by representing design knowledge in terms of components is observed to provide greater convenience to the program user, and to result in a database of engineering information which is easier both to maintain and to extend.

Dynamic Flow Management Problems in Air Transportation

NASA Technical Reports Server (NTRS)

Patterson, Sarah Stock

1997-01-01

In 1995, over six hundred thousand licensed pilots flew nearly thirty-five million flights into over eighteen thousand U.S. airports, logging more than 519 billion passenger miles. Since demand for air travel has increased by more than 50% in the last decade while capacity has stagnated, congestion is a problem of undeniable practical significance. In this thesis, we will develop optimization techniques that reduce the impact of congestion on the national airspace. We start by determining the optimal release times for flights into the airspace and the optimal speed adjustment while airborne taking into account the capacitated airspace. This is called the Air Traffic Flow Management Problem (TFMP). We address the complexity, showing that it is NP-hard. We build an integer programming formulation that is quite strong as some of the proposed inequalities are facet defining for the convex hull of solutions. For practical problems, the solutions of the LP relaxation of the TFMP are very often integral. In essence, we reduce the problem to efficiently solving large scale linear programming problems. Thus, the computation times are reasonably small for large scale, practical problems involving thousands of flights. Next, we address the problem of determining how to reroute aircraft in the airspace system when faced with dynamically changing weather conditions. This is called the Air Traffic Flow Management Rerouting Problem (TFMRP) We present an integrated mathematical programming approach for the TFMRP, which utilizes several methodologies, in order to minimize delay costs. In order to address the high dimensionality, we present an aggregate model, in which we formulate the TFMRP as a multicommodity, integer, dynamic network flow problem with certain side constraints. Using Lagrangian relaxation, we generate aggregate flows that are decomposed into a collection of flight paths using a randomized rounding heuristic. This collection of paths is used in a packing integer programming formulation, the solution of which generates feasible and near-optimal routes for individual flights. The algorithm, termed the Lagrangian Generation Algorithm, is used to solve practical problems in the southwestern portion of United States in which the solutions are within 1% of the corresponding lower bounds.

Job Shadowing Introduces the Realities of Manufacturing

ERIC Educational Resources Information Center

Frawley, Thomas A.

2009-01-01

Engineers and skilled tradesmen stood side by side with executives and politicians as Liverpool High School technology teacher Dan Drogo welcomed parents to a one-of-a-kind graduation ceremony at New Process Gear in Syracuse, New York. The manufacturing shadow program had immersed 25 high school students in an intensive five-week experience inside…

Server-Side Includes Made Simple.

ERIC Educational Resources Information Center

Fagan, Jody Condit

2002-01-01

Describes server-side include (SSI) codes which allow Webmasters to insert content into Web pages without programming knowledge. Explains how to enable the codes on a Web server, provides a step-by-step process for implementing them, discusses tags and syntax errors, and includes examples of their use on the Web site for Southern Illinois…

FX-87 performance measurements: data-flow implementation. Technical report

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

Hammel, R.T.; Gifford, D.K.

1988-11-01

This report documents a series of experiments performed to explore the thesis that the FX-87 effect system permits a compiler to schedule imperative programs (i.e., programs that may contain side-effects) for execution on a parallel computer. The authors analyze how much the FX-87 static effect system can improve the execution times of five benchmark programs on a parallel graph interpreter. Three of their benchmark programs do not use side-effects (factorial, fibonacci, and polynomial division) and thus did not have any effect-induced constraints. Their FX-87 performance was comparable to their performance in a purely functional language. Two of the benchmark programsmore » use side effects (DNA sequence matching and Scheme interpretation) and the compiler was able to use effect information to reduce their execution times by factors of 1.7 to 5.4 when compared with sequential execution times. These results support the thesis that a static effect system is a powerful tool for compilation to multiprocessor computers. However, the graph interpreter we used was based on unrealistic assumptions, and thus our results may not accurately reflect the performance of a practical FX-87 implementation. The results also suggest that conventional loop analysis would complement the FX-87 effect system« less

20 CFR 632.76 - Program management systems.

Code of Federal Regulations, 2010 CFR

2010-04-01

... NATIVE AMERICAN EMPLOYMENT AND TRAINING PROGRAMS Program Design and Management § 632.76 Program management systems. (a) All Native American grantees shall establish management information systems to... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Program management systems. 632.76 Section...

Comparison of cellulosic ethanol yields from midwestern maize and reconstructed tallgrass prairie systems managed for bioenergy

USDA-ARS?s Scientific Manuscript database

Maize- and prairie-based systems were investigated as cellulosic feedstocks by conducting a 9 ha side-by-side comparison on fertile soils in the Midwestern United States. Maize was grown continuously with adequate fertilization over years both with and without a winter rye cover crop, and the 31-spe...

Managing Element Interactivity in Equation Solving

ERIC Educational Resources Information Center

Ngu, Bing Hiong; Phan, Huy P.; Yeung, Alexander Seeshing; Chung, Siu Fung

2018-01-01

Between two popular teaching methods (i.e., balance method vs. inverse method) for equation solving, the main difference occurs at the operational line (e.g., +2 on both sides vs. -2 becomes +2), whereby it alters the state of the equation and yet maintains its equality. Element interactivity occurs on both sides of the equation in the balance…

75 FR 18572 - Supplemental Environmental Impact Statement for Sequoyah Nuclear Plant Units 1 and 2 License...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... the carbon emissions of its generating system and take advantage of lower carbon dioxide-emitting.... The SEIS will include examination of a range of supply-side and demand- side management options for... both the scope of alternatives and environmental issues that should be addressed as part of the SEIS...

The Bright and Dark Side Correlates of Creativity: Demographic, Ability, Personality Traits and Personality Disorders Associated with Divergent Thinking

ERIC Educational Resources Information Center

Furnham, Adrian

2015-01-01

This research examined the personality trait and personality disorder correlates of creative potential, as assessed by a divergent thinking (DT) test. Over 4,000 adult managers attending an assessment center completed a battery of tests including a "bright side," normal personality trait measures (NEO Personality Inventory-Revised, or…

Side-branch wire entrapment during bifurcation PCI: avoidance and management.

PubMed

Burns, Andrew T; Gutman, Jack; Whitbourn, Rob

2010-02-15

An LAD/D1 bifurcation intervention was complicated by side-branch wire entrapment and unravelling requiring goose-neck snare removal. Residual microfilaments were retrieved from the main branch after further balloon inflations with a satisfactory final angiographic result and one-year follow-up. Various methods are available to avoid and deal with this complication.

Medication adherence and subjective weight perception in patients with first-episode psychotic disorder.

PubMed

Wong, Mimi M C; Chen, E Y H; Lui, Simon S Y; Tso, Steve

2011-10-01

Medication adherence is critical to the management of psychotic disorder. Different factors associated with medication adherence have been investigated in previous studies. However, the association with subjective weight perception, which is related to the weight gain side effect of antipsychotics, has not been thoroughly investigated. Subjective weight perception may not equal objective weight status. This study tests the hypothesis that medication adherence is related to subjective weight perception in a group of patients with first-episode psychotic disorder who have taken antipsychotics for one year. This study recruited 160 participants with one-year histories of first-episode psychotic disorder and measured their actual and perceived weights, amount of weight gain in the past year, body size satisfaction and medication adherence levels. The associations between medication adherence and both the actual and perceived weight status were analyzed controlling for other confounding factors including insight, drug attitude, illness severity and other medication side effects. Stepwise multiple regression analysis found that the participants' perceived weight status, negative attitude toward their drugs and insight were the major factors associated with poor medication adherence. Of the participants who perceived themselves as being overweight, 86% believed that antipsychotics were responsible. Among those who had such beliefs, 72% had reduced their antipsychotic dosages on their own. About half of the participants had gained more than 7% of their baseline weight and 43.1% of the participants were found to be overweight after one year of treatment with antipsychotics. The results of this study indicate that medication adherence is associated with perceived weight status. Healthcare professionals should be aware of this relationship and address this issue early in the management of patients. Apart from weight management programs, education on a correct weight perception should be carried out with the promotion of proper drug attitudes and better insight for the improvement of medication adherence in the early course of psychotic disorder.

48 CFR 1301.671 - Assignment of program and project managers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... project managers. 1301.671 Section 1301.671 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE..., and Responsibilities 1301.671 Assignment of program and project managers. The Department's Program and Project Manager certification program for the assignment and certification of Program and Project Managers...

KENNEDY SPACE CENTER, FLA. -- NASA and United Space Alliance (USA) Space Shuttle program managers attend a briefing, part of activities during a leadership workday. The day is intended to provide management with an in-depth, hands-on look at Shuttle processing activities at KSC. Starting third from left are NASA Deputy Associate Administrator for Space Station and Shuttle Programs Michael Kostelnik, USA Vice President and Space Shuttle Program Manager Howard DeCastro, NASA Space Shuttle Program Manager William Parsons, and USA Associate Program Manager of Ground Operations Andy Allen.

NASA Image and Video Library

2003-12-19

KENNEDY SPACE CENTER, FLA. -- NASA and United Space Alliance (USA) Space Shuttle program managers attend a briefing, part of activities during a leadership workday. The day is intended to provide management with an in-depth, hands-on look at Shuttle processing activities at KSC. Starting third from left are NASA Deputy Associate Administrator for Space Station and Shuttle Programs Michael Kostelnik, USA Vice President and Space Shuttle Program Manager Howard DeCastro, NASA Space Shuttle Program Manager William Parsons, and USA Associate Program Manager of Ground Operations Andy Allen.

Move it or Lose it. Is it Reasonable for Older Adults with Osteoarthritis to Continue to Use Paracetamol in Order to Maintain Physical Activity?

PubMed

Lee, Kayla; Cooke, Julie; Cooper, Gabrielle; Shield, Alison

2017-06-01

Osteoarthritis is a common progressive disease in older adults, and those affected often have impaired physical function, co-existing disease states, and reduced quality of life. In patients with osteoarthritis, pain is reported as a primary cause of mobility limitation, and guidelines recommend a mix of pharmacologic and non-pharmacologic strategies for pain management. The benefits of exercise in the management of osteoarthritis are well established; however, pain appears to be the biggest barrier to patients engaging in, and adhering to, physical activity programs. Attitudes towards the use of pain medications differ widely, and lack of efficacy or fear of side effects may lead to sub-therapeutic dosing. Furthermore, a recent review suggesting that short-term paracetamol use is ineffective for osteoarthritis has added to the confusion. This narrative review investigates limitations of current medications, summarizes patient attitudes toward the use of analgesics for osteoarthritis pain (with a focus on paracetamol), and explores the uptake of physical activity for osteoarthritis management. Evidence suggests that, despite clear guidelines, symptoms of osteoarthritis generally remain poorly managed. More research is required to investigate clinical outcomes in patients with osteoarthritis through optimized medication plans to better understand whether longer-term analgesic use in conjunction with physical activity can assist patients to overcome mobility limitations.

Key articles and guidelines in the management of pulmonary arterial hypertension: 2011 update.

PubMed

Johnson, Samuel G; Kayser, Steven R; Attridge, Rebecca L; Duvall, Laura; Kiser, Tyree H; Moote, Rebecca; Reed, Brent N; Rodgers, Jo E; Erstad, Brian

2012-06-01

Pharmacotherapeutic approaches for the management of pulmonary arterial hypertension (PAH) have expanded greatly in the last 10 years. Pulmonary arterial hypertension is a relatively rare disease and is associated with myriad disease processes. The older term for PAH, primary PAH, has been changed to represent these differences and to distinguish it from postcapillary PAH associated with left-sided heart failure. Limitations in evaluating treatment approaches for PAH include its rarity, the small number of patients included in clinical trials, and issues regarding the use of placebo-controlled trials in a disease with such a high mortality rate if left untreated. Management options include the use of prostacyclin and prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase inhibitors, as well as traditional background therapy with diuretics, digoxin, calcium channel blockers, and warfarin. Numerous drugs are under investigation to evaluate their possible roles in management. Combination therapy is increasingly becoming a standard approach to therapy, with mounting literature to document effectiveness. Current or emerging roles for the pharmacist in the management of PAH largely involves ensuring access to drug therapy, facilitating specialty pharmacy dispensing, and providing patient counseling. Newer roles may include future drug development, optimized use of investigational drugs, and specialized disease management programs. This compilation includes a series of articles identifying important literature in cardiovascular pharmacotherapy. This bibliography focuses on pharmacotherapeutic management of pulmonary arterial hypertension (PAH). Most of the cited works present the results of significant human clinical studies that have shaped the management of patients with PAH. Limited primary literature is available for some topics, so in addition, consensus documents prepared by expert panels are reviewed. This compilation may serve as a teaching tool, reference resource, or update of the literature for pharmacy clinicians, physicians, and students. © 2012 Pharmacotherapy Publications, Inc.

Integrating personal medicine into service delivery: empowering people in recovery.

PubMed

MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

2013-12-01

Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Gymnema sylvestre for Diabetes: From Traditional Herb to Future's Therapeutic.

PubMed

Tiwari, Pragya; Ahmad, Khurshid; Baig, Mohammad Hassan

2017-01-01

Diabetes has increased at an unprecedented rate and is fast emerging as a global threat worldwide. The focus on pharmacological studies pertaining to diabetes has seen a remarkable shift from conventional medicines to therapeutics employing bioactive phytomolecules from natural sources. The prospective effectiveness of natural products together with their low cost and minimal side effects has revolutionized the entire concept of drug discovery and management programs. One such beneficial herb is Gymnema sylvestre, possessing remarkable hypoglycemic properties and forms the platform of diabetes therapeutics in the traditional system of medication. The present article discusses the significance of G. sylvestre in diabetes management, the herbal-formulations from the herb together with its standardization and clinical trials on animal models, and why Peroxisome Proliferator Activated Receptor gamma (PPARγ) may serve as a prospective molecular target for Gymnemic acid analogs. Such studies would define the molecular basis of bioactive molecules which would aid in the development of natural product based therapeutics in the treatment of diabetes. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management. Part 1

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

Not Available

This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management.

14 CFR 91.1049 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Management § 91.1049 Personnel. (a) Each program manager and each fractional owner must use in program... regulations. The program manager must provide oversight of those crews. (b) Each program manager must employ...) Program manager flight, duty, and rest time considerations, and in all cases within the limits set forth...

The Goddard High Resolution Spectrograph Scientific Support Contract

NASA Technical Reports Server (NTRS)

1997-01-01

In 1988, Computer Sciences Corporation (CSC) was selected as the Goddard High Resolution Spectrograph (GHRS) Scientific Support Contractor (SSC). This was to have been a few months before the launch of NASA's first Great Observatory, the Hubble Space Telescope (HST). As one of five scientific instruments on HST, the GHRS was designed to obtain spectra in the 1050-3300 A ultraviolet wavelength region with a resolving power, lambda/Delta(lambda) , of up to 100,000 and relative photometric accuracy to 1%. It was built by Ball AeroSpace Systems Group under the guidance of the GHRS Investigation Definition Team (IDT), comprised of 16 scientists from the US and Canada. After launch, the IDT was to perform the initial instrument calibration and execute a broad scientific program during a five-year Guaranteed Time Observation (GTO) period. After a year's delay, the launch of HST occurred in April 1990, and CSC participated in the in-orbit calibration and first four years of GTO observations with the IDT. The HST primary mirror suffered from spherical aberration, which reduced the spatial and spectral resolution of Large Science Aperture (LSA) observations and decreased the throughput of the Small Science Aperture (SSA) by a factor of two. Periodic problems with the Side 1 carrousel electronics and anomalies with the low-voltage power supply finally resulted in a suspension of the use of Side 1 less than two years after launch. At the outset, the GHRS SSC task involved work in four areas: 1) to manage and operate the GHRS Data Analysis Facility (DAF); 2) to support the second Servicing Mission Observatory Verification (SMOV) program, as well as perform system engineering analysis of the GHRS as nesessary; 3) to assist the GHRS IDT with their scientific research programs, particularly the GSFC members of the team, and 4) to provide administrative and logistic support for GHRS public information and educational activities.

Global HIV/AIDS funding and health systems: Searching for the win-win.

PubMed

Levine, Ruth; Oomman, Nandini

2009-11-01

Donors, developing country governments, and NGOs are searching for ways to use funding for HIV/AIDS programs that strengthen the functioning of weak health systems. This is motivated both by the realization that a large share of donor funding for global health is and will continue to be dedicated to HIV/AIDS, and that the aims of more and better treatment, prevention, and care can be achieved only with attention to systemic capacities. For AIDS resources to strengthen health systems, decision makers should: (a) mitigate the risks that AIDS spending may weaken the ability of health systems to respond to other health problems; (b) find ways for procurement, supply chain, management information, and other systems that are created to support AIDS treatment to be broadened to serve other types of services; and (c) build upon the ways in which AIDS programs have overcome some demand-side barriers to use of services. In pursuing this agenda, donors should recognize that health system development is a function of the national and local political economy and place respect for national sovereignty as a central tenet of their policies and practices.

Multimodal pediatric pain management (part 2).

PubMed

Friedrichsdorf, Stefan J

2017-05-01

Dr Stefan Friedrichsdorf speaks to Commissioning Editor Jade Parker: Stefan Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota in Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The pain and palliative care program is devoted to control acute, chronic/complex and procedural pain for inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota. The team also provides holistic, interdisciplinary care for children and teens with life limiting or terminal diseases and their families. Integrative medicine provides and teaches integrative, nonpharmacological therapies (such as massage, acupuncture/acupressure, biofeedback, aromatherapy and self-hypnosis) to provide care that promotes optimal health and supports the highest level of functioning in all individual children's activities. In this second part of the interview they discuss multimodal (opioid-sparing) analgesia for hospitalized children in pain and how analgesics and adjuvant medications, interventions, rehabilitation, psychological and integrative therapies act synergistically for more effective pediatric pain control with fewer side effects than a single analgesic or modality.

Scheduling Guide for Program Managers

DTIC Science & Technology

2001-10-01

58 Chapter 8 TIME MANAGEMENT ....................................................................................... 59...8.1 Time Management and the Program...60 8.2 Time Management and the Program Manager

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options.

PubMed

Gordon, Karen; Henkin, Yael; Kral, Andrej

2015-07-01

Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an "aural preference syndrome" in which single-sided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence. Copyright © 2015 by the American Academy of Pediatrics.

Effects of fire and fuels management on water quality in eastern North America

Treesearch

R. K. Kolka

2012-01-01

Fuels management, especially prescribed fire, can have direct impacts on aquatic resources through deposition of ash to surface waters. On the terrestrial side, fuels management leads to changes in vegetative structure and potentially soil properties that affect ecosystem cycling of water and inorganic and organic constituents. Because surface water systems (streams,...

Managed competition in health care and the unfinished agenda

PubMed Central

Enthoven, Alain C.

1986-01-01

A market made up of health care financing and delivery plans and individual consumers, without a carefully drawn set of rules to mitigate market failures, and without mediation by collective action on the demand side, cannot produce efficiency and equity. The concept of competition that can achieve these goals, at least to a satisfactory approximation, is managed competition, with intelligent active agents on the demand side, called sponsors, that contract with the competing health care plans and continuously structure and adjust the market to overcome its tendencies to failure. A great deal remains to be done to achieve the goals envisioned by the “procompetition reformers.” PMID:10311922

A Proposal of Product Development Collaboration Method Using User Support Information and its Experimental Evaluation

NASA Astrophysics Data System (ADS)

Tanaka, Mitsuru; Kataoka, Masatoshi; Koizumi, Hisao

As the market changes more rapidly and new products continue to get more complex and multifunctional, product development collaboration with competent partners and leading users is getting more important to come up with new products that are successful in the market in a timely manner. ECM (engineering chain management) and SCM (supply chain management) are supply-side approaches toward this collaboration. In this paper, we propose a demand-side approach toward product development collaboration with users based on the information gathered through user support interactions. The approach and methodology proposed here was applied to a real data set, and its effectiveness was verified.

Towards smart environments using smart objects.

PubMed

Sedlmayr, Martin; Prokosch, Hans-Ulrich; Münch, Ulli

2011-01-01

Barcodes, RFID, WLAN, Bluetooth and many more technologies are used in hospitals. They are the technological bases for different applications such as patient monitoring, asset management and facility management. However, most of these applications exist side by side with hardly any integration and even interoperability is not guaranteed. Introducing the concept of smart objects inspired by the Internet of Things can improve the situation by separating the capabilities and functions of an object from the implementing technology such as RFID or WLAN. By aligning technological and business developments smart objects have the power to transform a hospital from an agglomeration of technologies into a smart environment.

Management of side effects during and post-treatment in breast cancer survivors.

PubMed

Palesh, Oxana; Scheiber, Caroline; Kesler, Shelli; Mustian, Karen; Koopman, Cheryl; Schapira, Lidia

2018-03-01

Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are commonly experienced symptoms that share psychological and physical manifestations. One or more of these symptoms will affect nearly all patients at some point during their course of treatment or survivorship. These side effects are burdensome and reduce patients' quality of life well beyond their cancer diagnosis and associated care treatments. Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are likely to have multiple etiologies that make it difficult to identify the most effective method to manage them. In this review, we summarized the information on cancer-related fatigue, insomnia, and cancer-related cognitive impairment incidence and prevalence among breast cancer patients and survivors as well as recent research findings on pharmaceutical, psychological, and exercise interventions that have shown effectiveness in the treatment of these side effects. Our review revealed that most current pharmaceutical interventions tend to ameliorate symptoms only temporarily without addressing the underlying causes. Exercise and behavioral interventions are consistently more effective at managing chronic symptoms and possibly address an underlying etiology. Future research is needed to investigate effective interventions that can be delivered directly in clinic to a large portion of patients and survivors. © 2017 Wiley Periodicals, Inc.

A Diamond in the Rough: Carat's Organizational and Administrative Leadership (COAL) Program

ERIC Educational Resources Information Center

Brown, Kathleen M.; Schainker, Stanley A.

2006-01-01

A diamond is a chunk of coal that stood up under pressure. Carat's Organizational and Administrative Leadership (COAL) program is a diamond in the rough--experiencing strong political pressure from multiple sides. As the state's premiere educational leadership preparation program, expectations are high. While striving to live up to its national…

Read Hard, Play Later: Putting Summer Reading into Action.

ERIC Educational Resources Information Center

Wemett, Lisa C.; Bolan, Kimberly

1998-01-01

Provides an overview of "Read on the Wild Side," a summer reading program for young adults established by the Webster (New York) Public Library, and "Read Hard, Play Later," a young adult summer reading program of the Pioneer Library System (New York). Highlights include reading logs, T-shirts, publicity, program evaluation,…

PUZZLE - A program for computer-aided design of printed circuit artwork

NASA Technical Reports Server (NTRS)

Harrell, D. A. W.; Zane, R.

1971-01-01

Program assists in solving spacing problems encountered in printed circuit /PC/ design. It is intended to have maximum use for two-sided PC boards carrying integrated circuits, and also aids design of discrete component circuits.

Would you admit your mother to the residency service? Introducing the JCHIMP resident safety column.

PubMed

Foster, Paul N

2014-01-01

There remain tremendous opportunities to improve the stability and safety of American health care. Within this context, residents and residency programs face two essential questions: how to reduce the risk to patients resulting from resident inexperience, and how to change our programs to create the safer physician of the future? The spread of side-by-side teaching and non-teaching services creates a natural setting to study these questions and improve both services. When asked the question, "Would you admit your mother to the resident service?", many of us respond, "It depends". We are focusing this column on helping programs answer this question definitively in the positive, share potential best practices, and underscore community hospital's contribution to our understanding of patient safety.

Spatial decision supporting for winter wheat irrigation and fertilizer optimizing in North China Plain

NASA Astrophysics Data System (ADS)

Yang, Xiaodong; Yang, Hao; Dong, Yansheng; Yu, Haiyang

2014-11-01

Production management of winter wheat is more complicated than other crops since its growth period is covered all four seasons and growth environment is very complex with frozen injury, drought, insect or disease injury and others. In traditional irrigation and fertilizer management, agricultural technicians or farmers mainly make decision based on phenology, planting experience to carry out artificial fertilizer and irrigation management. For example, wheat needs more nitrogen fertilizer in jointing and booting stage by experience, then when the wheat grow to the two growth periods, the farmer will fertilize to the wheat whether it needs or not. We developed a spatial decision support system for optimizing irrigation and fertilizer measures based on WebGIS, which monitoring winter wheat growth and soil moisture content by combining a crop model, remote sensing data and wireless sensors data, then reasoning professional management schedule from expert knowledge warehouse. This system is developed by ArcIMS, IDL in server-side and JQuery, Google Maps API, ASP.NET in client-side. All computing tasks are run on server-side, such as computing 11 normal vegetable indexes (NDVI/ NDWI/ NDWI2/ NRI/ NSI/ WI/ G_SWIR/ G_SWIR2/ SPSI/ TVDI/ VSWI) and custom VI of remote sensing image by IDL; while real-time building map configuration file and generating thematic map by ArcIMS.

Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology

PubMed Central

Dreno, B; Bensadoun, RJ; Humbert, P; Krutmann, J; Luger, T; Triller, R; Rougier, A; Seité, S

2013-01-01

Currently, numerous patients who receive targeted chemotherapy for cancer suffer from disabling skin reactions due to cutaneous toxicity, which is a significant problem for an increasing number of patients and their treating physicians. In addition, using inappropriate personal hygiene products often worsens these otherwise manageable side-effects. Cosmetic products for personal hygiene and lesion camouflage are part of a patients’ well-being and an increasing number of physicians feel that they do not have adequate information to provide effective advice on concomitant cosmetic therapy. Although ample information is available in the literature on pharmaceutical treatment for cutaneous side-effects of chemotherapy, little is available for the concomitant use of dermatological skin-care products with medical treatments. The objective of this consensus study is to provide an algorithm for the appropriate use of dermatological cosmetics in the management of cutaneous toxicities associated with targeted chemotherapy such as epidermal growth factor receptor inhibitors and other monoclonal antibodies. These guidelines were developed by a French and German expert group of dermatologists and an oncologist for oncologists and primary care physicians who manage oncology patients. The information in this report is based on published data and the expert group’s opinion. Due to the current lack of clinical evidence, only a review of published recommendations including suggestions for concomitant cosmetic use was conducted. PMID:23368717

Differential Learning as a Key Training Approach to Improve Creative and Tactical Behavior in Soccer.

PubMed

Santos, Sara; Coutinho, Diogo; Gonçalves, Bruno; Schöllhorn, Wolfgang; Sampaio, Jaime; Leite, Nuno

2018-03-01

The aim of this study was to identify the effects of a differential-learning program, embedded in small-sided games, on the creative and tactical behavior of youth soccer players. Forty players from under-13 (U13) and under-15 (U15) were allocated into control and experimental groups and were tested using a randomized pretest to posttest design using small-sided games situations. The experimental group participated in a 5-month differential-learning program embodied in small-sided games situations, while the control group participated in a typical small-sided games training program. In-game creativity was assessed through notational analyses of the creative components, and the players' positional data were used to compute tactical-derived variables. The findings suggested that differential learning facilitated the development of creative components, mainly concerning attempts (U13, small; U15, small), versatility (U13, moderate; U15, small), and originality (U13, unclear; U15, small) of players' actions. Likewise, the differential-learning approach provided a decrease in fails during the game in both experimental groups (moderate). Moreover, differential learning seemed to favor regularity in pitch-positioning behavior for the distance between players' dyads (U13, small; U15, small), the distance to the team target (U13, moderate; U15, small), and the distance to the opponent target (U13, moderate; U15, small). The differential-learning program stressed creative and positional behavior in both age groups with a distinct magnitude of effects, with the U13 players demonstrating higher improvements over the U15 players. Overall, these findings confirmed that the technical variability promoted by differential learning nurtures regularity of positioning behavior.

On Viviani's Theorem and Its Extensions

ERIC Educational Resources Information Center

Abboud, Elias

2010-01-01

Viviani's theorem states that the sum of distances from any point inside an equilateral triangle to its sides is constant. Here, in an extension of this result, we show, using linear programming, that any convex polygon can be divided into parallel line segments on which the sum of the distances to the sides of the polygon is constant. Let us say…

Mapping the Social Side of Pre-Service Teachers: Connecting Closeness, Trust, and Efficacy with Performance

ERIC Educational Resources Information Center

Liou, Yi-Hwa; Daly, Alan J.; Canrinus, Esther T.; Forbes, Cheryl A.; Moolenaar, Nienke M.; Cornelissen, Frank; Van Lare, Michelle; Hsiao, Joyce

2017-01-01

This exploratory study foregrounds the important, but often understudied social side of pre-service teacher development and its relation to teaching performance in one university-based teacher preparation program in the US. We examine the extent to which pre-service elementary teachers' social relationships and perceptions of peer trust and…

Comparison of Virginia's 2009 Mathematics Standards of Learning with the Common Core State Standards for Mathematics

ERIC Educational Resources Information Center

Virginia Department of Education, 2011

2011-01-01

This first draft of the "Comparison of Virginia's 2009 Mathematics Standards of Learning (SOL) with the Common Core State Standards (CCSS) for Mathematics" provides a side-by-side overview demonstrating how the 2009 Mathematics SOL are aligned to the CCSS. The comparison was made using Virginia's complete standards program for supporting…

Inclusion and Disability Awareness Training for Educators in the Kids Like You, Kids Like Me Program

ERIC Educational Resources Information Center

Mickel, Julie; Griffin, Jayne

2007-01-01

As a result of improvements in and the reauthorization of the Individuals with Disabilities Education Act of 2004 (Public Law 108-446), classrooms across America are evolving into inclusive learning environments where children with and without disabilities learn side-by-side. Often, however, general education teachers find themselves unsure of how…

76 FR 16747 - Applications for New Awards; Hispanic-Serving Institutions STEM and Articulation Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

...'' is 8.5'' x 11'' on, one side only, with 1'' margins at the top, bottom, and both sides. Double space... equipment, such as furniture, file cabinets, bookcases, typewriters, or word processors. (8) Payment of any... operational in nature rather than developmental in nature. We reference other regulations outlining funding...

Sandia National Laboratories California Waste Management Program Annual Report February 2008.

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

Brynildson, Mark E.

The annual program report provides detailed information about all aspects of the Sandia National Laboratories, California (SNL/CA) Waste Management Program. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. This annual program report describes the activities undertaken during the past year, and activities planned in future years to implement the Waste Management (WM) Program, one of six programs that supports environmental management at SNL/CA.

The impact of middle manager affective commitment on perceived improvement program implementation success.

PubMed

Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective commitment to an improvement program could strengthen program implementation success by facilitating frontline worker support for the program. Furthermore, providing the organizational support items in our survey construct may bolster middle manager affective commitment.

The Academic Manifesto: From an Occupied to a Public University

ERIC Educational Resources Information Center

Halffman, Willem; Radder, Hans

2015-01-01

Universities are occupied by management, a regime obsessed with "accountability" through measurement, increased competition, efficiency, "excellence", and misconceived economic salvation. Given the occupation's absurd side-effects, we ask ourselves how management has succeeded in taking over our precious universities. An…

5. Photo copy of photograph, (original in Forest Service Office, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photo copy of photograph, (original in Forest Service Office, Elkins, WV, photo #298167, 'Nursery Manager's residence and garage,'), D. A. Oliver, November 1934. VIEW NORTHEAST. - Parsons Nursery, Manager's Residence, South side of U.S. Route 219, Parsons, Tucker County, WV

A Moderate-Intensity Weight-Bearing Exercise Program for a Person With Type 2 Diabetes and Peripheral Neuropathy

PubMed Central

Hastings, Mary K.; Mueller, Michael J.

2012-01-01

Background and Purpose The exercise guidelines for people with diabetes mellitus and peripheral neuropathy (DM+PN) have recently changed to allow moderate-intensity weight-bearing exercise, but there are few reports in the literature describing appropriate weight-bearing exercise for those with DM+PN. This case report describes a successful and safe progressive exercise program for an individual with DM+PN. Case Description The patient was a 76-year-old man with a 30-year history of DM+PN. He participated in a 12-week, moderate-intensity, progressive exercise program (heart rate approximately 75% of maximum heart rate; rate of perceived exertion=11–13; 3 times per week) involving walking on a treadmill, balance exercises, and strengthening exercises for the lower extremities using body weight resistance. Outcomes Measurements were taken before and after the 12 weeks of exercise. The patient's Six-Minute Walk Test distance increased from 1,200 to 1,470 ft. His Physical Performance Test score did not change. His Foot and Ankle Ability Measure questionnaire score improved from 89 to 98. Dorsiflexor and plantar-flexor peak torque increased (dorsiflexor peak torque: right side=4.5–4.6 N·m, left side=2.8–3.8 N·m; plantar-flexor peak torque: right side=44.7–62.4 N·m, left side=40.8–56.0 N·m), as did his average daily step count (6,176–8,273 steps/day). Close monitoring of the plantar surface of the feet indicated that the exercise program was well tolerated and there were no adverse events. Discussion and Conclusions This case report describes a moderate-intensity exercise program that was successful in increasing some measures of muscle strength, physical function, and activity without causing injury in an individual with DM+PN. PMID:21921252

An Integrated Approach to Functional Engineering: An Engineering Database for Harness, Avionics and Software

NASA Astrophysics Data System (ADS)

Piras, Annamaria; Malucchi, Giovanni

2012-08-01

In the design and development phase of a new program one of the critical aspects is the integration of all the functional requirements of the system and the control of the overall consistency between the identified needs on one side and the available resources on the other side, especially when both the required needs and available resources are not yet consolidated, but they are evolving as the program maturity increases.The Integrated Engineering Harness Avionics and Software database (IDEHAS) is a tool that has been developed to support this process in the frame of the Avionics and Software disciplines through the different phases of the program. The tool is in fact designed to allow an incremental build up of the avionics and software systems, from the description of the high level architectural data (available in the early stages of the program) to the definition of the pin to pin connectivity information (typically consolidated in the design finalization stages) and finally to the construction and validation of the detailed telemetry parameters and commands to be used in the test phases and in the Mission Control Centre. The key feature of this approach and of the associated tool is that it allows the definition and the maintenance / update of all these data in a single, consistent environment.On one side a system level and concurrent approach requires the feasibility to easily integrate and update the best data available since the early stages of a program in order to improve confidence in the consistency and to control the design information.On the other side, the amount of information of different typologies and the cross-relationships among the data imply highly consolidated structures requiring lot of checks to guarantee the data content consistency with negative effects on simplicity and flexibility and often limiting the attention to special needs and to the interfaces with other disciplines.

12 CFR 1710.19 - Compliance and risk management programs; compliance with other laws.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Compliance and risk management programs... Practices and Procedures § 1710.19 Compliance and risk management programs; compliance with other laws. (a... management program. (1) An Enterprise shall establish and maintain a risk management program that is...

14 CFR 91.1003 - Management contract between owner and program manager.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Management contract between owner and... RULES Fractional Ownership Operations § 91.1003 Management contract between owner and program manager... the program manager pertaining to the operational safety of the program and those records required to...

Five Go Marking an Exam Question: The Use of Adaptive Comparative Judgement to Manage Subjective Bias

ERIC Educational Resources Information Center

Barber, Jill

2018-01-01

Adaptive Comparative Judgement (ACJ) is an alternative to conventional marking in which the assessor (judge) merely compares two answers and chooses a winner. (Scripts are typically uploaded to the CompareAssess interface as pdf files and are presented side-by-side.) Repeated comparisons and application of the sorting algorithm leads to scripts…

How Gamers Manage Aggression: Situating Skills in Collaborative Computer Games

ERIC Educational Resources Information Center

Bennerstedt, Ulrika; Ivarsson, Jonas; Linderoth, Jonas

2012-01-01

In the discussion on what players learn from digital games, there are two major camps in clear opposition to each other. As one side picks up on negative elements found in games the other side focuses on positive aspects. While the agendas differ, the basic arguments still depart from a shared logic: that engagement in game-related activities…

Balancing power: A grounded theory study on partnership of academic service institutes.

PubMed

Heshmati Nabavi, Fatemeh; Vanaki, Zohreh; Mohammadi, Eesa; Yazdani, Shahram

2017-07-01

Governments and professional organizations have called for new partnerships between health care providers and academics to improve clinical education for the benefit of both students and patients. To develop a substantive grounded theory on the process of forming academic-service partnerships in implementing clinical education, from the perspective of academic and clinical nursing staff members and managers working in Iranian settings. The participants included 15 hospital nurses, nurse managers, nurse educators, and educational managers from two central universities and clinical settings from 2009 to 2012. Data were collected through 30 in-depth, semi-structure interviews with the individual participants and then analyzed using the methodology of Strauss and Corbin's grounded theory. Utilizing "balancing power" as the core variable enabled us to integrate the concepts concerning the partnership processes between clinical and educational institutes. Three distinct and significant categories emerged to explain the process of partnership: 1) divergence, 2) conflict between educational and caring functions, and 3) creation of balance between educational and caring functions. In implementing clinical education, partnerships have been formed within a challenging context in Iran. Conflict between clinical and educational functions was the main concern of both sides of the partnership in forming a collaborative relationship, with our findings emphasizing the importance of nursing educators' role in the establishment of partnership programs.

A regional waterway management system for balancing recreational boating and resource protection.

PubMed

Swett, Robert A; Listowski, Charles; Fry, Douglas; Boutelle, Stephen; Fann, David

2009-06-01

Florida's coasts have been transformed over the past three decades as population growth and unprecedented demand for individual shore access to bays and estuaries led to the creation of residential canal developments. Thousands of miles of channels and basins were dredged as a by-product of this urbanization process. The navigable waterways that resulted are now being stressed by increasing boat traffic and canal-side activities. Recognizing their common goal to preserve the recreational and ecological value of southwest Florida waterways, the Florida Department of Environmental Protection, the four-county West Coast Inland Navigation District, and the University of Florida Sea Grant College Program signed a Memorandum of Agreement. The signatories agreed to develop a science-based Regional Waterway Management System (RWMS), which is a new approach to waterway planning and permitting based on carefully mapped channel depths, a census of actual boat populations, and the spatial extent of natural resources. The RWMS provides a comprehensive, regional overview of channel conditions and the geographic distribution and severity of existing impediments to safe navigation and resource protection. RWMS information and analyses result in regional-scale permitting to accommodate water-dependent uses while minimizing environmental impacts and reducing public expenditures. Compared with traditional approaches to waterway management, the science-based RWMS is relatively unbiased, objective, transparent, ecologically sound, and fiscally prudent.

Exploring efficacy of residential energy efficiency programs in Florida

NASA Astrophysics Data System (ADS)

Taylor, Nicholas Wade

Electric utilities, government agencies, and private interests in the U.S. have committed and continue to invest substantial resources in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. Program investments, and the demand for impact evaluations that accompany them, are projected to grow in coming years due to increased pressure from state-level energy regulation, costs and challenges of building additional production capacity, fuel costs and potential carbon or renewable energy regulation. This dissertation provides detailed analyses of ex-post energy savings from energy efficiency programs in three key sectors of residential buildings: new, single-family, detached homes; retrofits to existing single-family, detached homes; and retrofits to existing multifamily housing units. Each of the energy efficiency programs analyzed resulted in statistically significant energy savings at the full program group level, yet savings for individual participants and participant subgroups were highly variable. Even though savings estimates were statistically greater than zero, those energy savings did not always meet expectations. Results also show that high variability in energy savings among participant groups or subgroups can negatively impact overall program performance and can undermine marketing efforts for future participation. Design, implementation, and continued support of conservation programs based solely on deemed or projected savings is inherently counter to the pursuit of meaningful energy conservation and reductions in greenhouse gas emissions. To fully understand and optimize program impacts, consistent and robust measurement and verification protocols must be instituted in the design phase and maintained over time. Furthermore, marketing for program participation must target those who have the greatest opportunity for savings. In most utility territories it is not possible to gain access to the type of large scale datasets that would facilitate robust program analysis. Along with measuring and optimizing energy conservation programs, utilities should provide public access to historical consumption data. Open access to data, program optimization, consistent measurement and verification and transparency in reported savings are essential to reducing energy use and its associated environmental impacts.

Non-operative management of right side thoracoabdominal penetrating injuries--the value of testing chest tube effluent for bile.

PubMed

De Rezende Neto, João Baptista; Guimarães, Tiago Nunes; Madureira, João Lopo; Drumond, Domingos André Fernandes; Leal, Juliana Campos; Rocha, Aroldo; Oliveira, Rodrigo Guimarães; Rizoli, Sandro B

2009-05-01

While mandatory surgery for all thoracoabdominal penetrating injuries is advocated by some, the high rate of unnecessary operations challenges this approach. However, the consequences of intrathoracic bile remains poorly investigated. We sought to evaluate the outcome of patients who underwent non-operative management of right side thoracoabdominal (RST) penetrating trauma, and the levels of bilirubin obtained from those patients' chest tube effluent. We managed non-operatively all stable patients with a single RST penetrating injury. Chest tube effluent samples were obtained six times within (4-8 h; 12-16 h; 20-24 h; 28-32 h; 36-40 h; 48 h and 72 h) of admission for bilirubin measurement and blood for complete blood count, bilirubin, alanine (ALT) and aspartate aminotransferases (AST) assays. For comparison we studied patients with single left thoracic penetrating injury. Forty-two patients with RST injuries were included. All had liver and lung injuries confirmed by CT scans. Only one patient failed non-operative management. Chest tube bilirubin peaked at 48 h post-trauma (mean 3.3+/-4.1 mg/dL) and was always higher than both serum bilirubin (p<0.05) and chest tube effluent from control group (27 patients with left side thoracic trauma). Serum ALT and AST were higher in RST injury patients (p<0.05). One RST injury patient died of line sepsis. Non-operative management of RST penetrating trauma appears to be safe. Bile originating from the liver injury reaches the right thoracic cavity but does not reflect the severity of that injury. The highest concentration was found in the patient failing non-operative management. The presence of intrathoracic bile in selected patients who sustain RST penetrating trauma, with liver injury, does not preclude non-operative management. Our study suggests that monitoring chest tube effluent bilirubin may provide helpful information when managing a patient non-operatively.

Thermal Assessment of Swift BAT Instrument Thermal Control System in Flight

NASA Technical Reports Server (NTRS)

Choi, Michael K.

2005-01-01

THE BAT is the primary instrument on the Swift spacecraft. The Swift mission is part of the National Aeronautics and Space Administration (NASA) Medium-Size Explorer (MIDEX) Program, and is managed by Goddard Space Flight Center (GSFC). It is designed to detect gamma ray burst over a broad region of the sky in a low Earth orbit of 600-km altitude and quickly align the telescopes on the spacecraft to the gamma ray source. It was successfully launched into orbit on November 20, 2004. The Swift mission is a first of its kind of multi-wavelength transient observatory for gamma ray burst astronomy. Its mission life is 2 years. The inclination is 22 deg maximum. The spacecraft bus voltage to the instruments is in the 24 V to 35 V range. The instruments will be turned off when the voltage is below 27 V. The BAT is mounted to the optical bench through five titanium flexures. The BAT has been developed at GSFC. Its telescope assembly consists of 256 Detector Modules (DMs) in the Detector Array. There are 16 Detector Array Blocks. Each Block holds 16 DMs, 3 Block Voltage Regulator (BVR) units and 3 Block Command & Data Handling (BCDH) units. The power dissipation of each Block has been measured to be 13 W. Therefore the total power dissipation of the 16 Blocks is 208 W. The DAP is 1.3 m (4.3 ft) x 1 m (3.3 ft), accommodates all the 16 Blocks. It also provides the mounting surface and the positional stability for the Blocks. The DMs are located at the top (+X side) of the DAP and is enclosed by graded-Z shields on the sides and a coded mask at the top. The BVRs and BCDHs are located at the bottom (-X side) of the DAP. Eight Blocks are located at the front (-Z side or radiator side) of the DAP, and eight are located at the rear (+Z side) of the DAP. The DMs and top of DAP are insulated with a 7-layer multi-layer insulation (MLI). There is a 5.08 cm (2 in) x 5.08 cm (2 in) MLI cutout over each Block heater controller so that heat radiates from the heater controller to the mask. The exterior of the mask, graded-Z shields and bottom of DAP is insulated with a 15-layer MLI.

Managing the human side of change in VA's transformation.

PubMed

Backer, T E

1997-01-01

Transformational change interventions often fail or short fall of their intended impact on organizations and systems. One main reason is that these interventions frequently do not strategically address the complex human dynamics of change. This happens despite awareness of and commitment to intervening at this level by top management and change leaders. The wisdom that "systems don't change; people change" is widely acknowledged but inadequately applied. These are exactly the conditions the U.S. Department of Veterans Affairs (VA) faces in deploying its new Veterans Integrated Services Networks (VISNs). Applying validated behavioral science strategies that address the human side of change will help VA implement VISNs effectively. Six strategies derived from many years of study and practice in the public and private sectors are discussed, along with suggestions for VISN managers about how to implement them.

Future directions: Integrated resource planning

NASA Astrophysics Data System (ADS)

Bauer, D. C.; Eto, J.

Integrated resource planning or IRP is the process for integrating supply- and demand-side resources to provide energy services at a cost that balances the interests of all stakeholders. It now is the resource planning process used by electric utilities in over 30 states. The goals of IRP have evolved from least cost planning and encouragement of demand-side management to broader, more complex issues including core competitive business activity, risk management and sharing, accounting for externalities, and fuel switching between gas and electricity. IRP processes are being extended to other interior regions of the country, to non-investor owned utilities, and to regional (rather than individual utility) planning bases, and to other fuels (natural gas). The comprehensive, multi-valued, and public reasoning characteristics of IRP could be extended to applications beyond energy, e.g., transportation, surface water management, and health care in ways suggested.

[A new joint approach to drug management: clinical pharmacy services and risk management unit].

PubMed

Schwartz, Vardit; Kravitz, Martine Szyper

2015-04-01

According to the "To Err is Human" report, medication-related errors are common in medicine and may have several and different effects. Clinical Pharmacy is a leading worldwide established pharmacy service which has been improving the quality of care for the last 30 years. The accumulated experience shows improved quality of care, improved patient safety and economic benefit. These understandings led to the definition and expansion of the Clinical Pharmacist Intervention Program and a joint project with the Risk Management Unit was created. A characterization process was conducted, parameters were defined for monitoring and surveillance and interventions were devised. The relevant data requiring pharmacist intervention was defined (e.g., dose adjustments, contraindications, side-effects); a report was devised, based on the patient's electronic medical record; daily follow-up included analysis, stratification, quantification and understanding of the different types of pharmacist interventions. The pharmacist interventions were summed up and assessed for performance and quality control. Between March 2013 and February 2014 the medical records of 14,499 patients were examined in our hospital Only in 16% of the records an active pharmacist intervention was performed, according to the parameters defined. Interventions for potentially high risk events such as therapeutic duplication, drug administration in spite of contraindication and in spite of documented allergy were very rare, less than 2% of all the pharmacist interventions. This joint venture, which is based on an existing platform, reflects an up-to-date view of an important facet of the clinical work performed at the hospital, helps identify trends, potential failures and vulnerabilities with regard to medication treatment and allows the formulation of intervention programs to improve the quality and safety of drug therapy.

46th Annual Targets, UAVs and Range Operations Symposium and Exhibition

DTIC Science & Technology

2008-10-10

introduction  mr. Ken Hislop , QF-16 Program manager, eglin aFB, FL 1:40 Pm - 2:00 Pm U.s. navy  CaPt Pat Buckley, Usn, Program manager...Bruce Ringstad Subscale & TCS Flight Lead Mr. Jim Cornwell Program Manager Mr. Ken Hislop Program Manager Ms. Lee Neugin Program Manager & Lead...Missiles Fired / 18 Kills AAC/PA 09-26-08-429 18 QF-16 Air Superiority Target Program Manager: Mr. Ken Hislop Description Full Scale Target for Threat

Repository-Based Software Engineering Program: Working Program Management Plan

NASA Technical Reports Server (NTRS)

1993-01-01

Repository-Based Software Engineering Program (RBSE) is a National Aeronautics and Space Administration (NASA) sponsored program dedicated to introducing and supporting common, effective approaches to software engineering practices. The process of conceiving, designing, building, and maintaining software systems by using existing software assets that are stored in a specialized operational reuse library or repository, accessible to system designers, is the foundation of the program. In addition to operating a software repository, RBSE promotes (1) software engineering technology transfer, (2) academic and instructional support of reuse programs, (3) the use of common software engineering standards and practices, (4) software reuse technology research, and (5) interoperability between reuse libraries. This Program Management Plan (PMP) is intended to communicate program goals and objectives, describe major work areas, and define a management report and control process. This process will assist the Program Manager, University of Houston at Clear Lake (UHCL) in tracking work progress and describing major program activities to NASA management. The goal of this PMP is to make managing the RBSE program a relatively easy process that improves the work of all team members. The PMP describes work areas addressed and work efforts being accomplished by the program; however, it is not intended as a complete description of the program. Its focus is on providing management tools and management processes for monitoring, evaluating, and administering the program; and it includes schedules for charting milestones and deliveries of program products. The PMP was developed by soliciting and obtaining guidance from appropriate program participants, analyzing program management guidance, and reviewing related program management documents.

An Evaluation of the Consumer Costs and Benefits of Energy Efficiency Resource Standards

NASA Astrophysics Data System (ADS)

Lessans, Mark D.

Of the modern-day policies designed to encourage energy efficiency, one with a significant potential for impact is that of Energy Efficiency Resource Standards (EERS). EERS policies place the responsibility for meeting an efficiency target on the electric and gas utilities, typically setting requirements for annual reductions in electricity generation or gas distribution to customers as a percentage of sales. To meet these requirements, utilities typically implement demand-side management (DSM) programs, which encourage energy efficiency at the customer level through incentives and educational initiatives. In Maryland, a statewide EERS has provided for programs which save a significant amount of energy, but is ultimately falling short in meeting the targets established by the policy. This study evaluates residential DSM programs offered by Pepco, a utility in Maryland, for cost-effectiveness. However, unlike most literature on the topic, analysis focuses on the costs-benefit from the perspective of the consumer, and not the utility. The results of this study are encouraging: the majority of programs analyzed show that the cost of electricity saved, or levelized cost of saved energy (LCSE), is less expensive than the current retail cost of electricity cost in Maryland. A key goal of this study is to establish a metric for evaluating the consumer cost-effectiveness of participation in energy efficiency programs made available by EERS. In doing so, the benefits of these programs can be effectively marketed to customers, with the hope that participation will increase. By increasing consumer awareness and buy-in, the original goals set out through EERS can be realized and the policies can continue to receive support.

"There is a chain of connections": using syndemics theory to understand HIV treatment side effects.

PubMed

Gagnon, Marilou

2018-03-12

Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects.

Right Versus Left Colon Cancer Biology: Integrating the Consensus Molecular Subtypes.

PubMed

Lee, Michael S; Menter, David G; Kopetz, Scott

2017-03-01

Although clinical management of colon cancer generally has not accounted for the primary tumor site, left-sided and right-sided colon cancers harbor different clinical and biologic characteristics. Right-sided colon cancers are more likely to have genome-wide hypermethylation via the CpG island methylator phenotype (CIMP), hypermutated state via microsatellite instability, and BRAF mutation. There are also differential exposures to potential carcinogenic toxins and microbiota in the right and left colon. Gene expression analyses further shed light on distinct biologic subtypes of colorectal cancers (CRCs), with 4 consensus molecular subtypes (CMSs) identified. Importantly, these subtypes are differentially distributed between right- and left-sided CRCs, with greater proportions of the "microsatellite unstable/immune" CMS1 and the "metabolic" CMS3 subtypes found in right-sided colon cancers. This review summarizes important biologic distinctions between right- and left-sided CRCs that likely impact prognosis and may predict for differential responses to biologic therapy. Given the inferior prognosis of stage III-IV right-sided CRCs and emerging data suggesting that anti-epidermal growth factor receptor antibody therapy is associated with worse survival in right-sided stage IV CRCs compared with left-sided cancers, these biologic differences between right- and left-sided CRCs provide critical context and may provide opportunities to personalize therapy. Copyright © 2017 by the National Comprehensive Cancer Network.

ePORT, NASA's Computer Database Program for System Safety Risk Management Oversight (Electronic Project Online Risk Tool)

NASA Technical Reports Server (NTRS)

Johnson, Paul W.

2008-01-01

ePORT (electronic Project Online Risk Tool) provides a systematic approach to using an electronic database program to manage a program/project risk management processes. This presentation will briefly cover the standard risk management procedures, then thoroughly cover NASA's Risk Management tool called ePORT. This electronic Project Online Risk Tool (ePORT) is a web-based risk management program that provides a common framework to capture and manage risks, independent of a programs/projects size and budget. It is used to thoroughly cover the risk management paradigm providing standardized evaluation criterion for common management reporting, ePORT improves Product Line, Center and Corporate Management insight, simplifies program/project manager reporting, and maintains an archive of data for historical reference.

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

Busbey, A.B.

Seismic Processing Workshop, a program by Parallel Geosciences of Austin, TX, is discussed in this column. The program is a high-speed, interactive seismic processing and computer analysis system for the Apple Macintosh II family of computers. Also reviewed in this column are three products from Wilkerson Associates of Champaign, IL. SubSide is an interactive program for basin subsidence analysis; MacFault and MacThrustRamp are programs for modeling faults.

Snow water equivalent measured with cosmic-ray neutrons: reviving a little known but highly successful field method

NASA Astrophysics Data System (ADS)

Desilets, D.

2012-12-01

Secondary cosmic-ray neutrons are attenuated strongly by water in either solid or liquid form, suggesting a method for measuring snow water equivalent that has several advantages over alternative technologies. The cosmic-ray attenuation method is passive, portable, highly adaptable, and operates over an exceptionally large range of snow pack thicknesses. But despite promising initial observations made in the 1970s, the technique today remains practically unknown to snow hydrologists. Side-by-side measurements performed over the past several years with a snow pillow and a submerged cosmic-ray probe demonstrate that the cosmic-ray attenuation method merits consideration for a wide range of applications—especially those where alternative methods are made problematic by dense vegetation, rough terrain, deep snowpack or a lack of vehicular access. During the snow-free season, the instrumentation can be used to monitor soil moisture, thus providing another widely sought field measurement. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration. With main facilities in Albuquerque, N.M., and Livermore, C.A., Sandia has major R&D responsibilities in national security, energy and environmental technologies, and economic competitiveness.

Nonsurgical treatment to regain hip abduction motion in Perthes disease: a retrospective review.

PubMed

Carney, Brian T; Minter, Christin L

2004-05-01

The purpose of this study was to document the ability of a nonsurgical program to improve restricted passive hip abduction in children with Perthes disease. Containment as a form of treatment was recommended if passive hip abduction of 30 degrees or more could be achieved. Medical records and radiographs were retrospectively reviewed for 74 children. Age at admission and onset, side, length of stay, and measurement of passive hip abduction at admission/discharge were recorded. The average increase in abduction with the hip extended was 13 degrees. Forty-two children achieved 30 degrees or more of abduction with the hip extended. Average length of stay was 13 days. Management of restricted abduction in an inpatient setting can allow consideration of containment in 61% of children previously not thought to have the required motion.

Integrating market processes into utility resource planning

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

Kahn, E.P.

1992-11-01

Integrated resource planning has resulted in an abundance of alternatives for meeting existing and new demand for electricity services: (1) utility demand-side management (DSM) programs, (2) DSM bidding, (3) competitive bidding for private power supplies, (4) utility re-powering, and (5) new utility construction. Each alternative relies on a different degree of planning for implementation and, therefore, each alternative relies on markets to a greater or lesser degree. This paper shows how the interaction of planning processes and market forces results in resource allocations among the alternatives. The discussion focuses on three phenomena that are driving forces behind the unanticipated consequences'more » of contemporary integrated resource planning efforts. These forces are: (1) large-scale DSM efforts, (2) customer bypass, and (3) large-scale independent power projects. 22 refs., 3 figs., 2 tabs.« less

Accelerating k-NN Algorithm with Hybrid MPI and OpenSHMEM

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

Lin, Jian; Hamidouche, Khaled; Zheng, Jie

2015-08-05

Machine Learning algorithms are benefiting from the continuous improvement of programming models, including MPI, MapReduce and PGAS. k-Nearest Neighbors (k-NN) algorithm is a widely used machine learning algorithm, applied to supervised learning tasks such as classification. Several parallel implementations of k-NN have been proposed in the literature and practice. However, on high-performance computing systems with high-speed interconnects, it is important to further accelerate existing designs of the k-NN algorithm through taking advantage of scalable programming models. To improve the performance of k-NN on large-scale environment with InfiniBand network, this paper proposes several alternative hybrid MPI+OpenSHMEM designs and performs a systemicmore » evaluation and analysis on typical workloads. The hybrid designs leverage the one-sided memory access to better overlap communication with computation than the existing pure MPI design, and propose better schemes for efficient buffer management. The implementation based on k-NN program from MaTEx with MVAPICH2-X (Unified MPI+PGAS Communication Runtime over InfiniBand) shows up to 9.0% time reduction for training KDD Cup 2010 workload over 512 cores, and 27.6% time reduction for small workload with balanced communication and computation. Experiments of running with varied number of cores show that our design can maintain good scalability.« less

Spanish approach to research and development applied to steam generator tubes structural integrity and life management

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

Lozano, J.; Bollini, G.J.

1997-02-01

The operating experience acquired from certain Spanish Nuclear Power Plant steam generators shows that the tubes, which constitute the second barrier to release of fission products, are susceptible to mechanical damage and corrosion as a result of a variety of mechanisms, among them wastage, pitting, intergranular attack (IGA), stress-corrosion cracking (SCC), fatigue-induced cracking, fretting, erosion/corrosion, support plate denting, etc. These problems, which are common in many plants throughout the world, have required numerous investments by the plants (water treatment plants, replacement of secondary side materials such as condensers and heaters, etc.), have meant costs (operation, inspection and maintenance) and havemore » led to the unavailability of the affected units. In identifying and implementing all these preventive and corrective measures, the Spanish utilities have moved through three successive stages: in the initial stage, the main source of information and of proposals for solutions was the Plant Vendor, whose participation in this respect was based on his own Research and Development programs; subsequently, the Spanish utilities participated jointly in the EPRI Steam Generator Owners Group, collaborating in financing; finally, the Spanish utilities set up their own Steam Generator Research and Development program, while maintaining relations with EPRI programs and those of other countries through information interchange.« less

5 CFR 10.3 - OPM authority to review personnel management programs and practices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... management programs and practices. 10.3 Section 10.3 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... (RULE X) § 10.3 OPM authority to review personnel management programs and practices. The Office of Personnel Management may review the human resources management programs and practices of any agency and...

12 CFR 1710.19 - Compliance and risk management programs; compliance with other laws.

Code of Federal Regulations, 2011 CFR

2011-01-01

... management program. (1) An Enterprise shall establish and maintain a risk management program that is reasonably designed to manage the risks of the operations of the Enterprise. (2) The risk management program... executive officer of the Enterprise. The risk management officer shall report regularly to the board of...

The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management.

PubMed

Wassersug, Richard J; Oliffe, John L

2009-04-01

Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise. Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT. We draw on academic literature, media accounts, and web-based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues. By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress. The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy. Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of gynecomastia is made available through psychosocial support programs. For example, PCa patients may learn to accept gynecomastia through reconceptualizing their breasts as autoerotic. Support programs modeled on those of the breast cancer community, including Encore and dragon boat racing, may also help to build communities to serve patients with gynecomastia while defending individuals against shame, isolation, and loss of self-esteem.

Software for Better Documentation of Other Software

NASA Technical Reports Server (NTRS)

Pinedo, John

2003-01-01

The Literate Programming Extraction Engine is a Practical Extraction and Reporting Language- (PERL-)based computer program that facilitates and simplifies the implementation of a concept of self-documented literate programming in a fashion tailored to the typical needs of scientists. The advantage for the programmer is that documentation and source code are written side-by-side in the same file, reducing the likelihood that the documentation will be inconsistent with the code and improving the verification that the code performs its intended functions. The advantage for the user is the knowledge that the documentation matches the software because they come from the same file. This program unifies the documentation process for a variety of programming languages, including C, C++, and several versions of FORTRAN. This program can process the documentation in any markup language, and incorporates the LaTeX typesetting software. The program includes sample Makefile scripts for automating both the code-compilation (when appropriate) and documentation-generation processes into a single command-line statement. Also included are macro instructions for the Emacs display-editor software, making it easy for a programmer to toggle between editing in a code or a documentation mode.

Integration and Exposure of Large Scale Computational Resources Across the Earth System Grid Federation (ESGF)

NASA Astrophysics Data System (ADS)

Duffy, D.; Maxwell, T. P.; Doutriaux, C.; Williams, D. N.; Chaudhary, A.; Ames, S.

2015-12-01

As the size of remote sensing observations and model output data grows, the volume of the data has become overwhelming, even to many scientific experts. As societies are forced to better understand, mitigate, and adapt to climate changes, the combination of Earth observation data and global climate model projects is crucial to not only scientists but to policy makers, downstream applications, and even the public. Scientific progress on understanding climate is critically dependent on the availability of a reliable infrastructure that promotes data access, management, and provenance. The Earth System Grid Federation (ESGF) has created such an environment for the Intergovernmental Panel on Climate Change (IPCC). ESGF provides a federated global cyber infrastructure for data access and management of model outputs generated for the IPCC Assessment Reports (AR). The current generation of the ESGF federated grid allows consumers of the data to find and download data with limited capabilities for server-side processing. Since the amount of data for future AR is expected to grow dramatically, ESGF is working on integrating server-side analytics throughout the federation. The ESGF Compute Working Team (CWT) has created a Web Processing Service (WPS) Application Programming Interface (API) to enable access scalable computational resources. The API is the exposure point to high performance computing resources across the federation. Specifically, the API allows users to execute simple operations, such as maximum, minimum, average, and anomalies, on ESGF data without having to download the data. These operations are executed at the ESGF data node site with access to large amounts of parallel computing capabilities. This presentation will highlight the WPS API, its capabilities, provide implementation details, and discuss future developments.

Integrated Care and Connected Health Approaches Leveraging Personalised Health through Big Data Analytics.

PubMed

Maglaveras, Nicos; Kilintzis, Vassilis; Koutkias, Vassilis; Chouvarda, Ioanna

2016-01-01

Integrated care and connected health are two fast evolving concepts that have the potential to leverage personalised health. From the one side, the restructuring of care models and implementation of new systems and integrated care programs providing coaching and advanced intervention possibilities, enable medical decision support and personalized healthcare services. From the other side, the connected health ecosystem builds the means to follow and support citizens via personal health systems in their everyday activities and, thus, give rise to an unprecedented wealth of data. These approaches are leading to the deluge of complex data, as well as in new types of interactions with and among users of the healthcare ecosystem. The main challenges refer to the data layer, the information layer, and the output of information processing and analytics. In all the above mentioned layers, the primary concern is the quality both in data and information, thus, increasing the need for filtering mechanisms. Especially in the data layer, the big biodata management and analytics ecosystem is evolving, telemonitoring is a step forward for data quality leverage, with numerous challenges still left to address, partly due to the large number of micro-nano sensors and technologies available today, as well as the heterogeneity in the users' background and data sources. This leads to new R&D pathways as it concerns biomedical information processing and management, as well as to the design of new intelligent decision support systems (DSS) and interventions for patients. In this paper, we illustrate these issues through exemplar research targeting chronic patients, illustrating the current status and trends in PHS within the integrated care and connected care world.

Sport Management Graduate Programs: Characteristics of Effectiveness.

ERIC Educational Resources Information Center

Li, Ming; And Others

1994-01-01

Reports a study that examined the characteristics that enable graduate sport management programs to achieve their objectives. Surveys of sport management educators found they agreed on 11 characteristics that indicated a sport management program's effectiveness. Respondents believed an effective program should produce sport managers, not…

KENNEDY SPACE CENTER, FLA. -- From left, NASA Deputy Program Manager of the Space Shuttle Program Michael Wetmore, United Space Alliance (USA) Vice President and Space Shuttle Program Manager Howard DeCastro, NASA Deputy Associate Administrator for Space Station and Shuttle Programs Michael Kostelnik, and a USA technician examine cold plates in Orbiter Processing Facility Bay 2. NASA and USA Space Shuttle program management are participating in a leadership workday. The day is intended to provide management with an in-depth, hands-on look at Shuttle processing activities at KSC.

NASA Image and Video Library

2003-12-19

KENNEDY SPACE CENTER, FLA. -- From left, NASA Deputy Program Manager of the Space Shuttle Program Michael Wetmore, United Space Alliance (USA) Vice President and Space Shuttle Program Manager Howard DeCastro, NASA Deputy Associate Administrator for Space Station and Shuttle Programs Michael Kostelnik, and a USA technician examine cold plates in Orbiter Processing Facility Bay 2. NASA and USA Space Shuttle program management are participating in a leadership workday. The day is intended to provide management with an in-depth, hands-on look at Shuttle processing activities at KSC.

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Managing the Multigenerational Workplace: Answers for Managers and Trainers

ERIC Educational Resources Information Center

Bartley, Sharon J.; Ladd, Patrick G.; Morris, M. Lane

2007-01-01

"How do I get through to this new gang of Millennial workers?" "Why can't my boss just lighten up?" Employees and managers ask questions such as these from all sides of the generational battle lines forming in workplaces today. The emerging trend of what we have called "generational diversity" in the workplace is a growing challenge for managers…

The Legal Side of Campus Threat Assessment and Management: What Student Counselors Need to Know

ERIC Educational Resources Information Center

Nolan, Jeffrey J.; Moncure, Thomas M., Jr.

2012-01-01

This article identifies what student mental health professionals need to know about legal issues of relevance to threat assessment and management. The article summarizes the common law duties and the common law and statutory standards of care that are likely to apply to the work of college and university threat assessment and management teams. The…

IN² Program Validates Data Center Cooling Solution | News | NREL

Science.gov Websites

IN2 Program Validates Data Center Cooling Solution February 21, 2018 IN2 Program Validates Data Center Cooling Solution NREL researchers and LiquidCool Solutions representatives stand along-side centers on average consuming an estimated 70 billion kWh per year, a disruptive energy-saving solution is

Lightning Mapper Sensor Lens Assembly S.O. 5459: Project Management Plan

NASA Technical Reports Server (NTRS)

Zeidler, Janet

1999-01-01

Kaiser Electro-Optics, Inc. (KEO) has developed this Project Management Plan for the Lightning Mapper Sensor (LMS) program. KEO has integrated a team of experts in a structured program management organization to meet the needs of the LMS program. The project plan discusses KEO's approach to critical program elements including Program Management, Quality Assurance, Configuration Management, and Schedule.

KENNEDY SPACE CENTER, FLA. -- From left, United Space Alliance (USA) Deputy Space Shuttle Program Manager of Operations Loren Shriver, USA Associate Program Manager of Ground Operations Andy Allen, NASA Deputy Associate Administrator for Space Station and Shuttle Programs Michael Kostelnik, and USA Vice President and Space Shuttle Program Manager Howard DeCastro examine a tile used in the Shuttle's Thermal Protection System (TPS) in KSC's TPS Facility. NASA and USA Space Shuttle program management are participating in a leadership workday. The day is intended to provide management with an in-depth, hands-on look at Shuttle processing activities at KSC.

NASA Image and Video Library

2003-12-19

KENNEDY SPACE CENTER, FLA. -- From left, United Space Alliance (USA) Deputy Space Shuttle Program Manager of Operations Loren Shriver, USA Associate Program Manager of Ground Operations Andy Allen, NASA Deputy Associate Administrator for Space Station and Shuttle Programs Michael Kostelnik, and USA Vice President and Space Shuttle Program Manager Howard DeCastro examine a tile used in the Shuttle's Thermal Protection System (TPS) in KSC's TPS Facility. NASA and USA Space Shuttle program management are participating in a leadership workday. The day is intended to provide management with an in-depth, hands-on look at Shuttle processing activities at KSC.

An Online Learning Module to Increase Self-Efficacy and Involvement in Care for Patients With Advanced Lung Cancer: Research Protocol.

PubMed

Janssen, Anna; Shaw, Tim; Nagrial, Adnan; Pene, Christopher; Rabbets, Melanie; Carlino, Matteo; Zachulski, Clare; Phillips, Jane; Birnbaum, Robert; Gandhi, Tejal; Harnett, Paul

2016-08-08

Improving patient care for individuals with lung cancer is a priority due to the increasing burden of the disease globally. One way this can be done is by improving patient self-management capabilities through increasing their self-efficacy. This can improve positive outcomes for patients with chronic conditions and increase their ability to manage the challenges of such illnesses. Unfortunately, patients with chronic conditions often struggle to travel far from home to engage with patient education events, a common means of improving self-efficacy. The development of more accessible tools for improving patient self-efficacy is required to increase quality of life for patients with chronic conditions. To evaluate the feasibility of delivering symptom identification and management information to patients with advanced lung cancer using an online program. This article describes a pre-post test study to evaluate a Qstream online learning platform to improve patient self-efficacy for managing advanced lung cancer symptoms. Undertaking this program should increase participant knowledge about the side-effects they may experience as a result of their treatment and in turn increase help-seeking behavior and self-efficacy for the participant cohort. Quantitative data collected by the Qstream platform on the completion rates of participants will be used as a tool to evaluate the intervention. Additionally, validated scales will be used to collect data on patient self-efficacy. Qualitative data will also be collected via an exit survey and thematic content analysis of semi-structured interviews. The research is in the preliminary stages but thus far a protocol has been approved in support of the project. Additionally, advisory committee members have been identified and initial meetings have been undertaken. Development of new approaches for increasing patient understanding of their care is important to ensure high quality care continues to be delivered in the clinical setting.

75 FR 41798 - Solicitation of Letters of Interest to Participate in Biotechnology Quality Management System...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

...] Solicitation of Letters of Interest to Participate in Biotechnology Quality Management System Program AGENCY... participate in the APHIS Biotechnology Quality Management System Program. The Biotechnology Quality Management..., audit-based compliance assistance program known as the Biotechnology Quality Management System Program...

14 CFR 91.1019 - Conducting tests and inspections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program manager under this subpart is complying with title 49 of the United States Code, applicable regulations, and the program manager's management specifications. (b) The program manager must— (1) Make available to the Administrator at the program manager's principal base of operations, or at a place approved...

32 CFR Appendix A to Part 806 - References

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Information Security Program Management AFI 31-501, Personnel Security Program Management AFI 31-601, Industrial Security Program Management AFI 33-129, Transmission of Information Via the Internet AFI 35-205... Management (will convert to AFPD 33-3) AFI 37-124, The Information Collections and Reports Management Program...

32 CFR Appendix A to Part 806 - References

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Information Security Program Management AFI 31-501, Personnel Security Program Management AFI 31-601, Industrial Security Program Management AFI 33-129, Transmission of Information Via the Internet AFI 35-205... Management (will convert to AFPD 33-3) AFI 37-124, The Information Collections and Reports Management Program...

32 CFR Appendix A to Part 806 - References

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Information Security Program Management AFI 31-501, Personnel Security Program Management AFI 31-601, Industrial Security Program Management AFI 33-129, Transmission of Information Via the Internet AFI 35-205... Management (will convert to AFPD 33-3) AFI 37-124, The Information Collections and Reports Management Program...